Cited by 201Mindfulness and Compassion InterventionsPsychotherapy Techniques and ApplicationsPersonality Disorders and Psychopathology

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Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations

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Craig, Catriona, Hiskey, Syd, Spector, Aimee·2020·Expert Review of Neurotherapeutics

DOI 10.1080/14737175.2020.1746184

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Abstract

Introduction: Compassion focused therapy (CFT) is an increasingly popular therapeutic modality. Its holistic and integrative approach to universal human suffering means that it is well placed as a transdiagnostic therapy. Research into its effectiveness and acceptability has increased over the previous 10 years as the therapy has evolved, and to help consider its status as an evidence-based therapy research concerning its treatment outcomes needs evaluating.Areas covered: This paper reviews research investigating the effectiveness of CFT in clinical populations.Expert opinion: CFT shows promise for a range of mental health problems, especially when delivered in a group format over at least 12 hours. This is important for funding bodies and commissioning groups to consider as they allocate healthcare resources in light of current evidence-based practice. CFT is demonstrably well accepted by clients and clinicians and there is now a clear need for an updated, universally deployed, standard manual to direct future research. This will be critical in enabling widespread implementation and further adoption into mainstream clinical practice, will address the lack of standardization in the current research, and pave the way for further randomized control trials aimed at reducing existing methodological limitations.

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Background
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Sherwell, C. S., & Kirby, J. N. (2024) · Oxford University Press eBooks · doi:10.1093/oso/9780198888727.003.0018 · Cited by 9
Does Compassion-Focused Therapy-Based Online Intervention Work for Chinese International Students With High Self-Criticism? A Randomized Controlled Trail
Gu, X., Li, S., & Hyun, M. (2022) · SAGE Open · doi:10.1177/21582440221121596 · Cited by 10
“Recently, Craig et al. (2020) reviewed CFT’s effectiveness and acceptability focusing on clinical population.”
Background
Internet-based group compassion-focused therapy for Swedish young people with stress, anxiety and depression: a pilot waitlist randomized controlled trial
Vestin, M., Wallin, L., Naesström, M., Blomqvist, I., Svedin, C. G., Beaumont, E., Jokinen, J., & Dennhag, I. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1547046 · Cited by 8
“Over the past 30 years, studies on CFT have demonstrated benefits for adults, including reductions in depression, self-criticism, distress, and anxiety (Ferrari et al., 2019; Marsh et al., 2018; Williamson, 2020; Craig et al., 2020; Wakelin et al., 2022; Petrocchi et al., 2023).”
The missing construct: Impathy
Neubrand, S., & Gaab, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.726029 · Cited by 7
“A growing body of research points to the effectiveness of CFT across a wide range of well-being and mental health outcomes (for reviews see, Leaviss and Uttley, 2015; Craig et al., 2020).”
Background
Theory Paper: Suggesting Compassion-Based Approaches for Treating Complex Post-traumatic Stress Disorder
Rushforth, A., Kotera, Y., & Kaluževičiūtė, G. (2022) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-022-00856-4 · Cited by 10
“, 2019), one systematic review (Craig et al., 2020) and one literature review (Kirby, 2017) regarding the efficacy of compassion-based interventions yielded five interventional studies using comparison groups exploring loving kindness meditation, mindfulness-based cognitive therapy with a self-compassion element, mind…”
Compassionate mind training for ex‐service personnel with PTSD and their partners
Romaniuk, M., Hampton, S., Brown, K., Fisher, G., Steindl, S. R., Kidd, C., & Kirby, J. N. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2825 · Cited by 10
Self-Compassion-Based Interventions in Oncology: A Review of Current Practices
Grégoire, C., Paye, A., & Vanhaudenhuyse, A. (2024) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.2401007 · Cited by 7
An evaluation of compassion‐focused therapy groups for women accessing a specialist perinatal service in England
Lawrence, K., Nicholson, H., Iwanow, M., Johnston, T., Skelhorn, L., Toole, E., & O’Shaughnessy, R. (2024) · Counselling and Psychotherapy Research · doi:10.1002/capr.12860 · Cited by 8
Defining compassion: A Delphi study of compassion therapists’ experiences when introducing patients to the term ‘compassion’
McEwan, K., & Minou, L. (2022) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12423 · Cited by 7
“Several compassion- based interventions have become available and reviews and meta- analyses demonstrate their effectiveness in improving well- being across both clinical and non- clinical populations (Craig et al., 2020; Kirby, 2017; Leaviss & Uttley, 2015).”
Background
Reducing emotion dysregulation online in nonclinical population with compassion focused therapy and emotional competencies program: A randomized controlled trial
Paucsik, M., Baeyens, C., Tessier, D. P., & Shankland, R. (2024) · Journal of Clinical Psychology · doi:10.1002/jclp.23748 · Cited by 8
Age Inclusive Compassion-Focused Therapy: a Pilot Group Evaluation
Altavilla, A., & Strudwick, A. (2022) · International Journal of Cognitive Therapy · doi:10.1007/s41811-022-00132-2 · Cited by 7
Compassion Focused Therapy for Groups: Transdiagnostic Treatment for Turbulent Times
Erekson, D. M., Griner, D., & Beecher, M. E. (2024) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2024.2314278 · Cited by 9
“In addition, the researchers included seven studies that had been synthesized in Craig et al. (2020) in a meta-analysis, applying a statistical conglomeration to Craig et al.’s (2020) narrative review.”
BackgroundMethodInfluential
The Efficacy of a Group Program Integrating Compassionate Mind Training with Cognitive Behavioral Therapy for College Students With Test Anxiety in Mainland China
Guo, M., Liu, A., Wang, X., & Liu, Y. (2024) · Mindfulness · doi:10.1007/s12671-024-02342-5 · Cited by 7
“Moreover, previous studies have demonstrated that cognitive restructuring and compassionate imagery exercises can effectively reduce individuals’ depression, anxiety, and stress (Craig et al., 2020; Han & Kim, 2023).”
Efficacy of Compassion-Based Interventions in Breast Cancer Patients and Survivors: A Systematic Review of Randomized Controlled Trials
López-Contreras, J. P., Sebri, V., Sarrión-Castelló, P., Martínez‐Sanchis, S., & Cebolla, A. (2024) · The Spanish Journal of Psychology · doi:10.1017/sjp.2024.31 · Cited by 6
“Craig et al. (2020) supported the relevance of CBIs, considering their integrative and holistic approach to universal human suffering, enabling its further adoption into mainstream clinical practice.”
Exploring the Impact of Trauma and the Role of Compassion Before and After a Phase-orientated Intervention for Complex Trauma
Willis, D. N., Dowling, A. P. C., Deehan, T., & O'Reilly, P. G. (2022) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2022.100308 · Cited by 8
The Way is in Training: Martial Arts-informed Compassionate Mind Training to enhance CFT Therapists’ Compassionate Competencies
Clapton, N., & Hiskey, S. (2023) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.2301001 · Cited by 6
Integrating Cognitive-Behavioral Therapy With Compassion-Focused Therapy for the Treatment of Social Anxiety Disorder: An Evidence-Based Case Study
Baumgardner, M., & Allen, K. B. (2023) · Clinical Case Studies · doi:10.1177/15346501231197403 · Cited by 7
“A recent meta-analysis supports the preliminary ef ﬁ cacy of CFT for a range of transdiagnostic symptoms, including anxiety (Craig et al., 2020).”
BackgroundMethod
Psychometric Properties of the Swedish Version of the Compassion Scale
Wolgast, S. N., Wolgast, M., & Hoff, E. V. (2024) · Mindfulness · doi:10.1007/s12671-024-02310-z · Cited by 6
“…been informed largely by Buddhist philosophy and has been incorporated into clinical psychology in order to understand and alleviate mental distress, as well as to facilitate growth and promote well-being (e.g. Craig et al., 2020; de Vibe et al., 2012; Klimecki et al., 2013; Mongrain et al., 2011).”
Compassionate mind training for people with Parkinson's disease: A pilot study and predictors of response
Morte, S. D., Berti, E., Lalli, C., Modugno, N., Morgante, F., Schrag, A. E., Makovac, E., & Ricciardi, L. (2024) · European Journal of Neurology · doi:10.1111/ene.16286 · Cited by 5
“A number of studies have shown that CTM is feasible and effective in reducing stress and anxiety in several medical conditions [15, 33].”
Background
Receiving self-compassion in the virtual world: Testing the potential value of biofeedback
Greig, L., Coundouris, S. P., Randhir, S., Henry, J. D., & Baghaei, N. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104596 · Cited by 9
Effectiveness of Compassion-Based Interventions for Reducing Stress in Workers: A Systematic Review
Martins, F. J., Palmeira, L., & Matos, M. (2025) · Mindfulness · doi:10.1007/s12671-025-02590-z · Cited by 8
“For example, CFT was found to be generally effective in reducing symptoms of depression, anxiety, and trauma-related issues (e.g., Craig et al., 2020), as well as in addressing self-criticism (Leaviss & Uttley, 2015) and stress, particularly in clinical populations with high levels of…”
Body dissatisfaction, stigma and eating disorders: a scoping study on the role of compassion focused therapy
Dover, S., & Clements, F. A. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01292-0 · Cited by 6
“One of the more recent comprehensive reviews of CFT examined the efficacy and acceptability of CFT within clinical populations [38].”
Social rank and compassion: How insecure striving, social safeness and fears of compassion mediate the relationship between masculinity, depression and anxiety
Kirby, J. N., Day, J. J., & Gilbert, P. (2024) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12520 · Cited by 8
A Compassion-Focused Therapy group for young people who live in foster, adoptive or kinship care: Initial development, reflections, and ways forward
Lau‐Zhu, A., & Vella, L. (2023) · Adoption & Fostering · doi:10.1177/03085759231207397 · Cited by 6
“…of evidence supporting CFT’s effectiveness for a range of clinical presentations, including anxiety, depression, disordered eating, and post-traumatic stress disorder (PTSD), although more robust study designs are sorely needed (Craig, Hiskey and Spector, 2020; Kirby, Tellegen and Steindl, 2017).”
Background
‘Like I'd been listened to without actually saying words’: Picturing the nurturer in compassion‐focused therapy
Crone, R. L., Brown, R. J., & Bell, T. (2023) · Counselling and Psychotherapy Research · doi:10.1002/capr.12730 · Cited by 6
Compassion-Focused Therapy for an Older Adult with Motor Functional Neurological Disorder: A Case Study
Zarotti, N., Poz, R., & Fisher, P. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2022.2130124 · Cited by 9
Psychological Treatment Targeting Acceptance and Compassion in Patients With Chronic Pain: A Randomized Controlled, Internet-delivered, Treatment Trial
Buhrman, M., Tillfors, M., Holländare, F., Lekström, E., Håkansson, A., & Boersma, K. (2023) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000001157 · Cited by 5
“19 A meta-analysis 20 found a relationship between self-compassion and well-being; the relationship was stronger for cognitive and psychological well-being compared with affective well-being.”
Background
Exploring transdiagnostic factors of internalizing and externalizing symptoms in transitional-age youth: Using a variable-centered and person-centered approach
Keulen, J., Deković, M., Vervoort, L., & Bodden, D. H. M. (2025) · Current Psychology · doi:10.1007/s12144-025-08328-3 · Cited by 4
“…factors that are already often targeted in existing transdiagnostic interventions, such as Compassion Focused Therapy (targeting self-compassion) (Craig et al., 2020), Acceptance and Commitment Therapy (targeting psychological flexibility) (Hayes et al., 2006), Competitive Memory Training…”
The role of shame in functional and epileptic seizures
Popoluska, E., Levita, L., & Reuber, M. (2024) · Seizure · doi:10.1016/j.seizure.2024.06.028 · Cited by 4
Weight self-stigma, but not body dissatisfaction, predicts binge eating across one academic year
Patarinski, A. G. G., Athanasaw, K., Garban, A. L., Hahn, S. L., & Davis, H. A. (2025) · Body Image · doi:10.1016/j.bodyim.2025.101902 · Cited by 4
O que é Compaixão?
Matos, M., Gilbert, P., Gonçalves, E., Melo, I., Baumann, T., Yiu, R. X. Q., & Steindl, S. R. (2021) · Psychologica · doi:10.14195/1647-8606_64-2_1 · Cited by 5
Self-Acceptance Mediates the Relationship between Perceived Parenting Behaviors and Fears of Compassion
Wang, J., Guo, M., Day, J. J., & Kirby, J. N. (2023) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02522-8 · Cited by 5
“Given the benefits derived from compassion, it is not surprising that it has become a core intervention target in therapeutic interventions (Craig et al., 2020; Forster & Kanske, 2021; Kirby, 2017), such as Mindful Self-Compassion Program (Neff & Germer, 2013), Cultivating Compassion Training…”
Background
A mixed methods evaluation of a compassion‐focused therapy group intervention for people with an intellectual disability
Hewitt, O. M., Codd, J., Maguire, K., Balendra, M., & Tariq, S. (2023) · British Journal of Learning Disabilities · doi:10.1111/bld.12528 · Cited by 5
A conceptual framework for internet child abuse material offenders: risk-relevant therapy based on assessed risk factors
Garrington, C., Kelty, S. F., Rickwood, D., & Boer, D. P. (2023) · Psychiatry Psychology and Law · doi:10.1080/13218719.2023.2251149 · Cited by 5
The effectiveness of brief workplace compassion-focussed training in improving wellbeing of stressed school employees
Healy, K. L., Payne, K., & Kirby, J. N. (2024) · Australian Journal of Management · doi:10.1177/03128962241270860 · Cited by 8
“To date, systematic reviews examining effectiveness of treating stress-related mental illness have concluded that CFT shows promise as an intervention for depression (Craig et al., 2020; Leaviss and Uttley, 2015).”
Subjective changes in mind-body attunement associated with transdiagnostic group–based compassion-focused therapy
Mernagh, M., Baird, K., & Guérin, S. (2020) · Mindfulness · doi:10.1007/s12671-020-01417-3 · Cited by 4
Compassion and complex interpersonal trauma in adolescence: An early systematic review
Amari, N., & Mahoney, A. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2689 · Cited by 4
Drivers and drainers of compassion in intensive care medicine: An empirical study using video vignettes
Siddiqui, S., & Hartog, C. S. (2023) · PLoS ONE · doi:10.1371/journal.pone.0283302 · Cited by 4
“The intention and focus of care and compassion are “sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it” [7].”
Background
A House with Many Doors – Toward a More Nuanced Self-Compassion Intervention Science
Finlay‐jones, A. L. (2023) · Mindfulness in behavioral health · doi:10.1007/978-3-031-22348-8_24 · Cited by 5
Exploring Perceptions and Use of Compassionate Care with Early Interventionists and Caregivers: A Mixed Methods Investigation
D’Agostino, S. R., Dueñas, A. D., Douglas, S. N., & Meadan, H. (2023) · Behavior Analysis in Practice · doi:10.1007/s40617-023-00831-y · Cited by 4
An internet-based compassion course for healthcare professionals: Rationale and protocol for a randomised controlled trial
Bratt, A. S., Johansson, M., Holmberg, M., Fagerström, C., Elmqvist, C., Rusner, M., & Kaldo, V. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100463 · Cited by 7
A Compassion-Focused Approach to Support Parents After Preterm Birth
Lloyd-Collins, T. M., Fitzallen, G. C., & Kirby, J. N. (2025) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-025-00549-z · Cited by 3
“Systematic reviews have demonstrated CFT’s effectiveness as a treat-ment for a range of mental health conditions (Craig et al., 2020; Millard et al., 2023; Petrocchi et al., 2024).”

Authors: Craig, C., Hiskey, S., & Spector, A.
Affiliations: Oxford Health NHS Foundation Trust (GB)
Oaks Hospital (GB)
University College London (GB)
Corresponding author: Craig, Catriona
ORCID: Craig, Catriona
Spector, Aimee
Venue: Expert Review of Neurotherapeutics
Publisher: Informa UK Limited
Published: 2020-04-02
Volume: 20
Issue: 4
Pages: 385-400
ISSN: 1473-7175 (ISSN-L)
1744-8360
DOI: 10.1080/14737175.2020.1746184
OpenAlex: W3011072785
Cited by: 201
References: 58
Citations by year: 2026: 29 · 2025: 36 · 2024: 37 · 2023: 36 · 2022: 35 · 2021: 24 · 2020: 3
FWCI: 1.92
Type: journal article
Language: en
Open access: green
discovery.ucl.ac.uk
Locations: Expert Review of Neurotherapeutics (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: compassion-focused therapy, treatment effectiveness, acceptability, transdiagnostic treatment, group therapy, mental illness, evidence-based practice, healthcare resource allocation
MeSH terms: Empathy, Humans, Patient Acceptance of Health Care, Psychotherapy, Outcome Assessment, Health Care

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Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations

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