Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design
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Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients (N = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120-min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID-19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.
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Compassion-focused therapy has been found to be effective in treatment-resistant OCD.
“compassion‐focused therapy has been found to be effective in treatment‐resistant OCD (Patel et al., 2022; Petrocchi et al., 2021).”
From A preliminary investigation of the relationships between attachment insecurity, fear of compassion, and <scp>OCD</scp> severity (2025) · cites this paper as Petrocchi et al., 2021
The Discussion reports that all eight treatment-resistant OCD patients had significant symptom reductions after the compassion-focused intervention. It describes the evidence for clinical effectiveness as preliminary and promising, however, so the unqualified claim that the therapy has been found effective overstates this small pilot study. (LLM, conf=0.86)
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Kleiman, K., Marks, D. R., Block-Lerner, J., Tirch, D., Brady, V., Foote, B., & Silberstein-Tirch, L. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1509396 · Cited by 4 · see citing works
Saliani, A. M., Perdighe, C., Zaccari, V., Luppino, O. I., Mancini, A., Tenore, K., & Mancini, F. (2024) · PubMed Central · doi:10.36131/cnfioritieditore2023060104 · Cited by 3 · see citing works
“…the existence of a close link between self-criticism, guilt, and OCD, only a few studies have examined the effectiveness of interventions targeting moral self-criticism and guilt (Cosentino et al., 2012; Gragnani et al., 2022; Perdighe & Mancini, 2012; Petrocchi et al., 2021; Tenore et al., 2020).”
BackgroundSelf-citationMcNeil, A., & Purdon, C. (2025) · British Journal of Clinical Psychology · doi:10.1111/bjc.12533 · Cited by 1 · see citing works
“Furthermore, compassion-focused therapy has been found to be effective in treatment-resistant OCD (Patel et al., 2022; Petrocchi et al., 2021).”
Moeini, F. R., Goodarzi, N., Dabbaghi, P., Rahnejat, A. M., & Ghasemzadeh, M. R. (2024) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh-2023-0027 · Cited by 1 · see citing works
- Authors
- Petrocchi, N., Cosentino, T., Pellegrini, V., Femia, G., D’Innocenzo, A., & Mancini, F.
- Affiliations
- John Cabot University (IT)
- Sapienza University of Rome (IT)
- Marconi University (IT)
- Corresponding author
- Petrocchi, Nicola
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2021-01-12
- Volume
- 11
- Pages
- 594277-594277
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC7835278
- OpenAlex
- W3120266103
- Cited by
- 39
- References
- 19
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 8 · 2023: 10 · 2022: 4
- FWCI
- 3.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- treatment-resistant OCD, compassion-focused therapy, group therapy, self-criticism, self-reassurance, common humanity, depression, augmentation therapy, treatment acceptability, COVID-19 lockdown
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