A case series study of compassion‐focused therapy for distressing experiences in psychosis

Abstract

AbstractObjectivesCompassion‐focused therapy (CFT) is an evolution‐informed biopsychosocial approach that seeks to cultivate attachment and care motivational systems and their psychophysiological regulators. These can counteract some of the harmful effects of social threat, inferiority, shame, self‐criticism and depression, which are common in people with psychosis and undermine their well‐being, social trust and ability to feel safe. This study aimed to test the acceptability of a novel manualized individual CFT intervention for psychosis (CFTp).DesignA non‐concurrent, multiple‐baseline, case series design, with three phases: baseline, intervention and follow‐up.MethodsThe 26‐session CFTp intervention was provided for a sample of eight people with distressing psychotic experiences and a psychosis‐related diagnosis. The study aimed to assess acceptability of CFTp and to test clinically reliable improvements while receiving the intervention, compared to a baseline period.ResultsSeven of eight participants completed the therapy, and clinically reliable improvements were found at both the single‐case and group level of analysis. At the single‐case level, over half the participants showed improvements in depression (5/7), stress (5/7), distress (5/7), anxiety (4/7) and voices (3/5). One participant showed a deterioration in anxiety (1/7) and dissociation (1/7). At the group level (n = 7), there were significant improvements in depression, stress, distress, voices and delusions. The improvements in voices, delusions and distress were sustained at 6‐ to 8‐week follow‐up, but depression and stress dropped slightly to trend‐level improvements.ConclusionsCFTp is a feasible and acceptable intervention for psychosis, and further investigation is warranted with a randomized controlled trial.