DOI: 10.1111/bjc.12437 ISSN:

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

Charles Heriot‐Maitland, Andrew Gumley, Til Wykes, Eleanor Longden, Chris Irons, Paul Gilbert, Emmanuelle Peters
  • Clinical Psychology
  • General Medicine



Compassion‐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).


A non‐concurrent, multiple‐baseline, case series design, with three phases: baseline, intervention and follow‐up.


The 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.


Seven 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.


CFTp is a feasible and acceptable intervention for psychosis, and further investigation is warranted with a randomized controlled trial.

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