How might the evidence from group interventions of compassion focused therapy for shame and self-criticism be applicable to the treatment of self-harm

Abstract

Treatment for self-harm remains limited despite research indicating the need to address underlying functions (Slee et al., 2008). Shame and self-criticism are pathogenic processes linked to self-harm (Gilbert & Irons, 2005) therefore CFT (compassion focused therapy) which is designed for shame and self-criticism could be an effective treatment.This review aimed to synthesise the literature on group based CFT for mental health difficulties with underlying shame and self-criticism and conceptualise how CFT group treatment could be effective for self-harm based on evidence from the papers. A systematic literature search was undertaken and 11 papers were reviewed according to the inclusion criteria which limited references to peer reviewed journal articles in English, from the year 2000 and those pertaining to group based CFT in adult clinical populations. A thematic synthesis was conducted after applying some key questions to the papers.Four key themes emerged from the thematic synthesis and were discussed with reference to questions around the effectiveness and acceptability of group CFT for addressing shame and self-criticism. The themes were, ‘moving from self-criticism to self-compassion’, ‘aversion to compassion’, ‘group process’ and ‘skills development’.Evidence from the papers around CFT group interventions were discussed with reference to their application to the treatment of self-harm in terms of building affiliative connections with others and the development of compassion as an adaptive coping mechanism, decreasing distress and reducing the need to engage in self-harm.