Compassion Focused Therapy (CFT) is an emerging transdiagnostic treatment which aims to attenuate common psychological problems including shame and self-criticism through building compassionate skills. These problems are considered relevant and implicated in the maintenance of eating disorders. Imagery in particular has attracted attention as an important treatment technique for its strong links with memory. The aim of this thesis was to explore the effect of Compassion Focused Imagery (CFI) in women with sub-clinical eating disorder symptoms. Paper 1 is a systematic review of the CFT literature across disorders and in transdiagnostic groups. The main aims of the review were to evaluate the literature, synthesise the content of CFT across studies and provide preliminary effect size calculations. Eighteen articles were identified including clinical and non-clinical, treatment and experimental studies. The current body of evidence includes transdiagnostic samples, eating disorders, psychosis, acquired brain injury, depression, posttraumatic stress disorder (PTSD), personality disorder, individuals high in self-criticism and those with acne. The review includes a synthesis of intervention content, modalities, training and supervision of CFT within the literature. Strongest evidence was identified within transdiagnostic groups with more limited evidence for CFT within PTSD, personality disorders, acne sufferers and high self-critics. Effect sizes varied from 0-0.9 across shame, self-criticism and self-compassion outcomes. The area is limited by few controlled evaluations and heterogeneous content of interventions. Paper 2 is an experimental study of the effect on CFI in an analogue (sub-clinical) sample of women with elevated levels of eating disorder symptoms. Following baseline assessments measuring shame, self-criticism, self-compassion and stress, anxiety and depression, women with global scores of 2.5 or over on the Eating Disorders Examination Questionnaire (EDE-Q) were randomly allocated to either CFI condition in which they were instructed to create an image of a compassionate other or to a neutral imagery condition which involved creating an image of a neutral object. A third group of individuals with global scores of 1.0 or less on the EDE-Q were recruited for comparison only. Following a practice period of five-to-seven days, participants were assessed a final time. Controlling for baseline scores, significantly greater reductions in shame were reported in the CFI group compared with the neutral imagery group. Increases in self-compassion and decreases in self-criticism and depression, anxiety and stress were favourable in the CFI group compared with those in the neutral imagery group; however, these findings did not reach statistical significance. Compassion focused imagery appeared to be well tolerated within the CFI group. Clinical and theoretical implications and future research directions are discussed. The third chapter offers a reflective discussion on the methodological strengths and weaknesses, clinical and theoretical implications beginning with the systematic review followed by the empirical paper. Chapter 3 concludes with a final section on personal and professional reflections throughout the research process.

Compassion Focused Therapy är en integrativ transdiagnostisk behandlingsform som syftar till att öka self-compassion och minska skam och självkritik hos individer med psykisk ohälsa. Skam och självkritik har i hög grad identifierats hos personer med ätstörningar, som också ofta anses svårbehandlade. Denna studie syftade till att undersöka huruvida CFT kan vara ett behandlingsalternativ vid ätstörningar. En single-subject design med upprepade mätningar användes (n=5). Studien visade på tvetydiga resultat men indikerar att en del individer kan vara hjälpta av denna behandling. Fortsatt forskning är således motiverad / Compassion Focused Therapy (CFT) is an integrative transdiagnostic treatment aiming at increasing self-compassion, and reducing levels of shame and self-criticism in individuals with psychiatric illness. High levels of shame and self-criticism have been identified in people suffering from eating disorders, disorders who are usually considered difficult to treat. The aim of the present study was to investigate if CFT could be considered a treatment option for eating disorders. A single-subject design with repeated measures was used (n=5). The results were ambiguous, though indicating that CFT could be helpful for some individuals with eating disorders. Further research is warranted.

Performance anxiety and stress are forefront problems for performers in the music industry. Within music training programs, these problems are particularly debilitating. These students are concerned both about performance situations and also their personal lives. The following study compared two treatments, heart rate variability (HRV) biofeedback and Compassion Focused Therapy (CFT) on the effects of cortisol and self-reported stress and mood before and after a required end of semester performance. Thirty students enrolled in a college music program participated in the five-visit intervention (14 in the HRV biofeedback group and 16 in the CFT group). Stress levels, measured by self-report, salivary cortisol, and salivary alpha amylase, showed no group differences between the CFT and HRV groups. Both groups had statistically significant improvement following the intervention on pre-performance DASS scores and alpha-amylase scores, showing lower sympathetic activation and lower report of mood symptoms despite the stress of the required performance. Cortisol and negative affect did not appear to be impacted by the intervention, however, cortisol returned to baseline levels 15 minutes after the intervention, showing relatively quick recovery for both groups. Further research with a larger, more diverse sample and control group is warranted.

Objectives. This study explored mechanisms of change for Compassion Focused Therapy (CFT) groups. The feasibility and acceptability of a new group therapy protocol were assessed in a college counseling center population.Method. Seventy-five participants engaged in eight transdiagnostic CFT groups. Group CFT consisted of 12 weekly sessions. Participants completed measures of fears of compassion, flows of compassion, self-reassurance, self-criticism, shame, and psychiatric distress at pre, mid, and post time points. Significant and reliable change was assessed. Potential mechanisms of change were examined using correlations. Self-report feasibility and acceptability data were collected from therapists and participants respectively.Results. Significant and reliable change was found for fears of self-compassion, fears of compassion from others, fears of compassion to others, self-compassion, compassion from others, self-reassurance, self-criticism, shame, and psychological distress. Improvements in fears and flows of compassion predicted improvements in self-reassurance, self-criticism, shame, and psychiatric distress. The protocol was judged to be feasible and acceptable.Conclusion. The new CFT group protocol appears to be feasible, acceptable, and effective in a transdiagnostic college counseling center population. The identified mechanisms of change support the theory of CFT that transdiagnostic pathological constructs of self-criticism and shame can be decreased by decreasing fears and increasing flows of compassion.

No description available.

No description available.

No description available.

No description available.

Ångest och depression är vanliga sökorsaker inom primärvården och klassas idag som folksjukdomar i Sverige. Svenska vårdcentraler har svårt att möta vårdbehovet kring psykisk ohälsa, och det finns därför anledning att utforska nya behandlingsalternativ för att effektivisera vården. I denna studie användes en kontrollerad mellangruppsdesign i syfte att undersöka hur Compassionfokuserad terapi (CFT) i grupp påverkar primärvårdspatienters grad av ångest och depression, samt huruvida detta skiljer sig från sedvanlig behandling i form av kognitiv beteendeterapi (KBT). Designen omfattade tre grupper; en interventionsgrupp (n = 20) som erhöll CFT, en aktiv kontrollgrupp (n = 12) som erhöll KBT, samt en passiv kontrollgrupp (n = 20) bestående av psykologstudenter som ej erhöll behandling i någon form. Självskattningsformulären Beck’s Depression Inventory II, Beck’s Anxiety Inventory samt Self-Compassion Scale administrerades vid två tillfällen i samtliga grupper. Förändringarna undersöktes med hjälp av t-test, variansanalys för upprepade mätningar samt effektstorlekar. Resultaten påvisade en signifikant skillnad mellan de grupper som erhållit behandling och den passiva kontrollgruppen men ingen signifikant skillnad mellan den aktiva kontrollgruppen och interventionsgruppen. Dock återfanns en större effektstorlek gällande depression för interventionsgruppen jämfört med den aktiva kontrollgruppen. Resultaten indikerar att CFT i grupp kan vara en effektiv behandling för primärvårdspatienter med ångest och depression. Vidare forskning efterfrågas för att undersöka de långsiktiga effekterna av CFT. / Anxiety and depression are conditions commonly occurring within primary health care and is currently a major health scourge in Sweden. Swedish primary health care centers are facing challenges in meeting the needs concerning mental illness, and therefore the exploration of new options for treatment is warranted for improved effectiveness. In this study a controlled between-group design was used in the aim of exploring how group delivered Compassion focused therapy (CFT) affects the degree of depression and anxiety in primary healthcare patients, and also whether it differs from treatment as usual consisting of cognitive behavioral therapy (CBT). The design comprised of three groups; an intervention group (n = 20) receiving CFT, an active control group (n = 12) receiving CBT, and a passive control group (n = 20) consisting of psychology students who did not receive any treatment. The self assessment questionnaires Beck’s Depression Inventory II, Beck’s Anxiety Inventory and Self-Compassion Scale was administered at two occasions in all groups. Changes were examined with t-tests, repeated measures analysis of variance and within-group effect sizes. The results showed a significant difference between the groups receiving treatment and the passive control group, but no significant difference between the intervention group and the active control group. However, a larger effect size was found regarding depression within the intervention group compared to the active control group. The results indicate that group delivered CFT may be an effective treatment regarding anxiety and depression in primary health care patients. Further research is warranted to explore the long term effects of CFT.

Studien undersökte gruppbaserad compassionfokuserad terapi (CFT) i en klinisk miljö hos ungdomar med psykisk ohälsa samt hos omsorgspersoner till ungdomar med psykisk ohälsa. Syftet var att undersöka samband mellan deltagarnas upplevelse av CFT och psykiskt mående före och efter behandling. Deltagarna beskrev fritt sina upplevelser av CFT i en utvärderingsenkät som undersöktes med innehållsanalyser. Psykiskt mående skattades med en anpassad version av The Child Outcome Rating Scale (CORS) och förändring mättes med beroende t-test. Sambandet mellan dessa undersöktes med datan från båda instrumenten. Resultatet visade en övergripande positiv upplevelse av behandlingen. Omsorgspersonernas psykiska mående förbättrades signifikant, men inte ungdomarnas. Ett möjligt samband mellan positiv förändring i psykiskt mående och positiv behandlingsupplevelse syntes. Däremot sågs inget tydligt samband kring försämring i psykiskt mående och en negativ behandlingsupplevelse. CFT tycks vara hjälpsamt för omsorgspersoner till barn med psykisk ohälsa och eventuellt även för ungdomar med psykisk ohälsa men vidare forskning krävs. / The study examined group-based compassion-focused therapy (CFT) for adolescents with mental health problems, and caregivers to adolescents with mental health problems, in a clinical environment. The purpose was to examine the association between participants´ experiences of CFT and changes in psychological distress before and after treatment. Participants freely described their experience in an evaluation questionnaire, which were examined with content analyzes. Psychological distress was rated with a constructed version of The Child Outcome Rating Scale (CORS) and changes were measured with dependent t-test. Comparisons between both assessments examined their association. The results showed positive experiences of the treatment. Caregivers rated a significant improvement in psychological distress, however, adolescents did not. A possible association was discovered between improvement in psychological distress and positive experiences. However, there was no obvious pattern between impairment of psychological distress and negative experiences. CFT seems to be a helpful treatment for caregivers to adolescents with mental health problems and possibly also to adolescents with mental health problems, but further research is required.