An Exploration of the Experiences of Group Compassion Focused Therapy for Hospital Outpatients with Long-Term Mental Health Difficulties

There is now good evidence for the efficacy of Compassion Focused Therapy (CFT) for a variety of mental health difficulties. To deepen understanding of the processes underpinning CFT’s effectiveness, this service evaluation explored the experiences and reflections of individuals with long-term mental health difficulties who had previously received therapy and attended an 11-week CFT group. Ten clients were invited to the group; one withdrew before the group started because of work and personal commitments and another attended five sessions, improved, was able to obtain employment and left. Eight participants attended eleven 2-hour sessions of group CFT. Five of the participants attended the first focus group at the end of the therapy and three of these participants also attended the second focus group 3 months after the group had ended. Focus groups were analysed using Reflexive Thematic Analysis. Participants highlighted the value of understanding the distinctions between safety and safeness, how to create social safeness between themselves and its link with compassion. These participants’ efforts enabled feelings of grounding, interconnectedness, openness and were de-shaming in ways they had not experienced before. They reflected on how they had benefitted from psychoeducation on the evolved functions of mind, their biopsychosocial properties and the nature of brain states. They had also gained new understandings into the nature of compassion, in particular the distinction between processes of empathic engagement and actions in response to distress. This enabled them to apply different components and processes of compassion flexibly and in relevant ways to their mental health difficulties and everyday life. CFT’s focus on evolution, tricky brain concepts and how compassion can change brain states was experienced as new and different from previous therapies. One participant described CFT as ‘life changing’. Although we did not set out to explore the impact on employment, five participants began to seek employment during the course of the group. While there is good evidence that CFT is a well-accepted and effective psychotherapy, this service evaluation adds to insights on some of the core micro-processes participants identify as central CFT themes, which were felt to be unique and important to their progress.