Compassion-Focused Therapy for Secondary Traumatic Stress (CFT for STS)

Staff and practitioners (e.g., support staff, caseworkers, social workers, supervisors, managers, administrators, directors, etc.)

Compassion-Focused Therapy (CFT) is an evolution-informed, biopsychosocial therapeutic approach that aims to help those who struggle with shame and self-criticism, which can result from experiences of abuse or neglect. CFT teaches clients to cultivate the skills of self-compassion and other-oriented compassion, and to build the courage and wisdom to address life’s difficulties and flourish. It utilizes psychoeducational concepts such as the three emotion regulation systems and understanding the ‘tricky brain,’ and guides participants through a range of mind-body practices. Clients and therapists collaborate on a set of therapeutic goals and tasks; formulation, assessment and therapeutic guidance are crucial.

Compassionate Mind Training (CMT) refers to the specific exercises that people practice in order to stimulate different systems in their brains, bodies, and social relationships. It is typically for nonclinical populations and may be used as a set of self-help exercises.

While the CEBC has only reviewed CFT for use with secondary traumatic stress, it can be used with non-caregiving adults, parents/caregivers, adolescents, and young adults to alleviate other symptoms.

Compassionate Mind Foundation team

• Agency/Affiliation: Compassionate Mind Foundation
• Website: https://www.compassionatemind.co.uk/
• Email: hello@compassionatemind.co.uk
• Phone: (013) 324-2337 x6

Compassionate Mind Foundation Research Team

• Agency/Affiliation: Compassionate Mind Foundation
• Website: https://www.compassionatemind.co.uk/
• Email: research@compassionatemind.co.uk Phone: 01332 423376
• Phone: (013) 324-2337 x6

The goals of Compassion-Focused Therapy (CFT) are:

• Reduce secondary traumatic stress
• Address underlying factors such as shame and self-criticism and promote self-acceptance
• Gain understanding of compassion as flow: compassion to others, being open to compassion from others, and compassion towards oneself.
• Learn practices that stimulate compassionate mental states and those that build a sense of the compassionate self-identity

The essential components of Compassion-Focused Therapy (CFT) include:

• How the human ability to self-monitor can be a source of shame, anxiety and depression, but also compassion to self and others
• How the three-affect regulation system (threat awareness & coping, reward & resource seeking, and contentment & soothing) forms complex patterns within the mind
• How early life experiences can shape the organization of emotions and sense of selves, and underpin mental health difficulties
• Fears, blocks, and resistances to compassion, and how to work with these in therapy
• Explore the components of self-compassion and how its application can ideally facilitate and promote well-being
• Techniques and exercises to help individuals acquire compassion and self-soothing skills, such as soothing rhythm breathing, safe place imagery, and imagining an ideal ‘compassionate other’

Recommended Intensity

One weekly 2-hour session with a break in the middle for groups

Recommended Duration

The number of sessions varies depending on individual needs, but the program usually comprises 12 modules spread over 12-24 weeks.

Delivery Settings

This program is typically conducted in a(n):

• Community-based Agency / Organization / Provider
• Foster / Kinship Care
• Group or Residential Care
• Hospital
• Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
• Outpatient Clinic
• Public Child Welfare Agency (Dept. of Social Services, etc.)
• School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

Clients receive handouts/memory notes for the purpose of recapping content covered in each module. In addition, they are usually asked to try to practice compassion in their everyday lives and practice meditation exercises at home with the provision of recordings (accessed online). Workbooks and practice diaries are also provided to help with this.

Languages

Compassion-Focused Therapy for Secondary Traumatic Stress (CFT for STS) has materials available in the following languages other than English:

• French
• German
• Greek
• Italian
• Portuguese

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed in this page).

Please contact the program contact (bottom of the page) if you require materials in a different language that is not listed – there are at least 18 international affiliate groups (see:https://www.compassionatemind.co.uk/resource/affiliates-and-partners)

Resources Needed to Run Program

The typical resources for implementing the program are:

A CFT-trained psychotherapist (or 2 CFT-trained facilitators for groups), a quiet room, flipchart and pen(s) or laptop and projector for mapping ideas.

Prerequisite/Minimum Provider Qualifications

Trainers will be qualified therapists with usually several years clinical experience using CFT and often have experience of providing training (e.g. in their other work settings/other training providers). Compassionate Mind Foundation is one provider of training, others include APT and Balanced Minds, who will have their own processes.

There is a Train the Trainers course for teachers: https://www.derby.ac.uk/short-courses-cpd/health-and-social-care/train-the-trainers/#:~:text=This%20is%20the%20third%20of,Decrease%20stress

Eligibility:

• Individuals must also already possess a recognized qualification (e.g., member of the British Association for Counseling and Psychotherapy (BACP), Health and Care Professions Council (HCPC), British Psychological Society (CPsychol) as well as qualified teacher status (QTS) or postgraduate certification (PGCert) or equivalent in other countries)
• Participants must have completed the Compassionate Mind Training - Teachers (https://www.derby.ac.uk/short-courses-cpd/health-and-social-care/compassionate-mind-training---teachers/) course or a recognized Compassionate Mind Training/Compassion Focused Therapy course via the Compassionate Mind Foundation (https://www.compassionatemind.co.uk/) or its affiliations.
• If a recognized Compassionate Mind Training/Compassion Focused Therapy course has been undertaken but doesn’t cover all elements outlined in the Compassionate Mind Training - Teachers course, participants must first engage with a pre-recorded online version of the Compassionate Mind Training - Teachers course (https://www.derby.ac.uk/short-courses-cpd/health-and-social-care/compassionate-mind-training---teachers/) at a reduced cost. https://www.derby.ac.uk/short-courses-cpd/health-and-social-care/compassionate-mind-training---teachers/

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Manual details:

• Gilbert, P., & Simos, G. (2022). Compassion Focused Therapy: Clinical practice and applications. London Routledge.
• Petrocchi, P., Kirby, J., & Baldi, B. (2024). Essentials of Compassion Focused Therapy. Routledge.

Manuals are available through their publisher and other booksellers.

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

Clinicians need to attend the Introduction to CFT (3-day) workshop as well as the Advanced Clinical Skills (3-day) workshop, with a break of at least 6 months in between. The Diploma in CFT, which is a 10-month British Psychological Association approved training, is also offered.

Training is provided by the Compassionate Mind Foundation, based in the UK and online (with affiliates offering training internationally). Bespoke workshops which can be tailored to the needs of the trainee’s organization are also offered.

Number of days/hours:

At least 6 days to cover both workshops.

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Compassion-Focused Therapy for Secondary Traumatic Stress.

Formal Support for Implementation

Formal support is required in the form of clinical supervision to ensure clinicians are supported in their work as well as fidelity to the model. Supervision may be provided in person or via teleconferencing, (e.g., Zoom or MS Teams). Formal training to become a CFT supervisor is also available

Fidelity Measures

There are no fidelity measures for Compassion-Focused Therapy for Secondary Traumatic Stress.

Established Psychometrics

There are no established psychometrics for Compassion-Focused Therapy for Secondary Traumatic Stress.

Fidelity Measures Required

No fidelity measures are required for Compassion-Focused Therapy for Secondary Traumatic Stress.

Implementation Guides or Manuals

There are no implementation guides or manuals for Compassion-Focused Therapy for Secondary Traumatic Stress.

Implementation Cost

There are no studies of the costs of Compassion-Focused Therapy for Secondary Traumatic Stress.

Research on How to Implement the Program

Petrocchi, N., Ottaviani, C., Cheli, S., Matos, M., Baldi, B., Basran, J. K., & Gilbert, P. (2024). The impact of compassion-focused therapy on positive and negative mental health outcomes: Results of a series of meta-analyses. Clinical Psychology: Science and Practice, 31(2), 230–247. https://doi.org/10.1037/cps0000193

"What is included in the Relevant Published, Peer-Reviewed Research section?"

• Santos, L., do Rosário Pinheiro, M., & Rijo, D. (2022). Compassionate mind training for caregivers of residential youth care: Early findings of a cluster randomized trial. Child Abuse & Neglect, 123, Article 105429. https://doi.org/10.1016/j.chiabu.2021.105429

  Type of Study: Randomized controlled trial

  Number of participants: 85

  Population:

  • Age — Treatment Group: Mean=43.17 years; Control Group: Mean=45.68 years
  • Race/Ethnicity — Not specified
  • Gender — Treatment Group: 95% Female and 5% Male; Control Group: 84% Female and 16% Male
  • Status — Participants were Residential Youth Care (RYC) staff

  Location/Institution: Portugal

  Summary:

  The purpose of the study was to test the efficacy of a Compassionate Mind Training program (the specific exercises used in Compassion Focused Therapy) for caregivers of Residential Youth Care (RYC) (CMT-Care Homes) following CONSORT guidelines. Participants were randomized to either the treatment group or to a non-treatment control group. Measures utilized include the Compassion Scale, Self-Compassion Scale (SCS), Fears of Compassion Scales (FCS), Emotional Climate in Organization Scales, (ECOS), and the Social Safeness and Pleasure Scale. Results indicate that there was a significant and large Time × Group interaction effect (Pillais' trace = 0.291, F = 2.719, p = .005, ηp² = 0.291). Univariate tests indicate significant and positive effects in compassion and fears of compassion (low and medium effect sizes), as well as in soothing related emotions (emotional climate) and social safeness (both with medium effect sizes), in favor of the treatment group. Limitations include self-report bias, inconsistent participation rate in the intervention group, and lack of follow-up.
  

  Length of controlled postintervention follow-up: None.

• Gilbert, P. (2010). The Compassionate Mind (Compassion Focused Therapy). Constable.

• Unstress with Dr. Ron Ehrlich. (2023). The Compassionate Mind - Prof Paul Gilbert. [Podcast]. https://drronehrlich.com/prof-paul-gilbert-the-compassionate-mind/

• The Weekend University. (2019, Feb. 10). Compassion Focused Therapy: An introduction - Prof. Paul Gilbert. [Video]. https://www.youtube.com/watch?v=mWfxrfrEBI8