A new manual to help clinicians and researchers with compassion focused therapy manual

Dr James Kirby 

A/Prof & Clinical Psychologist

Director: Compassionate Mind Research Group

The University of Queensland

Where my CFT journey began

I remember with great excitement (or with a very big blue circle for us CFTers) attending a 3-day Introduction to Compassion Focused Therapy workshop in Byron Bay (Northern New South Wales, Australia) back in 2013. It is slightly scary (that’s a big red!) to think that was over a decade ago now. 

The workshop was delivered by Professor Paul Gilbert, who developed Compassion Focused Therapy (CFT), and he was simply brilliant with how he weaved evolutionary theory, with attachment, and a biopsychosocial framework to describe the CFT approach. Not only that, but the workshop also featured several clips from my favourite movie, Good Will Hunting

Paul Gilbert Compassion Focused Therapy founder

For whatever reasons, call it fate, call it luck, call it karma, but those 3-days were transformational to my approach to therapy and research. I had already viewed some of Paul in action, as he is so generous with sharing so many free resources, if you have time, check out the free one-day workshop on CFT he did at Stanford back in 2013.  And I had begun to incorporate some of the CFT approach into my therapy, using things like multiple-selves or some of the guided compassion focused practices included in his terrific book Mindful Compassion which he wrote with Choden.

But, like my love for ice-cream, I wanted more. So, I bought all the many different compassion focused books I could, attended the experiential (on multiple occasions) and advanced CFT training, and started a CFT practice group with my buddy Stan Steindl. On top of that, being an academic, I was also examining compassion in my research. I started simple at first, writing conceptual pieces linking compassion and parenting (my PhD was focused on parenting and family), and I then moved into reviews and meta-analyses of compassion-based interventions. But what I really wanted to do was Randomised Controlled Trials (RCT) of CFT.

The Research Drive

There is a nice tension between clinical work in and research when it comes to therapy, as researchers need protocols and manuals – to examine mechanisms and key ingredients of a therapy model – whereas clinicians need flexibility and to work with their clients guided by case formulations. There is also a distinction between process-based evidence (which there is lots of for CFT), and evaluation or outcome-based research, which there is less of in CFT (although this is changing rapidly, with a recent meta-analysis by Niki Petrochhi and colleagues just published on CFT outcomes).
 
But in 2016 when this all started, I needed a manual so we could begin to conduct rigorous RCTs of CFT in my research. This led to my connection with the wonderful Niki Petrocchi, who has been examining CFT for longer than she probably cares to realise, but she has done brilliant work examining compassion in the mirror and compassion and heart rate variability. Together we started to write a proposed manual of CFT, which guides clinicians through key themes across the CFT journey. Across these 8 years of writing the manual we received enormous help from Paul.
 
But Niki and I also realised we needed more help and thankfully clinical psychologist and CFT trainer Beatrice Baldi joined the team. So, the three of us, painstakingly during the Covid era, would meet every Wednesday afternoon Australian time, and early morning Italian time to continue to update our manual. And to our absolute relief and joy, in late 2023 we finally submitted our manual to publishers Routledge.

The Essentials of Compassion Focused Therapy: A Practice Manual for Clinicians

So, what does the manual contain I hear you ask? Well, the manual is a 12-module transdiagnostic program to deliver CFT in group or individual settings. It is by no means the ‘only’ way to deliver CFT, it is simply ‘a way’ to deliver CFT, where we provide step-by-step guidance. The manual includes chapters introducing clinicians to how to use the manual, along with multiple approaches to do CFT formulations.

We then pivot to the 12-modules, with each module dedicated to a particular theme, which is explained through a brief introduction of the basic rationale underpinning the module for the clinician, and then developed and explored through psychoeducation for the client, followed by a variety of experiential exercises.

Each module includes therapist scripts, to help the clinician become more confident in delivering the practices, and client handouts to be used during the sessions and as home exercises.

To the right, you can see the outline of the manual content. Across these modules we have also introduced some new practices, for example, there is a new practice in module 9 on deepening compassion for the self which builds of Niki’s work with compassion in the mirror, which we hope will really help facilitate a deeper felt sense of self-compassion for people.

Module

Session Outline

Module 1

Introduction to Compassion

Module 2

Three Affect Regulation System

Module 3

Mindfulness

Module 4

Exploring Safety/Safeness

Module 5

The Compassionate Self

Module 6

The Multiple Selves

Module 7

Self-Criticism

Module 8

Shame and Guilt

Module 9

Deepening Compassion for the Self

Module 10

Compassionate Assertiveness

Module 11

Compassionate Forgiveness

Module 12

Envisioning a Compassionate Future

If you are interested in CFT, both as a clinician and researcher, I think you will find this manual really helpful. When I first started implementing CFT into my practice there were times where I felt a little lost, but thankfully with support and peer supervision I kept at it. I wish I had something like this manual when I first started, just to help provide some guidance and reassurance on how I was going implementing CFT.

compassion focused therapy manual
Compassion Focused Therapy Manual

You can pre-order the manual now, and it is due for official release by Routledge in April 2024. Already the manual is having an impact, as I have been involved in evaluating it in two evaluations. 

One was led by my PhD student at the time, the now Dr Alicia Carter, where we found the manual significantly reduced body weight shame, self-criticism and significantly improved self-compassion and wellbeing for those in bigger bodies.

In a separate study led by Dr Madeline Romaniuk we also found the CFT manual helped with veterans significantly reducing fears of compassion and PTSD symptoms, where we ran the manual as a group couples program. Now I am about to start examining the manual for those with depression in individual sessions.

I hope you find this manual helpful in supporting you with your CFT research and practice.

Dr James Kirby

Balanced Minds, Compassion Focused Therapy & Self-Compassion

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