A case series study of compassion-focused therapy for distressing experiences in psychosis

Charles Heriot-Maitland*, Andrew Gumley, Til Wykes, Eleanor Longden, Chris Irons, Paul Gilbert, Emmanuelle Peters

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Objectives: Compassion-focused therapy (CFT) is an evolution-informed biopsychosocial approach that seeks to cultivate attachment and care motivational systems and their psychophysiological regulators. These can counteract some of the harmful effects of social threat, inferiority, shame, self-criticism and depression, which are common in people with psychosis and undermine their well-being, social trust and ability to feel safe. This study aimed to test the acceptability of a novel manualized individual CFT intervention for psychosis (CFTp). Design: A non-concurrent, multiple-baseline, case series design, with three phases: baseline, intervention and follow-up. Methods: The 26-session CFTp intervention was provided for a sample of eight people with distressing psychotic experiences and a psychosis-related diagnosis. The study aimed to assess acceptability of CFTp and to test clinically reliable improvements while receiving the intervention, compared to a baseline period. Results: Seven of eight participants completed the therapy, and clinically reliable improvements were found at both the single-case and group level of analysis. At the single-case level, over half the participants showed improvements in depression (5/7), stress (5/7), distress (5/7), anxiety (4/7) and voices (3/5). One participant showed a deterioration in anxiety (1/7) and dissociation (1/7). At the group level (n = 7), there were significant improvements in depression, stress, distress, voices and delusions. The improvements in voices, delusions and distress were sustained at 6- to 8-week follow-up, but depression and stress dropped slightly to trend-level improvements. Conclusions: CFTp is a feasible and acceptable intervention for psychosis, and further investigation is warranted with a randomized controlled trial.

Original languageEnglish
Pages (from-to)762-781
Number of pages20
JournalBritish Journal of Clinical Psychology
Issue number4
Publication statusPublished - Nov 2023


  • auditory hallucinations
  • case series
  • compassion-focused therapy
  • delusions
  • psychosis
  • voices

Cite this