Kleiman Keryn, Marks Donald R, Block-Lerner Jennifer, Tirch Dennis, Brady Victoria, Foote Benjamin, Silberstein-Tirch Laura
Department of Advanced Studies in Psychology, Kean University, Union, NJ, United States.
The Center for Compassion Focused Therapy, New York, NY, United States.
Front Psychol. 2025 Apr 11;16:1509396. doi: 10.3389/fpsyg.2025.1509396. eCollection 2025.
Given the significant roles self-criticism and shame can play in the development and maintenance of psychological disorders, several compassion-based treatments, such as compassion-focused therapy (CFT), have been developed in recent years to address shame-based difficulties across a range of psychopathological conditions. CFT aligns with major tenets of acceptance and commitment therapy (ACT), which has been shown to be effective in treating various clinical disorders. Compassion focused acceptance and commitment therapy (CFACT) merges elements of CFT and ACT.
This study examined the feasibility, acceptability, and preliminary outcomes of a manualized CFACT protocol for transdiagnostic presentations in a community behavioral health clinic through a non-concurrent multiple baseline single-case experimental design. Participants received the therapy over 16-19 weekly sessions. Symptom severity, self-compassion, guilt, shame, attributional styles (detachment and externalization of blame), psychological flexibility, functioning in valued life contexts, and quality of life were assessed across baseline and treatment phases. Ratings of perceived utility and other aspects of interest/receptivity were also collected.
Results indicate strong acceptability and receptivity for CFACT across both participants and clinicians. Training clinicians in CFACT and implementing the treatment over telehealth in a training clinic setting was feasible. Most participants exhibited reliable decreases in symptom distress and psychological inflexibility, and reliable increases in self-compassion. Detachment level increased for most participants. Trajectories of guilt-proneness, shame-proneness, externalization of blame, and quality of life either varied across participants or remained unchanged. Supplemental cross-lagged correlation analyses did not demonstrate predictive associations between variables.
While quantitative outcome results were mixed, preliminary evidence suggests CFACT contributes to reduced symptom distress and increased psychological flexibility, self-compassion, and detached attributional style. Limitations and future directions are discussed.
鉴于自我批评和羞耻感在心理障碍的发展和维持中可能发挥的重要作用，近年来已经开发了几种基于同情的疗法，如以同情为中心的疗法（CFT），以解决一系列精神病理状况中基于羞耻感的困难。CFT与接受与承诺疗法（ACT）的主要原则相一致，ACT已被证明在治疗各种临床障碍方面有效。以同情为中心的接受与承诺疗法（CFACT）融合了CFT和ACT的要素。
本研究通过非同期多重基线单病例实验设计，在社区行为健康诊所检验了一种针对跨诊断表现的标准化CFACT方案的可行性、可接受性和初步结果。参与者在16 - 19次每周的疗程中接受治疗。在基线期和治疗期评估症状严重程度、自我同情、内疚、羞耻、归因风格（责备的超脱和外化）、心理灵活性、在有价值的生活情境中的功能以及生活质量。还收集了对感知效用和其他感兴趣/接受度方面的评分。
结果表明CFACT在参与者和临床医生中都具有很强的可接受性和接受度。在培训诊所环境中对临床医生进行CFACT培训并通过远程医疗实施治疗是可行的。大多数参与者的症状困扰和心理僵化程度可靠地降低，自我同情可靠地增加。大多数参与者的超脱水平提高。内疚感倾向、羞耻感倾向、责备外化和生活质量的轨迹在参与者之间各不相同或保持不变。补充的交叉滞后相关分析未显示变量之间的预测关联。
虽然定量结果好坏参半，但初步证据表明CFACT有助于减轻症状困扰，提高心理灵活性、自我同情和超脱的归因风格。讨论了局限性和未来方向。
