The impact of compassion-focused therapy on positive and negative mental health outcomes: Results of a series of meta-analyses

Objectives: Compassion-focused therapy (CFT) is an integrative, evolution-informed approach to mental health difficulties that has been growing rapidly in the last 30 years. This series of meta-analyses examined the overall efficacy of CFT on positive and negative mental health outcomes, in both clinical and nonclinical populations, compared to active and passive control conditions. Method: A systematic search of six databases was conducted, focusing on randomized controlled trials (RCTs) and controlled pilot/feasibility studies of CFT only. All non-English articles and studies focusing on other compassion-based approaches were excluded. Forty-seven controlled trials from the last 14 years were included, with data from 7,875 participants from 17 countries. Results: Even after the exclusion of extreme outliers, CFT was effective in reducing overall negative mental health outcomes (k = 32, g = 0.72, p < .0001), depression (k = 23, g = 0.49, p < .0001), self-criticism (k = 17, g = 0.40, p < .0001) and in improving compassion for self and others (k = 24, g = 0.51, p < .0001). Heterogeneity was high and only partially reduced by moderation analysis, which highlighted larger effects in specific subgroups. Publication bias was present in the meta-analyses conducted on negative outcomes and depressive symptoms. Discussion: Although the long-term effects of CFT are yet to be established and larger-scale, higher-quality RCTs are required, the current state of evidence highlights the benefits of CFT on a range of outcomes in both clinical and nonclinical samples.