What Compassion-Focused Therapy Looks Like, According to Therapists

Learn more about whether compassion-focused therapy is right for you.

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There are so many different types of therapy available now. It’s a great sign of the wide-ranging, tailored options each person has to get the support they want and need. But deciding which one is right can also be overwhelming. 

Here at Charlie Health, we aim to give individuals all the information they need to make an informed decision. One of the approaches we offer is something called compassion-focused therapy. Read on to learn more about how this therapy helps people build a compassionate relationship with themselves, respond to their inner critic and develop long-term emotional resilience.

What is compassion-focused therapy?

Paul Gilbert, PhD, FBPsS, created compassion-focused therapy in 2000. He now runs the Compassionate Mind Foundation, which offers resources on compassion-focused therapy, training for practitioners, and access to recent research on the topic. He’s currently a professor of clinical psychology and the director of the Centre for Compassion Research and Training at the University of Derby, and he worked as a consultant clinical psychologist for 40 years. 

In a 2009 article, Gilbert wrote for the Journal of Advances in Psychiatric Treatment, he stated that compassion-focused therapy “is an integrated and multimodal approach that draws from evolutionary, social, developmental, and Buddhist psychology, and neuroscience. One of its key concerns is to use compassionate mind training to help people develop and work with experiences of inner warmth, safeness, and soothing, via compassion and self-compassion.”

Gilbert explains that individuals with “high shame and self-criticism” might be dominated by their threat-protection system rather than a “social safeness system.” Compassion-focused therapy works to change this dynamic within people, fostering empathy, kindness, and acceptance toward themselves. 

The technique also takes into account humans’ “drive system,” which focuses on desires, achievements, and pleasure, among other things. According to Gilbert’s article, the drive system can sometimes become linked to the threat system, for instance, when looking for material goods or status that will make someone feel safe or avoid rejection. 

How does compassion-focused therapy work? 

As Charlie Health Group Facilitator Bree Williams, LPCA, puts it, compassion-focused therapy “teaches people how to soothe their nervous system, understand their emotional experiences, and cultivate a kinder, more supportive relationship with themselves. At its core, each session of compassion-focused therapy helps people shift from harsh self-judgment to inner warmth and emotional regulation.” It uses techniques such as visualization, mindfulness, and role-playing. It can also involve compassionate imagery or compassion meditation as tools for bringing forward a positive emotion. 

Through compassion-focused therapy, an individual can overcome shame and self-criticism and introduce kindness and compassion toward themselves, says Charlie Health Contemplative Practitioner Tairesha “Sunflower” Flemister, LMSW.

Starting compassion-focused therapy — or any therapeutic approach for that matter — can come with a variety of difficult emotions. “It can be scary for individuals to begin this type of therapy, because individuals who, for instance, experience shame and anger toward themselves may not remember anything ever being different,” says Charlie Health Primary Therapist Alysson Thewes, LCSW. “So, to begin the process of excavating feels like a lot.”

Who can benefit from compassion-focused therapy?

Compassion-focused therapy is all about finding a person’s inner safety and moving past their harmful reliance on the threat system. It can be incredibly “helpful when someone’s main struggle isn’t only the symptom itself, but the internal dialogue that intensifies it,” says Williams. 

“Compassion-focused therapy reminds us that healing isn’t only about changing thoughts or behaviors — it’s also about building a healthier relationship with ourselves,” says Flemister.

According to Flemister, compassion-focused therapy can benefit individuals who live with conditions such as:

• Depression
• Anxiety disorders
• PTSD and trauma-related symptoms
• Eating disorders
• Chronic self-criticism
• Social anxiety
• Anger that stems from fear or insecurity
• Relationship difficulties
• Low self-worth or perfectionism

Compassion-focused therapy might also benefit individuals living with attention-deficit/hyperactivity disorder (ADHD). Take a 2022 study in the Journal of Clinical Psychology, which found that a lack of or minimal self-compassion can adversely affect the mental health of someone living with ADHD more than someone who isn’t. The researchers put forward improving self-compassion as a potential tool for improving the mental health of individuals living with ADHD. 

Thewes stresses that people without one of the above conditions can also benefit from compassion-focused therapy. A person’s current experiences, beliefs, and goals also play a part in whether compassion-focused therapy is right for them. For instance, Charlie Health Licensed Creative Arts Therapist Courtney Way, MA, LCAT, explains that it can benefit individuals with:

• Insecure attachments
• High levels of shame or self-criticism
• Compassion fatigue
• A desire for a gentle approach to therapy
• An interest in experiential, mindfulness, and visualization work 

Flemister adds that it can also help people who spend their childhood in emotionally unsafe, critical, or invalidating spaces — such as an emotionally or psychologically abusive household.  

When compassion-focused therapy isn’t the right treatment

Compassion-focused therapy is not for everyone. Way suggests considering other treatment approaches or using another therapeutic technique in conjunction with compassion-focused therapy, such as cognitive behavioral therapy or dialectical behavior therapy, if it’s a person’s first time going to a therapy session for trauma or dissociation. 

Similarly, Thewes says that anyone in the “precontemplation stage of change” would not benefit from compassion-focused therapy. This technique can also be challenging for anyone who is uncomfortable feeling “positive or nurturing emotions,” adds Williams. Expressing self-compassion might even feel threatening in some cases. It can be challenging to bring forward a positive emotion or connect with the soothing system after experiencing ongoing difficult emotions, like fear or high shame. 

Compassion-focused therapy also has limitations that might stop it from working for certain individuals. According to Flemister and Williams, the limits of compassion-focused therapy include: 

• Initial discomfort
• Requires developing self-compassion, which is not always intuitive 
• Slow progression
• Requires a willingness for inner work and emotional exploration 
• Not enough for severe symptoms or acute crises

How Charlie Health can help

If you or a loved one is struggling with your mental health, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions, including mood disorders, trauma, and other disorders.

Our expert clinicians incorporate evidence-based therapies — including compassion-focused therapy, cognitive behavioral therapy, acceptance and commitment therapy, and more — into individual counseling, family therapy, and group sessions. With treatment, managing your well-being is possible. Fill out the form below or give us a call to start healing today.