A compassionate imagery intervention for patients with persecutory delusions

Abstract

Background: Negative beliefs about the self, including low self-compassion, have been identified as a putative causal factor in the occurrence of paranoia. Therefore, improving self-compassion may be one route to reduce paranoia. Aims: To assess the feasibility, acceptability, and potential clinical effects of a brief compassionate imagery intervention for patients with persecutory delusions. Method: Twelve patients with persecutory delusions received an individual four-session compassionate imagery intervention. Assessments of self-concept and paranoia were completed before treatment, immediately after treatment, and at 1-month follow-up. A qualitative study exploring participants’ experiences of the treatment was also completed. Results: Twelve out of 14 eligible patients referred to the study agreed to take part. All participants completed all therapy sessions and assessments. Post-treatment, there were improvements in self-compassion (change score –0.64, 95% CI –1.04, –0.24, d = –1.78), negative beliefs about the self (change score 2.42, 95% CI –0.37, 5.20, d = 0.51), and paranoia (change score 10.08, 95% CI 3.47, 16.69, d = 0.61). There were no serious adverse events. Three themes emerged from the qualitative analysis: ‘effortful learning’, ‘seeing change’ and ‘taking it forward’. Participants described a process of active and effortful engagement in therapy which was rewarded with positive changes, including feeling calmer, gaining clarity, and developing acceptance. Conclusion: This uncontrolled feasibility study indicates that a brief compassionate imagery intervention for patients with persecutory delusions is feasible, acceptable, and may lead to clinical benefits.

Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study

“…In addition, as a transdiagnostic therapy, and as noted in the introduction, CFT has a range of benefits for people with complex mental difficulties ( Gilbert and Simos, 2022 ). For example, Brown et al (2020) and Forkert et al (2022) found that compassionate imagery has significant impacts on people with paranoia beliefs and persecutory delusions. This paper outlined the basic science of the compassion and evolutionary approach to bipolar disorder and explored the experience and effectiveness of CFT for a small group of clients with a diagnosis of bipolar disorder.…”

“… Brown et al (2020) found that elements of compassionate mind training, in particular developing a compassionate image (coach) increased compassion for others and reduced paranoia in individuals with elevated paranoia scores. Forkert et al (2022) developed a four-session compassion imagery intervention for clients with persecutory delusions. They found that this compassion intervention was feasible, acceptable, and based on qualitative analyses, was experienced as being helpful.…”

The impact of family function on mental health status in patient with inflammatory bowel disease: The mediating role of self-esteem

“…The most notable finding was that self-esteem significantly mediated the relationship between family function and mental health status. This suggests that boosting a patient's self-esteem may enhance their mental health, such as through cognitive behavior therapy or human imagery intervention ( 51 , 52 ). IBD patients experience uncomfortable bowel symptoms (e.g., intestinal sounds, farting, bowel urgency).…”

A systematic review of the effectiveness of compassion focused imagery in improving psychological outcomes in clinical and non‐clinical adult populations

“…Notably, the two severe head injury studies(O'Neill, 2011 and Campbell et al 2019) both reported no statistically significant improvements in self-compassion and empathy in comparison with a control imagery condition. Some studies investigated the effectiveness of CFI on paranoia, both among clinical(Ascone et al 2017;Forkert et al 2022) and non-clinical populations(Lincoln et al 2013; Brown et al. 2020 andBibbey, 2019).…”

“…McEwan& Gilbert, 2016;Gilbert & Irons, 2004). One study(Forkert et al 2022) implemented a four session CFI intervention, which included elements of psychoeducation and opportunities for participants to practice in between-sessions. Three studies(Kamboj et al.…”