Effectiveness of compassion‐focused therapy for self‐criticism in patients with personality disorders: a multiple baseline case series study

Abstract

ObjectiveTargeting self‐criticism, the tendency to negatively evaluate and judge aspects of oneself, may improve treatment efficacy for personality disorders (PDs). This study aimed to test whether adding 12‐week group compassion‐focused therapy (CFT) that explicitly targets self‐criticism to treatment as usual (TAU) would reduce self‐criticism in patients with PDs.MethodTwelve patients with PDs participated in a multiple baseline study, randomly allocated to different baseline lengths. The primary outcome was twice‐weekly assessed self‐critical beliefs during baseline, treatment, and follow‐up phases. Secondary outcomes were self‐criticism, self‐compassion, and PD severity at the end of CFT and follow‐up (trial registered: NL8131).Nine participants completed the intervention. No significant changes were observed during CFT, but at follow‐up significant decrease in self‐critical beliefs (Cohen's d = −0.43; 95% CI = −0.73 to −0.12) was reported compared to baseline. On secondary outcomes, most participants showed reliable improvement on self‐reported criticism (66.7%) and self‐compassion (55.6%), and a minority of patients showed reliable improvement in PD severity (33.3%).ConclusionsThis study seems to provide preliminary evidence for the effectiveness of 12‐week CFT for self‐critical beliefs in patients with PDs compared to TAU. CFT for self‐criticism in PDs may complement treatment offerings and warrant further research.