SummaryCompassion-focused therapy (CFT) is embedded in an evolutionary, functional analysis of psychopathology, with a focus on affiliative, caring and compassion processes. CFT has been applied in a number of adult settings, but its clinical applications in child and adolescent psychopathology and psychotherapy have not been systematically explored. This article describes the applications of CFT in paediatric populations. Specifically, the following developmental considerations are discussed: the unique importance of parent-child and attachment relationships for the development of self-compassion, being open to compassion from others and being compassionate to others; the potential effect of com passion training on the maturing brain (affective regulation systems); and the therapeutic targeting of shame and self-criticism to alleviate psychological distress and enhance the effectiveness of cognitive-behavioural interventions.Learning Objectives• Understand and differentiate the three affect regulation systems and their links to different forms of child and adolescent psychopathology• Recognise the main components of compassionate mind training with children and adolescents, and related specific therapeutic strategies and exercises• Acknowledge the importance of adopting a parent-child approach in CFT