Compassion-Focused Therapy(CFT)
Showing plain-language explanations suitable for anyone.
Overview
Compassion-Focused Therapy is a psychological therapy designed to help people who experience high levels of shame and self-criticism. Developed by Paul Gilbert, CFT focuses on developing compassion toward self and others using evolutionary and neurobiological models of emotion regulation.
What this therapy focuses on
CFT helps balance the three emotion regulation systems — the threat system (protection), the drive system (seeking/achieving), and the soothing system (safeness/connection) — by cultivating compassionate capacity.
What sessions are usually like
Session length: 50 minutes
Frequency: Weekly
Experiential exercises common (breathing, imagery, compassionate letter-writing)
Practice between sessions encouraged
Can be delivered individually or in groups
Session profile
Common uses and suitability
What problems it is commonly used for
Who this therapy may suit best
- People who are highly self-critical
- Those for whom shame maintains distress
- Individuals who find thought-challenging triggering or insufficient
- People whose emotional difficulties relate to an overactive threat system
When it may need adapting or may not be suitable
- Compassion can initially feel threatening for people with histories of abuse where care was dangerous
- Requires pacing and careful clinical judgement
- Active psychosis requires adapted approaches
Where this therapy may not be enough
CFT may not be sufficient as a standalone treatment for conditions with specific evidence-based protocols (e.g., OCD, PTSD). It is most effective when shame and self-criticism are central maintaining factors.
What happens in therapy
Compassionate Imagery
Building an image of a compassionate being — someone (or something) that is wise, strong, warm, and non-judgemental — and practising receiving compassion.
Soothing Rhythm Breathing
A slow, steady breathing practice designed to calm the body’s threat response and activate the soothing system.
Compassionate Letter Writing
Writing a letter to yourself from the perspective of your ideal compassionate self — with wisdom, strength, and warmth.
Evidence Base
Guideline support
Limited but growing. CFT is not yet a standalone NICE recommendation but is increasingly used within services, particularly for shame-based and complex presentations.
Strength of evidence
Moderate for shame-based difficulties. Growing RCT evidence for depression, psychosis, and eating disorders.
Limitations
Evidence base is still developing. Often used integratively rather than as a standalone protocol, which complicates outcome research.
Evidence claims by condition
CFT helps reduce harsh self-criticism and shame by developing compassionate ways of relating to yourself.
Resources & Printables
For Adults
Understanding the Three Emotion Systems
A visual guide to the threat, drive, and soothing systems.
Compassion Practice Guide
Step-by-step compassionate imagery and breathing exercises.
Self-Criticism to Compassion Worksheet
A worksheet for transforming self-critical thoughts into compassionate responses.
For Children (6–11)
For Parents & Caregivers
Practitioner & Training Notes
Typical professional background
Psychologists, therapists, and mental health professionals with CFT training.
Recognised training routes
Training available through the Compassionate Mind Foundation and affiliated programmes. Workshops, supervision groups, and certification pathways available.
Registration considerations
Compassionate Mind Foundation provides training certification. Practitioners registered with broader bodies.
Source Registry
Link and paraphrase.
Last evidence review: January 2026. All sources are verified and checked on a scheduled cadence.