![A sheltered garden room with a glowing hearth while rain falls on the hills outside](https://viacara.com/img/content/approaches-compassion-focused-therapy-feature-light.webp) # Compassion-Focused Therapy (CFT) Learn how compassion-focused therapy (CFT) works with shame and a harsh inner critic, what sessions involve and what the research shows so far. ## What is compassion-focused therapy? Compassion-focused therapy (CFT) is a talking therapy for people who are very hard on themselves. Professor Paul Gilbert developed it for people with high levels of shame and self-criticism. Gilbert noticed that some people learned the skills of therapy but still felt no better. They could find a kinder thought, yet it did not feel true. He describes people who say things like this: > "I understand the logic of my alternative thinking but it doesn't really help me feel much better." CFT works on that gap between knowing and feeling. Researchers describe it as one of the newer "third wave" therapies, a group that also includes [ACT](https://viacara.com/approaches/acceptance-and-commitment-therapy/). Sources: [CMF: CFT overview](https://viacara.com/approaches/compassion-focused-therapy/#ref-1), [Gilbert 2009](https://viacara.com/approaches/compassion-focused-therapy/#ref-2), [Millard et al. 2023](https://viacara.com/approaches/compassion-focused-therapy/#ref-6), [Hayes et al. 2006](https://viacara.com/approaches/compassion-focused-therapy/#ref-3) ## How it *works* CFT uses a model of three systems that shape how we feel. CFT's three *emotion systems* - **Threat** Protection from danger, linked with fear or anger. - **Drive** Seeking rewards, achievement and pleasure. - **Soothing** Feeling safe, calm and connected. This is CFT's model of emotion regulation. The diagram does not measure brain activity or diagnose an imbalance. In people with a lot of shame and self-criticism, CFT suggests the threat system takes over. The soothing system is hard to reach. So even a fair and kind thought can fail to bring relief. The therapist uses compassion practices to strengthen soothing. This work develops a compassionate response, rather than trying to remove threat or drive. The aim is to replace self-criticism with self-kindness. Sources: [Gilbert 2009](https://viacara.com/approaches/compassion-focused-therapy/#ref-2), [CMF: CFT overview](https://viacara.com/approaches/compassion-focused-therapy/#ref-1) ## What *sessions* look like CFT often starts by making sense of what you struggle with. Your therapist helps you see that your difficulties are not your fault. They often grew out of ways you learned to keep yourself safe. Then the work turns to practice, which CFT calls compassionate mind training. Practices can include: - **Compassionate imagery.** Exercises that help you feel compassion towards yourself - **The compassionate self.** Practising each day how a deeply compassionate version of you would think and act - **Refocusing.** Bringing to mind your strengths, or times you were kind or were shown kindness - **Compassionate action.** Facing hard things with courage, rather than avoiding them Many people find kindness towards themselves strange, or even frightening, at first. CFT expects this. Much of the work goes into those fears. Source: [Gilbert 2009](https://viacara.com/approaches/compassion-focused-therapy/#ref-2) ![The view from the chair after the rain, the hills washed bright](https://viacara.com/img/content/approaches-compassion-focused-therapy-mid-light.webp) CFT works on the soothing system, so there is somewhere steadier to come back to. ## Compassion is not going easy on yourself In CFT, compassion does not mean avoiding what is difficult or painful. It takes courage, and it can mean facing a hard task. Gilbert argues that people who stop blaming themselves are freer to take responsibility and learn to cope. Source: [Gilbert 2009](https://viacara.com/approaches/compassion-focused-therapy/#ref-2) ## Who is it best *suited* to? It can be a good fit if you: - Have an inner critic that is harsh, constant or cruel - Carry a lot of shame - Can see a thought is unfair, but still feel it is true - Find it easy to be kind to others and hard to be kind to yourself - Have had other therapy, but the self-criticism stayed Camden and Islington NHS Talking Therapies runs a compassion-focused group for managing self-criticism. Our [low self-esteem page](https://viacara.com/support/self-esteem/) looks at where low self-esteem comes from and how it sounds. Source: [Camden & Islington: CFT](https://viacara.com/approaches/compassion-focused-therapy/#ref-7) ## The *evidence* An early review in 2015 found 14 studies. Only three were randomised trials. It called CFT promising for mood problems, especially in people high in self-criticism. It also said larger, better trials were needed before CFT could count as evidence-based practice. A 2020 review found the same promise, and called for a standard manual so studies can be compared. A 2023 review of 15 studies found improvements in self-compassion, self-criticism and depression. It rated the quality of about half the studies as unclear. Most of the people taking part were women. Sources: [Leaviss & Uttley 2015](https://viacara.com/approaches/compassion-focused-therapy/#ref-4), [Craig et al. 2020](https://viacara.com/approaches/compassion-focused-therapy/#ref-5), [Millard et al. 2023](https://viacara.com/approaches/compassion-focused-therapy/#ref-6) ## Where the evidence *stops* NICE has not recommended CFT. It is not among the therapies NICE names for depression or for generalised anxiety disorder. CFT is a reasonable option to ask about when shame or self-criticism is what you most want to change. If you have a diagnosis with a NICE-recommended treatment, ask about that too. Sources: [NICE NG222](https://viacara.com/approaches/compassion-focused-therapy/#ref-8), [NICE CG113](https://viacara.com/approaches/compassion-focused-therapy/#ref-9) On this page [What is compassion-focused therapy?](https://viacara.com/approaches/compassion-focused-therapy/#what-is-compassion-focused-therapy) [How it works](https://viacara.com/approaches/compassion-focused-therapy/#how-it-works) [What sessions look like](https://viacara.com/approaches/compassion-focused-therapy/#what-sessions-look-like) [Compassion is not going easy on yourself](https://viacara.com/approaches/compassion-focused-therapy/#compassion-is-not-going-easy-on-yourself) [Who is it best suited to?](https://viacara.com/approaches/compassion-focused-therapy/#who-is-it-best-suited-to) [The evidence](https://viacara.com/approaches/compassion-focused-therapy/#the-evidence) [Where the evidence stops](https://viacara.com/approaches/compassion-focused-therapy/#where-the-evidence-stops) Related [Low Self-Esteem](https://viacara.com/support/self-esteem/) [Acceptance and Commitment Therapy (ACT)](https://viacara.com/approaches/acceptance-and-commitment-therapy/) [Mindfulness-Based Cognitive Therapy](https://viacara.com/approaches/mindfulness-based-therapy/) [Person-Centred Therapy](https://viacara.com/approaches/person-centred/) [Cognitive Behavioural Therapy (CBT)](https://viacara.com/approaches/cbt/) [Understanding Different Approaches](https://viacara.com/guides/understanding-approaches/) Thanks for your interest. We're not taking on new clients at the moment. ## Interested in *compassion-focused* therapy? We ask what matters to you, then find professionals who fit. Leave your email and we'll let you know as soon as we're ready for you. This conversation helps us find you the right support. What you share helps us understand what you're looking for and find someone who fits. Your email keeps you updated on what's happening next and isn't shared with anyone we introduce you to. [Privacy policy](https://viacara.com/privacy/) [Terms of service](https://viacara.com/terms/) ## References 1. The Compassionate Mind Foundation (2026). *What is Compassion Focused Therapy?*. [compassionatemind.co.uk](https://www.compassionatemind.co.uk/what-is-compassion-focused-therapy) 2. Gilbert, P. (2009). *Introducing compassion-focused therapy*. Advances in Psychiatric Treatment. [doi:10.1192/apt.bp.107.005264](https://doi.org/10.1192/apt.bp.107.005264) 3. Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A. & Lillis, J. (2006). *Acceptance and commitment therapy: Model, processes and outcomes*. Behaviour Research and Therapy. [doi:10.1016/j.brat.2005.06.006](https://doi.org/10.1016/j.brat.2005.06.006) 4. Leaviss, J. & Uttley, L. (2015). *Psychotherapeutic benefits of compassion-focused therapy: an early systematic review*. Psychological Medicine. [doi:10.1017/S0033291714002141](https://doi.org/10.1017/S0033291714002141) 5. Craig, C., Hiskey, S. & Spector, A. (2020). *Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations*. Expert Review of Neurotherapeutics. [doi:10.1080/14737175.2020.1746184](https://doi.org/10.1080/14737175.2020.1746184) 6. Millard, L. A., Wan, M. W., Smith, D. M. & Wittkowski, A. (2023). *The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis*. Journal of Affective Disorders. [doi:10.1016/j.jad.2023.01.010](https://doi.org/10.1016/j.jad.2023.01.010) 7. Camden and Islington NHS Talking Therapies (2025). *Compassion Focused Therapy*. [camdenandislingtontalkingtherapies.nhs.uk](https://www.camdenandislingtontalkingtherapies.nhs.uk/camden-islington/groups-workshops/compassion-focused-therapy/) 8. National Institute for Health and Care Excellence (2022). *Depression in adults: treatment and management (NG222)*. [nice.org.uk](https://www.nice.org.uk/guidance/ng222) 9. National Institute for Health and Care Excellence (2011). *Generalised anxiety disorder and panic disorder in adults: management (CG113)*. [nice.org.uk](https://www.nice.org.uk/guidance/cg113) ## Related ### [Low Self-Esteem](https://viacara.com/support/self-esteem/) Low self-esteem is a learned opinion of yourself, and it can change. Find a professional who helps you see yourself more fairly. ### [Acceptance and Commitment Therapy (ACT)](https://viacara.com/approaches/acceptance-and-commitment-therapy/) Learn how acceptance and commitment therapy (ACT) works, what NICE says about it for long-term pain and what research shows for anxiety and low mood. ### [Mindfulness-Based Cognitive Therapy](https://viacara.com/approaches/mindfulness-based-therapy/) Learn how mindfulness-based cognitive therapy (MBCT) works, why NICE recommends it to stop depression returning and how it differs from MBSR. ### [Person-Centred Therapy](https://viacara.com/approaches/person-centred/) Learn how person-centred therapy works, what sessions look like and why the relationship with your therapist matters most. ### [Cognitive Behavioural Therapy (CBT)](https://viacara.com/approaches/cbt/) Learn how CBT works, what happens in sessions and what NICE says about it, and read about its forms for sleep, pain and self-help. ### [Understanding Different Approaches](https://viacara.com/guides/understanding-approaches/) A plain-English guide to the main therapeutic approaches including CBT, person-centred therapy, psychodynamic and integrative methods.