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Compassion-Focused Intervention for Highly Self-Critical Individuals: Pilot Study

  • Alexandra Rose (a1), Ruth McIntyre (a1) and Katharine A. Rimes (a1)


Self-criticism is a transdiagnostic process associated with a range of psychological problems. This uncontrolled pilot study evaluated the feasibility and acceptability of a six-session intervention using methods from compassion-focused therapy to reduce self-criticism, as well as investigating changes in a range of outcome measures. Twenty-three university student participants with significant impaired functioning associated with high levels of self-criticism received six individual weekly treatment sessions and a 2-month follow-up appointment. Acceptability was assessed through participant feedback. The intervention appeared to be feasible in terms of recruitment and retention of participants, and participant feedback indicated that overall the intervention seemed acceptable. There were statistically significant improvements between pre- and post-intervention for self-criticism, functional impairment, mood, self-esteem and maladaptive perfectionism with medium to large effect sizes at both post-intervention and follow-up. Gains were maintained or increased between post-treatment and 2-month follow-up. The study showed preliminary evidence of effectiveness of a compassion-focused intervention for self-critical students which appeared to be a feasible and acceptable treatment approach. This intervention now requires investigation in a randomized controlled trial.


Corresponding author

*Correspondence to Katharine A. Rimes, Department of Psychology, Henry Wellcome Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF. E-mail:


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Braehler, C., Gumley, A., Harper, J., Wallace, S., Norrie, J. and Gilbert, P. (2013). Exploring change processes in compassion focused therapy in psychosis: results of a feasibility randomized controlled trial. British Journal of Clinical Psychology, 52, 199214. doi: 10.1111/bjc.12009
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd edn). Hillsdale, NJ: Lawrence Earlbaum Associates.
Dunkley, D. M. and Kyparissis, A. (2008). What is DAS self-critical perfectionism really measuring? Relations with the five-factor model of personality and depressive symptoms. Personality and Individual Differences, 44, 12951305. doi: 10.1016/j.paid.2007.11.022
Dunkley, D. M., Sanislow, C. A., Grilo, C. M. and McGlashan, T. H. (2009). Self-criticism versus neuroticism in predicting depression and psychosocial impairment for 4 years in a clinical sample. Comprehensive Psychiatry, 50, 335346. doi: 10.1016/j.comppsych.2008.09.004
Dunkley, D. M., Zuroff, D. C. and Blankstein, K. R. (2006). Specific perfectionism components versus self-criticism in predicting maladjustment. Personality and Individual Differences, 40, 665676. doi: 10.1016/j.paid.2005.08.008
Fennell, M. J. (1998). Cognitive therapy in the treatment of low self-esteem. Advances in Psychiatric Treatment, 4, 296304.
Fennell, M. (2013). Cognitive Therapy for Low Self-Esteem: A Transdiagnostic Perspective. Workshop Handouts for University of Bath Clinical Psychology Doctorate.
Fennig, S., Hadas, A., Itzhaky, L., Roe, D., Apter, A. and Shahar, G. (2008). Self‐criticism is a key predictor of eating disorder dimensions among inpatient adolescent females. International Journal of Eating Disorders, 41, 762765. doi: 10.1002/eat.20573
Fox‐Wasylyshyn, S. M. and El‐Masri, M. M. (2005). Handling missing data in self‐report measures. Research in Nursing and Health, 28, 488495. doi: 10.1002/nur.20100
Frost, R. O., Marten, P., Lahart, C. and Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449468. doi: 10.1007/BF01172967
Gale, C., Gilbert, P., Read, N. and Goss, K. (2014). An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clinical Psychology and Psychotherapy, 21, 112. doi: 10.1002/cpp.1806
Gilbert, P. (2005). Compassion: Conceptualisations, Research and Use in Psychotherapy. East Sussex: Routledge
Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15, 199208. doi: 10.1192/apt.bp.107.005264
Gilbert, P. (2010a). An introduction to compassion focused therapy in cognitive behavior therapy. International Journal of Cognitive Therapy, 3, 97112. doi: 10.1521/ijct.2010.3.2.97
Gilbert, P. (2010b). Compassion Focused Therapy: The CBT Distinction Features Series. East Sussex: Routledge
Gilbert, P. and Procter, S. (2006). Compassionate mind training for people with high shame and self‐criticism: overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353379. doi: 10.1002/cpp.507
Hertzog, M. A. (2008). Considerations in determining sample size for pilot studies. Research in Nursing and Health, 31, 180191. doi: 10.1002/nur.20247
Hunt, J. and Eisenberg, D. (2010). Mental health problems and help-seeking behavior among college students. Journal of Adolescent Health, 46, 310. doi: 10.1016/j.jadohealth.2009.08.008
James, K., Verplanken, B. and Rimes, K. (2015). Self-criticism as a mediator in the relationship between unhealthy perfectionism and distress. Personality and Individual Differences, 79, 123128. doi: 10.1016/j.paid.2015.01.030
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12.
Judge, L., Cleghorn, A., McEwan, K. and Gilbert, P. (2012). An exploration of group-based compassion focused therapy for a heterogeneous range of clients presenting to a community mental health team. International Journal of Cognitive Therapy, 5, 420429. doi: 10.1521/ijct.2012.5. 4.420
Kroenke, K., Spitzer, R. and Williams, J. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613. doi: 10.3928/0048-5713-20020901-06
Statistics, Laerd (2017, October). ANOVA with repeated measures using SPSS Statistics. Available at: (accessed 16 May 2018).
Lucre, K. M. and Corten, N. (2013). An exploration of group compassion‐focused therapy for personality disorder. Psychology and Psychotherapy: Theory, Research and Practice, 86, 387400. doi: 10.1111/j.2044-8341.2012.02068
Luyten, P., Sabbe, B., Blatt, S. J., Meganck, S., Jansen, B., De Grave, C., Maes, F. and Corveleyn, J. (2007). Dependency and self‐criticism: relationship with major depressive disorder, severity of depression, and clinical presentation. Depression and Anxiety, 24, 586596. doi: 10.1002/da.20272
Mayhew, S. L. and Gilbert, P. (2008). Compassionate mind training with people who hear malevolent voices: a case series report. Clinical Psychology and Psychotherapy, 15, 113138. doi: 10.1002/cpp.566
Mayring, P. (2000). Qualitative content analysis. Forum: Qualitative Social Research, 1, 110. doi:
Mundt, J. C., Marks, I. M., Shear, M. K. and Greist, J. M. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. The British Journal of Psychiatry, 180, 461464. doi: 10.1192/bjp.180.5.461
Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2, 223250. doi: 10.1080/15298860390209035
Rimes, K.A. and Chalder, T. (2010). The Beliefs about Emotions Scale: validity, reliability and sensitivity to clinical change. Journal of Psychosomatic Research, 68, 295–282. doi: 10.1016/j.jpsychores.2009.09.014
Rosenberg, M. (1965). Society and the Adolescent Self-Image. Princeton, Princeton University Press.
Shahar, B., Szsepsenwol, O., Zilcha‐Mano, S., Haim, N., Zamir, O., Levi‐Yeshuvi, S., and Levit‐Binnun, N. (2015a). A wait‐list randomized controlled trial of Loving‐Kindness meditation programme for self‐criticism. Clinical Psychology and Psychotherapy, 22, 346356. doi: 10.1002/cpp.1893
Shahar, B., Doron, G. and Szepsenwol, O. (2015b). Childhood maltreatment, shame‐proneness and self‐criticism in social anxiety disorder: a sequential mediational model. Clinical Psychology and Psychotherapy, 22, 570579. doi: 10.1002/cpp.1918
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, M. S., Hergueta, T., Baker, R. and Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59 (suppl 20), 2233.
Sinclair, S. J., Blais, M. A., Gansler, D. A., Sandberg, E., Bistis, K. and LoCicero, A. (2010). Psychometric properties of the Rosenberg Self-Esteem Scale: overall and across demographic groups living within the United States. Evaluation and the Health Professions, 33, 5680. doi: 10.1177/0163278709356187
Smart, L. M., Peters, J. R. and Baer, R. A. (2015). Development and validation of a measure of self-critical rumination. Assessment, 112. doi: 10.1177/1073191115573300
Spitzer, R., Kroenke, K., Williams, J. and Löwe, B. (2006). A brief measure for assessing generalised anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 10921097. doi:10.1001/archinte.166.10.1092.
Stumpf, H. and Parker, W. D. (2000). A hierarchical structural analysis of perfectionism and its relation to other personality characteristics. Personality and Individual Differences, 28, 837852. doi:
Thompson, R. and Zuroff, D. C. (2004). The Levels of Self-Criticism Scale: comparative self-criticism and internalized self-criticism. Personality and Individual Differences, 36, 419430. doi:10.1016/S0191-8869(03)00106-5
Verplanken, B., Friborg, O., Wang, C. E., Trafimow, D. and Woolf, K. (2007). Mental habits: metacognitive reflection on negative self-thinking. Journal of Personality and Social Psychology, 92, 526. doi: 10.1037/0022-3514.92.3.526
Williams, M. J., Dalgleish, T., Karl, A. and Kuyken, W. (2014). Examining the factor structures of the five facet mindfulness questionnaire and the self-compassion scale. Psychological Assessment, 26, 407.


Compassion-Focused Intervention for Highly Self-Critical Individuals: Pilot Study

  • Alexandra Rose (a1), Ruth McIntyre (a1) and Katharine A. Rimes (a1)


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Compassion-Focused Intervention for Highly Self-Critical Individuals: Pilot Study

  • Alexandra Rose (a1), Ruth McIntyre (a1) and Katharine A. Rimes (a1)
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