Effectiveness of Self-Compassion Related Therapies: a Systematic Review and Meta-analysis

Abstract

This systematic review and meta-analysis investigated whether self-compassion-related therapies, including compassion-focussed therapy, mindfulness-based cognitive therapy and acceptance and commitment therapy, are effective in promoting self-compassion and reducing psychopathology in clinical and subclinical populations. A total of 22 randomised controlled trials met inclusion criteria, with data from up to 1172 individuals included in each quantitative analysis. Effect sizes were the standardised difference in change scores between intervention and control groups. Results indicated that self-compassion-related therapies produced greater improvements in all three outcomes examined: self-compassion (g = 0.52, 95% CIs [0.32, 0.71]), anxiety (g = 0.46, 95% CIs [0.25, 0.66]) and depressive symptoms (g = 0.40, 95% CIs [0.23, 0.57]). However, when analysis was restricted to studies that compared self-compassion-related therapies to active control conditions, change scores were not significantly different between the intervention and control groups for any of the outcomes. Patient status (clinical vs. subclinical) and type of therapy (explicitly compassion-based vs. other compassion-related therapies, e.g. mindfulness) were not moderators of outcome. There was some evidence that self-compassion-related therapies brought about greater improvements in the negative than the positive subscales of the Self-Compassion Scale, although a statistical comparison was not possible. The methodological quality of studies was generally good, although risk of performance bias due to a lack of blinding of participants and therapists was a concern. A narrative synthesis found that changes in self-compassion and psychopathology were correlated in several studies, but this relationship was observed in both intervention and control groups. Overall, this review presents evidence that third-wave therapies bring about improvements in self-compassion and psychopathology, although not over and beyond other interventions.