Feasibility and Preliminary Outcomes of Compassion-Focused Group Therapy for Depression and Anxiety

Depression and anxiety disorders are common psychiatric conditions, and some patients continue to experience significant symptoms despite receiving recommended psychological or pharmacological treatments. Compassion-focused therapy (CFT) is a psychological treatment approach developed to address self-criticism, shame, and difficulties in developing self-compassion. CFT may be particularly relevant for patients with persistent symptoms and pronounced self-critical thinking. This study was an open-label, single-arm pilot study conducted in a specialized psychiatric outpatient setting in Stockholm, Sweden, during 2023-2024. Its primary aim was to evaluate the feasibility and acceptability of an 11-week manualized compassion-focused group intervention and to explore preliminary clinical outcomes. Participants were adults with moderate to severe symptoms of depression and/or anxiety who had previously received at least one treatment consistent with Swedish national treatment guidelines and reported difficulties related to self-criticism or shame. Patients requiring immediate inpatient or emergency care, or unable to independently complete study questionnaires, were not eligible. The intervention consisted of 11 weekly group sessions lasting approximately 2 hours and 15 minutes each, supplemented by weekly individual telephone consultations of approximately 15 minutes. The treatment included psychoeducation, experiential exercises, compassion-focused practices, meditation, and individual case conceptualization. Additional individual appointments were offered before treatment, midway through treatment, and at the three-month follow-up. Feasibility was evaluated through recruitment and treatment initiation, treatment retention, attendance at group sessions, and participation in scheduled telephone consultations. The primary clinical outcome was self-compassion, assessed using the Self-Compassion Scale-Short Form (SCS-SF). Secondary clinical outcomes included depressive symptoms (Patient Health Questionnaire-9, PHQ-9), difficulties in emotion regulation (Difficulties in Emotion Regulation Scale-16, DERS-16), social safeness (Social Safeness and Pleasure Scale, SSPS), functional impairment (World Health Organization Disability Assessment Schedule 2.0, WHODAS-12), and quality of life (Brunnsviken Brief Quality of Life Scale, BBQ). Clinical outcomes were assessed at baseline, immediately after treatment, and at a three-month follow-up. The study included 21 participants allocated to three treatment groups. As a single-arm pilot study without a control group, it was designed to assess feasibility and explore preliminary changes rather than establish treatment efficacy. The findings were intended to guide future research and the potential implementation of compassion-focused group therapy within specialized psychiatric outpatient care.