Planning and designing a self-compassion intervention for family carers of people living with dementia: a person-based and co-design approach

Background This article describes the research activities undertaken to plan and design a self-compassion intervention for family carers of people living with dementia using a person-based and co-design approach. In providing this example, our aim is two-fold: to highlight the value of using qualitative research and co-design processes within intervention development; and to showcase systematic reporting of an intervention’s early planning and design stages. Methods A person-based and co-design approach informed the planning and design of the self-compassion intervention. In Stage 1, qualitative interviews were undertaken with 14 family carers of people living with dementia and 14 professional stakeholders. In Stage 2, intervention guiding principles were developed, psychological theory was incorporated, and six family carers of people living with dementia were engaged as co-designers. Results Knowledge generated during intervention planning identified that the intervention should be situated within the concept of compassion more broadly; address misperceptions, fears, blocks, and resistances to self-compassion; and target feelings of shame, guilt, and self-criticism. Subsequent intervention design activities determined that the needs of family carers of people living with dementia were best met by tailoring an existing intervention, namely group-based Compassion-Focused Therapy. Conclusions Our systematic approach highlights the value of incorporating in-depth qualitative research and co-design within the intervention development process to prioritise the perspectives and lived experiences of family carers of people living with dementia. The planning and design process outlined provides insight that is applicable to the development of our intervention and complex health interventions within gerontology and beyond.

Qualitative analysis of the cognitive triad in a sample of the general population in response to the COVID-19 pandemic

The COVID-19 pandemic has created a profound mental health challenge worldwide. The goal of this paper is to explore cognitive responses to the pandemic in order to better understand underlying beliefs for those reporting and not reporting symptoms of depression within the context of a period of realistic health, economic and social threat. This paper described a cross-sectional survey carried out with a convenience sample from the general population between December 2020 and February 2021. As part of that survey, adult respondents (n=555) were asked to fill in open text box questions which provided prompts of the Cognitive Triad: “I am…/I am not…”; “Others people are…/Other people are not…”; “The world is…”. These qualitative data were analysed using reflexive thematic analysis. Thematic responses between people who screened above and below the cut-off for moderate depressive symptoms showed noticeable overlap, especially in terms of negative cognitions. The largest distinct difference in cognitions was the lack of positively framed cognitions across the cognitive triad in those screening above the cut-off for moderate depressive symptoms. These data highlight the importance of developing a positive cognitive framework to the pandemic, indicating that approaches such as Positive Psychology or Compassion-Focused Therapy which emphasise positive emotions, empathy, and gratitude may be particularly helpful.

Effect of acceptance and commitment therapy combined with compassion-focused therapy on behavioral problems and mother-child interactions in children with hearing impairment

Background and Aim: Hearing loss is and invi­sible disability that adversely affects the quality of life. This study aimed to investigate the effect of acceptance and commitment therapy (ACT) combined with compassion-focused therapy (CFT) on behavioral problems and mother-child interactions in children with hearing impairment. Methods: This is a quasi-experimental study with pretest/posttest design using a control gro­up. The study population consists of all mothers of children with hearing impairment in Yazd, Iran. A total of 30 mothers were selected using a purposive sampling method, and randomly assi­gned into control (n = 15) and intervention (n = 15) groups. The intervention group received ACT combined with CFT at eight sessions of 90 minutes, one session per week, while the control did not receive any treatment. Data collections tool were the Parent-Child Relationship Scale and the Child Behavior Checklist. Data were ana­lyzed using descriptive and inferential statistics. Results: The intervention had a significant effect on mother-child interaction and behavioral prob­lems in children with hearing impairment. Conclusion: ACT combined with CFT can be used for intervention of mothers of children with hearing loss to reduce the behavioral problems of their children and improve their interactions with them. Keywords: Acceptance and commitment therapy; compassion focused therapy; behavioral problems; parent-child interaction; children with hearing impairment

The Effectiveness of Compassion-Focused Therapy on Distress Tolerance and Feeling of Guilt in Mothers of Children with Physical-Motor Disability

Aim: The purpose of this research was to determine the effectiveness of compassion-focused therapy on distress tolerance and feeling of guilt in mothers of children with physical-motor disability. Methods: The quasi-experimental research method included pre-test and post-test, with control group. The statistical population of this study consisted of all mothers of children with physical disability who had received education in special schools in city of Saqez during the Persian year of 1398. For this purpose, 24 mothers of physically disabled children were selected from the exceptional schools by convenient sampling method and randomly assigned to experimental and control groups (12 in each group). The experimental group received 10 sessions of intervention and no training was given to the control group. The instruments used in this study were the Distress Tolerance Scale (DTS) and the Test of Self-Conscious Affect (TOSCA-2), which were completed in the pre-test and post-test phases. Data were analyzed using covariance analysis. Findings: The findings of this study indicated that there was a significant difference between the experimental and control groups in pre-test and post-test in scores of distress tolerance and feeling of guilt. According to these findings, compassion-focused therapy is effective in decreasing feeling of guilt and increasing distress tolerance of mothers of children with physical disability. Conclusion: The results showed that self-compassion, through providing positive experiences, increasing adaptation to stressful situations, and expressing empathy and sympathy can increase distress tolerance in individuals and reduce the level of guilt of mothers with children with disabilities.

‘A Way of Being in the World’: An Exploration of the Experience of Developing Self-Compassion through Online Training

Compassion Focused Therapy (CFT) has increasingly been shown to have a positive impact for people experiencing a range of difficulties, and online self-help formats could provide a way of increasing its accessibility and scalability. This study explored adult participants’ subjective experiences of engaging with online self-compassion training drawn from Compassionate Mind Training (CMT) and CFT. Semi-structured interviews were conducted with 15 participants who had completed online self-compassion training, and the interview data was analysed using reflexive thematic analysis. The analysis generated four main themes and 17 sub-themes. The four main themes generated were ‘A way of being in the world’, ‘Old habits die hard’, The learning process, and Context and resources. These themes showed that while the process of developing self-compassion was often challenging, most participants described experiencing positive changes in their ways of relating to themselves and others. Participants identified many facilitators and barriers to change, including factors related to the training format and their wider social contexts. These findings support previous research into CMT and CFT, particularly in relation to some common positive changes people experience and some of the difficulties with this process (e.g. fears of compassion). Participants’ descriptions offer promise that approaches based on CMT and the CFT model can be experienced as acceptable and helpful by people engaging through an online self-help format as well as through individual and group-based interventions. The facilitators and barriers to change described by participants indicate the strong influence of people’s contexts and the need for these to be carefully considered when designing and implementing approaches.

A Comparison of Effectiveness of Compassion-Focused Therapy (CFT) and Mindfulness-Based Stress Reduction (MBSR) on Psychological Flexibility of HIV Patients in Imam Khomeini Hospital

Background: HIV patients are exposed to many psychological problems, including psychological inflexibility. It seems that psychological interventions can be effective to improve the psychological state of these patients. Therefore, in this study, we aimed to compare the effectiveness of interventions with 2 methods of Compassion-Focused Therapy (CFT) and Mindfulness-Based Stress Reduction (MBSR) program on psychological flexibility of HIV patients in Imam Khomeini Hospital. Methods: The present study was a descriptive-analytical study that was performed as an intervention in the period from May to January in 2020 on 54 HIV patients referred to Voluntary Counseling and Testing (VCT) center of Imam Khomeini Hospital Complex. The samples of the study mode were selected by available sampling and randomly divided in 3 groups of 18 people based on CFT, MBSR session and the control group. Each treatment was presented to 2 experimental groups for 10 sessions per week and the control group was placed on a waiting lists. Patients' psychological flexibility was assessed by the Acceptance and Action Questionnaire- II "AAQ-II" in 3 stages: pre-test, post-test and follow-up. SPSS 23 software and analysis of covariance, bonferoni test and one-way analysis of variance were used to analyze the data. Results: The results showed that CFT and MBSR were effective on increasing psychological flexibility of HIV patients (p < 0.01). Comparison of the effectiveness of the 2 therapies showed that CFT caused a further increase on increasing psychological flexibility (p < 0.01). Changes in follow-up 3 months after treatment also remained stable (p < 0.01). Conclusion: Findings of the study show that the use of therapies in this study can be effective in planning psychological interventions to promote and improve mental health in HIV patients.

Hurt people hurt people: using a trauma sensitive and compassion focused approach to support people to understand and manage their criminogenic needs

Purpose This paper aims to argue that to address those factors that contribute to the probability of offending, the origins of such factors should be understood, and interventions that recognise the functional aspects of criminogenic capacities should be developed. Design/methodology/approach The paper provides a theoretical basis for trauma sensitive practice by providing an evolutionary understanding of human harmfulness alongside a summary of the impact of adversity and abuse on the developing child. Findings The paper proposes an overarching framework that uses compassion-focused therapy for risk reducing interventions with men who cause harm to others. Practical implications This paper encourages forensic practitioners to develop a trauma aware approach to intervention design and delivery. The paper provides an overview of a compassion-focused therapy as approach to intervention that conceptualises criminogenic capacities within a more holistic and functional framework. Originality/value Forensic interventions have been slow to assimilate evidence from adverse childhood experience research and have therefore been limited in their ability to address the functional origins of criminogenic need. This paper offers a framework that allows practitioners to address risk while also allowing individuals to process their own trauma and adversity.