title: An exploration of compassion focused therapy following acquired brain injury.
abstract: BACKGROUND
  People with acquired brain injuries (ABI) frequently experience psychological difficulties such as anxiety and depression, which may be underpinned and maintained by high self-criticism and shame alongside an inability to self-soothe. Compassionate focused therapy (CFT) was developed to address shame and self-criticism and foster the ability to self-soothe.
  
  
  OBJECTIVE
  This is a naturalistic evaluation with the aim of assessing the feasibility, safety, and potential value of CFT for ABI patients with emotional difficulties receiving neuropsychological rehabilitation.
  
  
  METHODS
  This study employed a mixed methods design combining self-report measures and qualitative interviews. Twelve patients received a combination of CFT group and individual intervention. Self-report measures of self-criticism, self-reassurance, and symptoms of anxiety and depression were collected pre and post programme and analysed using Wilcoxon signed rank test (N=12; five female, seven males). Follow-up data were analysed in the same manner (N=9). Interviews were conducted with six patients and analysed using interpretative phenomenological analysis.
  
  
  RESULTS
  CFT was associated with significant reductions in measures of self-criticism, anxiety, and depression and an increase in the ability to reassure the self. No adverse effects were reported. Three superordinate themes emerged from the interviews: psychological difficulties; developing trust and finding safeness; and a new approach.
  
  
  CONCLUSIONS
  This study suggests that CFT is well accepted in ABI survivors within the context of neuropsychological rehabilitation. Furthermore, the results indicate that further research into CFT for psychological problems after ABI is needed and that there may be key aspects, which are specific to CFT intervention, which could reduce psychological difficulties after ABI.
  
  
  CONCLUSIONS
  CFT appears to be a feasible intervention for psychological problems after ABI. CFT was associated with a reduction in symptoms of anxiety and depression and associated self-criticism, as well as enhanced self-reassurance for ABI survivors. These ABI survivors reported that CFT provided them with tools to manage continued psychological difficulties.
authors.affiliation: Department of Psychology, Anglia Ruskin University, Cambridge, UK.|Oliver Zangwill Centre, Cambridgeshire Community Services, Cambridgeshire, UK.|Evelyn Community Head Injury Service, Cambridgeshire Community Services, Cambridgeshire, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Ashworth
authors.affiliation: Plym Neurorehabilitation Unit, Mount Gould Hospital, Plymouth, UK.
authors.forename: Alexis
authors.initials: A
authors.lastname: Clarke
authors.affiliation: Neurorehabilitation Unit, Rookwood Hospital, Cardiff, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.affiliation: Oxford Institute for Clinical Psychology Training, University of Oxford, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Jennings
authors.affiliation: Oliver Zangwill Centre, Cambridgeshire Community Services, Cambridgeshire, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Longworth
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D004645:Empathy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods; D036301:Qualitative Research; D012648:Self Care; D012649:Self Concept; D057566:Self Report; D012647:Self-Assessment; D012752:Shame; D016896:Treatment Outcome
keywords: anxiety; brain injury; compassion focused therapy; depression; self-criticism; self-soothing; stroke