Effectiveness of group CFT as treatment in addictions population
Research type
Research Study
Full title
Investigating the effectiveness of Group Compassion-Focused Therapy for individuals accessing psychological treatment for drug and alcohol addiction.
IRAS ID
322577
Contact name
Isabel Traynor
Contact email
Sponsor organisation
NHS Fife
Duration of Study in the UK
3 years, 0 months, 23 days
Research summary
Research Summary
Compassion Focused Therapy (CFT) is a third wave of cognitive-behavioural therapy. CFT explicitly includes and promotes the ability to self-soothe and develop the courage to engage with difficult emotions. Through this, individuals learn to move away from self shame, and instead work through these difficulties compassionately.
Research has shown that people use substances to cope with experiencing complex trauma2 and that those who become addicted to substances demonstrate shame and guilt surrounding both their adverse experiences and their substance use. In addition, self compassion has increased wellbeing and reduced shame, self criticism and drug craving for people with substance use disorders.
Self compassion has also been shown to be associated with inverse risk of substance use disorder development, indicating the potential use of self compassion in protecting against substance use as an unhealthy coping mechanism. This provides evidence to implement psychological interventions promoting compassion. Despite this, there is limited research looking at the feasibility of implementing CFT group interventions to promote wellbeing, and reduce psychological distress and shame for substance or alcohol users.
The current study aims to address this gap, to provide new evidence for psychological treatment in addictions. This is a growing field, which requires more evidence base due to the lack of research currently available.
Participants will be made aware of the CFT group by their keyworkers (employed by NHS Addiction Services or relevant third sector organisations), and provided with an information sheet at that point. If they decide they would like to take part, key workers must complete a referral form. Participants will then be screened by a clinician to check suitability. If participants are suitable, they will then be provided with a consent form.
The group will consist of 12 weekly sessions of CFT, each session for 2.5-3 hours. Individuals will be asked to complete questionnaires before and after the group. A small group of individuals will also be asked to conduct a short interview before and after the group, to look at the impact of CFT on an individual’s narrative.Summary of Results
Quantitative Analysis: Statistical Analysis (paired samples t-tests and non-parametric equivalents) were applied to the pre and post intervention data of participants who completed the study. Statistically significant improvements were found for measurements of reassuring oneself, overall self-compassion, a sense of shared humanity, kindness to oneself, mindfulness, symptoms of generalised anxiety disorder and symptoms of depression. The specific measures were the Forms of Self-Criticising/Self Attack, Self-Compassion Scale, Patient Health Questionnaire 9 and Generalised Anxiety Disorder. There was no significant correlation between whether participants completed or did not complete the study and age, gender, status of substance or alcohol dependency (past/present/never), types of trauma, or past psychological interventions. Despite lack of significant correlation, those who completed the study were considerably more likely to have previously engaged in psychological interventions focused on understanding and managing emotions, and were considerably less likely to be frequently using illicit substances or alcohol.
Qualitative Analysis: Narrative Analysis of interviews found identity formed as "I hate myself", "I am to blame for my suffering","There is something wrong with me" and "I don't fit in to society". Post intervention, identity was formed as "I am proud of myself", "The suffering I have experienced is not my fault", "Other people have similar experiences to me", "I am capable of changing my future". The identities were defined as the Resolve in Core Narratives identified. Core Narratives before the group highlighted some traumatic events, which participants evaluated largely as a reflection of themselves, hence resolve. In other areas, there was a distinct ommition of key events, or 'complicating actions ',or the details or related emotions. Post intervention, the Core Narratives drew more attention to traumatic events, however evaluation shifted away from personalising to acceptance that the early situations were outwith their control, or the consequence of how they had survived prior traumatic events. The shift in evaluation resulted in change in how participants resolved their narrative and, hence, a change in their sense of identity. The Core Narratives also changed with the addition of specific aspects of the CFT Group as key events, or 'complicating actions. In particular, participants demonstrated how learning about psychological theories and evidence of the impact of trauma on the brain and body, changed their evaluation of the suffering they had experienced. Similarly, they showed that learning about other people's experiences changed the narrative they held from being alone in suffering, to an acknowledgement that other people suffer as it is inevitable in life. Lastly, there was a shared change from a sense of hopelessness and self-blame, to a held narrative that "I cannot change the past, but with the knowledge, skills and support I have gained, I can change my future".
REC name
West Midlands - Edgbaston Research Ethics Committee
REC reference
23/WM/0140
Date of REC Opinion
26 Oct 2023
REC opinion
Further Information Favourable Opinion