When compassion, aka karuna, enters the Indian psychotherapy space: A mixed-method case-series study of compassion-focused therapy in depression

Background

Compassion-focused therapy (CFT) is transdiagnostic. It primarily targets shame and self-criticism in persons with depression. While there have been studies in the West to explore the beneficial effects of CFT, there is a need to unpack how CFT functions in the East.

Method

This study aimed to explore the utility and process of CFT in North-East India. The authors tailored a 12-session CFT module based on the suggestions of three local mental health professionals. A mixed-method design was employed. Five mental health service users in a tertiary mental healthcare hospital diagnosed with depression based on ICD-10 criteria were recruited in the study. For quantitative measurements, the Hamilton Depression Rating Scale (HDRS), Others as Shamer Scale (OAS), Fears of Compassion Scales (FOC), The Forms of Self-Criticizing and Reassuring Scale (FSCRS) and Compassionate Engagement and Action Scales (CEAS) were administered. Three time point assessments were taken, that is, baseline, post-intervention and 1-month follow-up. To understand the process of CFT, qualitative narrative analysis was undertaken on session notes, memos and reflective journals focusing on the nature of compassion, blocks of compassion, sense of shame and self-criticality.

Results

Quantitative findings indicated improvement of depressive symptoms and changes in sense of shame, fear of compassion, self-criticality, self-reassuring tendencies and compassionate engagements and actions. The qualitative findings shed light on the process of CFT.

Conclusion

The authors discussed the findings anchoring the existing theories of CFT and relevant studies. The findings support the preliminary evidence of the utility of CFT in persons with depression.