Considering compassion as a mechanism or outcome and its implications for process-based therapy.

Comments on the article by N. Petrocchi et al. (see record 2024-33588-001), which presents a series of meta-analyses of the impact of compassion focused therapy (CFT) on positive and negative mental health outcomes. Petrocchi et al. clearly treat compassion as the dependent variable in their meta-analysis. The present authors argue that it is just as reasonable to consider it a mediator—a mechanism that generates change in some other dependent variable, which in this case includes depressive symptoms and self-criticism. Connected to this, we will argue that rather than treating CFT as a therapeutic package in itself, it might be more pragmatic to consider it an ingredient in a larger process-based therapy package, thus liberating ourselves from the sometimes inhibitory effect of a more topographically defined therapeutic package. Finally, they argue that there are important measurement issues inherent to consider in this work, namely construct overlap between potential mediators and dependent variables, and the effects of socialization to therapeutic processes during therapy, both of which require further consideration.