Online self-compassion training for people living with long-term physical health conditions: A pilot study.

Interventions that teach self-compassion are increasingly used to address mental and physical health outcomes in individuals living with long-term health conditions. This systematic review aimed to summarize literature up until May 2022 that had investigated how compassion-based interventions (Compassion Focused Therapy (CFT), Compassionate Mind Training (CMT), Mindful Self Compassion (MSC), Cultivating Compassion Therapy (CCT), Cognitively Based Compassion Therapy (CBCT) and Attachment-Based Compassion Therapy (ABCT)) impact upon process (e.g. self-compassion), psychological, physical and functional outcomes in chronic illness. It also examined the quality of the questionnaires used to measure outcomes and how differences in compassion-based intervention formats may affect outcomes (e.g., mode of delivery, duration, use of technology). Cochrane, Medline, and PsycINFO databases were searched using “compassion” AND “chronic illness” and their synonyms. Eligible studies had an experimental design, with compassion training at the core of the course content, and in populations with long-term health conditions. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). The review included sixteen studies published between 2014-2022, including a total of 571 participants with nine different kinds of chronic illness and seven different intervention types. 10 of 16 studies were randomized controlled trials (RCTs) and the remaining six studies were non-randomized pre-post studies. There were trends for compassion-based interventions to improve self-compassion, mindfulness, pain acceptance and objective physical measures of well-being, whilst also decreasing self-criticism, shame, anxiety, depression and stress. There was more variation in findings with regards to whether these improvements remained significant in comparison to a control condition and at follow-up. Self-compassion may be a key transdiagnostic factor of psychopathological and physiological change processes in chronic conditions, although the mechanisms underlying these changes are not known and require further investigation. This in-turn calls for more RCT studies with larger sample sizes and studies that use appropriate measurement scales and feasibility/acceptability measures. Future studies should also examine moderating factors on treatment outcomes. Overall, compassion-based interventions in chronic illness is an emerging field and shows promise for improving self-compassion as well as other psychological and functional outcomes.



The aim of this pilot study was to assess the feasibility and acceptability of an online self-compassion training programme for people living with long-term physical health conditions. It also investigated changes in Process outcomes (self-compassion, self-criticism and self-reassurance); Psychological outcomes (depression, anxiety, stress and shame) and Functional outcomes (health-related quality of life and well-being) from pre- to post-intervention. This programme was composed of four online sessions, with one 30 minute video session per week, which set a basis for the in-between session practises and readings. The programme could be accessed by participants at any time by logging into the learning portal. Feasibility was examined in terms of ease of recruitment, study attrition (drop-out), treatment adherence and treatment engagement. Of the 105 participants who signed up to take part in the study, 78 participants adhered to the eligibility criteria. 45 of these 78 participants completed the pre-intervention measures, and 21 participants completed the 4-week training and post-intervention measures (53.33% attrition). Treatment adherence was 100% for all 21 study completers and more than half of participants reported that they used self-compassion principles a few times per week. The self-compassion course satisfied acceptability criteria with 80-90% participants reporting that they were satisfied with the course, that it was worth their time and that they would recommend the programme to a friend facing a similar difficulty. The results showed significant improvements in all process, psychological and functional outcomes, apart from anxiety, from pre- to post-intervention. Post-hoc analyses demonstrated that there were no significant differences in baseline measures for completers versus non-completers. This study lacked a control arm, and therefore pre–post changes in outcome measures could not be attributed to the self-compassion programme. Overall, online self-compassion training shows promise as a feasible and acceptable intervention for people living with chronic illness. Further research is needed to help understand the barriers to engagement and to help tailor its format to better suit participants who disengaged. RCT studies, with larger, more representative samples are needed to examine efficacy, and mediation/moderation analyses would help inform the potential mechanisms that underlie the self-compassion intervention.