Compassion-focused therapies for self-esteem: A systematic review and meta-analysis

Abstract

Purpose: To identify whether compassion-focused therapy (CFT) or compassion-based interventions are effective in improving self-esteem.

Methods: Databases (CINAHL, MEDLINE, and PsycINFO) were searched, along with OpenGrey literature. Experts were also contacted and handsearching of reference lists and citing articles undertaken. To be eligible, papers had to include an intervention identified as being compassion-based and mention 'self-esteem' as a variable or outcome. Papers were quality appraised using the Mixed Methods Appraisal Tool. Data were analysed using a random-effects meta-analysis model, with sensitivity analysis conducted in relation to the quality of studies.

Results: Ten eligible papers were identified. Within-group analysis of data from eight studies demonstrated a medium, significant overall effect size (g = 0.56, 95% CI [0.19-0.93], z = 3.54, p < .001), which increased slightly and remained significant (g = 0.61, 95% CI [0.05-1.17], z = 2.82, p = .005) when the lowest quality studies were removed.

Conclusions: Compassion-focused therapy or compassion-based interventions may be effective in improving self-esteem. However, there is large clinical and methodological heterogeneity amongst studies making further conclusions difficult.

Practitioner points: CFT/compassion-based interventions appear to be effective in improving self-esteem. Transdiagnostic concepts (such as low self-esteem and compassion-focused therapy) should be considered in supporting people with their mental health.

Keywords: compassion-focused; compassion-focused therapy; meta-analysis; review; self-esteem; therapy.