Compassion-Focused Therapy (CFT) - Competencies

Overview

Competencies for Compassion-Focused Therapy (CFT) have been established but have not been evaluated in research to date. Liddell, Allan, and Goss (2017) used a Delphi approach, recruiting 12 CFT experts to identify “the CFT competency framework (CFT-CF)”. This framework comprised six areas of competence: creating safeness, meta-skills, non-phase-specific skills, phase-specific skills, knowledge and understanding, and use of supervision. 25 primary competencies were identified within these areas.

Gilbert and Wood created an unpublished scale called the CFT Therapy Assessment Guide, a 45- item scale assessing “microskills, formulation skills, skills in explaining CFT, and contracting” (Horwood et al., 2020).

To build a more formal competency measure that included behavioral anchors, Horwood et al. (2020) used a Delphi approach and developed a CFT therapist competence rating scale (CFT-TCRS). The CFT-TCRS consists of 14 CFT unique competencies and 9 CFT microskills.

The CFT specific competencies include: psychoeducation, recognising motives and emotions, actively working with the three systems, understanding the relationship between three systems, compassionate mind training, building motivation, building courage, cultivating and tolerating positive feelings in the drive system, functional analysis, fears/blocks/resistances, unconscious emotions and processes, formulation, and multiple selves.

The CFT microskills include: non-verbal communication to build rapport, non-verbal communication and motivational/emotional systems, verbal communication, pacing, Socratic questioning, paraphrasing and summaries, agenda setting, validation and normalization, and mentalization.

Materials/Assessments/Work Products

CFT competency framework (CFT-CF)(Liddell, Allan, & Goss, 2017)  

CFT therapist competence rating scale (CFT-TCRS) (Horwood et al., 2020)

Bell, Hickey, and Bennett-Levy (2022) described the benefits of self-practice/self-reflection (SP/SR) training specifically for CFT therapists. There is a SP/SR book for CFT therapists (Kolts et al., 2018). Bell, Dixon, and Kolts (2017) reported the qualitative results of a 4-week SP/SR approach for CFT trainees to develop a compassionate internal supervisor.

Additional guidance for therapists has been published in multiple books (Gilbert & Simos, 2022; Kolts, 2016).

Additionally, some CFT experts have been publishing on the benefit of self-practice/self-reflection as a means to develop competence in CBT more generally (Thwaites et al., 2014;2015).

References

Bell, T., Dixon, A., & Kolts, R. (2017). Developing a compassionate internal supervisor: Compassion‐focused therapy for trainee therapists. Clinical psychology & psychotherapy, 24(3), 632-648.

Bell, T., Hickey, T., & Bennett-Levy, J. (2022). Self-practice/self-reflection (SP/SR) training for compassion-focused therapists. In P. Gilbert & G. Simos (Eds.), Compassion focused therapy: Clinical practice and applications (pp. 371–384). Routledge. https://doi.org/10.4324/9781003035879-14.

Gilbert, P., & Simos, G. (Eds.), Compassion focused therapy: Clinical practice and applications (pp. 371–384). Routledge.

Horwood, V., Allan, S., Goss, K., & Gilbert, P. (2020). The development of the compassion focused therapy therapist competence rating scale. Psychology and Psychotherapy: Theory, Research and Practice, 93(2), 387-407.

Kolts, R. L. (2016). CFT made simple: A clinician's guide to practicing compassion-focused therapy. New Harbinger Publications.

Kolts, R. L., Bell, T., Bennett-Levy, J., & Irons, C. (2018). Experiencing compassion-focused therapy from the inside out: A self-practice/self-reflection workbook for therapists. Guilford Publications.

Liddell, A. E., Allan, S., & Goss, K. (2017). Therapist competencies necessary for the delivery of compassion‐focused therapy: A Delphi study. Psychology and Psychotherapy: Theory, Research and Practice, 90(2), 156-176.

Thwaites, R., & Bennett‐Levy, Melanie Davis and Anna Chaddock, J. (2014). Using Self‐Practice and Self‐Reflection (SP/SR) to Enhance CBT Competence and Metacompetence. How to become a more effective CBT therapist: Mastering metacompetence in clinical practice, 239-254.

Thwaites, R., Cairns, L., Bennett‐Levy, J., Johnston, L., Lowrie, R., Robinson, A., ... & Perry, H. (2015). Developing Metacompetence in Low Intensity Cognitive‐Behavioural Therapy (CBT) Interventions: Evaluating a Self‐Practice/Self‐Reflection Programme for Experienced Low Intensity CBT Practitioners. Australian Psychologist, 50(5), 311-321.