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Using Compassion Focused Therapy as an adjunct to Trauma-Focused CBT for Fire Service personnel suffering with trauma-related symptoms

Published online by Cambridge University Press:  29 November 2016

Elaine Beaumont ,
Mark Durkin ,
Sue McAndrew  and
Colin R. Martin
Elaine Beaumont*
Affiliation:
School of Nursing, Midwifery, Social Work & Social Sciences, University of Salford, Salford, Greater Manchester, UK
Mark Durkin
Affiliation:
Department of Health and Human Sciences, University of Bolton, Bolton, UK
Sue McAndrew
Affiliation:
School of Nursing, Midwifery, Social Work & Social Sciences, University of Salford, Salford, Greater Manchester, UK
Colin R. Martin
Affiliation:
Institute of Mental Health, Bucks New University, High Wycombe, Bucks, UK
*
*Author for correspondence: Ms. E. Beaumont, School of Nursing, Midwifery, Social Work & Social Sciences, Mary Seacole Building, University of Salford, Frederick Road, Salford, Greater Manchester, UK, M6 6PU (email: E.A.Beaumont@salford.ac.uk).
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Abstract

Individuals working for the emergency services often bear witness to distressing events. This outcome study examines therapeutic interventions for Fire Service personnel (FSP) experiencing symptoms of trauma, depression, anxiety and low levels of self-compassion. This study aims to investigate the effectiveness of using Compassion-Focused Therapy (CFT) as an adjunct to Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) in reducing symptoms of trauma, anxiety and depression and increasing self-compassion. A convenience sample (n = 17) of participants, referred for therapy following a traumatic incident, were allocated to receive 12 sessions of either TF-CBT or TF-CBT coupled with CFT. The study employed a repeated-measures design. Data were gathered pre- and post-therapy, using three questionnaires: (1) Hospital Anxiety and Depression Scale; (2) Impact of Events Scale-R; (3) Self-Compassion Scale – Short Form. TF-CBT combined with CFT was more effective than TF-CBT alone on measures of self-compassion. Significant reductions in symptoms of depression, anxiety, hyperarousal, intrusion and avoidance and a significant increase in self-compassion occurred in both groups post-therapy. The study provides some preliminary evidence to suggest that FSP may benefit from therapeutic interventions aimed at cultivating self-compassion. Further research is warranted using a larger sample size and adequately powered randomized controlled trial, to detect statistically significant differences and to negate the risk of confound due to low numbers resulting in significant differences between groups at baseline. Using CFT as an adjunct to TF-CBT may help FSP, who bear witness to the distress of others, cultivate compassion for their own suffering.

Keywords

Compassion-Focused TherapyCompassionate Mind TrainingFire BrigadeFire Service personnelself-compassiontrauma-focused CBT
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 9 , 2016 , e34
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

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References

Recommended follow-up reading

Ehlers, A, Clark, DM (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319–345.Google Scholar
Gilbert, P (2010). Compassion Focused Therapy. London: Routledge.Google Scholar
Lee, D (2012). The Compassionate Mind Approach to Recovering from Trauma Using Compassion Focused Therapy. Routledge: London Google Scholar

References

APA (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Arlington, VA: American Psychiatric Publishing.Google Scholar
Badour, CL, Resnick, HS, Kilpatrick, DG (2015). Associations between specific negative emotions and DSM-5 PTSD among a national sample of interpersonal trauma survivors. Journal of Interpersonal Violence. Published online: 18 December 2015. doi:10.1177/0886260515589930.Google Scholar
Beaumont, E, Galpin, A, Jenkins, P (2012). Being kinder to myself: a prospective comparative study, exploring post-trauma therapy outcome measures, for two groups of clients, receiving either cognitive behaviour therapy or cognitive behaviour therapy and compassionate mind training. Counselling Psychology Review 27, 31–43 Google Scholar
Beaumont, E, Hollins Martin, CJ (2013). Using compassionate mind training as a resource in EMDR: a case study. Journal of EMDR Practice and Research 7, 186–199.Google Scholar
Beaumont, E, Hollins Martin, CJ (2015). A narrative review exploring the effectiveness of Compassion-Focused Therapy. Counselling Psychology Review 30, 21–32.Google Scholar
Berger, W, Coutinho, ESF, Figueira, I, Marques-Portella, C, Luz, MP, Neylan, TC, Mendlowicz, MV (2012). Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Social Psychiatry and Psychiatric Epidemiology 47, 1001–1011.Google Scholar
Bisson, J, Ehlers, A, Mathews, R, Pilling, S, Richards, D, Turner, S (2007). Psychological treatments for chronic post-traumatic stress disorder. Systematic review and meta-analysis. British Journal of Psychiatry 190, 97–104.Google Scholar
Boersma, K, Hakanson, A, Salomonsson, E, Johansson, I (2015). Compassion focused therapy to counteract shame, self-criticism and isolation. A replicated single case experimental study for individuals with social anxiety Journal of Contemporary Psychotherapy 45, 89–98.Google Scholar
Bowyer, L, Wallis, J, Lee, D (2014). Developing a compassionate mind to enhance trauma-focused cbt with an adolescent female: a case study. Behavioural and Cognitive Psychotherapy 42, 248–254.Google Scholar
Bradley, R, Greene, J, Russ, E, Dutra, L, Westen, D (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry 162, 214–217 Google Scholar
Braehler, C, Gumley, A, Harper, J, Wallace, S, Norrie, J, Gilbert, P (2012). Exploring change processes in compassion focused therapy in psychosis: results of a feasibility randomized controlled trial. British Journal of Clinical Psychology 52, 199–214.Google Scholar
Brooks, M, Kay-Lambkin, F, Bowman, J, Childs, S (2012). Self-compassion amongst clients with problematic alcohol use. Mindfulness 3, 308–317.Google Scholar
Cicognani, E, Pietrantoni, L, Palestini, L, Prati, G (2009). Emergency workers’ quality of life: the protective role of sense of community, efficacy beliefs and coping strategies. Social Indicators Research 94, 449–463.Google Scholar
Carroll, C, Patterson, M, Wood, S, Booth, A, Rick, J, Balain, S (2007). A conceptual framework for implementation fidelity. Implementation Science 2, 1–9.Google Scholar
Del Ben, KS, Scotti, JR, Chen, Y, Fortson, BL (2006). Prevalence of posttraumatic stress disorder symptoms in firefighters. Work and Stress 20, 37–48.Google Scholar
Ehlers, A, Clark, DM (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319–345.Google Scholar
Ehlers, A, Clark, DM, Hackmann, A, McManus, F, Fennell, M (2005). Cognitive therapy for PTSD: development and evaluation. Behaviour Research and Therapy 43, 413–431 Google Scholar
Field, AP (2013). Discovering Statistics Using IBM SPSS Statistics: And Sex and Drugs and Rock ‘n’ Roll, 4th edn. Los Angeles: SAGE.Google Scholar
Foa, EB, Hembree, EA, Cahill, SP, Raunch, SAM, Riggs, DS, Feeny, NC, Yadin, E (2005). Randomized trial of prolonged exposure for post-traumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. Journal of Consulting and Clinical Psychology 73, 953–964.Google Scholar
Fullerton, CS, McCarroll, JE, Ursano, RJ, Wright, KM (1992). Psychological responses of rescue workers: fire fighters and trauma. American Journal of Orthopsychiatry 62, 371–379.Google Scholar
Gale, C, Gilbert, P, Read, N, Goss, K (2014). An evaluation of the impact of introducing compassion focused therapy to a standard treatment programme for people with eating disorders. Clinical Psychology & Psychotherapy 21, 1–12.Google Scholar
Gilbert, P (2000). Social mentalities: internal ‘social’ conflicts and the role of inner warmth and compassion in cognitive therapy. In: Genes on the Couch: Explorations in Evolutionary Psychotherapy (ed. Gilbert, P. & Bailey, K. G.), pp. 118–150. Hove: Brenner-Routledge.Google Scholar
Gilbert, P (2009). The Compassionate Mind. London: Constable.Google Scholar
Gilbert, P (2010). Compassion Focused Therapy. London: Routledge.Google Scholar
Gilbert, P (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology 53, 6–41.Google Scholar
Gilbert, P, Irons, C (2004). A pilot exploration of the use of compassionate images in a group of self-critical people. Memory 12, 507–516.Google Scholar
Gilbert, P, Procter, S (2006). Compassionate mind training for people with high shame and self-criticism: overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy 13, 353–379.Google Scholar
Harman, R, Lee, D (2010). The role of shame and self-critical thinking in the development and maintenance of current threat in post-traumatic stress disorder. Clinical Psychology and Psychotherapy 17, 13–24.Google Scholar
Harris, MB, Baloglu, M, Stacks, J (2002). Mental health of trauma-exposed firefighters and critical incident stress debriefing. Journal of Loss and Trauma 7, 223–238.Google Scholar
Haslam, C, Mallon, K (2003). A preliminary investigation of posttraumatic stress symptoms among firefighters. Work and Stress 17, 277–285.Google Scholar
Horowitz, M, Wilner, N, Alvarez, W (1979). Using Compassion Focused Therapy as an adjunct to Trauma-Focused CBT for Fire Service personnel suffering with trauma-related symptoms. PSYC Medicine 41, 209–218.Google Scholar
Jonsson, A, Segesten, K (2004). Guilt, shame and need for a container: a study of post-traumatic stress among ambulance personnel. Accident Emergency Nursing 12, 215–223.Google Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.Google Scholar
Leahy, R (2001). Overcoming Resistance in Cognitive Therapy. New York: Guilford Press.Google Scholar
Lee, DA (2009). Compassion focused cognitive therapy for shame-based trauma memories and flashbacks in PTSD. In: A Casebook of Cognitive Therapy for Traumatic Stress Reactions (ed. Grey, N.), chapter 15. London: Routledge.Google Scholar
Lee, DA, Scragg, P, Turner, SW (2001). The role of shame and guilt in reactions to traumatic events: a clinical formulation of shame-based and guilt based PTSD. British Journal of Medical Psychology 74, 451–466.Google Scholar
Leskela, J, Dieperink, M, Thras, P (2002). Shame and post-traumatic stress disorder. Journal of Traumatic Stress 15, 223–226.Google Scholar
Lord, FM (1967). A paradox in the interpretation of group comparisons. Psychological Bulletin 68, 304–305.Google Scholar
Mayhew, S, Gilbert, P (2008). Compassionate mind training with people who hear malevolent voices. A case series report. Clinical Psychology and Psychotherapy, 15, 113–138.Google Scholar
Neff, KD (2003). The development and validation of a scale to measure self-compassion. Self and Identity 2, 223–250.Google Scholar
NICE (2005). Guidelines for Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care. National Institute for Health and Clinical Excellence (http://www.nice.org.uk/CG26). Accessed 12 May 2015.Google Scholar
Raes, F, Pommier, E, Neff, K, Van Gucht, D (2011). Construction and factorial validation of a short form of the self-Compassion Scale. Clinical Psychology & Psychotherapy 18, 250–255.Google Scholar
Resick, PA, Nishith, P, Weaver, TL, Astin, MC, Feuer, CA (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 70, 867–879.Google Scholar
Resick, P, Schnicke, M (1993). Cognitive Processing Therapy for Rape Victims: A Treatment Manual. Newbury Park, CA.Google Scholar
Skogstad, M, Skorstad, M, Lie, A, Conradi, HS, Heir, T, Weisæth, L (2013). Work-related post-traumatic stress disorder. Occupational Medicine 63, 175–182.Google Scholar
Smith, P, Yule, W, Perrin, S, Tranah, T, Dalgleish, T, Clark, DM (2007). Cognitive-behavioral therapy for PTSD in children and adolescents: a preliminary randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry 46, 1051–1061.Google Scholar
Snaith, RP, Zigmond, AS (1994). The Hospital Anxiety and Depression Scale Manual. Berkshire: Nelson Publishing.Google Scholar
Thompson, B, Waltz, J (2008). Self-compassion and PTSD symptom severity. Journal of Traumatic Stress 21, 556–558.Google Scholar
Wagner, D, Heinrichs, M, Ehlert, U (1998). Prevalence of symptoms of posttraumatic stress disorder in German professional fire-fighters. American Journal of Psychiatry 155, 1727–1732.Google Scholar
Weiss, DS, Marmar, CR (1996). The Impact of Event Scale – Revised. In: Assessing Psychological Trauma and PTSD (ed. Wilson, J. & Keane, T. M.), pp. 399–411. New York: Guilford.Google Scholar
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