The Benefits of Self-Compassion in Mental Health Professionals: A Systematic Review of Empirical Research

Figures & data

Figure 1 Systematic process followed for reviewing empirical research.

Table 1 Experimental and Quasi-Experimental Research on the Benefits of Self-Compassion

Study	Sample	Program Type	Comparison of Groups (YES/NO)RCT/no RCT	Groups Design	Time of Measure	Dependent Variables	Main Results
Eriksson et al (2018).^Citation22	Practicing psychologists	Internet Program. Mindfulness and compassion with self and others (Schenström, 2017).	Yes/ RCT	-EG N=40 -CG waiting list=41	Pre/post/no follow-up	SCS FFMQ PSS SMBQ	● Increase in total SCS and total FFMQ. Larger effect size in SCS than in FFMQ. ● Reduced levels of self-coldness (SCS subscale), perceived stress and burnout symptoms. ● Correlational results: measures of stress and burnout are more associated with the self-coldness dimension than with the positive dimension of self-compassion.
Finlay-Jones et al (2017).^Citation16	Psychology trainees	Self-Compassion Online (SCO) program 6-week self-guided online self-compassion cultivation program.	No/ No RCT	-EG N=37	Pre/post/follow-up 12 weeks	SCS PSS AHI DERS DASS-21 Program feedback	● Significant improvements in self-compassion, happiness, perceived stress, emotion regulation difficulties, and psychophysiological symptoms of depression and stress between pre- and posttest. Additionally, these changes were maintained at 3-month follow-up. ● Significant decreases in anxiety between pretest and follow-up. ● Average ratings across modules were high for enjoyableness, relevance, comprehension, and learning, and low to moderate on difficulty. ● Positive effects on the therapeutic work of the participants: increased authenticity, responsiveness and a greater ability to “be present” and “practice what is preached” ● Increased resilience in the face of stress and expressed appreciation for the value of self-care practices.
Jiménez-Gómez et al (2022).^Citation23	Clinical and Health Psychologist trainees.	MSC original.	Yes/partial RCT	-EG N=34 -CG active MBSR N=26 -CG waitlist= 28	Pre/post/no follow-up	SCS FFMQ STAI-S BDI Satisfaction with training and participation	● MSC training improves pre-post scores in mindfulness and self-compassion and also in relation to CG waitlist. Anxiety scores are maintained in relation to CG waitlist. Significant decrease in pre-post depression, but not different from that observed in the CG waiting list. ● MBSR decreases mindfulness, anxiety and depression relative to CG waitlist. ● Both MSC and MBSR produce significant decreases in self-compassion, mindfulness and anxiety. MBSR also significantly reduces depression relative to MSC. ● No differences between MBSR and MSC in overall level of involvement and practice, satisfaction with the program, and time spent in formal and informal practice.
Yela et al (2020).^Citation3	Clinical and Health Psychologist trainees.	MSC original.	Yes/No RCT	-EG Self-reported high adherence to training N=30 -CG Self-reported low adherence to training N=31	Pre/post/no follow-up	SCS FFMQ STAI-S BDI PWBS	● EG significantly improves self-compassion, mindfulness and psychological well-being in relation to CG. ● Positive correlation between degree of adherence/practice and improvement in self-compassion, mindfulness and psychological well-being. ● Higher increases in self-compassion from pre- to post-intervention were significantly connected to increased mindfulness and psychological well-being and to reduced depression symptoms over time. ● No effect on Anxiety and Depression (floor effect; low range of scores).

Abbreviations: RCT, Randomized Controlled Trial; EG, Experimental Group; CG, Control Group; MSC, Mindful Self-Compassion program; MBSR, Mindfulness-Based Stress Reduction program; AHI, Authentic Happiness Inventory; Peterson & Park, 2008; BDI, Beck Depression Inventory; Beck et al, 1961; DASS-21, Depression Anxiety and Stress Scales; Lovibond & Lovibond, 1995; DERS, Difficulties in Emotion Regulation Scale; Gratz & Roemer, 2004; FFMQ, Five Facets of Mindfulness Questionnaire, Baer et al, 2006; PSS, Perceived Stress Scale; Cohen et al, 1983; PWBS, Psychological Well-Being Scales; Ryff, 1989; SCS, Self-Compassion Scale; Neff (2003); SMBQ, Shirom Melamed Burnout Questionnaire; Melamed et al, 1999; STAI-S, State-Trait Anxiety Inventory; Spielberger et al, 1982.

Table 2 Cross-Sectional Research on the Benefits of Self-Compassion

Study	Sample	N	Variables Analyzed	Associations Between SC and Other Variables	Complex Relationships Among Variables (Mediation and Moderation)
Aruta et al (2022).^Citation40	Counselors	158	SCS-SF; MHSIS; MHSAS	Mental help-seeking intention (+); mental help-seeking attitudes (+)	Self-compassion → Mental help-seeking attitudes → Mental help-seeking intention The relationship between Self-compassion and Mental help-seeking attitudes is moderated by age.
Beaumont et al (2016).^Citation27	Students counsellors and student cognitive behavioral psychotherapists.	54	PROQOL; SCS; WEMWBS-SF; CS	Burnout (-); secondary traumatic stress (-); well-being (+)
Bourgault & Dionne (2019).^Citation38	Psychologists	178	SCS-SF; FFMQ; TPI-T; IDPESQ-14	Mindfulness (+); therapeutic presence (+); psychological distress (-)	Mindfulness → Self-compassion and Psychological distress→ Therapeutic presence
Finlay-Jones et al (2015).^Citation39	Professional and trainee psychologists	198	SCS-SF; DERS; DASS-21 (stress subscale); BFI-N	Emotion regulation difficulties (-); stress (-)	Self-compassion → Emotion regulation difficulties→ Stress
Fulton (2016).^Citation42	Master’s counselling students	48 students and 55 patients	FFMQ; SCS; SEQ; AAQ-II; MSTATS; BLRI-CF;	Mindfulness (+); Session depth (assessed by therapist) (+); experiential avoidance (-); tolerance to ambiguity (+)
Fulton, (2018).^Citation43	Master’s counselling interns	152	SOFI; FFMQ	Mindfulness (+); Compassion for others (+)	Mindfulness → Self-compassion → Compassion for others
Kotera et al (2021).^Citation28	Psychotherapists	126	MBI (2-items); SCS-SF; WLBC; TS	Emotional exhaustion (-); depersonalisation (-); work-life balance (+)	Work-life balance → Self-compassion → Emotional exhaustion
Latorre et al (2021).^Citation41	Counselling and clinical psychology doctoral trainees	192	SCS-SF; MAAS; CSES; PCS-R	Mindfulness (+); self-efficacy (+); professional competencies (+)	Mindfulness → Self-compassion → Self-efficacy Mindfulness → Self-compassion → Self-assessed professional competency
McCade et al (2021).^Citation29	Psychologists	248	SCS-SF; CBI; DASS-21 (depression subscale)	Burnout (-); depression (-)	Self-compassion moderates the relationship between burnout and depression
Ondrejková & Halamová (2022).^Citation30	Helping professions (nurses, doctors, paramedics, home nurses, teachers, psychologists, psychotherapists and coaches, social workers, priests and pastors, and police officers).	607	PROQOL; SOCS-S; SOCS-O; FSCRS	Compassion fatigue (-)	Profession → self-compassion and self-criticism → Compassion fatigue
Richardson et al (2020).^Citation31	Students in clinical/counseling psychology doctoral programs	119	APS-R (Discrepancy subscale); SCS; IDAS-II; CBI (Personal burnout subscale); SCS; IDAS-II; CBI (Personal burnout subscale).	Burnout (-); depression (-); self-critical perfectionism (-)	Self-critical perfectionism → Self-compassion → Depression Self-critical perfectionism → Self-compassion → Burnout
Roxas et al (2019).^Citation37	School counselors, counseling psychologists and counselors-in-training	231	CS; SCS; HFS; SWBSF-SF; SWBSF-SF	Compassion for others (+); well-being (+); forgiveness of others/self (+)	Compassion for others → Forgiveness of others → Subjective Well Being. Self-compassion → Forgiveness of others → Subjective Well Being.
Tigranyan et al (2021).^Citation44	Clinical and counselling psychology doctoral students	84	SCS-SF; AMS-R; GAD-7; GSE; PHQ-9; PCI; RSES; CIPS	Perfectionistic cognitions (+); anxiety (+); achievement motives (-); experiences of impostor phenomenon (+)
Yip et al (2017).^Citation32	Clinical psychologists and trainees.	77	SCS-SF; IMF-SF; PROQOL; CS; SDRS-5	Self-warmth: Mindfulness (+); compassion to clients (+); age (+); years of experience (+); self-coldness (-); burnout (-); secondary traumatic stress (-) Self-coldness: Burnout (+); secondary traumatic stress (+); mindfulness (-); compassion to clients (-); age (-); years of experience (-)	Mindfulness → Self-coldness → Burnout Mindfulness → Self-coldness → Secondary Traumatic Stress Mindfulness → Self-warmth → Compassion to clients Mindfulness → Self-warmth → Secondary Traumatic Stress

Notes: (+) and (-) represent positive and negative associations between variables, respectively; the arrow → represents associations between variables involved in mediation relationships.

Abbreviations: AAQ-II, Acceptance and Action Questionnaire - II (Bond et al, 2011); AMS-R, Achievement Motives Scale (Lang & Fries, 2006); APS-R, Discrepancy subscale of the Almost Perfect Scale-Revised (Slaney et al, 2001); FI, Neuroticism subscale of the Big Five Inventory (John et al, 1991); BLRI, Barrett-Lennard Relationship Inventory-Client Form (Barrett-Lennard, 1962); CBI, Copenhagen Burnout Inventory (Kristensen et al, 2005); CIPS, Clance Impostor Phenomenon Scale (Clance, 1986); CS, Compassion to Others Scale (Pommier, 2011); CSES, Counselor Self-Efficacy Scale (Melchert et al, 1996); DASS-21, Depression Anxiety Stress Scales (Lovibond & Lovibond, 1995); DERS, Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004); FFMQ, Five Facets Mindfulness Questionnaire (Baer et al, 2006); FMI-SF, Freiburg Mindfulness Inventory (Walach et al, 2006); FSCRS, Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (Gilbert et al, 2004); GAD-7, Generalized Anxiety Disorder (Spitzer, Kroenke, Williams, and Löwe, 2006); GSE, General Self-Efficacy Scale (Schwarzer & Jerusalem, 1995); HFS, Heartland Forgiveness Scale (Thompson et al, 2005); IDAS-II, Inventory of Depression and Anxiety Symptoms-Second Version (Watson et al, 2012); IDPESQ-14, Psychological Distress Index - Santé Québec Survey (Préville et al, 1992); MAAS, Mindfulness Attention Awareness Scale (Brown & Ryan, 2003); MBI, Maslach Burnout Inventory 2 item-version (West et al, 2012); MHSAS, Mental Help-Seeking Attitudes Scale (Hammer et al, 2018); MHSIS, Mental Help-Seeking Intention Scale (Hammer & Spiker, 2018); MSTATS, Multiple Stimulus Types Ambiguity Tolerance Scale-II (McClain, 2009); PCI, Perfectionistic Cognitions Inventory (Flett et al, 1998); PCS-R, Professional Competency Scale-Revised (Taylor, 2015); PHQ-9, Patient Health Questionnaire (Kroenke et al, 2001); PROQOL, Professional Quality of Life Scale, version 5 (Stamm, 2009, 2010); RSES, Rosenberg Self-Esteem Scale (Nho, 2000); SCS, Self-Compassion Scale (long version) (Neff, 2003); SCS-SF, Self-Compassion Scale - Short Form (Raes et al, 2011); SDRS-5, Socially Desirable Response Set (Hays et al, 1989); SEQ, Session Evaluation Questionnaire-Form 5 (Stiles & Snow, 1984); SOCS-O, Sussex-Oxford Compassion for Others scale (Gu et al, 2019); SOCS-S, Sussex-Oxford Compassion for the Self Scale (Gu et al, 2019); SOFI, Self-Other Four Immeasurables (Kraus & Sears, 2009); SWBSF-SF, Subjective Well-Being Scale for Filipinos- Short Form (Hernández, 2010); TPI-T, Therapeutic Presence Inventory - Psychotherapist version (Geller, 2002); TS, Telepressure Scale (Montemurro & Perrini, 2020); WEMWBS-SF, Short Warwick and Edinburgh Mental Well-being Scale (Tennant et al, 2009); WLBC, Work-Life Balance Checklist (Daniels & Carraher, 2000).

Table 3 Qualitative Research on the Benefits of Self-Compassion for Mental Health Professionals

Study	Sample	N	Method	Main Results on the Benefits of Therapists’ Self-Compassion
Barton (2020).^Citation15	Counselors	5	Interpretative Phenomenological Analysis (IPA; Smith et al, 2009).	(a) self-care and self-compassion are essential parts of being a therapist that may be prioritized during professionals’ training as a means to cope with demands and challenges that therapists face in their work; (b) existence of barriers to self-care: it is not unusual for those who care for others to struggle with self-care (eg feeling selfish).
Patsiopoulos & Buchanan (2011).^Citation45	Counselors	15	Narrative analysis process described by Lieblich et al (1998).	(a) better management of occupational stress and challenges (eg recognizing and addressing signs of depletion, working through ethical dilemmas, and processing decisions and their consequences); (b) overall sense of well-being: physical, psychological and emotional health, greater existential and/or spiritual sense of connectedness; (c) positive impacts on therapists’ ability to work effectively with clients and therapeutic relationship
Quaglia et al (2021).^Citation46	Counseling interns (Master’s level)	20	Thematic analysis (Braun & Clarke, 2006).	(a) supporting self-attunement, ie ability to observe one’s internal experience, attending to their emotional experience and promoting a sense of personal kindness and self-acceptance; (b) lessening self-criticism and perfectionism: feelings of “not being enough”, greater acceptance to moments of uncertainty and perceived missteps or mistakes, greater acceptance to limitations as a therapist in training (tolerate not knowing the “perfect” therapeutic response, imposter syndrome); (c) fostering intrapersonal emotion regulation (when receiving difficult feedback from clients during session and when counselors experienced activation from client material; (d) modeling self-compassion for clients.

Table 4 Qualitative Research on the Effect of Mindfulness and Compassion-Based Interventions on the Therapists’ Self-Compassion

Study	Sample Size (N) and Type	Program Type	Duration of Training	Qualitative Methodology	Main Ideas/Results
Bell et al (2017).^Citation68	N=6. Trainee cognitive-behavioural therapists	Adapted version (“internal supervisor”) of Compassion Focused Therapy (CFT)	4 weeks	Interpretative Phenomenological Analysis	Increased ability to be self-compassionate: (a) increased awareness and sensitivity to one’s own difficulties (expressions of care, empathy and support); (b) their self-talks were “affirming”, “reassuring” and encouraging; (c) the change in internal dialogue was identified as a change in mind-set rather than solely an alteration to the verbal content of cognitions; (d) all participants identified a change in their self-to-self relationship and an increased ability to provide, and be open to, self-care (characterised as “kind” and “warm”)
Bibeau et al (2020).^Citation62	N=3. Psychotherapists with regular practice in mindfulness	Compassion meditation	4 weeks	Phenomenological Analysis	Improved therapist’s relationship with self: (a) self-compassion appeared to be the foundation of the compassion for others, the key factor that allow to be present, more accepting, and more tolerant toward the suffering of the clients, as well as more empathetic; (b) to feel less pressure to perform or to offer a quick fix that would alleviate the client’s suffering.
Boellinghaus et al (2013).^Citation61	N=12. Psychological therapists in training	Loving-kindness Meditation (LKM)	6 weeks	Interpretative Phenomenological Analysis	(a) all participants were more accepting of themselves in relation to difficult feelings, and distanced themselves more from self-critical thoughts; (b) they were more compassionate when feeling stressed by work, and gave themselves permission to be “a good enough student” and “take the pressure off”; (c) some used positive self-talk, and others encouraged themselves to set a better work-life balance and to engage in nurturing activities; (d) however, not all participants found it easy to be self-compassionate.
Dorian & Killebrew (2014).^Citation63	N= 21. Female psychotherapists in training	Course on mindfulness	10 weeks	The Constant Comparative Method of analysis (Glaser, 1965) Dedoose™ software program	(a) most students stated that practice helped them gain compassion for self and others: letting go of negative judgments; (b) this theme covers a range of qualities that allow participants an understanding of self or other in a thoughtful way; (c) it also touches the concept of “loving-kindness”, which centers on sensitive and benevolent contemplation.
Felton et al (2015).^Citation65	N=41. Master’s-level graduate students in mental health counselling	Program based on Mindfulness-Based Stress Reduction program (MBSR)	15 weeks	Content Analysis (Hsieh and Shannon 2005).	(a) increased acceptance and non-judgmental attitude toward their own clinical abilities and limits; (b) to put less pressure to perform, reply instantly, offer amazing insight, use the right skill, and to “do something”; (c) importance of boundaries when reflecting on self-compassion: “being more gentle with myself and respect my mind and body, giving myself space and time to feel vulnerable, sick, or tired, without trying to always fight it or push my limits all the time”
Gale et al (2017).^Citation67	N=10. CFT-trained therapists	Compassion Focused Therapy (CFT)	Advanced training in CFT; personal practice workshops; CFT-specific supervision	Inductive Thematic Analysis	Personal practice improved both compassion for others (particularly their clients), and self-compassion: (a) they were more aware of how they were relating to themselves; (b) enabled them to face their emotions and to cope with difficult emotions; (c) being self-compassionate also felt to be important as it meant that participants were able to be compassionate toward others.

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