CBTp vs Compassion-Focused Therapy
A side-by-side comparison: mechanism, evidence, the conditions each treats, philosophical roots, and where they actually disagree clinically.
At a glance
CBTp
- Tradition
- Cognitive-Behavioral
- Founder
- Kingdon / Turkington (1994)
- Evidence
- Guideline-recommended
- Focus
- Skill + Relational
- Format
- Individual
- Duration
- Medium-term
Compassion-Focused Therapy
- Tradition
- Cognitive-Behavioral
- Founder
- Paul Gilbert (2005)
- Evidence
- RCT-supported
- Focus
- Experiential + Skill
- Format
- Individual + Group
- Duration
- Short-medium
How they work
CBTp
Core mechanism: Normalizing psychotic experiences + examining evidence for beliefs + reducing distress associated with symptoms
Ontology: Psychotic symptoms exist on a continuum; distress is driven by appraisal of experiences, not just their presence
Compassion-Focused Therapy
Core mechanism: Activating the soothing/affiliative system through compassion practices counteracts threat-based shame and self-criticism
Ontology: Shame and self-criticism driven by overactive threat system and underdeveloped soothing/safeness system
Conditions treated
0 shared · 1 CBTp-only · 6 Compassion-Focused Therapy-only
Only CBTp
Only Compassion-Focused Therapy
What each assumes — and misses
CBTp
Philosophical roots: Jaspers (form vs. content of psychotic experience); continuum models of psychosis; social constructionism (what counts as delusional is partly social); anti-psychiatry echoes (Laing, Szasz)
Blind spots: Effect sizes debated when controlling for researcher allegiance; may underemphasize social determinants of psychosis
Therapeutic voice: You mentioned the voices got louder this week. What was happening in your life right before they intensified?
Compassion-Focused Therapy
Philosophical roots: Buddhist compassion practices (Dalai Lama, Shantideva); evolutionary psychology (Gilbert — three emotion regulation systems); attachment theory; Neff (self-compassion research)
Blind spots: Compassion imagery can paradoxically increase distress in highly shame-prone individuals initially; limited outside depression/shame
Therapeutic voice: Imagine your compassionate self — wise, strong, warm. What would that self say to you right now?
Choosing between them
CBTp and Compassion-Focused Therapy both sit within the Cognitive-Behavioral tradition — they share a worldview about what suffering is and how change happens. Differences are more often about technique and emphasis than about underlying theory.
For deeper coverage: see the full CBTp and Compassion-Focused Therapy pages, or use the interactive comparison tool to add more modalities to this comparison.