Compassion Focused Group Therapy for University Counseling Centers

A Clinician’s Guide

Kara Cattani, Derek Griner, David M. Erekson, Gary M. Burlingame, Mark E. Beecher, Cameron T. Alldredge

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781000436969
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Compassion focused therapy (CFT) articulates an approach that faces suffering head-on to understand, alleviate, and prevent suffering in ourselves and in others. Compassion Focused Group Therapy for University Counseling Centers is a one-of-a-kind 12-session manual for conducting compassion focused group therapy on university campuses with students presenting a diverse set of complex mental health concerns.

Beginning with suggested readings designed to enrich understanding of the principles covered, each module presents psychoeducation interventions, engaging intrapersonal and interpersonal exercises, and process-oriented instructions. Modules can be followed session-by-session or adapted according to the needs of the group. Eye-catching handouts are included at the end of the modules to help leaders provide visual representation of the themes discussed in each session.

This manual is designed to be used by licensed clinicians and should be used in conjunction with the manual's companion Compassion Focused Therapy Participant Workbook which provides clients with summaries of each session, handouts, and key exercises.

Module 1: Introduction, Compassion, & Tricky Brain

DOI: 10.4324/9781003202486-1

REMEMBER: Do not sacrifice the moment for the manual. Allow the group to process throughout. If you find yourself explaining for long periods of time, you are probably doing too much. Be sure to attend to diversity within the group and be aware of ways that fears, blocks, and resistances may be both similar and different for members from marginalized and majority groups.

Therapist Readings

• Mindful Compassion: Chapters 1 and 2
• Compassionate Mind: Chapter 2
• Compassion Focused Therapy: Clinical Practice and Applications: Chapters 2, 8, and 16

Overall Aims

• Establish group rules, norms, and safety.
• Define what compassion is and is not.
• Discuss the flows of compassion.
• Talk about our tricky brains and evolutionary theory.
• Discuss ways our minds get into unhelpful loops that we have the power to change.
• Explore compassionate wisdom.
• Wrap up with a compassionate cultivation meditation.

Establish Group Rules, Norms, and Safety

Materials: Handout 1.1

Review Group Rules and Norms

Invite group members to discuss group rules (Handout 1.1)

Step In/Me Too Exercise

One way to establish cohesion early on is to have clients discuss reasons that they are attending group and reasons that this may be scary for them.

Have clients stand in a circle. Ask each person to share:

1. a concern that prompted them to attend the group, and
2. a fear/worry/concern about attending the group.

Instruct group members to step forward into the circle each time they relate to what another client is expressing. Before each new person begins to share, all group members return to their original positions in the circle in order to allow for stepping forward when relating to a new topic.

As you do this exercise, keep an eye out for people whose goals are to get rid of things and discuss this early on. Establish that CFT is about learning how to work with difficulties rather than getting rid of them.

Background/Group Overview

Today we’re going to introduce you to compassion focused therapy, (CFT). CFT is a bio-psycho-social model, which means that we will focus on the impacts that biology, psychology, and social environments have on each of us. In this group, speaking up and sharing our experiences will be far more important than any of the content we may cover. So please, be sure to share your thoughts, insights, worries, and concerns.

During our time together over the next several weeks, we hope to help everyone increase wisdom and understanding of how our hardware (brain) and software (past experiences) affect our daily lived experience. Throughout the group, we’re going to introduce skills to help change behaviors. The skills we learn in this group are like any other skill—the more you practice, the better you get. We’ve found that people who practice the skills we teach here on a daily basis tend to make significant progress. Please, practice the skills that we talk about during group outside of group.

Today we’re going to talk about what compassion is and is not. We’re also going to talk about the three core qualities of compassion: strength, wisdom, and commitment. These are ideas that we’ll continue to use throughout our group.

CFT Definition of Compassion

In order to help clients understand what compassion is and is not, it is often very helpful to do the following guided imagery exercise:

Since this is a compassion focused therapy group, it’s useful for us to think about what we mean when we use the word compassion. You probably have your own insights as to what compassion is. To help you recognize that you already have an understanding of compassion, I want you to go ahead and slow your breath for just a moment and, if you’re comfortable, close your eyes and really bring an event to mind in which you helped someone who was struggling. (Pause) As you’re doing this, don’t focus too much on their distress, but on what was happening in you. (Pause) Go ahead and allow yourself to reflect on this for a moment. (Pause)

What was going on in your mind? What were you thinking?

Process.

What were you feeling?

Process.

And what did you want to do?

Process.

Validate the intuitive wisdom of the group for the answers they provide. Using the whiteboard, ask clients to define compassion. Create two columns: one for what compassion is, and one for what compassion is not.

Thinking about your own experiences with compassion, as well as compassionate people you know, let’s try to come up with some definitions for what compassion is.

Process. Write group members’ responses in the appropriate columns.

Ideas to cover if they are not brought up by group members:

• Compassion is not stupid or weak, but actually uses wisdom, strength, and commitment.
• Compassion is dedicated to being helpful to ourselves and others.
• Compassion is not just being nice or kind.
• Compassion is not complacency (e.g., sitting around and watching television all day, skipping class to go to the movies, etc.).
• Compassion is not just feeling sorry for people.
• Compassion is not being submissive. In fact, compassion can be quite assertive.
• Compassion is also not necessarily about love. It’s easy to be compassionate with those we do love, but compassion for those we don’t love or like is harder. Compassion doesn’t mean we have to like people. It simply means that we don’t wish to cause them harm; and if they are suffering, we would try to help them. Again, we might not even like the person, but we can be compassionate toward them.

Compassion focused therapy defines compassion as: “Sensitivity to suffering and distress in self and others with a commitment to try to alleviate and prevent it.” One insightful group once defined compassion as: “empathy in action.” (Write these definitions on the whiteboard.) As you can see, compassion requires both understanding and action. For example, when a kid skins their knee, they need comforting and a bandage. Only a bandage or only comforting are often not enough. If a person goes to a doctor with a broken arm and the doctor only validates, this really doesn’t heal a broken arm. The doctor needs to have training and have gained wisdom to know what to do with a broken arm.

There are three key qualities that help enable the development of compassion: (1) wisdom, (2) strength, and (3) commitment. (Write these qualities on the whiteboard.)

Flows of Compassion

As we’ve been defining what compassion is, you’ve probably noticed that compassion can flow in many directions. We can be compassionate to others, we can receive compassion from others, and we can receive compassion from ourselves. It is common for people to have blocks toward compassion for a wide variety of reasons. For some, it is easy to give compassion to others, but difficult to receive from others. For some, it may be easy to receive compassion from others, but difficult to give.However, the flow of compassion from oneself toward oneself is often the most difficult for people, and people resist it the most.

Does that sound accurate? Which flows are easy/hard for you? How does that play out in here?

Process.

Tricky Brain, Genes, Evolution

Materials: Handouts 1.2 and 1.3

Let’s talk more about the wisdom component of compassion. Wisdom is based on understanding and knowledge. As we learn more about why our minds function the way they do, we will be better able to engage with suffering and solve difficult problems. The human body and mind have all kinds of difficulties wired into them, through no fault of our own.

Think ab...

Table of contents

• Cover
• Endorsements
• Half Title
• Title Page
• Copyright Page
• Dedication Page
• Contents
• List of Handouts
• Foreword
• Acknowledgements
• Introduction
• Module 1 Introduction, Compassion, & Tricky Brain
• Module 2 Three Systems of Emotion
• Module 3 Mindfulness
• Module 4 Feeling Safe and Receiving Compassion from Others
• Module 5 Compassionate-Self
• Module 6 Multiple Selves
• Module 7 Self-Criticism
• Module 8 Shame and Guilt
• Module 9 Deepening Compassion for the Self
• Module 10 Compassionate Assertiveness
• Module 11 Forgiveness
• Module 12 Envisioning a Compassionate Future
• Index