Compassion-Focused Therapy for non-suicidal self-injury, shame, and self-criticism in adolescent girls: A pilot study

Background: Non-suicidal self-injury (NSSI) is common among adolescents and is often associated with suicidal behaviour. NSSI generally functions as a dysfunctional emotion regulation strategy maintained by shame and self-criticism. Compassion-Focused Therapy (CFT) aims to modify these processes through developing self-compassion.Objective: This pilot study evaluated the feasibility and preliminary effectiveness of CFT in reducing NSSI behaviours, shame, and self-criticism in adolescent girls engaging in NSSI.Methods: In this pilot quasi-experimental study, 30 self-harming adolescent girls (mean = 16.76 years; SD = 1.38 years; range = 16 to 19 years) from Tabriz, Iran (2024), were recruited via convenience sampling and randomly allocated to an experimental group (n = 15) receiving eight weekly 70-minute CFT sessions based on Gilbert's protocol, or a no-intervention control group (n = 15). The State Shame and Guilt Scale-shame subscale, the Levels of Self-Criticism Scale-internalised subscale, and the Deliberate Self-Harm Inventory were administered at pre-test and one-week post-intervention. Data were analysed using MANCOVA and follow-up univariate ANCOVAs (controlling for baseline scores) with Bonferroni correction.Results: Compared to the control group, the CFT group showed significant and large reductions at post-test in NSSI severity (adjusted mean diff: -3.20, F(1,27) = 76.75, p < 0.001, η2 = 0.74), shame (adjusted mean diff: -3.59, F(1,27) = 35.50, p < 0.001, η2 = 0.57), and self-criticism (adjusted mean diff:-16.53, F(1,27) = 215.59, p < 0.001, η2 = 0.89). The control group showed no significant changes.Conclusion:This study provides preliminary evidence supporting the feasibility and potential effectiveness of CFT in concurrently reducing NSSI behaviours, shame, and self-criticism among adolescent girls. Findings support CFT's potential as a targeted intervention addressing core mechanisms underlying NSSI in this vulnerable population, warranting further investigation with larger samples and longer follow-ups.