Compassion Focused Therapy as a Treatment for Body Weight Shame Associated with Obesity.

INTERVENTION: Compassion focused therapy will be delivered to participants across 12 x 2 hour sessions. The intervention will be co‐facilitated by an experienced registered clinical psychologist and a provisional health psychologist at the University of Queensland, Brisbane. The procedures, activities and processes used will follow the 12 week therapy protocol of Compassion Focused Therapy titled 'Compassion Focused Therapy: Group Manual' by Gilbert, Kirby and Petrocchi (in press). It will be delivered face to face in a group therapy format. Covering understanding the mind, mindfulness, compassion and compassion cultivation. The Compassion Focused Group Therapy program is comprised of approximately one 2‐hour session per week. The program will focus on practices including: (1) a soothing rhythm breathing practice; (2) a practice focused on creating friendly facial expressions and voice tones as part of compassion; (3) a practice aimed to develop mindfulness and increase attention to one’s current mental state; (4) a practice aimed to develop the sense of a compassionate self that is based upon feelings of wisdom, strength and commitment to be supportive and helpful to self and others; (5) an imagery practice aimed to develop a compassionate image of another mind that has caring intent towards the self; and (6) a practice aimed to develop a compassionate self that has caring intent towards the self and how to use compassion focusing to work with self‐criticism and life difficulties. Below is weekly agenda outlining the content covered during each session: 1. An introduction to compassion 2. Fears and blockers, the balancing effect of compassion and a compassion focused reality check 3. Mindfulness and soothing, rhythm, breathing 4. Introduction to compassion from others 5. Introduction to the compassionate self 6. Self‐criticism 7. Shame and guilt 8. Compassion for self 9. Understanding of our multiple selves 10. Compassion for others 11. Compassion assertiveness 12. Wrap‐up content and reflection Inclusion criteria (obesity ‐ as determined by body weight index and body weight shame) will be assessed over the phone as self reported measures when participant interest is expressed. Availability, participants must agree to attend all sessions. If they are unavailable to commit to the required therapy times they will not be allowed to participate in the study. All participants must be over the age of 18. Assessment items (pre and post) will be administered online via Qualtrics for self‐report surveys and in person for physiological assesment. Participants will be asked if they wish to complete follow‐up assessment items administered online via Qualtrics 6‐months after the completion of the intervention. Participants attendance will be reordered via a roll check list at the start of each session by the lead researcher. Groups will consist of approximately 6 participants as per previous research recommendations (Dutton et al 2014). CONDITION: Anxiety Compassion Depression General psychological well‐being Obesity Stress PRIMARY OUTCOME: Body weight shame. Measured through the following online, self report survey: ; • Body weight shame (BISS) ; ; Body image shame scale (BISS) is a valid and reliable measure for the assessment of body image shame (Duarte, Pinto‐Gouveia, Ferreira & Batista., 2014). ; ; All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. ; • Eating Attitudes Test (EAT) ; ; The EAT has been deemed a valid and reliable across previous research in clinical and non clinical populations. INCLUSION CRITERIA: 1) Age (over the age of 18+) SECONDARY OUTCOME: Compassion comprises of two outcome measurements. The first outcome is compassion, engagement and action. Measured through the online, self‐report Compassion, Engagement and Action Scale (CEAS). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. Compassion comprises of two outcome measurements. The second outcome is fears of compassion. This is measured through the Fears of Compassion Scale (FOCS). ; All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. Mental health will be measured through four scales: The first outcome will be depression, stress and anxiety measured by: Depression, Stress and Anxiety Scale (DASS) All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. 2) Body weight shame (score greater than 2 on the body weight shame scale) 3) Obesity (as measured through body mass index) ; Process variables consist of 7 outcome measures. The fifth of which is a sense of failed struggle and losing rank. This is measured online, through self‐report on the Defeat Scale (DScale). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. Process variables consist of 7 outcome measures. The final of which is group cohesion. This is measured online, through self‐report on the Group Cohesion Questionnaire (GCQ). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. Process variables consist of 7 outcome measures. The first of which is social identification as Obese. This is measured online, through self‐report on the single item social identity measure (SISI). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. Process variables consist of 7 outcome measures. The fourth of which is behavioural submission and depression. This is measured online, through self‐report on Submissive Behaviour Scale (SBS). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. Process variables consist of 7 outcome measures. The second of which is social identification as a member of the therapy group. This is measured online, through self‐report on the single item social identity measure (SISI). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. Process variables consist of 7 outcome measures. The sixth of which is the completion of the work practice diary. This is measured online, through self‐report on the a checklist of completing practice tasks. The practice diary is an element of the CFT manual. Process variables consist of 7 outcome measures. The third of which is the perception of social rank and social standing. This is measured online, through self‐report on Social Comparison Rating Scale (SCRS). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. The final measurement of Mental Health will be acquired through the online self‐report measure of criticism and reassurance outcomes. This is achieved through the Forms of Self‐Criticising/Attacking and Self‐Reassurance Scale (SCASRS). All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. The fourth secondary outcome measure is: Physical changes. Measured through Heart Rate Variability assessment preformed by EEG studies. The second element of mental health, mental well being outcome, will be measured through the Mental Well‐being (WEMWB) scale. All scales have been deemed valid and reliable across previous research in clinical and non clinical populations. The third element of mental health, will be measured by assessed levels of internal shame, external shame, proneness to shame, guilt, pride and detachment outcomes. This will be measured through the Other As Shamer (OAS) scale. All scales have been deemed valid and reliable across previous research in clinical and non clinical populations The third secondary outcome measure is: Relationship with food. Measured through the following online, self report survey: