Elsevier

Behavior Therapy

Volume 48, Issue 6, November 2017, Pages 778-792
Behavior Therapy

A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions

https://doi.org/10.1016/j.beth.2017.06.003Get rights and content

Highlights

  • Scientific interest in compassion has increased in the last 20 years

  • There are a number of compassion-based interventions available

  • We meta-analysed 21 compassion-based intervention RCTs

  • Moderate effect sizes were found for all seven outcomes variables

  • 20 recommendations are provided to improve compassion-based intervention research

Abstract

Objective

Scientific research into compassion has burgeoned over the past 20 years and interventions aiming to cultivate compassion towards self and others have been developed. This meta-analysis examined the effects of compassion-based interventions on a range of outcome measures.

Method

Twenty-one randomized controlled trials (RCTs) from the last 12 years were included in the meta-analysis, with data from 1,285 participants analyzed. Effect sizes were standardized mean differences calculated using the difference in pre-post change in the treatment group and control group means, divided by the pooled pre-intervention standard deviation.

Results

Significant between-group differences in change scores were found on self-report measures of compassion (d = 0.55, k = 4, 95% CI [0.33-0.78]), self-compassion (d = 0.70, k = 13, 95% CI [0.59-0.87]), mindfulness (d = 0.54, k = 6, 95% CI [0.38-0.71]), depression (d = 0.64, k = 9, 95% CI [0.45-0.82]), anxiety (d = 0.49, k = 9, 95% CI [0.30-0.68]), psychological distress (d = 0.47, k = 14, 95% CI [0.19-0.56]), and well-being (d = 0.51, k = 8, 95% CI [0.30-0.63]). These results remained when including active control comparisons. Evaluations of risk of bias across studies pointed towards a relative lack of publication bias and robustness of findings. However, the evidence base underpinning compassion interventions relies predominantly on small sample sizes.

Conclusions

Future directions are provided for compassion research, including the need for improved methodological rigor, larger scale RCTs, increased specificity on the targets of compassion, and examination of compassion across the lifespan. Although further research is warranted, the current state of evidence highlights the potential benefits of compassion-based interventions on a range of outcomes.

Section snippets

Defining compassion

Definitions of compassion vary, with some defining it as an emotion (Goetz et al., 2010), others as a multidimensional construct (⁎Jazaieri et al., 2013, Strauss et al., 2016), and others as a motivational system (Gilbert, 2014). Goetz and colleagues (2010) specifically define compassion as “the feeling that arises in witnessing another’s suffering and that motivates a subsequent desire to help” (p. 351). This definition emphasizes compassion as an emotion; however, among emotion scientists,

Protocol and registration

The review protocol was prospectively registered in PROSPERO (Kirby, Tellegen, & Steindl, 2015), and our meta-analysis followed the standards of the PRISMA guidelines (Moher, Liberati, Tetzlaff, & Altman, 2009). There was no funding for this meta-analysis.

Eligibility criteria

To be included in the meta-analysis, studies had to meet the following eligibility criteria: (a) the study evaluated an intervention where one of the explicit main objectives of the intervention was to purposively generate compassion or

Study selection

The searches yielded a total of 1,918 papers. After removing duplicates, 1,510 papers remained. After assessing for eligibility, 1,439 studies were excluded as they were not an intervention study (n = 1,236), not in English (n = 12), not an adult population (n = 5), or did not include a compassion-based intervention (n = 186). After screening, 71 full-text articles were assessed for eligibility and 42 were excluded as they were not an RCT (n = 34), did not have full-text available (n = 4), did

Discussion

This is the first meta-analysis to investigate the effects of compassion-based interventions. Overall, meta-analytic techniques were performed on 21 RCT studies (containing data from 1,285 participants), which were conducted over a 12-year period, from different countries around the world (e.g., Canada, Chile, Greece, Hong Kong, Israel, Japan, Korea, Netherlands, New Zealand, Hong Kong, Spain, Sweden, and United States). There were significant pre-post intervention moderate effect sizes

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

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