Compassion-focused approaches in forensic and inpatient mental health services: a systematic review

Purpose Compassion-focused approaches were developed to support individuals with complex and chronic mental health needs and aimed to increase the ability to develop compassion in individuals who experience high levels of shame and self-criticism. This systematic literature review explored the use and effectiveness of compassion-focused approaches with people in inpatient mental health and forensic settings, who often experience these emotions. The purpose of this paper is to present the findings of the systemati literature review, and to outline future implications for practice. Design/methodology/approach A systematic literature review, following PRISMA guidelines (Page et al., 2021) was conducted with methodological quality assessed by the Mixed Methods Appraisal Tool (MMAT: Hong et al., 2018). Nine databases were searched on 25 January 2023 and included articles published up to and including 31 December 2022. Findings Twelve studies were reviewed, with variable methodological quality. Compassion-focused approaches included group intervention for both patients and staff (e.g. compassion-focused therapy, mindfulness self-compassion and recovery after psychosis) and an individual intervention for adolescents detained in a prison, aimed at reducing psychopathic traits and disruptive behaviour. The synthesis of studies indicated that compassion-focused approaches were being used, with positive outcomes reported across all 12 studies that focused on a variety of mental health and criminogenic needs. Issues related to methodological quality and gender representation within participant samples were identified. Practical implications Findings indicated that compassion-focused approaches improved self-compassion and compassion for others, while reducing fear of threat and shame. Originality/value To the best of the authors’ knowledge, this is the first systematic literature review focusing specifically on the use of compassion-focused approaches within inpatient mental health and forensic settings.