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

<i>Background:</i> 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.<i>Objective:</i> 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.<i>Methods:</i> 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 (<i>n</i> = 15) receiving eight weekly 70-minute CFT sessions based on Gilbert's protocol, or a no-intervention control group (<i>n</i> = 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.<i>Results:</i> Compared to the control group, the CFT group showed significant and large reductions at post-test in NSSI severity (adjusted mean diff: -3.20, <i>F</i>(1,27) = 76.75, <i>p</i> < 0.001, <i>η</i>² = 0.74), shame (adjusted mean diff: -3.59, <i>F</i>(1,27) = 35.50, <i>p</i> < 0.001, <i>η</i>² = 0.57), and self-criticism (adjusted mean diff:-16.53, <i>F</i>(1,27) = 215.59, <i>p</i> < 0.001, <i>η</i>² = 0.89). The control group showed no significant changes.<i>Conclusion:</i>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.