Review of empirical findings on shame, self-compassion, and acceptance and commitment therapy

We have a new paper out in the journal Current Opinion in Psychology about shame, self-criticism, stigma, and compassion in ACT.

Five studies show ACT helps with shame and self-stigma
In this paper, we reviewed the existing research demonstrating that Acceptance and Commitment Therapy (ACT) can help with shame and what is called self-stigma, or buying into negative public attitudes related to a certain characteristic (e.g., “I’m a dirty smoker.”) At the time we wrote this paper, there were five studies showing that ACT helps to ease shame and self-stigma. These studies focused on people struggling with substance abuse, obesity, sexuality-related distress and stigma, and stigma related to HIV.

Evidence that ACT helps increase compassion
In addition to reviewing the evidence that ACT is helpful for shame and self-stigma, we also reviewed the evidence that ACT may help people to increase compassion. At the time we wrote this paper, we only found two studies looking at self-compassion in ACT. One study showed that self-compassion explained why people with chronic pain felt better after a brief ACT treatment. This study is interesting because the treatment was not enhanced with self-compassion techniques, but self-compassion increased regardless. Although ACT does not explicitly address self-compassion unless a client holds it as a value, we wonder whether ACT may help people to be more self-compassionate anyway. Acceptance includes self-acceptance, defusion may help distance from self-critical thoughts, self-as-context may help people to connect with their common humanity by accessing a transcendent self, and present moment work involves experiencing emotions while they are happening, rather than moving away from them.

Adding compassion-focused work into ACT
While it seems that ACT is inherently compassionate, it might be able to help people build even more compassion by drawing on deliberate compassion-building work. One pilot study examined this by adding compassion-focused therapy techniques into ACT, and found the combination effective in reducing HIV stigma. Recently, a randomized controlled trial using ACT to increase self-compassion has been published in the Journal of Contextual Behavioral Science. Together, these studies suggest that perhaps incorporating deliberate self-compassion work into ACT may be even more helpful than ACT without self-compassion work for people experiencing shame and stigma.​

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