Les troubles anxieux et dépressifs, fréquents et souvent comorbides, sont difficiles à traiter avec des approches centrées sur un seul trouble comme la thérapie comportementale et cognitive (TCC). Les modèles transdiagnostiques ciblant des processus psychologiques communs offrent une alternative. La thérapie fondée sur la compassion (TFC) s’adresse aux patients présentant honte et autocritique élevées, souvent liées à des expériences adverses précoces. En s’appuyant sur la psychologie évolutionniste, la théorie de l’attachement et les neurosciences affectives, la TFC vise à renforcer l’auto-apaisement et la bienveillance envers soi, contribuant à réduire les symptômes anxiodépressifs. Cette revue de la portée synthétise les données disponibles sur son efficacité.

Une étude de la portée a été réalisée via PsycINFO, PubMed, CINAHL, Web of Science, Google Scholar et la littérature grise pour recenser systématiquement les publications de 1984 à 2024 sur l’effet de la TFC sur les symptômes anxieux et dépressifs chez l’adulte.

Les études recensées présentent une hétérogénéité méthodologique importante. La majorité rapporte une réduction des symptômes anxieux, dépressifs ou mixtes après TFC, bien que quelques travaux ne montrent pas de différence significative. Les participants incluaient patients psychiatriques, échantillons non cliniques et individus présentant des affections somatiques. Les interventions, majoritairement groupales, comprenaient 8 à 12 séances et mobilisaient principalement l’imagerie compassionnelle, le développement du soi compatissant et la pleine conscience. L’autocompassion émerge comme mécanisme principal, accompagnée de la réduction de l’autocritique et de l’amélioration de l’auto-réassurance, suggérant un effet par renforcement de la bienveillance envers soi et autrui et par une meilleure régulation émotionnelle.

La TFC apparaît prometteuse pour réduire les symptômes anxiodépressifs. Toutefois, l’hétérogénéité des études et le faible nombre d’essais contrôlés limitent les conclusions. Des recherches rigoureusement conçues sont nécessaires pour confirmer son efficacité et préciser ses mécanismes et conditions optimales d’intervention.

Anxiety and depressive disorders are among the most common psychiatric conditions and have a high comorbidity rate. While cognitive behavioral therapy (CBT) remains the gold standard psychotherapeutic treatment, its protocols which focus on a specific disorder have limitations when faced with clinical complexity. Transdiagnostic approaches aim to overcome these constraints by targeting processes common to different mental disorders. Compassion-Focused Therapy (CFT) is part of this approach. It is particularly aimed at patients with overwhelming shame and marked self-criticism, often linked to early adverse experiences and associated with resistance to treatment. Drawing on evolutionary psychology, attachment theory, and affective neuroscience, CFT seeks to restore the ability to self-soothe and cultivate self-compassion, which can reduce anxiety and depressive symptoms, among other benefits. This scoping review aims to synthesize the available data on the effectiveness of CFT in the treatment of anxiety and depressive disorders.

A scoping review was conducted using the PsycINFO, PubMed, CINAHL, Web of Science, and Google Scholar search engines, as well as gray literature to include unpublished studies, so as to systematically identify articles published between 1984 and 2024 on the effect of CFT on anxiety and depressive symptoms in adults.

The included studies were highly heterogeneous in terms of methodology. The majority reported a significant reduction in anxiety ( n = 11), depression ( n = 14), and anxiety-depressive symptoms ( n = 30) after the intervention, while others showed no significant difference in anxiety ( n = 7), depression ( n = 2), or anxiety-depressive symptoms ( n = 3) compared to control groups (waiting list, usual treatment, other therapies). Participants came from a variety of populations: psychiatric patients (mood disorders, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, psychotic disorder, personality disorder, bulimia, dementia) (51 %, n = 32), non-clinical samples (students, parents, teachers, the general public) (31 %, n = 20), or subjects with somatic conditions (irritable bowel syndrome, cancer, pain, chronic illness, acne, multiple sclerosis, cardiovascular disease) (14 %, n = 9). CFT, most often delivered in groups ( n = 44, 70 %) of 8 to 12 sessions ( n = 22), generally lasting 90 to 120 minutes ( n = 26), mainly incorporated compassionate imagery techniques ( n = 39), development of a compassionate self ( n = 37), and mindfulness practices ( n = 36). Self-compassion was the most frequently identified mechanism of action ( n = 21). Other mechanisms explored included self-criticism ( n = 14), self-reassurance ( n = 11), fears related to self-compassion ( n = 8), fear of compassion towards others ( n = 5), ability to receive compassion from others ( n = 5), ability to offer compassion to others ( n = 5), rumination ( n = 3), comparison between oneself and others ( n = 3), and physiological factors such as heart rate variability ( n = 2). These results suggest that CFT may exert its effects by promoting a more compassionate and accepting relationship with oneself and others, reducing self-criticism, and improving emotional regulation.

CFT appears to be a promising approach for reducing anxiety and depression symptoms. However, the heterogeneity of the studies and the lack of randomized controlled trials limit the scope of the conclusions. Additional rigorously designed research is needed to confirm its effectiveness, clarify the conditions under which it is most effective, and specify its mechanisms of action.