The effectiveness of a compassion focused therapy-informed intervention for a young person experiencing shame associated with harmful sexual behaviour: A case study report

Background: Shame is hypothesised to influence young people’s engagement in harmful sexual behaviour (HSB) through complex interactions. Compassion focused therapy (CFT) was in-part developed to address shame through the cultivation of affiliative and caring processes, and may therefore support HSB risk reduction. There is, however, limited foundation concerning the application and effectiveness of CFT in supporting young people who experience shame relating to HSB both experienced and perpetrated. Objective: This case study presents the development and delivery of a concurrent individual and family-based CFT-informed intervention for a young person experiencing shame associated with HSB and adverse childhood experiences. Results: Psychometric assessment of socially desirable responding met cut-off criteria, suggesting self-report measures administered pre- and post-intervention may be invalid. Standardised assessment of experienced shame, psychological distress, health and social functioning and clinical outcomes is presented but should be interpreted with caution. Self-deceptive enhancement demonstrated a statistically reliable reduction post-intervention. Through qualitative feedback, the young person reported a reduction in shame and improved psychological wellbeing, supported by behavioural observation. Caregivers reported greater understanding of the young person, an increase in reparative actions and support amongst the family, and reduced familial conflict. Conclusions: Results indicate that this joint individual and family-based CFT-informed intervention was feasible and therapeutic for the young person and their caregivers. Identification of the young person’s predominant experience of external shame and related ego-protective strategies necessitated adaptations to traditional approaches to CFT intervention. The importance of adopting a systemic approach to reducing external shame to promote wellbeing and HSB risk reduction is discussed. N.b., a bibliography for this work is available at: https://osf.io/kqe9d/?view_only=4b367c8f229b4ef2bf2e529ed87525f8 This research output was originally presented at the Institute of Mental Health Research Day 2024 on 7 July 2024.