Brain Impairment


Compassion Focused Therapy After Traumatic Brain Injury: Theoretical Foundations and a Case Illustration

Fiona Ashwortha1 c1, Fergus Graceya2 and Paul Gilberta3

a1 The Oliver Zangwill Centre, the Princess of Wales Hospital, United Kingdom.

a2 The Oliver Zangwill Centre, the Princess of Wales Hospital, United Kingdom.

a3 University of Derby, Mental Health Research Unit, United KIngdom.


Acquired brain injury (ABI) commonly results in a range of interacting difficulties including regulating emotion, managing social interactions and cognitive changes. Emotional adjustment to ABI can be difficult and requires adaptation of standard psychological therapies. This article outlines a case where cognitive– behavioural therapy (CBT) was of limited effectiveness but was significantly enhanced with compassion focused therapy (CFT). This article describes Jenny, a 23-year-old woman who suffered a traumatic brain injury 3 years prior to attending rehabilitation. Jenny presented with low self-esteem and mental health difficulties. Neuropsychological assessment revealed executive functioning difficulties. Jenny entered a holistic neuropsychological rehabilitation program aimed at improving complex interacting difficulties, receiving CBT as part of this. As CBT was of limited effectiveness, reformulation of Jenny's difficulties was presented to her based on CFT. The CFT intervention employed aimed to help Jenny develop self-validation and acceptance through producing feelings of kindness and warmth. Shifting the affective textures to the self is a key process for CFT. Self-report measures of mental health and self-esteem showed positive changes and the usefulness of CFT for Jenny. Adaptations in the context of Jenny's ABI are discussed. In conclusion, CFT may be useful in conceptualising emotional responses and developing intervention in rehabilitation after ABI, especially because CFT is based on a neurophysiological model of affect regulation that pays particular attention to the importance of affiliative emotions in the regulation of threat-focused emotion and self-construction.


  • compassion;
  • positive emotion;
  • emotion regulation;
  • brain injury


c1 Address for correspondence: Fiona Ashworth, The Oliver Zangwill Centre, The Princess of Wales Hospital, Lynn Road, Ely, Cambridgeshire, CB6 1DN, United Kingdom.