Intervention group: compassion-focussed therapy and breathing pattern retraining
The CFT and BPR intervention will be delivered in a group format and will last approximately 90 min per group session. Group sessions will each comprise two segments, one being CFT and the other being BPR. The CFT will seek to emphasise concepts such as practising compassion, fostering self-awareness, self-soothing, mindfulness exercises, reducing self-criticism and practising kindness and inner warmth. The BPR segments will seek to introduce and develop breath work that can aid self-soothing, relaxation and bodily activation. The physicality of the breath work is largely performed by the treating psychologist (SL) but is also assisted by a senior physiotherapist from the Mater hospital by way of training videos that participants can view and use for practice. Further details of each individual session and its content are provided in Table Layout of the 6-week compassion-focussed therapy and breathing pattern retraining interventionPart 1: Breathing pattern retraining education, breathing assessment, simple breath work. Physiotherapy demo in video and simple breath workPart 2: Understanding compassion, CFT explained, model and intervention review; why we need compassion, our tricky brains and defining emotions such as shame, fear and loneliness; Monkey Mind meditation, just noticing our busy mindsPart 1: Motivation and our complex brains; understanding motives and emotions—breaking through fear and blocksPart 2: How our thoughts and images affect our minds and brains; breathing patterns—the mind–body connection. Breathing pattern retraining education—exploring the physiotherapy-led exercisesPart 1: Compassionate thinking; the 3 components of self-compassion: mindfulness, common humanity and kindness. How this links with soothing breathingPart 2: Dysfunctional breathing and stress; breathing awareness and breathing practices such as tender self-compassion break and affectionate breathingPart 1: Compassionate mind training through imagery—creating your compassionate selfPart 2: Creating your compassionate self; breathing pattern retraining techniques and practice combining compassionate imageryPart 1: From self-criticism and loneliness/fear to self-compassion. Distancing and wise observing; breaking identification with one’s thoughtsPart 2: Loving kindness meditation; visualising ideal compassionate self; using our compassionate self to work on self-criticismPart 1: Compassionate thinking, attention, behaviour and feeling; cultivating kindness; letter to self and final sessionPart 2: Looking forward—sustaining our compassionate mind; what I have learned and achieved? Reading letter-to-self using the breath