Effects of Compassion-Focused Therapy on Self-criticism and Intolerance of Uncertainty in Women with Generalized Anxiety Disorder: A Randomized Controlled Trial

Abstract

Background: Generalized anxiety disorder (GAD) is characterized by persistent, excessive, and difficult-to-control worry, often exacerbated by difficulties concentrating and emotional distress. Objectives: This study aimed to evaluate the effectiveness of compassion-focused therapy (CFT) in reducing self-criticism and intolerance of uncertainty among women diagnosed with GAD at posttreatment and the 2-month follow-up. Methods: This randomized controlled trial included pretest, posttest, and 2-month follow-up assessments. Thirty women diagnosed with GAD were recruited via convenience sampling from psychology clinics in Ahvaz, Iran, in 2025 and were randomly allocated to an experimental group (n = 15) or a wait-list control group (n = 15). The experimental group participated in ten weekly 90-minute group sessions based on Gilbert's CFT protocol, whereas the wait-list control group received no treatment during the study period. Outcomes were assessed using the Levels of Self-Criticism Scale and the Intolerance of Uncertainty Scale. Data were analyzed using repeated-measures analysis of variance with Bonferroni post hoc tests. Results: Compassion-focused therapy produced significant decreases in mean self-criticism and intolerance of uncertainty scores in the experimental group at posttest and 2-month follow-up (P < 0.001, with large effect sizes), whereas the wait-list control group showed no notable changes. Conclusions: Compassion-focused therapy is an effective clinical intervention for mitigating core transdiagnostic vulnerabilities—specifically self-criticism and intolerance of uncertainty—and thereby improving psychological well-being in women with GAD.