Emotion-Focused Treatment for Self-Criticism in a Nonclinical Population: RCT

López-Cavada, C., Jódar, R., Timulak, L., & Corbella, S. (2025). Emotion-focused treatment for self-criticism in a nonclinical population: A randomized controlled trial. Journal of Counseling Psychology, 72(1), 56–68. https://doi.org/10.1037/cou0000768

Rationale

Self-criticism is a pervasive issue linked to various mental health problems, including depression, anxiety, and personality disorders (Egan et al., 2011).

While research has demonstrated the efficacy of interventions like cognitive behavioral therapy (CBT) in addressing self-criticism (Felts et al., 2017), there is a growing interest in exploring alternative approaches.

Emotion-focused therapy (EFT), with its emphasis on emotional processing and self-acceptance, offers a promising avenue for treating self-criticism (Gilbert, 2009).

Previous studies have primarily focused on clinical populations, so this study adds to the growing body of literature supporting the broader applicability of EFT.

Method

This study employed a randomized controlled trial (RCT) design.

Participants were randomly assigned to either an EFT group or a wait-list control group.

The EFT group received 12 weekly sessions of EFT, while the wait-list control group received no intervention during the study period.

Assessments were conducted at pre-treatment, post-treatment, and 6-month follow-up.

Procedure:

1. Participants were recruited through online advertisements and community outreach.
2. Eligible participants completed a baseline assessment battery.
3. Participants were randomly assigned to either the EFT group or the wait-list control group.
4. The EFT group received 12 weekly sessions of EFT delivered by trained therapists.
5. The wait-list control group received no intervention during the study period.
6. Both groups completed assessments at post-treatment and 6-month follow-up.

Sample:

• The study involved 52 participants.
• The sample was predominantly female (73%).
• The mean age of the participants was 32.5 years (SD = 10.1).
• Participants were recruited from a nonclinical population, meaning they did not meet criteria for a current mental health disorder.

Measures:

• Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS): Measures self-criticism, self-attacking, and self-reassuring tendencies.
• Inadequate Self and Hated Self Scales: Subscales of the FSCRS that specifically assess feelings of inadequacy and self-hatred.
• Beck Depression Inventory-II (BDI-II): Measures severity of depressive symptoms.
• Symptom Checklist-90-Revised (SCL-90-R): Assesses a broad range of psychological symptoms, including anxiety, depression, and interpersonal problems.
• Self-Compassion Scale (SCS): Measures levels of self-compassion.

Statistical measures:

• Repeated measures ANOVAs: To examine changes in outcome measures over time (pre-treatment, post-treatment, follow-up) between the EFT and control groups.
• Effect sizes: To quantify the magnitude of the observed effects.

Results

Hypothesis 1:

EFT would lead to significant reductions in self-criticism compared to the control group.

This hypothesis was supported.

The EFT group showed significant decreases in Inadequate Self and Hated Self scores from pre-treatment to post-treatment and follow-up, while the control group did not.

Hypothesis 2:

EFT would lead to significant improvements in depression, general distress, self-compassion, and self-reassurance compared to the control group.

This hypothesis was partially supported.

The EFT group showed significant improvements in depression, general distress, self-compassion, and self-reassuring scores, while the control group did not.

However, there were no significant changes in self-attacking scores in either group.

Insight

This study provides compelling evidence for the effectiveness of EFT in reducing self-criticism and improving overall psychological well-being in a nonclinical population.

The findings are particularly informative because they suggest that EFT can be beneficial even for individuals who do not meet criteria for a clinical diagnosis.

This opens up the possibility of using EFT as a preventive measure to help individuals develop healthier coping mechanisms and emotional regulation skills. T

The study also highlights the importance of addressing self-criticism, as it is a transdiagnostic risk factor for various mental health problems.

Future research could explore the mechanisms through which EFT works to reduce self-criticism. It would also be valuable to investigate the long-term effects of EFT and compare its efficacy to other interventions, such as CBT or mindfulness-based therapies.

Clinical Implications

The findings of this study have important implications for practitioners and policymakers.

EFT can be integrated into mental health services as an effective intervention for self-criticism, even in the absence of a clinical diagnosis.

This could lead to earlier intervention and prevention efforts, potentially reducing the burden of mental health problems associated with self-criticism.

Policymakers could consider incorporating EFT into mental health programs and promoting its use in community settings.

However, there are also challenges to implementing EFT on a wider scale.

EFT requires specialized training, and there may be a shortage of qualified therapists.

Additionally, EFT may not be suitable for all individuals, particularly those with severe mental health disorders.

Therefore, careful consideration should be given to matching individuals with the appropriate intervention based on their specific needs and circumstances.

Strengths

• Randomized controlled trial design, which enhances internal validity.
• Use of validated measures to assess outcome variables.
• Inclusion of a follow-up assessment to evaluate the long-term effects of EFT.

Limitations

• The sample size was relatively small.
• The sample was predominantly female, which may limit the generalizability of the findings.
• The study did not include a direct comparison with other interventions, such as CBT.

References

López-Cavada, C., Jódar, R., Timulak, L., & Corbella, S. (2025). Emotion-focused treatment for self-criticism in a nonclinical population: A randomized controlled trial. Journal of Counseling Psychology, 72(1), 56–68. https://doi.org/10.1037/cou0000768

• Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 31(2), 203–212. ¹  
• Felts, A. B., Holmberg, E. B., & Hope, D. A. (2017). Self-criticism and social anxiety disorder: A review of the relationship and treatment implications. Cognitive Behaviour Therapy, 46(1), 1–15.
• Gilbert, P. (2009). The compassionate mind: A new approach to life’s challenges. Constable & Robinson.

Socratic Questions

• How might the findings of this study inform the development of preventive interventions for self-criticism?
• What are the potential benefits and challenges of implementing EFT in different settings, such as schools, workplaces, or community centers?
• How might the focus on emotional processing in EFT differ from other approaches to addressing self-criticism, such as CBT?
• What are some of the ethical considerations that practitioners should be mindful of when working with clients struggling with self-criticism?
• How can individuals apply the principles of EFT to their own lives to manage self-criticism and promote self-acceptance?