Compassion focused therapy in a university counseling and psychological services center: A feasibility trial of a new standardized group manual.

Objectives: The feasibility and acceptability of a new Compassion Focused Therapy (CFT) group protocol were assessed in a university counseling and psychological services (CAPS) center. Outcome measures included mechanisms of change, compassion, and general psychiatric distress. Method: Eight transdiagnostic CFT groups composed of 75 clients met for 12 weekly sessions. Clients completed measures of fears of compassion, flows of compassion, self-reassurance, self-criticism, shame, and psychiatric distress at pre, mid, and post time points. Self-report feasibility and acceptability data were collected from therapists and clients, respectively. Significant and reliable change was assessed along with exploratory analysis of CFT mechanisms of change using correlational analysis. Results: Significant and reliable change was found for fears of self-compassion, fears of compassion from others, fears of compassion to others, self-compassion, compassion from others, self-reassurance, self-criticism, shame, and psychological distress. Improvements in fears and flows of compassion predicted improvements in self-reassurance, self-criticism, shame, and psychiatric distress. Conclusion: The new CFT group protocol appears to be feasible, acceptable, and effective in a transdiagnostic CAPS population. The identified mechanisms of change support the theory of CFT that transdiagnostic pathological constructs of self-criticism and shame can improve by decreasing fears and increasing flows of compassion.

Establishing best practices for structured NSQIP review.

INTRODUCTION: We describe an institutional program (INR- Interval NSQIP Review), to augment NSQIP utility through structured, multidisciplinary review of surgical outcomes in order to create near 'real-time' adverse event (AE) monitoring and improve surgeon awareness. METHODS: INR is a monthly meeting of quality analysts, surgeons and nursing leadership initiated to validate AE with NSQIP criteria, review data in real-time, and perform in-depth case analyses. Occurrence classification concerns were referred for national NSQIP review. Monthly reports were distributed to surgeons with AE rates and case-specific details. RESULTS: Since implementation, 377/3,026 AE underwent in-depth review. Of those, 7 occurrences were referred for clarification by central NSQIP review. Overall 37 (1.2%) were not consistent with NSQIP-defined AE after INR. Time from occurrence to surgeon review decreased by 223 days (296 vs. 73 days, p = 0.006). DISCUSSION: Structured monthly institutional review of AE prior to submission can create greater transparency and confidence of NSQIP data, reduce time from occurrence to surgeon recognition, and improve stakeholder understanding of AE definitions. This approach can be tailored to institutional needs and should be evaluated for downstream improvement in patient outcomes.