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Table 3 Guiding principles for the self-compassion intervention

From: Planning and designing a self-compassion intervention for family carers of people living with dementia: a person-based and co-design approach

Key issue Design objective Key intervention features
Self-compassion is an unfamiliar term to many family carers of people living with dementia and it is often understood in relation to the concept of compassion more broadly • To provide family carers of people living with dementia with a better understanding of what self-compassion is and how it relates to the concept of compassion more broadly (i.e., compassion for self, to others, from others) ¬ Provide a clear definition of compassion and define self-compassion within the concept of compassion more broadly (i.e., compassion for self, to others, from others)
¬ Differentiate compassion with similar concepts/feelings (i.e., empathy, sympathy, apathy, self-esteem)
¬ Highlight evidence-base supporting the benefits of compassion
¬ Use clear, simple, non-academic language
Self-compassion is generally perceived as a positive concept; however, some family carers of people living with dementia will hold negative perceptions and may be initially resistant to the idea of self-compassion • To address and clarify family carers’ misperceptions of self-compassion and facilitate understanding about why family carers of people living with dementia may feel resistant to the idea of being self-compassionate ¬ Address and clarify family carers’ potential discomfort to the idea of self-compassion (e.g., societal expectations, cultural influences etc.).
¬ Frame self-compassion as beneficial to the caregiving role, but not as a panacea/fix-all
¬ Use examples and metaphors that relate to the caregiving role
Family carers’ ability to cultivate self-compassion may be inhibited by the demands and nature of the caregiving role • To highlight the practical blocks to cultivating self-compassion in the caregiving role and focus on using exercises and practices that can be easily incorporated into family carers’ daily lives ¬ Validate the 24/7 demands of the caregiving role that can make cultivating self-compassion hard
¬ Highlight the relationship between the three aspects of compassion (i.e., compassion for self, to others, from others) and how the outward focus of the role (compassion for others) might influence their ability to be self-compassionate
¬ Use exercises and practices that can be easily incorporated into family carers’ daily lives/routines
Some family carers of people living with dementia may have limited capacity and willingness to engage in self-compassion for fear of emotional reflection that could lead to feelings of shame, guilt, and self-criticism • To address and validate family carers’ fears of self-compassion and facilitate understanding about how self-compassion may help with feelings of shame, guilt, and self-criticism ¬ Validate the need to ‘keep going’ as a family carer and the fear of emotional reflection, but highlight the costs of not attending to the emotional needs of the self
¬ Deliver psychoeducation on how self-compassion can help with feelings of shame, guilt, and self-criticism
Implementation of the intervention may be enhanced by considering issues related to pitch, mode of delivery, facilitation, and alternative care support arrangements • To address practical issues that could inhibit family carers’ attendance and consider factors that may hinder implementation ¬ Promote the intervention using simple language, emphasising an explicit focus on the carer but with benefits to the caring role more broadly
¬ Offer different/mixed modes of delivery to support carer learning and attendance needs
¬ Throughout the intervention address differences in understandings, perceptions, and experiences of compassion depending on the family carers’ background characteristics (i.e., relationship; family dynamics; age; culture; gender etc.)
¬ Emphasise delivery by trained facilitators
¬ Help/sign-post family carers to access care support arrangements (both formal and informal) to enable attendance