Brief Emotion-Focused Therapy for Self-Criticism: A Comparison With a Cognitive-Behavioral Therapy Approach

Measured using the Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS).

The FSCRS provides separate scores for Inadequate Self, Hated Self, and Reassured Self. Scores range from 0 to 4, where higher scores indicate greater levels of the respective self-critical or self-reassuring tendencies.

Reduction in the Inadequate Self and Hated Self subscales indicates improvement in self-criticism, while increases in Reassured Self indicate improvement in self-compassion.

Measured using the Clinical Outcome in Routine Evaluation-10 (CORE-10), a Measure of Global Symptomatology.

The CORE-10 is a brief, self-report measure of general psychological distress experienced over the past week. It consists of 10 items assessing symptoms such as of anxiety, depression, daily functioning, and risk to self.

Each item is rated on a 5-point Likert scale (0 = not at all to 4 = most or all of the time). Item scores are summed to yield a single total score ranging from 0 to 40, with higher scores indicating greater psychological distress and symptom severity.

No subscale scores are calculated. The CORE-10 is widely used in clinical and research settings to monitor treatment outcomes and change over time.

The MHC-SF is a 14-item self-report measure of global mental health and wellbeing, assessing emotional, social, and psychological well-being over the last week. Items are rated on a 6-point Likert scale reflecting the frequency of specific feelings or experiences (0 = never to 5 = every day). Item scores are summed to produce a total score ranging from 0 to 70, with higher scores indicating greater overall well-being. The MHC-SF provides a global index of positive mental health and is widely used in clinical and research settings to assess well-being and monitor mental health changes over time.

Measured using the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is a self-report measure designed to assess the presence and severity of depressive symptoms over the past week. It consists of 9 items that correspond to the diagnostic criteria for major depressive disorder, including mood, sleep, appetite, energy, concentration, and suicidal thoughts. Each item is rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day). Total scores range from 0 to 27, with higher scores indicating greater depressive symptom severity. The PHQ-9 is widely used in both clinical practice and research for screening, diagnosis, and monitoring treatment outcomes.

Measured using the GAD-7 (Generalized Anxiety Disorder - 7-item scale):

GAD-7 is a brief self-report measure used to assess the severity of generalized anxiety symptoms over the past week. It consists of 7 items evaluating common anxiety-related experiences, including nervousness, uncontrollable worry, restlessness, irritability, and difficulty relaxing. Each item is rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day). Total scores range from 0 to 21, with higher scores indicating greater severity of anxiety. The GAD-7 is widely used in clinical and research settings for screening, assessing symptom severity, and monitoring treatment outcomes.

Measured using: Rosenberg Self-Esteem Scale (RSES). The RSES is a widely used 10-item self-report measure assessing global self-esteem and an individual's overall sense of self-worth and self-acceptance. Each item is rated on a 4-point Likert scale (0 = strongly disagree to 3 = strongly agree). Item scores are summed to produce a total score ranging from 0 to 30, with higher scores indicating greater self-esteem. The RSES is commonly used in both research and clinical settings to evaluate self-esteem levels and monitor changes over time.

Measured using Positive and Negative Affect Schedule (PANAS). The PANAS is a 20-item self-report measure designed to assess two primary dimensions of affect: positive affect (PA) and negative affect (NA). Each dimension consists of 10 items describing specific feelings and emotions, such as enthusiasm, alertness, distress, or nervousness. Respondents rate the extent to which they have experienced each feeling over the last week on a 5-point Likert scale (1 = very slightly or not at all to 5 = extremely). Scores for each subscale range from 10 to 50, with higher scores indicating stronger positive or negative affect. The PANAS is widely used in clinical and research settings to assess mood, emotional states, and changes in affect over time.

Measured using: Self-Compassion Scale (SCS). The SCS is a 26-item self-report measure assessing an individual's tendency to be kind and understanding toward oneself in times of difficulty or failure. Items cover six components of self-compassion: self-kindness, self-judgment, common humanity, isolation, mindfulness, and over-identification. Each item is rated on a 5-point Likert scale (1 = almost never to 5 = almost always). Higher total scores indicate greater levels of self-compassion. The SCS is widely used in research and clinical settings to evaluate self-compassion, emotional resilience, and related psychological outcomes.

Measured using: Working Alliance Inventory - Short Revised (WAI-SR).

The WAI-SR is a 12-item self-report measure assessing the quality of the therapeutic alliance between a client and therapist. It evaluates three key dimensions: agreement on goals, agreement on tasks, and the development of a personal bond.

Each item is rated on a 7-point Likert scale (1 = rarely or never to 7 = always), with total scores ranging from 12 to 84. Higher scores indicate a stronger perceived therapeutic alliance.

In this study, the WAI-SR is assessed only before Session 5 to capture the early formation of the client-therapist relationship. Measuring at Session 5 provides a balance, reflecting a stabilized alliance while minimizing bias from treatment completion.