The scale, grounded in service user experience, has been developed at St Patrick’s Mental Health Services (SPMHS).
SPMHS’ Compassion Focused Therapy Group for Eating Disorders (CFT-E) offers a comprehensive psychological therapy for people managing recovery from their eating disorder in the community.
This day service programme provides education for both service users and their family members and integrates skill-building and therapeutic components for service users. It is designed to address the biological factors and psychological processes that contribute to the development and maintenance of an eating disorder.
The programme supports service users to cultivate greater self-compassion and promotes social connection and belonging.
The Swift CFT-E Scale
The Swift CFT-E Scale, co- developed by Elizabeth O’Brien, Psychologist in Clinical Training at SPMHS, as part of her doctoral research on the University College Dublin (UCD) Clinical Psychology Programme, is designed to support assessment and treatment monitoring within CFT-E groups. This work was undertaken in partnership with SPMHS, UCD, and the University of Ulster (UU), under the supervision and guidance of Professor Gary O’Reilly, Professor Mark Shevlin, Adjunct Professor Clodagh Dowling and Sean Blake from our Service User and Supporters Council.
Building on established research
The Swift CFT-E Scale, named in honour of our founder, Jonathan Swift, is derived from qualitative themes identified in earlier published doctoral research conducted at UCD by Dr Georgina Mullen, which examined participants’ experiences of the SPMHS CFT-E programme (Mullen, et al., 2019 DOI: 10.1002/capr.12283)
In that study, service users were interviewed before and after completing CFT-E around their relationship with themselves, with others, and with their eating disorder. The rich qualitative data generated a set of themes that formed the conceptual foundation for the development of this new measure.
A rigorous development process
A team of CFT-E experts were presented with the themes from Dr Mullen’ s research and asked to generate 10 questionnaire items for each theme. These experts and service users rated the best items for each theme, reducing the item set to 60.
The 60 items were then administered to 720 adults drawn from a purposely collected, nationally representative sample in the United Kingdom to further reduce the item pool to 19 items for the Swift CFT-E Scale.
The four subscales
The final result is a 19-item scale with four subscales that include:
1. Emotional Dysregulation (5 items)
2. Safety Behaviours (5 items)
3. Body Shame (4 items)
4. Self-Compassion (5 items)
Designed for clinical practice
Designed for use in clinical practice, the scale can now be administered to service users as part of pre-intervention assessment, with results interpreted against our nationally representative dataset. It may also be re-administered during and after intervention to monitor progress over time, enabling the measurement of individual change while maintaining reference to national benchmarks.
Benefits for service users
The measure reflects lived experience and therapeutic themes identified by service users which then captures their experience and outcome in a briefer, more concise format than the previous four measures that were administrated prior to this development.
The scale can offer a clear understanding of a service user’s presentation at the beginning of treatment. In monitoring changes over time, progress in treatment can be more visible and measurable for the service user.
The Swift CFT-E Scale can help facilitate collaborative discussions with clinical teams and can assist with goal setting and care planning, offering service users active involvement in their journey of recovery.
Benefits for clinicians
The Swift CFT-E Scale offers clinicians a structured, evidence-based tool to support assessment and outcome monitoring. By gathering pre-intervention information, progression can be examined, tracked and interpreted against nationally representative data. The scale can support collaborative care, informed clinical decision-making and service evaluation.
Now freely available
The Swift CFT-E Scale is now freely available for clinicians, researchers, and services nationally and internationally, through the support of SPMHS, UCD and UU.
Research informing practice
This collaborative research, with service user input, underlines the work within our Psychology Department that delivers meaningful, practice-based outcomes that positively enhance care and treatment.
Ongoing commitment to innovation and collaboration
Together, SPMHS’ CFT-E programme and the Swift CFT-E Scale represent positive outcomes from integrating research, lived experience and clinical practice.
By combining an evidence-based therapeutic approach and service user feedback with a rigorously developed outcome measure, we are strengthening our ability to support recovery within the community.
This work demonstrates how research, lived experience and clinical expertise can meaningfully enhance treatment and recovery outcomes that benefit clinical teams and service users.
