A Kind Coach for a Hard Illness: A Compassion-Focused Worksheet for Long COVID

Self-Compassion · CFT · Emerging

A compassion-focused sheet for the harsh voice about being ill, such as "I should be doing more", "I am a burden" and "Everyone else copes". It rates how loud the voice is, notes what happens in the body when it speaks, introduces the three qualities of a kind coach (wisdom, strength and warmth) and invites a message to a close friend and then a short note from the coach, paired with three slow breaths. A systematic review supports the acceptability and benefit of compassion-focused therapy across clinical populations, but it has not been tested in Long COVID, so the rating is emerging.

Underlying mechanism: Compassion-Focused Compassionate Coach Exercise for Shame and Self-Criticism in Long COVID

What it helps with

  • Softening self-criticism and threat-system activation about being ill, so that values work in the next session lands more openly.
  • Putting words to the harsh voice and to what it does in the body, without arguing with it.
  • Building a warmer and steadier relationship with oneself while living with a hard illness.
  • Pairing a kind message with the settling breath from earlier in the protocol.

How clinicians use it

  • Use it in Session 6, before the ACT session by design.
  • Introduce the threat, drive and soothe systems in a sentence or two, then work with the three qualities of a caring coach.
  • Rate the harsh voice before and after the note and the three breaths, and keep the exercise short and low in demand.
  • If grief or shame is large, give it room and do not rush towards action.

Clinical Implementation Guide

  1. Name the harsh voice and rate how loud it is on a hard day.
  2. Write what the client would say to a close friend, then a short note from the kind coach.
  3. Pair the note with three slow breaths and rate the harsh voice again.

What the worksheet looks like

A Kind Coach for a Hard Illness — worked example
Quality of a kind coachWhat it means
WisdomUnderstands that illness is not a choice or a character flaw
StrengthSteady and able to stay with hard feelings without being swept away
WarmthCares about me and wants me to feel supported

Clinical cautions

Sadness or grief can come up and does not mean something is going wrong. The client may stop at any time, and some clients find self-compassion work threatening at first, so go slowly and follow their pace. Stop or adapt the breathing if attention on the breath raises anxiety. Never imply that the illness is a character flaw or that the client should cope better. This tool does not diagnose any condition and is not a substitute for individual face-to-face therapy or for emergency crisis support.

References

  1. Craig, C., Hiskey, S., & Spector, A. (2020). Compassion focused therapy: A systematic review of its effectiveness and acceptability in clinical populations. Expert Review of Neurotherapeutics, 20(4), 385-400. https://doi.org/10.1080/14737175.2020.1746184.
  2. Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41. https://doi.org/10.1111/bjc.12043.

Copyright and use in research

© 2026 Dr Richard Pomfret and Third Wave Therapy Tools. May be used in research with the author and site cited. Version 1.1, approved 21 October 2026, revised as the evidence develops.

Suggested citation (APA 7th edition): Pomfret, R. (2026). Steady Ground: A stepped, measurement-led psychological protocol for adults with Long COVID (Version 1.1) [Therapist guide and worksheets]. Third Wave Therapy Tools. https://thirdwavetherapytools.com/

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Steady Ground

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