Suffering is ubiquitous and impacts individuals from every walk of life. In very simplistic terms, compassion is a sensitivity to suffering (either in ourselves or others), with a motivation to take action to alleviate it. The concept of compassion is certainly not new and has deep historical and philosophical roots that cut across time and culture. In a multicultural arena, the expression and perception of compassion is undoubtedly influenced and shaped by cultural factors. Thus, there is not just one way to talk or think about compassion. With this in mind, this chapter addresses compassion that is influenced by the US perspectives we hold. We will discuss ways that the work of Professor Paul Gilbert, the founder of Compassion Focused Therapy (CFT), is an ideal theory to address concerns in a multicultural world and how group is an ideal format for members to engage in the three flows of compassion to enact change. We provide readers with a description of a guide we collaboratively created with Paul that we have used to lead process-oriented CFT psychotherapy groups. We emphasise that, when using this guide, therapists can, and should, modify treatment to better match the unique needs of the individuals attending. To manualise CFT, or to try to codify cultural adaptations, would take away the flexibility needed to adapt in helpful and meaningful ways. To help illustrate how a therapist might use CFT principles found in the aforementioned guide and adapt according to the needs of their group, we provide a clinical vignette demonstrating one way this might be done. We conclude by discussing benefits and potential difficulties in leading such groups. We wish to acknowledge the wisdom that Paul Gilbert shared in our collaborations with him that helped shape this chapter and the work we do.