Compassion-Focused Therapy (CFT) offers an evolutionary, biopsychosocial approach to shame, self-criticism, and threat activation processes that are highly salient in Irish and Northern Irish contexts. Both jurisdictions across the island of Ireland are shaped by conflict legacy, institutional harms, adverse childhood experiences, and violence against women and girls. This chapter appraises the pertinence of CFT across the island of Ireland (Republic of Ireland and Northern Ireland) and outlines pragmatic routes for culturally sensitive, trauma-informed implementation within the statutory, voluntary and cross-border services. It summarises CFT’s theoretical foundations and compassion cultivation methods, including Compassionate Mind Training, links these mechanisms to population needs North and South, and reviews early island-based practice evidence alongside broader empirical findings. It maps service structures, identifies delivery options, group, digital and stepped-care, and highlights assessment tools such as CEAS, fears of Compassion, to guide pacing and safeguarding. Embedding compassion processes within routine care may improve engagement and outcomes for shame-based and trauma-related difficulties. Success will depend on careful cultural and faith sensitive approaches, safeguarding, workforce training, and ongoing, embedded evaluation across NI and ROI systems.