Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism

Shafran, Roz; Wade, Tracey

doi:10.1016/j.brat.2023.104258

Cited by 13 publications

(15 citation statements)

References 73 publications

(108 reference statements)

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“…There is a need to consider a constructive way forward to work together as researchers in perfectionism, with the shared goal of improving treatment and outcomes for those with perfectionism. For the interested reader, we point them to the ideas outlined in Shafran et al (2023), which provide a critique and future research agenda in this area. Shafran et al (2023) outline that a key area for development is comparing CBT-P to active treatments.…”

Section: Future Directionsmentioning

confidence: 99%

“…For the interested reader, we point them to the ideas outlined in Shafran et al (2023), which provide a critique and future research agenda in this area. Shafran et al (2023) outline that a key area for development is comparing CBT-P to active treatments. There are currently further studies in progress comparing CBT-P to active treatment comparisons (e.g., Buhrman et al, 2020), adding to a small number of comparisons (e.g., Mahmoodi et al, 2021;Shu et al, 2019).…”

Section: Future Directionsmentioning

confidence: 99%

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Towards high standards of evidence for cognitive behaviour therapy for perfectionism: A critique of Smith et al. (2023).

Egan,

Wade,

Watson

et al. 2023

Canadian Psychology / Psychologie canadienne

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Perfectionism is associated with symptoms of multiple psychological disorders. In this commentary, we outline our numerous concerns regarding a recent meta-analysis by Smith et al. (2023) that examined the efficacy of cognitive behaviour therapy for perfectionism (CBT-P). To ensure health care and policy decisions are based on high-quality evidence, evidence summaries need to be held to high standards of accountability. The study did not systematically search the literature, and omitted previous studies included in the meta-analyses they sought to reanalyze. Additionally, there was insufficient statistical power to detect intervention effects with small numbers of studies and multiple outcomes, other statistical concerns (e.g., numbers-needed-to-treat analysis), and conflation of the issue of dropout and treatment tolerance. To ensure appropriate guidance for the health care sector, evidence summaries of intervention effects must uphold high standards of quality. CBT-P has demonstrated efficacy in addressing the risk factor of perfectionism and preventing and decreasing symptoms of anxiety, depression, and eating disorders. Further systematic reviews and meta-analyses with rigorous methodology are encouraged.

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Section: Future Directionsmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

Towards high standards of evidence for cognitive behaviour therapy for perfectionism: A critique of Smith et al. (2023).

Egan,

Wade,

Watson

et al. 2023

Canadian Psychology / Psychologie canadienne

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“…This randomized controlled feasibility study found further support for the EFI derived from the PCPM (Dunkley, 2017), with individualized feedback delivered in-person and online by student research assistants to individuals with higher SC perfectionism. Considering that longer perfectionism interventions (Shafran et al, 2023) are not well tolerated by many individuals with perfectionism (Smith et al, 2023), our findings suggest that the single-session PCPM-EFI can have broad applicability, conceptual utility, and effectiveness for perfectionistic individuals.…”

Section: Discussionmentioning

confidence: 87%

“…The single-session EFI might instigate and support important processes of change and allow for more effective tailoring of therapeutic interventions (Schleider et al, 2020), rather than relying on symptom-based, "one size fits all" treatment protocols characterized by extreme comprehensiveness (e.g., CBT). The EFI might also help focus CBT interventions for perfectionism on one to three treatment elements rather than eight or more separate modules, which require sustained effort over several weeks (Shafran et al, 2023), resulting in low engagement and dropout (Smith et al, 2023). The feedback entertaining multiple mechanisms at multiple levels has the advantage of increased flexibility in interventions (e.g., shifting between different mechanisms to align with the situation and/or individual preferences; Kuyken et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…The tripartite model of depression and anxiety (Clark & Watson, 1991) was used to test whether the EFI reduces general depressive and anxiety symptoms, as well as specific depressive symptoms (i.e., anhedonia) and specific anxiety symptoms (i.e., somatic arousal). We did not expect reductions in SC perfectionism measures because the EFI does not directly target perfectionism itself and existing randomized controlled trials data shows that one session is insufficient for reducing perfectionism (Shafran et al, 2023). We also did not expect that there would be any significant differences in delivery modality (i.e., in-person vs. online) on the effectiveness of the EFI, consistent with previous findings (Suh et al, 2019).…”

Section: The Pcpmmentioning

confidence: 99%

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Empowering self-critical perfectionistic students: A waitlist controlled feasibility trial of an explanatory feedback intervention on daily coping processes.

Dunkley¹,

Richard²,

Tobin³

et al. 2023

Journal of Counseling Psychology

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This study of 176 university students tested a single-session explanatory feedback intervention (EFI), derived from the perfectionism coping processes model. Participants with higher self-critical perfectionism completed daily measures of stress appraisals, coping, and affect for 7 days. A randomized control design was used to compare an EFI condition with a waitlist control condition over 4 weeks with individualized feedback delivered one-on-one by student trainees in-person or remotely through videoconferencing. The feasibility of the individualized analyses of each participant’s daily data was supported by identifying daily trigger patterns, maintenance tendencies, strengths, common triggers, and best targets for reducing negative mood and increasing positive mood across several stressors for each participant. Participant ratings indicated that the comprehensive feedback was coherent and functional. Participants in the EFI condition, compared to those in the control condition, reported increases in empowerment, coping self-efficacy, and problem-focused coping, as well as decreases in depressive and anxious symptoms. Between-group effect sizes were moderate-to-large. There were reliable improvements in empowerment and depressive symptoms for 56% and 36%, respectively, of participants in the EFI condition. These findings demonstrate the broad applicability, conceptual utility, and effectiveness of the EFI for self-critical perfectionistic individuals.

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A pilot feasibility and acceptability trial of an internet indicated prevention program for perfectionism to reduce eating disorder symptoms in adolescents

O’Brien,

Anderson,

Mazzucchelli

et al. 2024

Eat Weight Disord

Self Cite

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Purpose Perfectionism is a transdiagnostic risk factor for eating disorders. Treating perfectionism can reduce symptoms of eating disorders. No research has examined an indicated prevention trial using internet-based Cognitive-Behavioural Therapy for Perfectionism (ICBT-P) in adolescent girls at elevated risk for eating disorders. Our aim was to conduct a preliminary feasibility trial using a co-designed ICBT-P intervention. It was hypothesised that a higher proportion of participants in the ICBT-P condition would achieve reliable and clinically significant change on perfectionism, eating disorders, anxiety and depression, compared to waitlist control. Methods Twenty-one adolescent girls with elevated symptoms of eating disorders (M age = 16.14 years) were randomised to a 4-week online feasibility trial of a co-designed ICBT-P prevention program or waitlist control. Qualitative surveys were used to gain participant perspectives. Results The ICBT-P condition had a higher proportion of participants achieve reliable change and classified as recovered on perfectionism and symptoms of eating disorders and anxiety, compared to waitlist control. Qualitative findings indicated that 100% of participants found the program helpful. Conclusion The results indicate ICBT-P is a feasible and acceptable program for adolescent girls with elevated eating disorder symptoms. Future research is required to examine outcomes in a randomised controlled trial. Level of evidence Level III: Evidence obtained from well-designed cohort or case–control analytic studies. Trial registration number This trial was prospectively registered with Australian and New Zealand Clinical Trials Registry (ACTRN12620000951954P) on 23/09/2020.

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Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism

Cited by 13 publications

References 73 publications

Towards high standards of evidence for cognitive behaviour therapy for perfectionism: A critique of Smith et al. (2023).

Towards high standards of evidence for cognitive behaviour therapy for perfectionism: A critique of Smith et al. (2023).

Empowering self-critical perfectionistic students: A waitlist controlled feasibility trial of an explanatory feedback intervention on daily coping processes.

A pilot feasibility and acceptability trial of an internet indicated prevention program for perfectionism to reduce eating disorder symptoms in adolescents

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