Treating Perfectionism Using Internet-Based Cognitive Behavior Therapy

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

138 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-24

Study Completion Date

2021-11-01

Brief Summary

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Perfectionism is characterized by setting high standards and striving for achievement, sometimes at the expense of social relationships and wellbeing. Despite sometimes being viewed as a positive feature by others, people with perfectionism tend to be overly concerned about their performance and how they are being perceived by people around them. This tends to create inflexible standards, cognitive biases, and performance-related behaviors that maintain a belief that self-worth is linked to accomplishments. Cognitive behavior therapy has been shown to be a viable treatment for perfectionism, both in terms of reducing levels of perfectionism and improving psychiatric symptoms. Furthermore, a number of recent studies indicate that it can be successfully delivered via the Internet, both with regular support and guidance on demand from a therapist. In the present study protocol, a clinical trial for perfectionism is described and outlined. In total, 128 participants will be recruited and randomized to either a treatment that has already been demonstrated to have many benefits, Internet-based Cognitive Behavior Therapy for perfectionism (iCBT-P), or an active comparison condition, Internet-based Unified Protocol (iUP), targeting the emotions underlying depression and anxiety disorders. The results will be investigated with regard to self-reported outcomes of perfectionism, psychiatric symptoms, self-compassion, and quality of life, at post-treatment and at six- and 12-month follow-up. Both iCBT-P and iUP are expected to have positive effects, but the difference between conditions and adherence to respective treatment are currently unknown and will be explored. The clinical trial is believed to lead to a better understanding of how perfectionism can be treated, with the aim of providing efficacious treatments in an accessible format via the Internet.

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Detailed Description

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Conditions

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Perfectionism Anxiety Depression Stress

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cognitive Behavior Therapy

An eight-week Internet-based self-guided treatment, delivered with guidance on demand from therapists in training. The treatment is based on cognitive behavior therapy and includes both cognitive interventions, e.g., cognitive restructuring and behavioral experiments, and behavioral interventions, behavioral activation. The treatment was manualized by Egan et al. (2016) and has been tested in several clinical trials, both via the Internet and face-to-face.

Group Type EXPERIMENTAL

Cognitive Behavior Therapy

Intervention Type BEHAVIORAL

A standardized evidence-based treatment manual based on cognitive behavior therapy, developed specifically for targeting perfectionism (Egan et al., 2016). Includes the following components: 1) providing psychoeducation about perfectionism and creating an individualized conceptualization 2) broadening the domains for self-evaluation 3) testing out beliefs and predictions, and 4) addressing personal standards and self-criticism.

Week 1: Understanding your perfectionism.

Week 2: Your own model, values, and motivation.

Week 3: Surveys and experiments.

Week 4: Dealing with perfectionistic behaviors.

Week 5: New ways of thinking.

Week 6: Self-criticism and self-compassion.

Week 7: Self-worth.

Week 8: Maintain and continue positive change.

Unified Protocol

An eight-week Internet-based self-guided treatment, delivered with guidance on demand from therapists in training. The treatment is based on a transdiagnostic approach derived from cognitive behavior therapy called Unified Protocol, focusing on the shared emotional aspects underlying depression and anxiety disorders. The treatment was manualized by Ellard et al. (2010) and has been tested in several clinical trials, but so far not over the Internet.

Group Type ACTIVE_COMPARATOR

Unified Protocol

Intervention Type BEHAVIORAL

A standardized evidence-based treatment manual based on cognitive behavior therapy, developed to target the shared emotional factors in depression and anxiety disorders (Ellard et al., 2010). Fundamental to this approach is to register and become more aware of the emotions, cognitions, and physical sensations that occur in difficult situation, and to try out more adaptive ways of coping in these instances.

Week 1: Emotional symptoms.

Week 2: Understanding your emotions.

Week 3: Emotional awareness.

Week 4: Thoughts.

Week 5: Behaviors.

Week 6: Emotional exposure.

Week 7: Continued emotional exposure.

Week 8: Planning ahead.

Interventions

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Cognitive Behavior Therapy

A standardized evidence-based treatment manual based on cognitive behavior therapy, developed specifically for targeting perfectionism (Egan et al., 2016). Includes the following components: 1) providing psychoeducation about perfectionism and creating an individualized conceptualization 2) broadening the domains for self-evaluation 3) testing out beliefs and predictions, and 4) addressing personal standards and self-criticism.

Week 1: Understanding your perfectionism.

Week 2: Your own model, values, and motivation.

Week 3: Surveys and experiments.

Week 4: Dealing with perfectionistic behaviors.

Week 5: New ways of thinking.

Week 6: Self-criticism and self-compassion.

Week 7: Self-worth.

Week 8: Maintain and continue positive change.

Intervention Type BEHAVIORAL

Unified Protocol

A standardized evidence-based treatment manual based on cognitive behavior therapy, developed to target the shared emotional factors in depression and anxiety disorders (Ellard et al., 2010). Fundamental to this approach is to register and become more aware of the emotions, cognitions, and physical sensations that occur in difficult situation, and to try out more adaptive ways of coping in these instances.

Week 1: Emotional symptoms.

Week 2: Understanding your emotions.

Week 3: Emotional awareness.

Week 4: Thoughts.

Week 5: Behaviors.

Week 6: Emotional exposure.

Week 7: Continued emotional exposure.

Week 8: Planning ahead.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* At least 18 years
* Adequate reading and writing levels in Swedish
* A computer, smartphone, or tablet with Internet access
* Elevated levels of perfectionism, as determined by a score of \>29 on the subscale Concerns over Mistakes on the Frost Multidimensional Perfectionism Scale

Exclusion Criteria

* Diagnoses warranting immediate care, e.g., anorexia nervosa, substance abuse, bipolar disorder, psychosis, and schizophrenia
* Severe depression, as determined by a score of \>15 points on the Patient Health Questionnaire - 9 Items
* Suicidality, as determined by \>2 points on the item on suicidal ideation on the Patient Health Questionnaire - 9 Items

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes