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Internet-based cognitive behaviour therapy for perfectionism: More is better but no need to be prescriptive

Wade, TD; Kay, E; de Valle, MK; Egan, SJ; Andersson, G; Carlbring, P; Shafran, R; (2019) Internet-based cognitive behaviour therapy for perfectionism: More is better but no need to be prescriptive. Clinical Psychologist , 23 (3) pp. 196-205. 10.1111/cp.12193. Green open access

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Abstract

Background: The current study explored whether higher- (up to 8 modules) versus lower-dose (3 or less modules) unguided internet CBT for perfectionism (ICBT-P) was more effective, and the best method to promote higher dosage. Methods: Two sequential randomized ICBT-P studies were conducted with participants who selfidentified as having difficulties with perfectionism; in the first participants (N=51) received 3-module ICBT-P or wait-list, and in the second participants (N=55) received fixed (asked to complete all 8 modules two per week over 4-weeks) or flexible format (after completing the first psychoeducational module, participants decided how many/in what order they completed the modules). We examined impact on our primary variables, perfectionistic concerns and standards, and secondary outcomes of negative affect, body image flexibility, and self-efficacy. Results: More modules were completed in the higher- (M modules=4.36, SD=3.29) versus lower-dose (M=1.96, SD=1.23) ICBT-P, d = 0.86 (95% CI: 0.39, 1.34). The latter impacted perfectionism but not secondary outcomes; the former impacted all outcomes (except for self-efficacy), and within-group effect size improvements were double in the high- compared to low-dose ICBT-P. There was no difference between the fixed and flexible formats in terms of the number of modules completed or impact. Conclusion: We can offer a patient-centred approach to ICBT-P that is effective, while suggesting completion of more modules can result in larger, more pervasive improvements.

Type: Article
Title: Internet-based cognitive behaviour therapy for perfectionism: More is better but no need to be prescriptive
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/cp.12193
Publisher version: https://doi.org/10.1111/cp.12193
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Perfectionism; internet cognitive-behavioral therapy; fixed or flexible format; negative affect, body image flexibility.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10078775
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