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Cited by 115Perfectionism, Procrastination, Anxiety StudiesAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesObsessive-Compulsive Spectrum Disorders

The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: A systematic review and meta-analysis

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Galloway, Ricky, Watson, Hunna, Greene, Danyelle, Shafran, Roz, Egan, Sarah J.·2022·Cognitive Behaviour Therapy
DOI 10.1080/16506073.2021.1952302
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Abstract

Perfectionism is a transdiagnostic process across anxiety, depression, and eating disorders. The aim of this systematic review was to examine the efficacy of self-help and face to face CBT for perfectionism in reducing perfectionism and anxiety, depression, and eating disorders. A total of 15 randomised controlled trials of CBT for perfectionism were identified (N = 912 participants; mean pooled age = 23 years) which met inclusion criteria. There were medium or large effect sizes found on perfectionism measures; personal standards (g = 0.57, 95% CI = 0.43–0.72), concern over mistakes (g = 0.89, 95% CI = 0.71–1.08) and clinical perfectionism (g = 0.87, 95% CI = 0.70–1.04). There were medium effects for symptoms of eating disorders (g = 0.61, 95% CI = 0.36–0.87) and depression (g = 0.60, 95% CI = 0.28–0.91), and a small-medium effect on anxiety (g = 0.42, 95% CI = 0.21–0.62). There was no publication bias found. Limitations included the small number of trials included and lack of active treatment comparisons. Results suggested that CBT for perfectionism is efficacious in reducing perfectionism and symptoms of depression, anxiety and eating disorders. Future research should examine comparisons of CBT for perfectionism with other psychological treatments.

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  • Over the last two decades, CBT-P has been successfully used to modify the standards, concerns, and behaviours of perfectionists with the goal of alleviating their symptoms of depression, anxiety, and eating disorders.

    “Over the last two decades, a cognitive behavioural therapy for perfectionism (CBT-P) has been successfully used to modify the standards, concerns, and behaviours of perfectionists (e.g. Egan and Shafran, 2018; Egan et al ., 2016) with the goal of alleviating their symptoms of depression, anxiety, and eating disorders”

    From The impact of internet-based cognitive behavior therapy for perfectionism: a reinterpretation through the lens of the Model of Excellencism and Perfectionism (2024) · cites this paper as Galloway et al., 2022

    The Efficacy of CBT for Perfectionism section reports improvements in personal standards and concern over mistakes, as well as depression, anxiety, and eating-disorder symptoms; the Discussion likewise concludes that CBT for perfectionism reduces these symptoms. The passages do not establish that perfectionists’ behaviours changed or substantiate the stated two-decade timeframe. Page numbers were not available in our copy. (LLM, conf=0.82)

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  • CBT for perfectionism is the leading treatment for perfectionism.

    “CBT for perfectionism is undoubtedly the leading treatment for perfectionism and has been examined in 15 randomised controlled trials (RCTs), across a variety of groups (see Galloway et al., 2022).”

    From Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism (2023) · cites this paper as Galloway et al., 2022

    The Study Characteristics section (page unavailable) reports 15 RCTs, and the Discussion (page unavailable) concludes that CBT for perfectionism is efficacious. The paper does not establish that it is the leading treatment relative to other treatments, so the claim overstates its findings. (LLM, conf=0.87)

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  • The efficacy of CBT for perfectionism has been demonstrated via statistical significance in all 15 RCTs included in the Galloway et al. (2022) meta-analysis, in addition to reliable and clinically significant change.

    “The efficacy of treatment has been demon strated via statistical significance (all 15 RCTs included in the Galloway et al., 2022 meta-analysis), in addition to reliable and clinically signif icant change (e.g., Handley et al., 2015; Hoiles et al., 2022; Riley et al., 2007; Shu et al., 2019).”

    From Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism (2023) · cites this paper as Galloway et al., 2022

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  • Significant improvement in psychological adjustment after CBT-P was found in a recent meta-analytical review and discussed in a reflection of the first 21 years of the intervention.

    “Significant improvement in psychological adjustment after CBT-P was found in a recent meta-analytical review (Galloway et al ., 2022) and discussed in a reflection of the first 21 years of the intervention (Shafran et al ., 2023).”

    From The impact of internet-based cognitive behavior therapy for perfectionism: a reinterpretation through the lens of the Model of Excellencism and Perfectionism (2024) · cites this paper as Galloway et al., 2022

  • Fifteen randomised controlled trials have demonstrated the efficacy of CBT for perfectionism in reducing perfectionism and symptoms of anxiety, depression and eating disorders.

    “Despite 15 randomised controlled trials which have demonstrated the efficacy of CBT for perfectionism in reducing perfectionism and symptoms of anxiety, depression and eating disorders, strong responses to this work continue to appear in the literature.”

    From Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism (2023) · cites this paper as Galloway et al., 2022

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Research works printed but not linked: 7

  1. [5]5. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II: Beck Depression Inventory Manual (2nd ed.). The Psychological Corporation.
  2. [14]14. Fairburn, C. G., & Belgin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? The International Journal of Eating Disorders, 16, 363- 370. http://doi.org/ 10.1002/1098-108X · DOI
  3. [20]20. Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470. https://doi.org/10.1037/0022- 3514.60.3.456 · DOI
  4. [26]26. Klauer, K. J. (Ed.). (2001). Handbuch kognitives training [Handbook of cognitive training]. Göttingen: Hogrefe
  5. [31]31. Light, R., & Pillemer, D. (1984). Summing up: The science of reviewing research. Harvard University Press.
  6. [34]34. Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335-343. https://doi.org/10.1016/0005-7967(94)00075 · DOI
  7. [44]44. Rosenthal, R., & Rosnow, R. L. (1991). Essentials of Behavioural Research: Methods and Data Analysis (2nd ed.). McGraw-Hill.

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Authors
Galloway, R., Watson, H., Greene, D., Shafran, R., & Egan, S. J.
Affiliations
  • Curtin University (AU)
  • University of North Carolina at Chapel Hill (US)
  • University College London (GB)
Corresponding author
Egan, Sarah J.
ORCID
Venue
Cognitive Behaviour Therapy
Publisher
Informa UK Limited
Published
2021-08-04
Volume
51
Issue
2
Pages
170-184
ISSN
  • 1650-6073 (ISSN-L)
  • 1651-2316
DOI
10.1080/16506073.2021.1952302
OpenAlex
W4229072348
Cited by
115
References
45
Citations by year
2026: 24 · 2025: 28 · 2024: 24 · 2023: 24 · 2022: 14 · 2021: 1
FWCI
2.09
Type
journal article
Language
en
Open access
Locations
  • Cognitive Behaviour Therapy (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
Funders
not funded
Topics
  • Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Keywords
perfectionism, self-help intervention, anxiety, depression, eating disorders, transdiagnostic mechanisms, concern over mistakes, personal standards, clinical perfectionism, treatment efficacy

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