Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-05-02T05:25:29.083Z Has data issue: false hasContentIssue false

Are Perfectionist Therapists Perfect? The Relationship between Therapist Perfectionism and Client Outcomes in Cognitive Behavioural Therapy

Published online by Cambridge University Press:  27 February 2017

Vickie L. Presley*
Affiliation:
University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
Christopher A. Jones
Affiliation:
University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
Elizabeth K. Newton
Affiliation:
University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
*
Correspondence to: Vickie Presley, School of Psychological, Social and Behavioural Sciences, Coventry University, Priory Street, Coventry CV1 5FB. Email: vickie.presley@coventry.ac.uk

Abstract

Background: The psychological literature suggests that therapist perfectionism is common and potentially detrimental to client recovery. Little is known about the relationship between therapist perfectionism and client outcomes. Aims: This study aimed to measure perfectionism in High Intensity Cognitive Behavioural therapists, and establish any relationships between dimensions of therapist perfectionism, client outcomes and drop-out rates in treatment. Method: Thirty-six therapists took part in the study; levels of perfectionism were measured using a self-report questionnaire and these were analysed in relation to the clinical outcomes from a sample of their clients. Results: The results indicated that therapist perfectionism may be less common than previously suggested. Overall, a number of significant negative associations were observed between aspects of therapist perfectionism (e.g. having high standards for others), treatment efficacy and client retention in treatment. Conclusions: Therapist perfectionism is associated with CBT treatment outcomes; tentative recommendations for therapists managing their own schema as part of their clinical practice have been made, although further investigation is required.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bennet-Levy, J. (2006). Therapist skills: a cognitive model of their acquisition and refinement. Behavioural and Cognitive Psychotherapy, 34, 5778.CrossRefGoogle Scholar
Blatt, S. J. (1995). The destructiveness of perfectionism: implications for the treatment of depression. The American Psychologist, 50, 10031020.Google Scholar
Burns, D. (1980). The perfectionist's script for self defeat. Psychology Today, November, 3452.Google Scholar
DiBartolo, P. M., Yen Li, C. and Frost, R. O. (2008). How do the dimensions of perfectionism relate to mental health? Cognitive Therapy and Research, 28, 401417.Google Scholar
Egan, S. J., Wade, T. D. and Shafran, R. (2011). Perfectionism as a transdiagnostic process: a clinical review. Clinical Psychology Review, 31, 203212.CrossRefGoogle ScholarPubMed
Ferguson, K. L. and Rodway, M. R. (1994). Cognitive behavioural treatment of perfectionism: initial evaluation series. Research on Social Work Practice, 4, 283308.Google Scholar
Frost, R. O., Heimberg, R. G., Holt, C. S., Mattia, J. I. and Neubauer, A. L. (1993). A comparison of two measures of perfectionism. Personality and Individual Differences, 14, 119126.Google Scholar
Frost, R. O., Marten, P., Lahart, C. and Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449468.CrossRefGoogle Scholar
Haarhoff, B. A. (2006). The importance of identifying therapist schema in cognitive therapy training and supervision. New Zealand Journal of Psychology, 35, 126131.Google Scholar
Hewitt, P. L. and Flett, G. L. (1991). Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456470.CrossRefGoogle ScholarPubMed
Hill, R. W., Huelsman, T. J., Furr, R. M., Kibler, J., Vicente, B. B. and Kennedy, C. (2004). A new measure of perfectionism: the perfectionism inventory. Journal of Personality Assessment, 82, 8091.Google Scholar
Horney, K. (1950). Neurosis and Human Growth. New York: Norton.Google Scholar
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 1219.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. W. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.Google Scholar
Leahy, R. L. (2001). Overcoming Resistance in Cognitive Therapy. New York: The Guilford Press.Google Scholar
Leahy, R. L. (2008). The therapeutic relationship in cognitive behavioural therapy. Behavioural and Cognitive Psychotherapy, 36, 769777.Google Scholar
Lloyd, S., Schmidt, U., Khondoker, M. and Tchanturia, K. (2015). Can psychological interventions reduce perfectionism? A systematic review and meta-analysis. Behavioural and Cognitive Psychotherapy, 43, 705731.Google Scholar
Pretorius, W. M. (2006). Cognitive behavioural therapy supervision: recommended practice. Behavioural and Cognitive Psychotherapy, 34, 413420.CrossRefGoogle Scholar
Shafran, R. and Mansell, W. (2001). Perfectionism and psychopathology: a review of research and treatment. Clinical Psychology Review, 21, 879906.CrossRefGoogle ScholarPubMed
Shafran, R., Cooper, Z. and Fairburn, C. G. (2002). Clinical perfectionism: a cognitive-behavioural analysis. Behaviour Research and Therapy, 40, 773791.CrossRefGoogle ScholarPubMed
Shahar, G., Blatt, S. J., Zuroff, D. C., Krupnick, J. L. and Sotsky, S. M. (2004). Perfectionism impedes social relations and response to brief treatment for depression. Journal of Social and Clinical Psychology, 23, 140154.Google Scholar
Spitzer, R. L., Kroenke, K. and Williams, J. B. W. (1999). Validation and utility of a self-report version of the PRIME-MD: the PHQ primary care study. Journal of the American Medical Association, 202, 17371744.Google Scholar
Spitzer, R. L., Kroenke, K. and Williams, J. B. W. (2006). A brief measure for assessing generalised anxiety disorder: the GAD-7. Archive of International Medicine, 166, 10921097.Google Scholar
Stoeber, J. and Otto, K. (2006). Positive conceptions of perfectionism: approaches, evidence, challenges. Personality and Social Psychology Review, 10, 295319.CrossRefGoogle ScholarPubMed
Young, J. E., Klosko, J. S. and Weishaar, M. E. (2003). Schema Therapy: A Practitioner's Guide. New York: The Guilford Press.Google Scholar
Zuroff, D. C., Blatt, S. J., Sotsky, S. M., Krupnick, J. L., Martin, D. J., Sanislow, C. A. III and Simmens, S. (2000). Relation of therapeutic alliance and perfectionism to outcome in brief outpatient treatment of depression. Journal of Consulting and Clinical Psychology, 68, 114124.Google Scholar
Submit a response

Comments

No Comments have been published for this article.