TY - JOUR
T1 - Internet-based cognitive behaviour therapy for perfectionism
T2 - More is better but no need to be prescriptive
AU - Wade, Tracey D.
AU - Kay, Enola
AU - de Valle, Madelaine K.
AU - Egan, Sarah J.
AU - Andersson, Gerhard
AU - Carlbring, Per
AU - Shafran, Roz
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background: The current study explored whether higher- (up to 8 modules) versus lower-dose (3 or less modules) unguided internet Cognitive Behaviour Therapy for perfectionism (ICBT-P) was more effective, and the best method to promote higher dosage. Methods: Two sequential randomised ICBT-P studies were conducted with participants who self-identified 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% confidence interval: 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. Conclusions: 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. ANZCTR Trial Number: ACTRN12619000147189.
AB - Background: The current study explored whether higher- (up to 8 modules) versus lower-dose (3 or less modules) unguided internet Cognitive Behaviour Therapy for perfectionism (ICBT-P) was more effective, and the best method to promote higher dosage. Methods: Two sequential randomised ICBT-P studies were conducted with participants who self-identified 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% confidence interval: 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. Conclusions: 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. ANZCTR Trial Number: ACTRN12619000147189.
KW - body image flexibility
KW - fixed or flexible format
KW - internet cognitive-behavioural therapy
KW - negative affect
KW - perfectionism
UR - http://www.scopus.com/inward/record.url?scp=85068657142&partnerID=8YFLogxK
U2 - 10.1111/cp.12193
DO - 10.1111/cp.12193
M3 - Article
AN - SCOPUS:85068657142
SN - 1328-4207
VL - 23
SP - 196
EP - 205
JO - Clinical Psychologist
JF - Clinical Psychologist
IS - 3
ER -