A randomized controlled trial of acceptance and commitment therapy for clinical perfectionism
Section snippets
Participants
Participants were recruited from a western U.S. town using newspaper advertisements, flyers posted in the community and on the local university campus, and announcements in university classes. Recruitment materials specified intervention targets as “procrastination, spending a lot of time planning/organizing, and difficulty starting/completing tasks because you need to get them exactly right.” Inclusion criteria were: (1) score of at least five on the Dimensional Obsessive-Compulsive Scale
Screening measure
Dimensional Obsessive-Compulsive Scale (DOCS)—Symmetry (Abramowitz et al., 2010). This five-item subscale assesses severity of avoidance, distress, and interference due to a perceived need to make things “just right” (Abramowitz et al., 2010). Examples of this type of avoidance and/or distress include a perceived need for “symmetry, evenness, balanced, or exactness” and behavioral repetition to obtain a feeling of being “just right” or “balanced.” Given the overlap between rigid pursuit of a
Sample descriptives
Mean age of the sample was 25.4 years (SD = 12.3). The majority of participants identified as female (74%), European American (85%), single (74%), and members of The Church of Jesus Christ of Latter-day Saints (79%; see Table 1 for details). The most common DSM-5 diagnoses assigned were OCPD, GAD, and OCD. There were no significant differences between groups on demographic, outcome, or process variables at pretreatment (see Table 1). There were significantly more participants diagnosed with GAD
Discussion
Our findings indicate ACT was superior to a waitlist control condition on clinical perfectionism, psychological functioning, and processes of change from pretreatment to follow-up. Within-group improvement over time was significant for all outcomes, further supporting the efficacy of ACT with respect to clinical perfectionism and global outcomes. In addition, the observed effect sizes are comparable to those obtained from CBT treatment trials for clinical perfectionism (Egan et al., 2014;
Conflicts of interest
Declarations of interest: none.
Funding source
This study was supported by a grant from the International OCD Foundation.
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2022, Behaviour Research and TherapyCitation Excerpt :This unique circumstance could have suppressed well-being scores, even though participants were seeing improvement in perfectionism and psychological skills. Furthermore, previous perfectionism trials reported less change in quality of life measures relative to symptom-focused measures at follow-up assessments (e.g., Egan et al., 2014; Ong et al., 2019), suggesting that well-being may be more difficult to change, especially over shorter periods of time (e.g., length of a research study), in this population. The PBT model requires processes of change to be malleable by available methods and relevant to personally meaningful outcomes.
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2022, Clinical Psychology ReviewCitation Excerpt :Meta-analyses of treatment refusal and dropout rates for other psychotherapies provided comparison benchmarks for the pooled CAT refusal and dropout rates. An electronic search of literature databases for recent meta-analyses of therapy dropout produced five reviews reporting specific therapy pooled dropout rates for CBT (Fernandez et al., 2015), dialectical behaviour therapy (DBT; Dixon & Linardon, 2020), interpersonal psychotherapy (IPT; Linardon, Fitzsimmons-Craft, Brennan, Barillaro, & Wilfley, 2019), schema therapy (ST; Gülüm, 2018) and acceptance and commitment therapy (ACT; Ong et al., 2019). The most recent overall review of dropout from adult psychotherapy and/or pharmacotherapy was also included to provide a general overview (Swift et al., 2017).
In-person and online-delivered acceptance and commitment therapy for hoarding disorder: A multiple baseline study
2021, Journal of Contextual Behavioral ScienceCitation Excerpt :For these latter outcomes, 5/6 participants experienced gains in the expected direction, indicating relatively less consistent effects on these variables. This finding somewhat contradicts research showing significant improvements in wellbeing and psychological inflexibility following ACT for conditions related to HD (e.g., perfectionism, anxiety; Arch et al., 2012; Ong et al., 2019); this discrepancy may be explained by the experimental nature of the current intervention. More modifications to the current protocol to emphasize flourishing may be needed.