Cognitive Behavioral Model Of Clinical Perfectionism

A licensed copy of Shafran and colleagues (2002) cognitive behavioral model of clinical perfectionism.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Overview

People with perfectionism pursue high standards in one or more areas of their life and base their self-worth on their ability to achieve these standards, even though this has negative consequences (Shafran, Egan, & Wade, 2010). Shafran, Cooper, & Fairburn's (2002) CBT model of perfectionism suggests that clinical perfectionism is maintained by an individual's biased evaluation of their progress towards achieving self-imposed high standards. Failure to meet these high standards is met with self-criticism and, if the standards are met, they may be re-evaluated as being insufficient. This information handout can be used to help conceptualize a client's perfectionism and enable exploration into its maintenance factors.

Why Use This Resource?

Understanding the underpinnings of clinical perfectionism is important for effective intervention. This resource helps clinicians to:

  •  Understand the mechanisms that maintain clinical perfectionism.
  • Explain key aspects of perfectionism, such as high standards, self-criticism, and avoidance.
  • Develop appropriate case formulation for clients struggling with perfectionism.

Key Benefits

Education

Acts as an informative client handout.

Discussion

Promotes exploration of key factors in perfectionism.

Learning

Supports clinician knowledge and supervision.

Who is this for?

Eating Disorders

Perfectionism associated with shape, weight, and eating.

Obsessive-Compulsive Disorder

Perfectionism associated with rituals and compulsions.

Anxiety Disorders

Perfectionistic standards associated with worry and anxiety.

Integrating it into your practice

01

Learn

Understand more about the cognitive behavioral model of clinical perfectionism.

02

Organize

Use the model as a template to organize your case formulations.

03

Educate

Use your knowledge of the model to explain maintenance processes to clients.

04

Discuss

Engage clients in discussions about their beliefs and behaviors.

05

Tailor

Customize interventions based on individual maintenance mechanisms.

06

Reflect

Use in supervision to discuss case conceptualizations and treatment plans.

Theoretical Background & Therapist Guidance

People with perfectionism pursue high standards in one or more areas of their life and base their self-worth on their ability to achieve these standards, even though this has negative consequences (Shafran, Egan, & Wade, 2010). Perfectionism can arise in domains including: work, appearance, bodily hygiene, social and romantic relationships, eating habits, health, time management, hobbies and leisure activities, sports, orderliness, and several others (Stoeber, J., & Stoeber, F., 2009). Core symptoms of perfectionism include, pursuing standards that are highly demanding, fear of failure, intense self-criticism when standards are unmet, and counterproductive performance-related behaviors (e.g., excessive checking, comparison-making, or reassurance-seeking).

The high levels of perfectionism observed amongst individuals with eating disorders led Shafran, Cooper & Fairburn (2002) to develop the first cognitive behavioral model of perfectionism. The model was later revised to explain more explicitly the role of performance-checking behaviors – such as reassurance-seeking – in perfectionism (Shafran, Egan, & Wade, 2010). Some of the key components of the earlier model include self-evaluation which is overly dependent on striving to meet standards, setting standards that are excessive, evaluating performance in a dichotomous manner. 

What's inside

  • A graphical depiction of the model.
  • Insights into key maintenance mechanisms.
  • Guidelines for using the resource with clients.
Get access to this resource

FAQs

No, positive perfectionism exists, but clinical perfectionism is detrimental due to its impact on self-worth and psychological distress.
Yes, it can be used alongside treatments for disorders exacerbated by perfectionism, such as anxiety and eating disorders.
Clinicians use it to guide their case formulation, helping them to effectively target their interventions.

How This Resource Improves Clinical Outcomes

By applying the model, therapists and clients benefit from:

  • Targeted interventions focusing on key maintenance mechanisms.
  • Enhanced client engagement through increased understanding of their difficulties.
  • Improved treatment outcomes by addressing core psychological features.

Clinicians Who Use This Resource Also Use

References And Further Reading

  • Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 31, 203-212.
  • Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014). Cognitive-behavioral treatment of perfectionism. Guilford Press.
  • Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
  • Lee, M., Roberts-Collins, C., Coughtrey, A., Phillips, L., & Shafran, R. (2011). Behavioral expressions, imagery and perfectionism. Behavioural and Cognitive Psychotherapy, 39, 413-425.
  • Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2017). The relationship between perfectionism and psychopathology: A meta-analysis. Journal of Clinical Psychology, 73, 1301–1326.
  • Maloney, G. K., Egan, S. J., Kane, R. T., Rees, C. S. (2014). An etiological model of perfectionism. PloS One, 9, e94757.
  • Riley, C., & Shafran, R. (2005). Clinical perfectionism: A preliminary qualitative analysis. Behavioural and Cognitive Psychotherapy, 33, 369-374.
  • Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). Clinical perfectionism: A cognitive-behavioral analysis. Behaviour Research and Therapy, 40, 773-791.
  • Shafran, R., Egan, S., & Wade, T. (2010). Overcoming perfectionism: A self-help guide using cognitive behavioural techniques. Constable and Robinson.
  • Smith, M. M., Sherry, S. B., Chen, S., Saklofske, D. H., Mushquash, C., Flett, G. L., & Hewitt, P. L. (2018). The perniciousness of perfectionism: A meta-analytic review of the perfectionism-suicide relationship. Journal of Personality, 86, 522-542.
  • Stoeber, J., Kobori, O., & Tanno, Y. (2010). The Multidimensional Perfectionism Cognitions Inventory – English (MPCI-E): Reliability, validity, and relationships with positive and negative affect. Journal of Personality Assessment, 92, 16-25.
  • Stoeber, J., & Stoeber, F. S. (2009). Domains of perfectionism: Prevalence and relationships with perfectionism, age, gender, and satisfaction with life. Personality and Individual Differences, 46, 530-535.
  • Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.

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