

































98

Graduate Student Journal of Psychology
2022, Vol. 19

Copyright 2022 by the Department of Counseling and Clinical Psychology
Teachers College, Columbia University

�АǓǉȠș�ȅǟ�ƺ�^ǩǿǠǹǓে^Ǔșșǩȅǿ�2ǿȠǓȖΚǓǿȠǩȅǿ�
Targeting Perfectionism in College Students

Haley E. Ward  and  Michael G. Wheaton, Ph.D.,
Department of Psychology, Barnard College 

Perfectionism is a well-established transdiagnostic factor that contributes to the maintenance and exacerbation 
ȅǟ� ƺ�ΛǩǏǓ� ȖƺǿǠǓ�ȅǟ�ȒșΡǉǦȅȒƺȠǦȅǹȅǠΡঀ��ǹȠǦȅȣǠǦ� ǓАǓǉȠǩΚǓॹ�ǾȅșȠ� ȠȖǓƺȠǾǓǿȠș� ǟȅȖ�ȒǓȖǟǓǉȠǩȅǿǩșǾ�ƺȖǓ� ǩǿƺǉǉǓșșǩǈǹǓ� Ƞȅ� ȠǦǓ�
general population, and are time-, resource-, and cost-intensive. Online single-session interventions (SSIs) display 
promise in preventing and treating negative mental health symptoms; however, no studies have examined the ef-
fectiveness of an online SSI targeting perfectionism. To address this, the present study sought to evaluate a novel 
computerized, self-guided SSI. The two primary aims of the study were: 1) to assess the intervention’s acceptabil-
ity, likability, and utility, and 2) to examine whether the intervention reduces perfectionistic attitudes, depression, 
anxiety, and stress in a college student population. At baseline, students at a liberal arts college (N=79) were ran-
domized to receive a 40-minute perfectionism SSI or a stress-management control. Participants rated the perfec-
tionism intervention as highly helpful, acceptable, and likable. The perfectionism intervention was associated 
ΛǩȠǦ�ǠȖǓƺȠǓȖ� ǩǾȒȖȅΚǓǾǓǿȠș� ǩǿ�ȒǓȖǟǓǉȠǩȅǿǩșǾॹ�ǏǓȒȖǓșșǩȅǿॹ�ƺǿΠǩǓȠΡॹ�ƺǿǏ�șȠȖǓșșআ�ǦȅΛǓΚǓȖॹ�ȠǦǓ�ǏǩАǓȖǓǿǉǓș� ǩǿ�ȖǓǏȣǉȠǩȅǿș�
ǈǓȠΛǓǓǿ� ȠǦǓ� ǠȖȅȣȒș�ΛǓȖǓ�ǿȅȠ� șȠƺȠǩșȠǩǉƺǹǹΡ� șǩǠǿǩЙǉƺǿȠঀ�(ǩΚǓǿ� ȠǦǓ� șǾƺǹǹ� șƺǾȒǹǓ� șǩΦǓॹ� ȠǦǓ� șȠȣǏΡ�Λƺș� ǹǩǷǓǹΡ�ȣǿǏǓȖȒȅΛ-
ǓȖǓǏ� Ƞȅ� ǏǓȠǓǉȠ� ǏǩАǓȖǓǿǉǓș� ǈǓȠΛǓǓǿ� ǉȅǿǏǩȠǩȅǿșঀ� 'ȣȠȣȖǓ� ȖǓșǓƺȖǉǦ� ΛǩȠǦ� ǹƺȖǠǓȖ� șƺǾȒǹǓ� șǩΦǓșॹ� ƺ� ǹǓșș� ȒȅȠǓǿȠ� ǉȅǿȠȖȅǹ�
ǠȖȅȣȒॹ�ƺǿǏ�ǉǹǩǿǩǉƺǹ�ȒȅȒȣǹƺȠǩȅǿș�ǩș�ǿǓǓǏǓǏ�Ƞȅ�ȠǓșȠ�ȠǦǓ�ǓАǓǉȠș�ȅǟ�ȠǦǓ�ǩǿȠǓȖΚǓǿȠǩȅǿ�ǾȅȖǓ�ǓΠȠǓǿșǩΚǓǹΡঀ�FǓΚǓȖȠǦǓǹǓșșॹ�ȠǦǩș�
study demonstrates that single-session perfectionism interventions hold promise and merit future investigation.
Keywords: Perfectionism, Single-Session Interventions, Online Interventions, College Students

 XǓȖǟǓǉȠǩȅǿǩșǾ�ǩș�ǏǓЙǿǓǏ�ƺș�ȠǦǓ�șȠȖȅǿǠ�ǿǓǓǏ�Ƞȅ�ȒǓȖ-
ǟȅȖǾ� ƺȠ� ƺ� МƺΛǹǓșș� ǹǓΚǓǹ� ƺǿǏ� Ƞȅ�ǾǓǓȠ� ǓΠǉǓșșǩΚǓǹΡ� ǦǩǠǦ�
standards (Flett & Hewitt, 2002). Although perfec-
tionism is multidimensional and can have adaptive 
elements, it is considered a transdiagnostic factor as-
sociated with many forms of psychopathology (Sha-
fran & Mansell, 2001; Egan, Wade, & Shafran, 2011). 
The type of perfectionism that contributes to psycho-
pathology is known as maladaptive perfectionism, 
which is characterized by the pursuit of personally 
demanding standards and the basing of self-worth 
on performance outcomes in one or more important 
life domains, despite negative consequences (Shafran, 
Cooper, & Fairburn, 2002). Maladaptive perfection-
ism involves critical self-evaluations, concerns about 
making mistakes and being negatively evaluated by 
others, and fear of failure (Frost, Marten, Lahart, & 
Rosenblate, 1990; Egan, Wade, Shafran, & Antony, 
2016). Many individuals with high levels of maladap-
tive perfectionism have core beliefs that they are weak, 
МƺΛǓǏॹ�ƺǿǏ�ȣǿΛȅȖȠǦΡ�শ�ǓșșǓȖॹ�'ǹǓȠȠॹ�૭�/ǓΛǩȠȠॹࢵࢱࢱࢳ�ষঀ�
Given these characteristics, it is unsurprising that per-
fectionism is elevated across eating (Limburg, Wat-
son, Hagger, & Egan, 2017), anxiety (Gnilka, Ashby, 
& Noble, 2012), depressive (Hewitt & Flett, 1991), 
and personality disorders (Overholser & Dimaggio, 
2020). Perfectionism has particular relevance to obses-
sive-compulsive personality disorder (OCPD), as one 
of the diagnostic criteria for OCPD involves perfec-

tionism that interferes with normal task completion 
(American Psychological Association, 2013; Egan, 
Wade, & Shafran, 2011). Likewise, obsessive-com-
pulsive disorder (OCD) often involves perfection-
istic tendencies; the Obsessive-Compulsive Cogni-
tions Working Group postulates that perfectionism 
is one of six central cognitive processes involved in 
obsessive-compulsive disorder (OCCWG, 1997).
 In addition to the heightened perfectionism 
common among clinical populations, a substantial 
number of individuals who do not meet the diagnos-
tic criteria for any given disorder have high levels of 
maladaptive perfectionism (Grzegorek et al., 2004). 
In nonclinical samples, perfectionism is highly cor-
related with subthreshold symptoms of various forms 
of psychopathology (Kearns, Forbes, & Gardiner, 
2007). For instance, Ferrari (1995) found that per-
ǟǓǉȠǩȅǿǩșǾ� șǉȅȖǓș� ΛǓȖǓ� șǩǠǿǩЙǉƺǿȠǹΡ� ȖǓǹƺȠǓǏ� Ƞȅ� ȅǈșǓș-
sional thoughts, compulsive acts, anger-suppression, 
anger expression, social desirability, and compulsive 
checking in a nonclinical college student population. 
Perfectionism levels are also associated with hopeless-
ness, non-suicidal self-injury, and suicidal ideation 
and attempts (O’Connor, 2003; O’Connor, 2007). 
More broadly, perfectionism gives rise to high levels 
of stress and worry, behavioral impairments, physical 
health problems, impaired daily functioning, inferi-
or academic performance, and interpersonal prob-
lems (Shafran et al., 2002; Flett & Hewitt, 2002).



99

Treatments for Perfectionism
 Treatments for perfectionism are based on models 
that suggest cognitive and behavioral components may 
maintain the core biases and attitudes in perfectionism 
শ^ǦƺǟȖƺǿ� ǓȠ� ƺǹঀॹ� �ষঀ�EȅȖǓࢳࢱࢱࢳ șȒǓǉǩЙǉƺǹǹΡॹ�ǾƺǹƺǏƺȒȠǩΚǓ�
thinking patterns and cognitive biases such as dichot-
omous thinking, selective attention toward mistakes, 
rumination, self-criticism, self-blame, and overgeneral-
ization play a role in maintaining perfectionism and its 
poor outcomes (Egan et al., 2016; Shafran et al., 2002). 
Such biases may contribute to procrastination behav-
iors, higher standard-setting, and inability to complete 
tasks (Egan et al., 2016; Sirois, 2014). Perfectionism is 
also antithetical to self-compassion (Brown, 2008; Na-
ǏǓƺȣॹࢱࢳࢱࢳ�ষॹ�ƺș�ǩǿȠǓȖǿƺǹ�șǓǹǟ৉ǏǩƺǹȅǠȣǓ�ǩș�ȕȣǩȠǓ�ǦƺȖșǦ�ƺǿǏ�
ǩǿΚȅǹΚǓș� ƺȣȠȅǾƺȠǩǉ� ȒǓȖǟǓǉȠǩȅǿǩșǾ৉ȠǦǓǾǓǏ� ȠǦȅȣǠǦȠș�
ƺǈȅȣȠ�ȠǦǓ�șǓǹǟॹ�ǴȣǏǠǾǓǿȠșॹ�ƺǿǏ�ǓǹǓǾǓǿȠș�ȅǟ�șǓǹǟ৉ǿǓǠǹǓǉȠ�
(Ferrari, 1995; Hewitt, 2020). Self-criticism may even 
mediate the relationship between perfectionism, psy-
chological distress (James et al., 2015), and depression 
(Ferrari, Yap, Scott, Einstein, & Ciarrochi, 2018). Be-
cause of these cognitive and behavioral maintenance 
factors, a perfectionistic cycle is often quite resistant to 
change, thus some researchers suggest that perfection-
ǩșǾ�ǩș�ƺ�ЙΠǓǏ�ȒƺȖȠ�ȅǟ�ȒǓȖșȅǿƺǹǩȠΡ�শ/ǓΛǩȠȠ�ǓȠ�ƺǹঀॹࢸࢲࢱࢳ�ষঀ�
However, it might be more helpful to look at perfec-
tionism as a cognitive vulnerability factor related to 
psychopathology that can change with targeted treat-
ment (Egan et al., 2011). Indeed, perfectionistic beliefs 
can be changed through cognitive-behavioral therapy 
(CBT). Common elements of CBT target cognitive 
and behavioral processes in perfectionism via psycho-
education, cognitive restructuring, and self-compas-
sion techniques (Egan et al., 2016; Nadeau, 2020). 
 A growing body of evidence shows that CBT 
for nonclinical and clinical populations reduces per-
ǟǓǉȠǩȅǿǩșǾॹ�ΛǩȠǦ�ǾǓǏǩȣǾ�Ƞȅ�ǹƺȖǠǓ�ǓАǓǉȠ�șǩΦǓș�শ?ǓƺȖǿș�
et al., 2007; Lloyd, Schmidt, Khondoker, & Tchan-
turia, 2015). Targeting perfectionism may also lead 
to a reduction in other psychological disturbances 
characteristic of mental disorders (Egan et al., 2011; 
Lloyd et al., 2015). In particular, studies have found 
that depression, anxiety, and eating problems are of-
ȠǓǿ� ȖǓǏȣǉǓǏ� ΛǩȠǦ� ǾǓǏǩȣǾ� ǓАǓǉȠ� șǩΦǓș� ǩǿ� ǈȅȠǦ� ǉǹǩǿǩ-
cal and nonclinical samples (e.g. Kearns, Forbes, & 
Gardiner, 2007; Steele & Wade, 2008; Shafran et al., 
2017). There is also evidence supporting the utility 
of self-compassion interventions for perfectionism 

ǩǿ� ǿȅǿǉǹǩǿǩǉƺǹ� ȒȅȒȣǹƺȠǩȅǿșॹ� ƺǹȠǦȅȣǠǦ� ǓАǓǉȠș� ȅǿ� ȖǓ-
ducing secondary disorders are less consistent (Rose, 
McIntyre, & Rimes, 2018; Nadeau, 2020). There-
fore, combining more traditional cognitive-behavioral 
components with self-compassion techniques may be 
ǈǓǿǓЙǉǩƺǹ�ǩǿ�ƺǹǹǓΚǩƺȠǩǿǠ�ȒǓȖǟǓǉȠǩȅǿǩșǾॹ�ƺș�șȣǠǠǓșȠǓǏ�ǩǿ�
prior research (Fairweather-Schmidt & Wade, 2015).
 Although there has been a recent surge in ran-
domized controlled trials evaluating treatments for 
perfectionism (Lloyd et al., 2015), for many individ-
ȣƺǹș� ȒșΡǉǦȅȠǦǓȖƺȒΡ� ǩǿȠǓȖΚǓǿȠǩȅǿș� ȖǓǾƺǩǿ� ǏǩГǉȣǹȠ� Ƞȅ�
access given the face-to-face and individualized nature 
of treatment (Andersson, 2016). Cost, transporta-
tion issues, waiting lists, lack of trained mental health 
professionals, and stigma—typical barriers in facing 
treatment—might limit access to perfectionism in-
terventions. And such barriers may be particularly 
strong for under-resourced populations (Andrade et 
al., 2014). Further, those with subclinical problems 
(e.g. someone who is perfectionistic and anxious but 
doesn’t meet criteria for a disorder) would be unlikely 
to go to great lengths to seek out an intervention. This 
lack of access points to a clear need for more accessi-
ble mental health programs targeting perfectionism. 

Internet-Based Interventions
 As a response to lack of access, internet-based 
interventions have been rapidly developed. Inter-
ǿǓȠেǈƺșǓǏ� ǩǿȠǓȖΚǓǿȠǩȅǿș� ƺȖǓ� ǓАǓǉȠǩΚǓ� ǟȅȖ� ƺ� ΚƺȖǩǓȠΡ� ȅǟ�
mental health disorders and problems (e.g. Parks et 
al., 2018), including perfectionism (e.g. Rozental 
et al., 2017). Online interventions for perfection-
ism utilize the same techniques present in in-person 
treatment (e.g. cognitive restructuring, self-compas-
șǩȅǿষॹ�ƺȖǓ�ȠΡȒǩǉƺǹǹΡ�șǓǹǟেǠȣǩǏǓǏॹ�ƺǿǏ�ȅǟȠǓǿ�ȖǓȒȅȖȠ�ǓАǓǉȠ�
sizes comparable to in-person treatments (Suh et al., 
2019). For example, Suh and colleagues’ meta-anal-
ysis on 10 face-to-face and online interventions for 
ȒǓȖǟǓǉȠǩȅǿǩșǾ�ȖǓȒȅȖȠǓǏ�ȠǦƺȠ�ȠǦǓȖǓ�ΛǓȖǓ�ǿȅ�șǩǠǿǩЙǉƺǿȠ�
ǏǩАǓȖǓǿǉǓș� ǩǿ� ǏǓǹǩΚǓȖΡ� ǾȅǏƺǹǩȠΡ� ȅǿ� ǓАǓǉȠ� șǩΦǓș� ǟȅȖ�
perfectionism, depression, and anxiety (Suh et al., 
2019). At present, there have been several randomized 
controlled trials evaluating online programs which 
have demonstrated great value in reducing the bur-
den created by perfectionism (e.g. Egan et al., 2014).
 However, one potential problem with both face-
to-face and online perfectionism interventions is their 
length Lloyd and colleagues’ (2015) meta-analysis of 8 

SSI TARGETING PERFECTIONISM



100100

perfectionism interventions reported that the number 
of treatment sessions ranged from 8 to 14, resembling 
the typical length of cognitive-behavioral therapy. 
Non-completion rates were high in many of the stud-
ǩǓșॹ�ΛǦǩǉǦ�ƺȖǓ�ȖǓМǓǉȠǩΚǓ�ȅǟ�ȠȖǓƺȠǾǓǿȠ�ƺǏǦǓȖǓǿǉǓ�ǿȅȖǾșআ�
ȅǿǓ�ǩǿ�ЙΚǓ�ƺǏȣǹȠș�Λǩǹǹ�ǏȖȅȒ�ȅȣȠ�ȅǟ�ȠȖǓƺȠǾǓǿȠ�ǈǓǟȅȖǓ�ȠǦǓ�
recommended dose is complete (Olfson et al., 2009). 
Poor retention is even more common among online 
interventions. For instance, in the study conducted by 
^ǦƺǟȖƺǿ� ƺǿǏ� ǉȅǹǹǓƺǠȣǓș� শࢸࢲࢱࢳষॹ� ȠǦǓȖǓ� Λƺș� șǩǠǿǩЙǉƺǿȠ�
non-engagement and non-completion of modules, 
with 71% of participants completing fewer than half 
ȠǦǓ�ǾȅǏȣǹǓș�ƺǿǏ�ȅǿǹΡࢵࢲ�ঀࢶઔ�ȒǓȅȒǹǓ�ǉȅǾȒǹǓȠǩǿǠ�ЙΚǓ�ȅȖ�
more modules. Strikingly, even participants who had 
high rates of non-completion and non-engagement 
had reduced perfectionism. Change in perfectionism 
was largest at the beginning of the intervention, indi-
cating that potential may lie in briefer, more compact 
interventions. This is consistent with other research 
reporting that the number of sessions is often unrelat-
ǓǏ�Ƞȅ�ȠǦǓ�ǾƺǠǿǩȠȣǏǓ�ȅǟ�ȠǦƺȠ�ȠȖǓƺȠǾǓǿȠঢ়ș�ǓАǓǉȠ�শvǓǩșΦ�ǓȠ�
al., 2017). Rozental and colleagues (2017) and Shafran 
ǓȠ�ƺǹ�শࢸࢲࢱࢳষ�ǿȅȠǩǉǓǏ�ȠǦǓșǓ�ǓАǓǉȠș�ǩǿ�ȠǦǓǩȖࢹ�েΛǓǓǷ�ǹȅǿǠ�
online interventions for perfectionism, and they sug-
gested that brief, online interventions may have posi-
tive impacts on perfectionism and maximize scalability.
 One form of brief intervention that has been 
developed in response to the high likelihood that an 
individual will access a treatment only once is sin-
ǠǹǓেșǓșșǩȅǿ� ǩǿȠǓȖΚǓǿȠǩȅǿș� শ^^2șষঀ� ^^2ș� ƺȖǓ� ǓАǓǉȠǩΚǓ� ǟȅȖ�
adults (Campbell, 2012), youths (Schleider & Weisz, 
2017), and college students (Samson & Tanner-Smith, 
2015) with diagnosed psychiatric disorders and sub-
clinical issues. SSIs have been demonstrated to im-
prove anxiety, depression, problematic drug and al-
cohol use, and risk factors for mental health problems 
such as hopelessness, anxiety sensitivity, physiological 
șȠȖǓșș� șǓǹǟেǦƺȠǓॹ� ȒǓȖǉǓǩΚǓǏ� ǉȅǿȠȖȅǹॹ� ЙΠǓǏ�ǾǩǿǏșǓȠॹ� ƺǿǏ�
agency (Tanner-Smith et al., 2015; Schleider, Do-
bias, Sung, Mumper, & Mullarkey, 2020; Schleider, 
Dobias, Sung, & Mullarkey, 2020). Gains are often 
maintained at follow-up, and participants typically 
rate single-session interventions as likable, acceptable, 
and useful (Duan & Bu, 2017; Wasil et al., 2021; Sam-
son & Tanner-Smith et al., 2015; Schleider & Weisz, 
2017). These interventions are particularly useful 
when delivered in an online, self-guided format be-
cause they can be made widely accessible, reducing the 

barriers to mental health care (Schleider et al, 2020a).  
Although short-term therapies have been shown to 
reduce perfectionistic tendencies and related problems 
ƺǿǏ�ƺȖǓ�ǉȅǾȒƺȖƺǈǹǓ�ǩǿ�ǓАǓǉȠ�șǩΦǓș�শ�ȅǏǏ�ǓȠ�ƺǹঀॹࢺࢲࢱࢳ�আ�
Lloyd et al., 2014; Fairweather-Schmidt & Wade, 
2015), only one study has examined a single-session 
perfectionism intervention (LaSota, Ross, & Kearney, 
2017), which lasted for several hours in-person and 
focused on psychoeducation, setting high standards, 
fear over mistakes, and reducing stress. To-date, no 
brief online perfectionism interventions have been 
ȠǓșȠǓǏঀ�(ǩΚǓǿ�ȠǦƺȠ�ȅǿǹǩǿǓ�^^2ș�ƺȖǓ�ǓАǓǉȠǩΚǓ�ǩǿ�ȖǓǏȣǉǩǿǠ�
mental health concerns (Schleider & Weisz, 2018b), 
ƺǿǏ�ȅȠǦǓȖ� ȠΡȒǓș�ȅǟ�ǈȖǩǓǟ� ǩǿȠǓȖΚǓǿȠǩȅǿș�ƺȖǓ�ǓАǓǉȠǩΚǓ� ǩǿ�
reducing perfectionism (e.g. Dodd et al., 2019; Fair-
weather-Schmidt & Wade, 2015), an online SSI aim-
ing to decrease perfectionism might be particularly 
useful. The brevity and accessibility of such an inter-
vention may amplify its potential impact, decreasing 
costs, time, and other problems associated with receiv-
ing a normal length and/or in-person intervention. 
� �ȅǹǹǓǠǓ�șȠȣǏǓǿȠș�ǾƺΡ�ǈǓ�ƺ�ǠȅȅǏ�ЙȠ�ǟȅȖ�ƺ�șǩǿǠǹǓেșǓș-
sion intervention targeting perfectionism, considering 
that many students have problems with perfection-
ism, anxiety, and depression (LaSota et al., 2017), and 
mental health issues appear to be on the rise in college 
students (Curran & Hill, 2017). Perfectionism may be 
an etiological and maintenance factor of these mental 
health problems in college student populations for 
two primary reasons. First, work and studies are the 
two top domains of life in which people report being 
the most perfectionistic (Stoeber & Stoeber, 2009). 
Living in an academic environment could potential-
ly lead to the exacerbation of perfectionistic tenden-
cies. Second, college students are constantly evaluated 
based on their work and social skills and must meet 
certain self-presentation and performance-based stan-
dards (Klibert et al., 2014), which may contribute to 
the stress surrounding academic performance and the 
pressure to succeed that college students often report 
as a top stressor (Bedewey & Gabriel, 2015). An en-
ΚǩȖȅǿǾǓǿȠ� ЙǹǹǓǏ� ΛǩȠǦ� ǓΠǉǓșșǩΚǓ� șȠȣǏΡǩǿǠॹ� ƺǉƺǏǓǾǩǉ�
ȒȖǓșșȣȖǓॹ� ƺǿǏ� șȠȖǓșș� ΛȅȣǹǏ� ȣǿǏȅȣǈȠǓǏǹΡ� ǩǿМȣǓǿǉǓ�
perfectionism and may have particular relevance to 
highly competitive colleges that maintain a culture of 
perfectionism. Of relevance, Molnar and colleagues 
(2020) found that 14% of college students have ex-
tremely elevated levels of perfectionism, while other 

WARD, WHEATION



101

SSI TARGETING PERFECTIONISM

studies have found that two thirds can be categorized 
as perfectionists, with a quarter of those individu-
als meeting criteria for maladaptive perfectionism 
(Grzegorek et al., 2004). These rates have increased 
over the past decade, concurrent with rates of oth-
er mental health problems (Curran & Hill, 2017).  
 The increasing rates of perfectionism in college 
students may be contributing to the increase in mental 
illness among college populations, treatment-seeking 
behaviors, and other stressors (Pacewicz, Gotwals, and 
Blanton, 2018). Considering this information, there 
is an urgent need for brief, online interventions that 
reduce perfectionism and protect against the develop-
ment of anxiety and depression among college students 
(Klibert et al., 2014). Targeting perfectionism in an on-
line single-session intervention might help reduce the 
burden placed on college counseling centers, reduce 
distress among students, and prevent future dysfunc-
tion. Although traditional perfectionism programs are 
ǓАǓǉȠǩΚǓ�ǟȅȖ�ΚƺȖǩȅȣș�ǉǹǩǿǩǉƺǹ�ƺǿǏ�ǿȅǿǉǹǩǿǩǉƺǹ�ǉȅǿǉǓȖǿșॹ�
no research to date has assessed the impact of a brief, 
online perfectionism program in a college population.

The Present Study
 The present study extends prior research by con-
ǏȣǉȠǩǿǠ� ȠǦǓ� ЙȖșȠ� ȖƺǿǏȅǾǩΦǓǏ� ǉȅǿȠȖȅǹǹǓǏ� ȠȖǩƺǹ� ȅǿ� ƺ�
self-administered, online SSI designed to reduce per-
fectionism in a college student population. To assess 
ȠǦǓ�ǓАǓǉȠǩΚǓǿǓșș�ȅǟ�ȠǦǓ�ȒȖȅǠȖƺǾॹ�ΛǦǩǉǦ�ǩș�ǈƺșǓǏ�ȅǿ�ȒșΡ-
choeducation, cognitive restructuring, and self-com-
passion, a randomized controlled trial was conducted 
comparing the program with a stress-management 
control. It was hypothesized that the online single ses-
sion intervention will decrease perfectionism in college 
șȠȣǏǓǿȠșॹ�ΛǩȠǦ�șǓǉȅǿǏƺȖΡ�ǓАǓǉȠș�ȅǿ�ǏǓȒȖǓșșǩȅǿॹ�ƺǿΠǩǓȠΡॹ�
and stress. Participants were also asked to rate the inter-
vention’s acceptability and utility and we hypothesized 
it would be rated as acceptable, likable, and useful. 

Methods
Participants 
 Participants were undergraduate liberal arts col-
lege students who were enrolled in introductory psy-
chology courses. Participants were recruited via an on-
line platform (i.e. SONA) that allows students to sign 
up for studies in order to gain research credits. In total, 
91 students participated in the present study; however, 
ЙΚǓ�ȒƺȖȠǩǉǩȒƺǿȠș�ΛǓȖǓ�ȖǓǾȅΚǓǏ�ǟȅȖ�ǟƺǩǹǩǿǠ�ǈȅȠǦ�ƺȠȠǓǿ-

tion checks in each assessment or—admitting they did 
ǿȅȠ�ΛƺȠǉǦ�ȠǦǓ�ΚǩǏǓȅș�ȅȖ�ǠǩΚǓ�ȠǦǓǩȖ�ǈǓșȠ�ǓАȅȖȠ�ǩǿ�ǉȅǾ-
pleting the perfectionism intervention, leaving a total 
of 86 participants with usable pre-and post-data. Addi-
tionally, only 79 participants completed and passed the 
follow-up assessment. Participants were randomized to 
either the perfectionism (N=45) or control interven-
tion (N=41). In total, participants were 89.5% female 
ƺǿǏࢵ�ঀࢸઔ�ȅȠǦǓȖॹࢱࢹ�ઔ�ΛǓȖǓ�ǩǿ�ȠǦǓǩȖ�ЙȖșȠ�ƺǿǏ�șǓǉȅǿǏ�ΡǓƺȖ�
of college, 37.2% non-Hispanic White, 5.8% African 
�ǾǓȖǩǉƺǿॹ� �ઔࢳঀࢸࢴ �șǩƺǿইXƺǉǩЙǉ� 2șǹƺǿǏǓȖॹ� ƺǿǏ� �ઔࢹঀࢺࢲ
Other or Hispanic. As displayed in Table 1, the two 
ǠȖȅȣȒș� ǏǩǏ� ǿȅȠ� ǏǩАǓȖ� ȅǿ� ƺǿΡ� ǏǓǾȅǠȖƺȒǦǩǉ� ΚƺȖǩƺǈǹǓșঀ

Materials 
� �ΡșǟȣǿǉȠǩȅǿƺǹ� �ȠȠǩȠȣǏǓș� ^ǉƺǹǓেXǓȖǟǓǉȠǩȅǿে
ism (DAS-PA; Weissman & Beck, 1978). The DAS 
was originally developed to study depression and has 
several subscales, including perfectionism, which 
Λƺș� ǩǏǓǿȠǩЙǓǏ� ƺș� ƺ� șȣǈșǉƺǹǓ� ǈΡ� �ǓǉǷ� ƺǿǏ� ǉȅǹǹǓƺǠȣǓș�
(1991). The subscale measures perfectionistic atti-
tudes and has excellent internal consistency. Scores 
on the subscale are predictive of later depression and 
anxiety (Jacobs et al., 2009). The Likert Scale is a con-
tinuum from 0 (Fully Disagree) to 6 (Fully Agree). 
 Big Three Perfectionism Scale (BTPS; Smith, 
Saklofske, Stoeber, & Sherry, 2016). The BTPS eval-
uates three higher-order factors (rigid perfectionism, 
self-critical perfectionism, and narcissistic perfection-
ism) through 10 lower-order perfectionism facets 
(self-oriented perfectionism, self-worth contingen-
cies, concern over mistakes, doubts about actions, 
self-criticism, socially prescribed perfectionism, oth-
er-oriented perfectionism, hypercriticism, grandiosity, 
entitlement). This scale was selected over older, more 
traditional perfectionism measures (MPS and FMPS) 
due to accessibility and its assessment of the perfec-
tionistic attitudes targeted more directly in the inter-
vention. Other-oriented perfectionism, socially pre-
scribed perfectionism, and parental standards, which 
are assessed in other common measures of perfection-
ism, are not addressed in the intervention. Although 
the BTPS is new, it has strong psychometric properties 
(Smith et al., 2016). Participants respond on a Likert 
Scale from 0 (Disagree Strongly) to 4 (Agree Strongly).
 �ǓȒȖǓșșǩȅǿॹ� �ǿΠǩǓȠΡ� ƺǿǏ� ^ȠȖǓșș� ^ǉƺǹǓșেࢲࢳ�
(DASS-21; Lovibond & Lovibond, 1995). The DASS-
21 is a 21-item self-report questionnaire consisting of 



102

WARD, WHEATION

three subscales: depression, anxiety and stress. Rat-
ings are provided using Likert Scales ranging from 0 
(“Did not apply to me at all”) to 3 (``Applied to me 
very much or most of the time”).  The instructions 
on the DASS-21 were aligned with the timeline of 
the study; participants were asked to rate their symp-
toms ‘in the past week.’ The subscales and total score 
have good reliability and construct validity in both 
clinical and nonclinical samples (Antony, Bieling, 
Cox, Enns, & Swinson, 1998; Henry & Crawford, 
2005). DASS-21 scores are highly correlated with 
other measures of depression and anxiety (Osman 
et al., 2012) and perfectionism (Aldahadha, 2018).
 Additional Questions about Perfectionism and 
the Intervention. To assess the intervention’s ability 
to alter metacognitive self-appraisals about perfection-
ism, the following three questions were asked at base-
line: “Do you consider yourself to be a perfectionist?,” 
“Does perfectionism get in the way of your happi-
ness,” and “Does perfectionism slow progress toward 
your goals?” Participants also completed several ques-
tions about the acceptability, likability, and perceived 
helpfulness of the intervention, which were partially 
derived from the Program Feedback Scale (PFS), a 
valid and reliable measure used to assess acceptability 
and perceptions of internet based SSIs (Sung, Mump-
er, & Schleider, 2021). They were asked, “How much 
did you like the intervention?,” “How much do you 
feel like the intervention helped you understand per-
fectionism?,” and “How helpful do you think the 
intervention was in teaching you to combat your per-
fectionism?” In addition, perceived changes in perfec-
tionism were assessed at 1-week follow-up with the 
question: “Do you think that completing the program 
helped you with your perfectionism in the past week?”

Procedure 
 Approval for this study was received from the In-
stitutional Review Board (IRB) at Barnard College. 
Upon signing up for the study, participants were direct-
ed to a Qualtrics form, where they completed a consent 
form and agreed to study duties. Study duties required 
ȠǦǓ� ȒƺȖȠǩǉǩȒƺǿȠ� Ƞȅ� Йǹǹ� ȅȣȠ� ȒȖǓॹ� ȒȅșȠॹ� ƺǿǏ� �েΛǓǓǷࢲ ǟȅǹ-
low-up measures, in addition to actively engaging with 
the intervention. After providing consent, participants 
responded to a series of demographic questions and 
measures assessing perfectionism, depression, anxiety, 
and stress. Immediately following the completion of 

the measures, participants were randomly assigned to 
either the experimental or stress-management control 
condition through the Qualtrics randomizer element. 
The experimental intervention took approximately 40 
minutes and required participants to maintain active 
participation through video and open-ended respond-
ing, while the stress-management condition lasted for 
a similar amount of time and consisted of a video and 
articles about stress. Attention checks were included 
to ensure participants were paying attention, along 
with a direct question following the intervention 
which asks participants if they did their best. Follow-
ing the completion of the intervention, participants 
ǩǾǾǓǏǩƺȠǓǹΡ�ЙǹǹǓǏ�ȅȣȠ�ȠǦǓ�ǾǓƺșȣȖǓș�ǟȅȖ�ƺ�șǓǉȅǿǏ�ȠǩǾǓॹ�
except for the Depression, Anxiety, and Stress Scales. 
Participants had access to the follow-up assessment 
��ǦȅȣȖș�শșǓΚǓǿ�ǏƺΡșষ�ƺǟȠǓȖ�ȠǦǓΡ�ǉȅǾȒǹǓȠǓǏ�ȠǦǓǩȖ�ЙȖșȠࢹࢷࢲ
assessment and received a reminder email to take the 
assessment. If they did not take the assessment within 
24 hours of receiving the email, they were sent addi-
tional reminders. The follow-up assessment consisted 
of questions about perceived changes in perfection-
ism in addition to the same measures used at baseline. 
Participants were debriefed at the end of the study. 
Statistical analyses were conducted in SPSS. Indepen-
ǏǓǿȠ�șƺǾȒǹǓș�ȠেȠǓșȠș�ΛǓȖǓ�Ȗȣǿ�Ƞȅ�ƺșșǓșș�ǟȅȖ�ǏǩАǓȖǓǿǉǓș�
between groups at baseline and a series of repeated 
measures, ANOVAs, were utilized to examine the ef-
fect of the perfectionism intervention compared to the 
stress-management control on the various outcome 
measures. Descriptive statistics on the likability and 
acceptability of the intervention were also analyzed. 
 Perfectionism Intervention: The intervention 
was based on a treatment guide for clinical perfection-
ism (Egan et al., 2016), which has been used to develop 
prior perfectionism interventions (e.g. Rozental et al., 
2017; Shafran et al., 2017). The intervention was de-
livered through Qualtrics and consists of colorful text, 
images, and video clips. Participants can easily follow 
the intervention by clicking the arrows to the next 
page when they appear and writing in the text boxes 
ȒȖȅΚǩǏǓǏঀ�EȅȖǓ�șȒǓǉǩЙǉƺǹǹΡॹ�ȠǦǓ�ǩǿȠǓȖΚǓǿȠǩȅǿ�ǩǿǉǹȣǏǓǏ�
4 major modules that take around 40 minutes total 
to complete and last for approximately 10 minutes 
each: 1) psychoeducation about perfectionism and 
its negative consequences, 2) cognitive restructuring 
of self-critical perfectionistic thoughts, 3) self-com-
passion techniques, and 4) generalization and mainte-



103

SSI TARGETING PERFECTIONISM

nance of information learned in the intervention. 
 Psychoeducation and Consequences of Perে
fectionism: Given that perfectionism is considered 
ego-syntonic and perfectionists believe their high stan-
dards improve their functioning, it is important edu-
cate participants about the counterproductive nature 
ƺǿǏ� ǿǓǠƺȠǩΚǓ� ǓАǓǉȠș� ȅǟ� ȒǓȖǟǓǉȠǩȅǿǩșǾ� শKΚǓȖǦȅǹșǓȖ� ૭�
Dimaggio, 2020). By increasing awareness about the 
problems associated with perfectionism, clients may 
feel more motivated (Yeh et al., 2017) and be able to 
more easily change the thoughts and behaviors con-
tributing to these outcomes (Kutlesa & Arthur, 2008). 
eǦǓȖǓǟȅȖǓॹ�ȠǦǓ�ȒȖȅǠȖƺǾ�ǏǓЙǿǓș�ȒǓȖǟǓǉȠǩȅǿǩșǾ�ƺǿǏ�Ǐǩș-
ǉȣșșǓș�ǩȠș�ǉȅǿșǓȕȣǓǿǉǓș�ǩǿ�ȠǦǓ�ǟȅȖǾ�ȅǟ�ȠǓǹǹǩǿǠ�ЙǉȠǩȅǿƺǹ�
stories about characters who are perfectionists. After 
learning what perfectionism is, participants learn the 
various ways perfectionism can manifest in life and its 
multidimensional nature. Throughout the psychoed-
ucation module, they apply this information to their 
own lives.
 Cognitive Restructuring and Automatic 
Thoughts. Cognitive-behavioral therapy can reduce 
the tendency for unconstructive automatic thoughts 
about the self (Overholser & Dimaggio, 2020). Inter-
ventions can help perfectionists become aware of, chal-
lenge, and change their automatic self-critical thought 
processes (Besser et al., 2004; Overholser & Dimaggio, 
2020). Therefore, this section of the intervention ex-
plains how to combat the self-critical thoughts relat-
ed to perfectionism through utilizing the three-step 
process (catch, challenge, and change) of CBT. Chal-
lenging and changing is explained in the context of 
self-compassion. The primary way participants are 
instructed to challenge their thoughts is by thinking 
about what a loving friend would say about their 
thoughts. Participants will practice catching, chal-
lenging, and changing self-critical thoughts that both 
ƺ� ЙǉȠǩȅǿƺǹ� ǉǦƺȖƺǉȠǓȖ� ƺǿǏ� ȠǦǓΡ� ȠǦǓǾșǓǹΚǓș� ǓΠȒǓȖǩǓǿǉǓঀ
 ^Ǔǹǟে�ȅǾȒƺșșǩȅǿॸ� Because low self-compas-
sion is often characteristic of perfectionism (Brown, 
2008), and interventions rooted in self-compassion 
ƺȖǓ� ǓАǓǉȠǩΚǓ� ǩǿ� ȖǓǏȣǉǩǿǠ� ȒǓȖǟǓǉȠǩȅǿǩșǾ� শFƺǏǓƺȣॹ�
2020), participants will be taught how to be more 
compassionate, forgiving, and kind to themselves. 
Self-compassion principles (Raes et al., 2011) are 
fused throughout the CBT section (e.g., mindful-
ǿǓșș�ΚǓȖșȣș�ȅΚǓȖেǩǏǓǿȠǩЙǉƺȠǩȅǿষ�ƺǿǏ�ƺȖǓ�ƺǹșȅ�ǓΠȒǹƺǩǿǓǏ�
in the self-compassion module. Self-kindness over 

self-judgement is taught by explaining the tenden-
cy to focus on mistakes in perfectionism, the im-
ȒȅȖȠƺǿǉǓ� ȅǟ� ǟȅȖǠǩΚǓǿǓșșॹ� ƺǿǏ� ƺГȖǾƺȠǩȅǿ� ǓΠǓȖǉǩșǓșঀ�
Next, common humanity versus isolation is taught 
through a discussion and exercise on how everybody 
ǾƺǷǓș�ǾǩșȠƺǷǓș�ƺǿǏ�ǿȅ�ȅǿǓ�ǩș�ƺǹȅǿǓ�ǩǿ�ȠǦǓǩȖ�șȣАǓȖǩǿǠঀ
 Concluding Components: The intervention ends 
by discussing how reducing perfectionism can improve 
one’s life. Neurogenesis is explained to show that change 
is possible, although change requires commitment. 
Participants are encouraged to apply the cognitive dis-
tortion and self-compassion practices to everyday life.
 Stress Management Program: The stress-man-
agement program was designed as an active control, 
for comparison with the perfectionism intervention, 
and did not contain any perfectionism components. 
�ǹȠǦȅȣǠǦ� ǏǩАǓȖǓǿȠ� ǩǿ� șȠȖȣǉȠȣȖǓॹ� ȠǦǓ� ǉȅȣȖșǓ� ǉȅǿȠǓǿȠ�
was similar to stress management conditions used in 
prior studies (Hoge et al., 2013). Like the perfection-
ism intervention, the stress-management program last-
ed for around 40 minutes and was delivered through 
Qualtrics. Participants were instructed to watch a 
ΚǩǏǓȅ�ƺǿǏ�ȖǓƺǏ�ǓΠǉǓȖȒȠș�ǏǓșǉȖǩǈǩǿǠ�ȠǦǓ�ǓАǓǉȠș�ȅǟ�șȠȖǓșș�
and the various ways to manage stress.. The content 
ǩǿǉǹȣǏǓǏ�ǏǓȠƺǩǹș� ƺǈȅȣȠ�ǦȅΛ� ǉǦȖȅǿǩǉ� șȠȖǓșș� ƺАǓǉȠș� ȠǦǓ�
mind, body, and performance, and explored ways to re-
duce stress, including exercise, nutrition, mindfulness, 
positive experiences, time management, and sleep. 

Results
Baseline Scores and Group Comparisons
 Table 1 shows the demographic characteristics 
for each group and the group mean scores of each of 
the outcome measures. According to independent 
șƺǾȒǹǓș� ȠেȠǓșȠșॹ� ȠǦǓȖǓ� ΛǓȖǓ� ǿȅ� șǩǠǿǩЙǉƺǿȠ� ǏǩАǓȖǓǿǉǓș�
between the groups on any demographic or clinical 
variables at baseline. Scores on the Big Three Perfec-
tionism Scale and the Dysfunctional Attitudes Perfec-
tionism Scale were elevated in both groups (M=55.7 
on the DAS-PA; See Table 1) compared to previously 
studied populations, including a clinically depressed 
adolescent sample (M=53.7 on the DAS-PA; Jacobs 
et al., 2009). Total scores on the DASS-21 indicat-
ed mild to moderate levels of depression, anxiety, 
and stress (Lovibond & Lovibond, 1995) (See Table 
1). The majority of the sample (95.3%) considered 
themselves to be a perfectionist to some degree, to a 
considerable degree, or very much, while 74.7% ac-



104

WARD, WHEATION

knowledged that perfectionism sometimes gets in 
the way of their happiness, and 72.9% said that per-
fectionism sometimes slows progress towards goals.
Intervention Acceptability and Likability
 Participants reported liking the intervention; 
22.2% liked it “a little bit,” 42.2% liked it “somewhat.” 
and 35.6% liked it “very much,” while no one report-
ed disliking the intervention. Participants also indi-
cated that the intervention was helpful in increasing 
their understanding of perfectionism; in terms of 
how helpful it was, 2.2% said “not at all,” 6.7% said 
“a little bit,” 42.2% reported “somewhat,” and 48.9% 
selected “very.” Perceived helpfulness in teaching 
participants to combat their perfectionism was also 
assessed, with 4.4% of participants saying it was not 
at all helpful, 8.9% saying it was a little bit helpful, 
60% saying it was somewhat helpful, and 26.7% say-
ing it was very helpful. At the 1-week follow-up, par-
ticipants were asked, “Do you think that completing 
the program helped you with your perfectionism in 
the past week?” and 18.2% said “not at all,” 25% se-
lected “very little,” 52.3% said “somewhat,” and 4.5% 
said “very much.” When asked “How much did you 
try to implement the techniques learned into your 
ǏƺǩǹΡ�ǹǩǟǓঁॹ৛�ǾȅșȠ�ȒǓȅȒǹǓ�ȖǓȒȅȖȠǓǏ�ȒȣȠȠǩǿǠ�șȅǾǓ�ǓАȅȖȠ�
in; 6.8% said “not at all,” 22.7% selected “very little,” 
65.9% said “somewhat,” and 4.5% said “very much.” 
Twenty-two participants left open-ended feedback, 
and 19 of these comments were positive and empha-
sized the utility or likable features of the intervention.
Change in Outcome Measures 
 Repeated measures ANOVAs were utilized to test 
the hypothesis that the perfectionism intervention 
would reduce perfectionistic attitudes and depres-
sion, anxiety, and stress more than the stress-manage-
ǾǓǿȠ� ǉȅǿȠȖȅǹঀ� �ǩАǓȖǓǿǉǓș� ΛǓȖǓ� ƺșșǓșșǓǏ� ƺȠ� ǈƺșǓǹǩǿǓॹ�
immediate post-test, and 1-week follow-up, except 
for DASS-21, which was only assessed at baseline and 
�েΛǓǓǷࢲ ǟȅǹǹȅΛেȣȒঀ�eǦǓ�ЙȖșȠ��FKt��Λƺș� ǉȅǿǏȣǉȠǓǏ�
on the Dysfunctional Attitudes Perfectionism Sub-
scale, which violated Mauchly’s Test of Sphericity 
X2 (2)=25.924, p<.05, thus the degrees of freedom 
was adjusted for by reporting the Greenhouse-Geiss-
ǓȖ�ȖǓșȣǹȠșঀ�eǦǓ�ǓАǓǉȠ�ȅǟ�ȠǩǾǓ�Λƺș�șǩǠǿǩЙǉƺǿȠ�শ'�শࢲঀࢵࢶॹ�
115.782) = 6.145, p<.05, n2= .076); however, the 
ȠǩǾǓॴǉȅǿǏǩȠǩȅǿ� ǩǿȠǓȖƺǉȠǩȅǿ� ǓАǓǉȠ� Λƺș� ǿȅȠ� শ'ॹ� �ॹࢵࢶঀࢲ
115.782) = 1.935, p>.05, n2=.025) (See Figure 1). 
Similarly, Mauchly’s Test of Sphericity indicated 

that the assumption of sphericity was violated for 
the changes in the Big Three Perfectionism Scale (X2 
(2)=38.864, p<.05. After using the Greenhouse-Geiser 
ǉȅȖȖǓǉȠǩȅǿॹ�ȠǦǓ�ǓАǓǉȠ�Λƺș�șǩǠǿǩЙǉƺǿȠ�ǟȅȖ�ȠǩǾǓ�'শࢲঀࢸࢳࢴॹ�
74.335)=4.685, p<.05, n2=.077, but not for time*con-
dition F(1.327, 74.335)=.072, p>.05, n2=.001) (See 
Figure 2). Finally a repeated measures ANOVA of 
DASS total scores at baseline and at the 1-week fol-
ǹȅΛেȣȒ� ȖǓΚǓƺǹǓǏ� ȠǦƺȠ� ȠǦǓȖǓ�ΛǓȖǓ� șǩǠǿǩЙǉƺǿȠ�ǏǩАǓȖǓǿǉ-
es for time (F (1, 74) =185.872, p<.05, n2=.715), 
ǈȣȠ� ǿȅ� ǓАǓǉȠ� ǟȅȖ� ǉȅǿǏǩȠǩȅǿ� শ'� শࢲॹࢵࢸষ઀ࢹࢹࢲঀࢴࢵࢺॹ�
p>.05, n2=.011). Subscale scores were not analyzed 
ǏȣǓ� Ƞȅ� ȠǦǓ� ǹƺǉǷ� ȅǟ� șǩǠǿǩЙǉƺǿȠ� ǏǩАǓȖǓǿǉǓș� ǟȅȣǿǏ� ǟȅȖ�
time and time*condition on the DASS total scores.  

Discussion 
 The present study sought to examine the ef-
fectiveness of a single-session intervention in im-
proving perfectionism and associated mental 
health characteristics in a college-student pop-
ulation. Although symptoms improved for all 
clinical measures following the perfectionism in-
tervention, they similarly improved in the control con-
ǏǩȠǩȅǿঀ� eǦǓșǓ� ЙǿǏǩǿǠș� ƺȖǓ� ǏǩșǉȣșșǓǏ� ǩǿ� ǏǓȠƺǩǹ� ǈǓǹȅΛঀ���
 There are several potential reasons for the lack 
ȅǟ� șǩǠǿǩЙǉƺǿȠ� ǏǩАǓȖǓǿǉǓș� ǈǓȠΛǓǓǿ� ȠǦǓ� ǩǿȠǓȖΚǓǿȠǩȅǿ�
and control conditions in the study. Small sample 
șǩΦǓ�ǾƺΡ� ǦƺΚǓ� ǉȅǿȠȖǩǈȣȠǓǏ� Ƞȅ� ȠǦǓ� ǿȣǹǹ� ЙǿǏǩǿǠșঀ� eǦǓ�
decreases were fairly large for some measures, yet sta-
ȠǩșȠǩǉƺǹ�șǩǠǿǩЙǉƺǿǉǓ�Λƺș�ǿȅȠ�ƺǉǦǩǓΚǓǏঀ�'ȅȖ�ǩǿșȠƺǿǉǓॹ�ȠǦǓ�
mean score dropped from 55.31 at baseline to 48.01 
at 1-week follow-up on the Dysfunctional Attitudes 
Perfectionism Scale in the experimental group, which 
is almost a seven-point decrease and a decline of three 
points greater than the stress-management control. A 
post-hoc sensitivity analysis with the study’s sample 
size (N=79) suggested we had adequate power (.80) to 
ǏǓȠǓǉȠ�ƺǿ�ǓАǓǉȠ� șǩΦǓ�ȅǟ� ঀࢱࢲ�ȅȖ� ǹƺȖǠǓȖॹ�ΛǦǩǉǦ� ǩș� șǹǩǠǦȠǹΡ�
ǹƺȖǠǓȖ�ȠǦƺǿ�ƺ�ǾǓǏǩȣǾ�ǓАǓǉȠ�শȒƺȖȠǩƺǹ�ǓȠƺ�șȕȣƺȖǓǏ�઀�ঀࢺষঀ�
Therefore, our sample size was likely underpowered 
ǩǟ� ȠǦǓ� ǩǿȠǓȖΚǓǿȠǩȅǿ�ǦƺǏ�ƺ� șǾƺǹǹ� Ƞȅ�ǾǓǏǩȣǾ�ǓАǓǉȠঀ��ǹ-
though traditional 8-week perfectionism interventions 
ǦƺΚǓ�ǾǓǏǩȣǾ�Ƞȅ� ǹƺȖǠǓ�ǓАǓǉȠ�șǩΦǓșॹ� ȠǦǓ�ǓΠȠȖǓǾǓǹΡ�ǈȖǩǓǟ�
ǿƺȠȣȖǓ�ȅǟ�ȠǦǓ�ǩǿȠǓȖΚǓǿȠǩȅǿ�ǾƺǷǓș�ƺ�ǹƺȖǠǓȖ�ǓАǓǉȠ�șǩΦǓ�ǹǓșș�
probable. Additionally, although there were 79 partici-
pants who passed attention checks and submitted each 
assessment, many participants skipped questions. This 
led to fewer participants’ scores being analyzed in each 



105

SSI TARGETING PERFECTIONISM

ANOVA; for example, only 58 participants’ scores 
were analyzed for the repeated measures ANOVA for 
the BTPS. The majority of randomized controlled tri-
als conducted on online single-session interventions 
have included hundreds of participants (e.g., Schleider 
& Weisz, 2017), and the in-person SSI conducted on 
perfectionism included 105 participants in their data 
analysis with no control group (LaSota et al., 2017). 
Future work with larger samples is needed to further 
compare these conditions. In addition, it is possible 
that the single dose of perfectionism intervention was 
ǿȅȠ� șȣГǉǩǓǿȠ� Ƞȅ� ǏǓǾȅǿșȠȖƺȠǓ� șȣȒǓȖǩȅȖǩȠΡ� ȅΚǓȖ� șȠȖǓșș�
management. Most trials conducted on treatments 
for perfectionism have ranged from 8-16 sessions in 
length (LaSota et al., 2017), thus more practice and 
intervention time may be necessary to create score 
decreases greater than what the stress-management 
control produced. Relatedly, although one-week fol-
low-ups have been used in studies of single session 
interventions in the past (e.g., Davidson, Malloch, 
& Humphris, 2018; Duan & Bu, 2019), a longer fol-
low-up after the intervention would have provided 
participants with more time to implement practices 
they learned in their lives and utilize strategies more 
frequently. Therefore, future studies could include 3-, 
6-, or 12-month follow-ups and also explore whether 
repeated sessions and practice post-treatment con-
tribute to reductions in perfectionism symptoms. Al-
though there is nothing in the student timeline or a 
widespread stressful event that would have accounted 
for a decline in perfectionism, depression, anxiety, and 
stress from baseline to one-week follow-up, including 
follow-up assessments at various time points in fu-
ture research would allow for a more comprehensive 
understanding of changes in perfectionism over time.
 It is also plausible that the stress-management 
control condition represented an active intervention, 
suggesting that it was not necessarily an appropriate 
placebo control, but may provide information about 
ȠǦǓ�ȖǓȕȣǩȖǓǏ�șȒǓǉǩЙǉǩȠΡ�ȅǟ�ȒǓȖǟǓǉȠǩȅǿǩșǾ�ǩǿȠǓȖΚǓǿȠǩȅǿșঀ�
Perfectionistic behavior is thought to be associated 
with psychopathology, in part due to its association 
with stress..  Perfectionists have higher levels of stress 
exposure and stress reactivity (i.e.i.e., maladaptive 
ways of reacting to stressors), and they may gener-
ate or exacerbate stress for themselves by engaging in 
self-critical thinking in response to daily stressors and 
failing to reach high standards. If stressful events are 

reduced, it is likely that perfectionistic behavior and 
automatic perfectionistic thoughts will subsequently 
decrease, and when perfectionistic attitudes decrease, 
stress levels will fall, indicating a bidirectional relation-
ship (Hewitt & Flett, 2002). The results of the present 
study are similar to a study that had compared face-
to-face CBT for perfectionism to a stress-management 
ǉȅǿǏǩȠǩȅǿআ� ȠǦǩș� șȠȣǏΡ� ǩǿΚǓșȠǩǠƺȠǓǏ� ȠǦǓ� ǓАǓǉȠǩΚǓǿǓșș�ȅǟ�
an online 10-week CBT intervention for perfection-
ǩșǾ� ǩǿ� ЙȖșȠেΡǓƺȖ� ȒșΡǉǦȅǹȅǠΡ� șȠȣǏǓǿȠș� ƺǿǏ� ȖƺǿǏȅǾǹΡ�
assigned participants to either stress management, 
stress-management + CBT, or a control condition 
(Arpin-Cribbie et al., 2008). The techniques taught 
in their stress-management condition overlapped with 
some of the techniques presented in the stress-manage-
ment control of the current intervention. In line with 
our results, participants in the stress-management 
ǉȅǿǏǩȠǩȅǿ� ǦƺǏ� șǩǠǿǩЙǉƺǿȠ� ǏǓǉȖǓƺșǓș� ǩǿ� șǓǹǟেȅȖǩǓǿȠǓǏ�
perfectionism and concern over mistakes, although the 
perfectionism intervention and stress-management 
combined led to greater decreases in the perfectionism 
construct. The results from Arpin-Cribbie (2008) and 
the present study may indicate that stress management  
represents an active treatment for perfectionism and 
works well in combination with more targeted con-
tent. Thus, future research should further explore 
the complex relationship between perfectionism and 
stress, compare perfectionism interventions to other 
types of active controls, and work to elucidate the im-
ȒȅȖȠƺǿǉǓ�ȅǟ�șȒǓǉǩЙǉǩȠΡ�ǩǿ�ȒǓȖǟǓǉȠǩȅǿǩșǾ�ǩǿȠǓȖΚǓǿȠǩȅǿșঀ
� eǦǓ�ǩǿȠǓȖΚǓǿȠǩȅǿ�șǦȅȣǹǏ�ƺǹșȅ�ǈǓ�ȠǓșȠǓǏ�ǩǿ�ǏǩАǓȖǓǿȠ�
populations; one of the main limitations to the study 
is that the perfectionism intervention was designed 
for high levels of maladaptive perfectionism, yet it was 
tested in a typical nonclinical college-student popula-
tion. Although participants had higher than average 
levels of perfectionism, prior research indicates that 
perfectionism interventions, including single-session 
ǩǿȠǓȖΚǓǿȠǩȅǿș�ǾƺΡ�ǿȅȠ�ǈǓ�ǓАǓǉȠǩΚǓ�ǟȅȖ�ȠǦȅșǓ�ΛǩȠǦ�ǹȅΛ�
perfectionism. LaSota and colleagues (2017) focused 
on psychoeducation, setting high standards, fear over 
mistakes, and reducing stress in their in-person sin-
gle-session intervention, dividing participants into 
high, medium, and low perfectionists. They found 
that participants with low perfectionism showed 
ǿȅ� șǩǠǿǩЙǉƺǿȠ� ǉǦƺǿǠǓ�ȅΚǓȖ� ȠǩǾǓॹ�ΛǦǩǹǓ� ȠǦǓ�ȅȠǦǓȖ� ȠΛȅ�
groups did. Many perfectionism treatment studies 
have also utilized clinical samples (e.g., eating disorder 



106

WARD, WHEATION

or depressed populations) with high levels of maladap-
tive perfectionism (e.g., Kearns, Forbes, & Gardiner, 
2007). Additionally, most single-session interven-
tions have been tested in adolescents (Schleider et al., 
2020) and previous experience with psychoeducation 
about perfectionism or CBT for perfectionism could 
ȒȅȠǓǿȠǩƺǹǹΡ� ǹǩǾǩȠ� ǩȠș� ǓАǓǉȠǩΚǓǿǓșșঀ�eǦǩș�Λƺș�ǦǩǠǦǹǩǠǦȠ-
ed by one participant who wrote, “The intervention 
was likely not a good match for me as I have under-
gone CBT in the past for anxiety and perfectionism 
and already knew a lot of these techniques;” thus, 
those who have not undergone therapy in the past 
are younger and more capable of change—potentially 
making themselves better candidates. In addition to 
age, other demographic factors, such as gender, may 
interact with perfectionism (Gnilka & Novakovic, 
2017) and impact treatment response. Considering 
that the present sample was almost 90% female and 
previous literature on perfectionism consists of ma-
jority female participants (Stoeber & Stoeber, 2009), 
future research could aim to recruit more males to 
ǈǓȠȠǓȖ�ǓǹȣǉǩǏƺȠǓ�ȠǦǓ�ǩǾȒƺǉȠ�ȅǟ�ǠǓǿǏǓȖ�ȅǿ�ǓАǓǉȠǩΚǓǿǓșș�
of perfectionism treatments. Further research with 
larger sample sizes, especially research that includes 
populations with clinical perfectionism, is warranted.
 Despite the study’s limitations, many partici-
ȒƺǿȠș�ƺȒȒǓƺȖ�Ƞȅ�ǦƺΚǓ�ǈǓǿǓЙȠǓǏ�ǟȖȅǾ�ȠǦǓ�ǩǿȠǓȖΚǓǿȠǩȅǿॹ�
as respondents reported that the intervention was 
highly acceptable, engaging, and useful. All partici-
pants reported liking the intervention “at least a little 
bit” and 86.7% of participants thought the program 
was somewhat or very helpful. Additionally, 57% of 
students thought it was somewhat or very helpful in 
combating their perfectionism in the week following 
the intervention and 93% of respondents attempted to 
implement the learned skills into their daily lives. To 
ǉȅǿǉǹȣǏǓॹ� ȠǦǩș� șȠȣǏΡ� ǩș� ȠǦǓ�ЙȖșȠ� Ƞȅ� ǓΠƺǾǩǿǓ� ȠǦǓ� ǓАǓǉ-
tiveness of an online single-session intervention in re-
ducing perfectionism, depression, anxiety, and stress. 
Although prior literature was utilized to formulate 
hypotheses that the perfectionism intervention would 
ǈǓ�ǾȅȖǓ� ǓАǓǉȠǩΚǓ� ȠǦƺǿ� ƺ� șȠȖǓșșেǾƺǿƺǠǓǾǓǿȠ� ǉȅǿȠȖȅǹॹ�
ȠǦǓ� ȖǓșȣǹȠș� ȅǿǹΡ� ȖǓΚǓƺǹǓǏ� ƺ� șǩǠǿǩЙǉƺǿȠ� ǓАǓǉȠ� ǟȅȖ� ȠǩǾǓঀ�
eǦǓ� șȠȣǏΡ�Λƺș� ǹǩǷǓǹΡ� ȣǿǏǓȖȒȅΛǓȖǓǏ� Ƞȅ� ǏǓȠǓǉȠ� ǏǩАǓȖ-
ences between conditions, had limitations in that the 
sample contained many individuals with low perfec-
tionism, and the stress-management condition was 
ȒǓȖǦƺȒș� ǓАǓǉȠǩΚǓ� ƺȠ� ȖǓǏȣǉǩǿǠ� șȠȖǓșșॹ� ȠǦȣș� ǩǿǏǩȖǓǉȠǹΡ�

impacting perfectionism. Future research with larg-
er sample sizes, various types of control groups, and 
clinical populations is needed to more extensively 
ȠǓșȠ� ȠǦǓ�ǓАǓǉȠș�ȅǟ� ȠǦǓ� ǩǿȠǓȖΚǓǿȠǩȅǿঀ�FǓΚǓȖȠǦǓǹǓșșॹ� ȠǦǩș�
șȠȣǏΡ�ƺǏǏș�ǩǾȒȅȖȠƺǿȠ�ǩǿǟȅȖǾƺȠǩȅǿ�ƺǈȅȣȠ�ȠǦǓ�ǓАǓǉȠǩΚǓ-
ness of a perfectionism intervention when compared 
to a stress-management control, and it was rated as 
highly useful, likable, and acceptable by participants.  

References
Aldahadha, B. (2018). The psychometric properties of 

perfectionism scale and its relation to depression 
and anxiety. Cogent Psychology, 5(1), 1524324.

American Psychiatric Association. (2013). Diagnostic 
and statistical manual of mental disorders (5th 
ed.).

Andersson, G. (2016). Internet-delivered psychologi-
cal treatments. Annual Review of Clinical Psychol-
ogy, 12(1), 157–179. doi:https://doi.org/10.1146/
annurev-clinpsy-021815-093006 

Andrade, L. H., Alonso, J., Mneimneh, Z., Wells, J. 
E., Al-Hamzawi, A., Borges, G., ... & Florescu, S. 
(2014). Barriers to mental health treatment: results 
from the WHO World Mental Health (WMH) 
Surveys. Psychological medicine, 44(6), 1303. doi: 
https://doi.org/10.1017/s0033291713001943

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., 
& Swinson, R. P. (1998). Psychometric properties 
of the 42-item and 21-item versions of the De-
pression Anxiety Stress Scales (DASS) in clinical 
groups and a community sample. Psychological 
Assessment, 10, 176–181. doi: 10.1037/1040-
3590.10.2.176

Arpin-Cribbie, C.A., Irvine, J., & Ritvo, P (2008). 
Perfectionism and Psychological Distress: A Mod-
eling Approach to Understanding their Thera-
peutic Relationship. Journal of Rational-Emotive 
Cognitive-Behavioral Therapy. 26, 151–167. doi: 
10.1007/s10942-007-0065-2

Bedewy, D., & Gabriel, A. (2015). Examining percep-
tions of academic stress and its sources among 
university students: The Perception of Academ-
ic Stress Scale. Health psychology open, 2(2). doi: 
10.1177/2055102915596714

Besser, A., Flett, G., & Hewitt, P. (2004). Perfectionism, 
ǉȅǠǿǩȠǩȅǿॹ�ƺǿǏ�ƺАǓǉȠ� ǩǿ�ȖǓșȒȅǿșǓ�Ƞȅ�ȒǓȖǟȅȖǾƺǿǉǓ�
failure vs. success. Journal of Rational-Emotive 
and Cognitive-Behavior Therapy, 22(4), 301–328. 



107

SSI TARGETING PERFECTIONISM

doi:10.1023/B:JORE.0000047313.35872.5c  
Besser, A., Flett, G., Sherry, S., & Hewitt, P. (2020). Are 

perfectionistic thoughts an antecedent or a conse-
quence of depressive symptoms? A cross-lagged 
analysis of the Perfectionism Cognitions Invento-
ry. Journal of Psychoeducational Assessment, 38(1), 
99–111. doi: 10.1177/0734282919877764

�ǹƺȠȠॹ�^ঀ�=ঀॹ��ȣȖȅАॹ��ঀ��ঀॹ��ȅǿǏǩॹ��ঀ�Eঀॹ�^ƺǿǩșǹȅΛॹ��ঀ�
A. III, & Pilkonis, P. A. (1998). When and how 
perfectionism impedes the brief treatment of de-
pression: Further analyses of the National Insti-
tute of Mental Health Treatment of Depression 
Collaborative Research Program. Journal of Con-
sulting and Clinical Psychology, 66(2), 423–428. 
doi:10.1037//0022-006x.66.2.423  

Brown, B. (2008). I Thought It Was Just Me (But It 
Isn’t): Telling the Truth about Perfectionism.

Campbell, A. (2012). Single-session approaches to 
therapy: Time to review. Australian and New 
Zealand Journal of Family Therapy, 33(1), 15-26. 
doi:10.1017/aft.2012.3  

Center for Collegiate Mental Health. (2016). 2015 an-
nual report. https://ccmh.psu.edu/annual-reports 

Crandall, C. S., Preisler, J. J., & Aussprung, J. (1992). 
Measuring life event stress in the lives of college 
students: The Undergraduate Stress Question-
naire (USQ). Journal of behavioral medicine, 
15(6), 627-662. doi:10.1007/BF00844860 

Curran, T., & Hill, A. P. (2019). Perfectionism is in-
creasing over time: A meta-analysis of birth cohort 
ǏǩАǓȖǓǿǉǓș�ǟȖȅǾࢺࢹࢺࢲ��Ƞȅࢷࢲࢱࢳ�ঀ�Psychological Bul-
letin, 145(4), 410. doi: 10.1037/bul0000138 

Davidson, J., Malloch, M., & Humphris, G. (2018). 
A single-session intervention (the Mini-AFTERc) 
for fear of cancer recurrence: A feasibility study. 
Psycho-oncology, 27(11), 2668–2670. https://doi.
org/10.1002/pon.4724

De Graaf, L. E., Roelofs, J., & Huibers, M. J. (2009). 
Measuring dysfunctional attitudes in the general 
population: the dysfunctional attitude scale (form 
A) revised. Cognitive therapy and research, 33(4), 
345. doi: 10.1007/s10608-009-9229-y

Dodd, D. R., Parsons, E. M., Clerkin, E. M., For-
ȖǓșȠॹ� @ঀ� Fঀॹ� tǓǹǷȅАॹ� �ঀ� �ঀॹ� ?ȣǿșȠǾƺǿॹ� =ঀ�vঀॹ� ૭�
Smith, A. R. (2019). Perfectly imperfect: The use 
ȅǟ� ǉȅǠǿǩȠǩΚǓ� ǈǩƺș� ǾȅǏǩЙǉƺȠǩȅǿ� Ƞȅ� ȖǓǏȣǉǓ� ȒǓȖǟǓǉ-
tionism. Journal of behavior therapy and experi-
mental psychiatry, 64, 167-174. doi: 10.1016/j.

jbtep.2019.04.002 
Dozois D.J., Seeds P.M., & Collins K.A. (2009). Trans-

diagnostic approaches to the prevention of depres-
sion and anxiety. Journal of Cognitive Psychothera-
py, 23(1), 44-59. doi: 10.1891/0889-8391.23.1.44

Duan, W., & Bu, H. (2019). Randomized trial investi-
gating of a single-session character-strength-based 
cognitive intervention on freshman’s adaptability. 
Research on Social Work Practice, 29(1), 82-92. 
doi: 10.1177/1049731517699525

Egan, S. J., van Noort, E., Chee, A., Kane, R. T., Hoiles, 
K. J., Shafran, R., & Wade, T. D. (2014). A ran-
domised controlled trial of face to face versus pure 
online self-help cognitive behavioural treatment 
for perfectionism. Behaviour Research and Ther-
apy, 63, 107-113. doi: 10.1016/j.brat.2014.09.009 

Egan, S. J., Wade, T. D., & Shafran, R. (2011). Per-
fectionism as a transdiagnostic process: A clinical 
review. Clinical psychology review, 31(2), 203-212. 
doi: 10.1016/j.cpr.2010.04.009

Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. 
M. (2016). Cognitive-behavioral treatment of per-
fectionism. Guilford Publications. 

Fairweather-Schmidt, A. K., & Wade, T. D. (2015). Pi-
loting a perfectionism intervention for pre-adoles-
cent children. Behaviour research and therapy, 73, 
67–73. doi: 10.1016/j.brat.2015.07.004

Ferrari, J. R. (1995). Perfectionism cognitions with 
nonclinical and clinical samples. Journal of Social 
Behavior & Personality, 10(1), 143–156. https://
psycnet.apa.org/record/1995-31523-001 

Ferrari, M., Yap, K., Scott, N., Einstein, D. A., & Ci-
arrochi, J. (2018). Self-compassion moderates 
the perfectionism and depression link in both 
adolescence and adulthood. PloS one, 13(2). doi: 
10.1371/journal.pone.0192022

Fisak, B. J., Richard, D., & Mann, A. (2011). The 
prevention of child and adolescent anxiety: A me-
ta-analytic review. Prevention Science, 12(3), 255-
268. doi: 10.1007/s11121-011-0210-0

. Morbidity and Mortality Weekly Report, 67(23), 653–
658. https://doi.org/10.15585/mmwr.mm6723a1

Flett, G. L., Hewitt, P. L., Blankstein, K. R., & Mosh-
er, S. W. (1995). Perfectionism, life events, and 
depressive symptoms: A test of a diathesis-stress 
model. Current Psychology, 14(2), 112-137. doi: 
10.1007/BF02686885 

Frost, R. O., & Marten, P. A. (1990). Perfectionism 



108

WARD, WHEATION

and evaluative threat. Cognitive Therapy and Re-
search, 14, 559-572. doi: 10.1007/BF01173364

Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. 
(1990). The dimensions of perfectionism. Cog-
nitive Therapy and Research,14, 449–468. doi: 
10.1007/BF01172967

Gardenswartz, C. A., & Craske, M. G. (2001). Preven-
tion of panic disorder. Behavior Therapy, 32(4), 
725-737. doi: 10.1016/S0005-7894(01)80017-4

Gnilka, P. B., Ashby, J. S., & Noble, C. M. (2012). 
Multidimensional perfectionism and anxiety: Dif-
ferences among individuals with perfectionism 
and tests of a coping-mediation model. Journal of 
Counseling & Development, 90(4), 427–436. doi: 
10.1002/j.1556-6676.2012.00054.x

Gnilka, P. B., & Novakovic, A. (2017). Gender dif-
ferences in STEM students’ perfectionism, career 
șǓƺȖǉǦ�șǓǹǟেǓГǉƺǉΡॹ�ƺǿǏ�ȒǓȖǉǓȒȠǩȅǿ�ȅǟ�ǉƺȖǓǓȖ�ǈƺȖȖǩ-
ers. Journal of Counseling & Development, 95(1), 
56-66. doi: 10.1002/jcad.12117

Grzegorek, J. L., Slaney, R. B., Franze, S., & Rice, K. G. 
(2004). Self-Criticism, Dependency, Self-Esteem, 
and Grade Point Average Satisfaction Among 
Clusters of Perfectionists and Nonperfectionists. 
Journal of Counseling Psychology, 51(2), 192. doi: 
10.1037/0022-0167.51.2.192

Harvey, A. G., Watkins, E., & Mansell, W. (2004). Cog-
nitive behavioural processes across psychological dis-
orders: A transdiagnostic approach to research and 
treatment. Oxford University Press, Oxford.

Henry, J. D., & Crawford, J. R. (2005). The short-
form version of the Depression Anxiety Stress 
Scales (DASS-21): Construct validity and nor-
mative data in a large non-clinical sample. British 
journal of clinical psychology, 44(2), 227-239. doi: 
10.1348/014466505X29657

Hewitt, P. L., & Flett, G. L. (1991). Dimensions of 
Perfectionism in Unipolar Depression. Journal 
of Abnormal Psychology, 100(1), 98–101. doi: 
10.1037//0021-843x.100.1.98

. Morbidity and Mortality Weekly Report, 67(23), 
653–658. https://doi.org/10.15585/mmwr.mm6723a-
1Hewitt, P. L., Flett, G. L., & Mikail, S. F. (2017). 
Perfectionism: Conceptualization, assessment, and 
treatment. New York, NY: Guilford.

Hewitt, P. L. (2020). Perfecting, belonging, and re-
pairing: A dynamic-relational approach to per-
fectionism. Canadian Psychology, 61(2), 101. doi: 

10.1037/cap0000209
Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Mor-

ris, L. K., Robinaugh, D. J., Worthington, J. J., 
Pollack, M. H., & Simon, N. M. (2013). Random-
ized controlled trial of mindfulness meditation for 
ǠǓǿǓȖƺǹǩΦǓǏ�ƺǿΠǩǓȠΡ�ǏǩșȅȖǏǓȖॸ�ǓАǓǉȠș�ȅǿ�ƺǿΠǩǓȠΡ�ƺǿǏ�
stress reactivity. The Journal of clinical psychiatry, 
74(8), 786–792. doi: 10.4088/JCP.12m08083

James, K., Verplanken, B., & Rimes, K. A. (2015). 
Self-criticism as a mediator in the relationship be-
tween unhealthy perfectionism and distress. Per-
ȸȤȞǙȘȈȿͧ�ǙȞǮ�2ȞǮȈ͠ȈǮɂǙȘ��ȈωǲȵǲȞǨǲȸ128-�123࣓ࠔࠒ�࣓. 
doi: 10.1016/j.paid.2015.01.030

Jacobs, R. H., Silva, S. G., Reinecke, M. A., Curry, J. 
F., Ginsburg, G. S., Kratochvil, C. J., & March, 
J. S. (2009). Dysfunctional attitudes scale per-
fectionism: A predictor and partial mediator of 
acute treatment outcome among clinically de-
pressed adolescents. Journal of Clinical Child 
& Adolescent Psychology, 38(6), 803-813. doi: 
10.1080/15374410903259031

Kearns, H., Forbes, A., & Gardiner, M. (2007). A cog-
nitive behavioural coaching intervention for the 
treatment of perfectionism and self-handicapping 
in a nonclinical population. Behaviour Change, 
24(3), 157. doi: 10.1375/bech.24.3.157

Klibert, J., Lamis, D. A., Collins, W., Smalley, K. B., 
Warren, J. C., Yancey, C. T., & Winterowd, C. 
(2014). Resilience mediates the relations between 
perfectionism and college student distress. Journal 
of Counseling & Development, 92(1), 75-82. doi: 
10.1002/j.1556-6676.2014.00132.x 

Kutlesa, N., & Arthur, N. (2008). Overcoming nega-
tive aspects of perfectionism through group treat-
ment. Journal of Rational-Emotive and Cogni-
tive-Behavior Therapy, 26, 134–150. doi: 10.1007/
s10942-007-0064-3

LaSota, M. T., Ross, E. H., & Kearney, C. A. (2017). 
A cognitive-behavioral-based workshop interven-
tion for maladaptive perfectionism. Journal of 
Rational-Emotive & Cognitive-Behavior Therapy, 
35(3), 314-328. doi: 10.1007/s10942-017-0261-7 

Limburg, K., Watson, H. J., Hagger, M. S., & Egan, 
S. J. (2017). The relationship between perfection-
ism and psychopathology: A meta-analysis. Jour-
nal of clinical psychology, 73(10), 1301-1326. doi: 
10.1002/jclp.22435 

 Lloyd, S., Schmidt, U., Khondoker, M., & Tchan-



109

SSI TARGETING PERFECTIONISM

turia, K. (2015). Can psychological interven-
tions reduce perfectionism? A systematic review 
and meta-analysis. Behavioural and cognitive 
psychotherapy, 43(6), 705-731. doi: 10.1017/
S1352465814000162

Lovibond, P. F., & Lovibond, S. H. (1995). The struc-
ture of negative emotional states: Comparison of 
the Depression Anxiety Stress Scales (DASS) with 
the Beck Depression and Anxiety Inventories. Be-
haviour research and therapy, 33(3), 335-343. doi: 
10.1016/0005-7967(94)00075-u

Lundh, L. G., & Öst, L. G. (2001). Attentional bias, 
self-consciousness and perfectionism in social 
phobia before and after cognitive-behaviour ther-
apy. Scandinavian Journal of Behaviour Therapy, 
30(1), 4-16.  doi: 10.1080/02845710117841

Molnar, D., Sirois, F., Flett, G., & Sadava, S. (2020). 
A person-oriented approach to multidimen-
șǩȅǿƺǹ� ȒǓȖǟǓǉȠǩȅǿǩșǾॸ� XǓȖǟǓǉȠǩȅǿǩșǾ� ȒȖȅЙǹǓș�
in health and well-being. Journal of Psycho-
educational Assessment, 38(1), 127–142. doi: 
10.1177/0734282919877754

Nadeau, M. M., Caporale-Berkowitz, N. A., & Roch-
len, A. B. (2020). Improving women’s self-com-
passion through an online program: A randomized 
controlled trial. Journal of Counseling & Develop-
ment, 99(1), 47-59. doi: 10.1002/jcad.12353

Nehmy, T. J., & Wade, T. D. (2015). Reducing the on-
șǓȠ�ȅǟ�ǿǓǠƺȠǩΚǓ�ƺАǓǉȠ�ǩǿ�ƺǏȅǹǓșǉǓǿȠșॸ��ΚƺǹȣƺȠǩȅǿ�ȅǟ�
a perfectionism program in a universal prevention 
setting. Behaviour Research and Therapy, 67, 55-
63. doi: 10.1016/j.brat.2015.02.007

Obsessive Compulsive Cognitions Working Group. 
(1997). Cognitive assessment of obsessive com-
pulsive disorder. Behaviour Research and Therapy, 
35, 7. doi:10.1016/S0005-7967(97)00017-X

O’Connor, R., & O’Connor, D. (2003). Predicting 
hopelessness and psychological distress: The role 
of perfectionism and coping. Journal of Counseling 
Psychology, 50(3), 362–372. doi:10.1037/0022-
0167.50.3.362

O’Connor, R. (2007). The relations between perfec-
tionism and suicidality: A systematic review. Sui-
cide and Life-Threatening Behavior, 37(6), 698–
714. doi: 10.1521/suli.2007.37.6.698

Olfson, M., Mojtabai, R., Sampson, N. A., Hwang, I., 
Druss, B., Wang, P. S., ... & Kessler, R. C. (2009). 
Dropout from outpatient mental health care in 

the United States. Psychiatric Services, 60(7), 898-
907. doi: 10.1176/appi.ps.60.7.898

Osman, A., Wong, J. L., Bagge, C. L., Freedenthal, 
S., Gutierrez, P. M., & Lozano, G. (2012). The 
depression anxiety stress Scales—21 (DASS-21): 
further examination of dimensions, scale reliabil-
ity, and correlates. Journal of clinical psychology, 
68(12), 1322-1338. doi:10.1002/jclp.21908

Overholser, J., & Dimaggio, G. (2020). Struggling with 
perfectionism: When good enough is not good 
enough. Journal of Clinical Psychology, 76(11), 
2019-2027. doi: 10.1002/jclp.23047

Pacewicz, C. E., Gotwals, J. K., & Blanton, J. E. (2018). 
Perfectionism, coping, and burnout among inter-
collegiate varsity athletes: A person-oriented in-
ΚǓșȠǩǠƺȠǩȅǿ� ȅǟ� ǠȖȅȣȒ� ǏǩАǓȖǓǿǉǓș� ƺǿǏ� ǾǓǏǩƺȠǩȅǿঀ�
Psychology of Sport and Exercise, 35, 207-217. doi: 
10.1016/j.psychsport.2017.12.008

Parks AC, Williams A, Tugade M,  Hokes K, Hono-
michl R,  Zilca R. (2018). Testing a scalable web 
and smartphone based intervention to improve 
depression, anxiety, and resilience: A random-
ized controlled trial. International Journal of 
Wellbeing, (2), 22-67. https://internationaljour-
nalofwellbeing.org/index.php/ijow/article/down-
load/745/677/3641 

[ƺǓșॹ�'ঀॹ�XȅǾǾǩǓȖॹ��ঀॹ�FǓАॹ�?ঀ��ঀॹ�૭�tƺǿ�(ȣǉǦȠॹ��ঀ�
(2011). Construction and factorial validation of 
a short form of the Self-Compassion Scale. Clin-
ical Psychology & Psychotherapy. 18, 250-255. doi: 
10.1002/cpp.702

Rose, A., McIntyre, R., & Rimes, K. A. (2018). Com-
passion-focused intervention for highly self-criti-
cal individuals: Pilot study. Behavioural and cogni-
tive psychotherapy, 46(5), 583-600. doi: 10.1017/
S135246581800036X

Rozental, A., Shafran, R., Wade, T., Egan, S., Nor-
dgren, L. B., Carlbring, P., … Andersson, G. 
(2017). A randomized controlled trial of Inter-
net-Based Cognitive Behavior Therapy for per-
fectionism including an investigation of outcome 
predictors. Behaviour Research and Therapy, 95, 
79–86. doi: 10.1016/j.brat.2017.05.015

Samson, J. E., & Tanner-Smith, E. E. (2015). Single-ses-
sion alcohol interventions for heavy drinking col-
lege students: A systematic review and meta-analy-
sis. Journal of Studies on Alcohol and Drugs, 76(4), 
530-543. doi: 10.15288/jsad.2015.76.530



110

WARD, WHEATION

Schleider, J. L., Dobias, M., Sung, J., Mumper, E., & 
Mullarkey, M. C. (2020). Acceptability and Utility 
of an Open-Access, Online Single-Session Interven-
tion Platform for Adolescent Mental Health. doi: 
10.2196/20513 

Schleider JL, Dobias ML, Sung JY, Mullarkey MC. 
(2020). Future Directions in Single-Session Youth 
Mental Health Interventions. Journal of Clinical 
and Child Adolescent Psychology, 49(2):264–278. 
doi: 10.1080/15374416.2019.1683852

Schleider, J. L., & Weisz, J. R. (2016). Reducing risk 
ǟȅȖ�ƺǿΠǩǓȠΡ�ƺǿǏ�ǏǓȒȖǓșșǩȅǿ�ǩǿ�ƺǏȅǹǓșǉǓǿȠșॸ��АǓǉȠș�
of a single-session intervention teaching that per-
sonality can change. Behaviour research and thera-
py, 87, 170-181. doi: 10.1016/j.brat.2016.09.011

Schleider, J. L., & Weisz, J. R. (2017). Little treatments, 
ȒȖȅǾǩșǩǿǠ�ǓАǓǉȠșঁ�EǓȠƺেƺǿƺǹΡșǩș�ȅǟ�șǩǿǠǹǓেșǓșșǩȅǿ�
interventions for youth psychiatric problems. 
Journal of the American Academy of Child & Ado-
lescent Psychiatry, 56(2), 107-115. doi: 10.1016/j.
jaac.2016.11.007

Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). 
Clinical perfectionism: A cognitive–behavioural 
analysis. Behaviour research and therapy, 40(7), 
773-791. doi: 10.1016/s0005-7967(01)00059-6

Shafran, R., & Mansell, W. (2001). Perfectionism and 
psychopathology: A review of research and treat-
ment. Clinical Psychology Review, 21(6), 879–906. 
doi: 10.1016/S0272-7358(00)00072-6

Shafran, R., Wade, T. D., Egan, S. J., Kothari, R., All-
cott-Watson, H., Carlbring, P., ... & Andersson, 
G. (2017). Is the devil in the detail? A randomised 
controlled trial of guided internet-based CBT for 
perfectionism. Behaviour Research and Therapy, 
95, 99-106. doi: 10.1016/j.brat.2017.05.014

Sirois, F. M. (2014). Procrastination and 
stress: Exploring the role of self-compas-
sion. Self and Identity, 13(2), 128-145. doi: 
10.1080/15298868.2013.763404

Smith, M. M., Saklofske, D. H., Stoeber, J., & Sher-
ry, S. B. (2016). The big three perfectionism scale: 
A new measure of perfectionism. Journal of Psy-
choeducational Assessment, 34(7), 670-687. doi: 
10.1177/0734282916651539

Steele, A. L., & Wade, T. D. (2008). A randomised tri-
al investigating guided self-help to reduce perfec-
tionism and its impact on bulimia nervosa: A pilot 
study. Behaviour Research and Therapy, 46(12), 

1316-1323. doi: 10.1016/j.brat.2008.09.006
Stoeber, J., & Stoeber, F. S. (2009). Domains of per-

fectionism: Prevalence and relationships with per-
fectionism, gender, age, and satisfaction with life. 
XǲȵȸȤȞǙȘȈȿͧ�ǙȞǮ�ȈȞǮȈ͠ȈǮɂǙȘ�ǮȈωǲȵǲȞǨǲȸࠑࠏ�࣓ऒࠏओ�530࣓-
535. doi: 10.1016/j.paid.2008.12.006

Stober, J. (1998). The Frost Multidimensional Perfec-
tionism Scale: More perfect with four (instead of 
six) dimensions. Personality and Individual Dif-
ferences, 24(4), 481-491. https://core.ac.uk/down-
load/63723.pdf 

Suh, H., Sohn, H., Kim, T., & Lee, D. G. (2019). A re-
view and meta-analysis of perfectionism interven-
tions: Comparing face-to-face with online modal-
ities. Journal of Counseling Psychology, 66(4), 473. 
doi:10.1037/cou0000355

Sung, J. Y., Mumper, E., & Schleider, J. L. (2021). 
Empowering Anxious Parents to Manage Child 
Avoidance Behaviors: Randomized Control Trial 
of a Single-Session Intervention for Parental Ac-
commodation. JMIR mental health, 8(7), e29538. 
doi:10.2196/29538

Tanner-Smith, E. E., Steinka-Fry, K. T., Hennessy, E. 
A., Lipsey, M. W., & Winters, K. C. (2015). Can 
brief alcohol interventions for youth also address 
concurrent illicit drug use? Results from a me-
ta-analysis. Journal of youth and adolescence, 44(5), 
1011-1023. doi: 10.1007/s10964-015-0252-x 

Wasil, A. R., Taylor, M. E., Franzen, R. E., Steinberg, 
J. S., & DeRubeis, R. J. (2021). Promoting Grad-
uate Student Mental Health During COVID-19: 
Acceptability, Feasibility, and Perceived Utility 
of an Online Single-Session Intervention. Fron-
tiers in psychology, 12, 569785. doi: 10.3389/ 
fpsyg.2021.569785

Weissman, A. N., & Beck, A. T. (1978). Development 
and validation of the Dysfunctional Attitude Scale: 
A preliminary investigation. https://eric.ed.gov
/?id=ED167619 

Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., 
Ugueto, A. M., Vaughn-Coaxum, R., ... & Weers-
ǩǿǠॹ�tঀ�[ঀ� শࢸࢲࢱࢳষঀ�vǦƺȠ� ЙΚǓ� ǏǓǉƺǏǓș� ȅǟ� ȖǓșǓƺȖǉǦ�
ȠǓǹǹș� ȣș� ƺǈȅȣȠ� ȠǦǓ� ǓАǓǉȠș� ȅǟ� ΡȅȣȠǦ� ȒșΡǉǦȅǹȅǠǩǉƺǹ�
therapy: a multilevel meta-analysis and implica-
tions for science and practice. American Psycholo-
gist, 72(2), 79. doi: 10.1037/a0040360

Wheaton, M. G., Pinto, A. M., Cervoni, C., Crosby, 
=ঀ�Eঀॹ�eǩАȠॹ��ঀ��ঀॹ�EƺȠǦǓșॹ��ঀ�Eঀॹ�ঀঀঀ�૭�XǩǿȠȅॹ��ঀ�



111

SSI TARGETING PERFECTIONISM

(2020). Perfectionism in Intensive Residential 
Treatment of Obsessive–Compulsive Disorder. 
Cognitive Therapy and Research, 44(1), 136-144. 
doi: 10.1007/s10608-019-10047-6

Yeh, M. Y., Tung, T. H., Horng, F. F., & Sung, S. 
�ঀ� শࢸࢲࢱࢳষঀ� �АǓǉȠǩΚǓǿǓșș� ȅǟ� ƺ� ȒșΡǉǦȅǓǏȣǉƺȠǩȅǿƺǹ�
programme in enhancing motivation to change 
alcohol-addictive behaviour. Journal of Clinical 
Nursing, 26(21–22), 3724–3733. doi: 10.1111/
jocn.13744.

Zalta, A. K., & Shankman, S. A. (2016). Conduct-
ing psychopathology prevention research in the 
RDoC era. Clinical Psychology: Science and Prac-
tice, 23(1), 94-104. doi: 10.1111/cpsp.12144



112

WARD, WHEATION



113

SSI TARGETING PERFECTIONISM


