Efficacy of Internet-based cognitive behavioral therapy for reducing perfectionistic strivings in the Republic of Korea: A randomized controlled trial

互联网认知行为疗法在降低韩国完美主义倾向方面的疗效:一项随机对照试验

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Abstract

BACKGROUND: Perfectionistic strivings characterized by excessively high standards, fears of mistakes, and critical self-evaluations can lead to avoidance, worry, procrastination, and self-criticism, negatively impacting mental health. Since individuals with perfectionism are less likely to seek face-to-face therapy, internet-based cognitive behavioral therapy (ICBT) may improve accessibility. OBJECTIVES: This study evaluated the effectiveness of an ICBT program specifically designed to reduce perfectionistic strivings. METHODS: A total of 101 participants with significant perfectionism were randomly assigned to a 5-week unguided ICBT program or a waiting list control group. Online assessments were conducted at baseline and post-intervention using the Frost Multidimensional Perfectionism Scale (FMPS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and Satisfaction with Life Scale (SWLS). Intention-to-treat and completer analyses were performed. RESULTS: Of 101 participants, 62 (61.4 %) completed both assessments. The ICBT group completed an average of 3.71 out of 5 modules, with 58.8 % completing all. Compared to the control group, the ICBT group showed significant reductions in perfectionistic strivings (FMPS Concern over Mistakes: d = -0.65, 95 % CI [-1.05, -0.25]), anxiety (GAD-7: d = -0.42, 95 % CI [-0.83, -0.01]), and increased life satisfaction (SWLS: d = 0.62, 95 % CI [0.20, 1.03]). CONCLUSIONS: The ICBT program effectively reduced perfectionistic strivings and related symptoms, highlighting its potential as a scalable and accessible intervention. Further studies are warranted to directly compare ICBT with traditional face-to-face CBT and assess the durability of treatment effects.

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