The evaluation of a cognitive behavioural treatment protocol on perfectionism & low self-esteem amongst clients with mood and anxiety disorders : an interpretative phenomenological approach

Abstract

Perfectionism can be constructed as a trans diagnostic concept that co exists and probably contributes to the onset development and maintenance of a number of Axis 1 disorders. There is also a significant relationship between perfectionism and low self- esteem. There is considerable theoretical debate in the literature concerning whether perfectionism is uni or multi-dimensional with most therapies being based upon uni dimensional conceptualisations and thus overlooking interpersonal factors. This is also reflected in the relative absence of qualitative studies that explore perfectionism from a lived experience perspective. Aims: This study aims to explore the experiences of perfectionism and low self-esteem in different life domains. It also aims to evaluate the client’s experiences and efficacy of a proposed treatment protocol that targets perfectionism from a multidimensional perspective. Method: The study is divided into three phases. A Multiple baseline design is used to evaluate the treatment protocol including cognitive and behavioural interventions, compassionate mind training and assertiveness training to target perfectionism and low self-esteem. Two clinical groups experiencing Axis 1 disorders and high perfectionism are divided amongst the different phases of this study, 13 and 8 participants respectively. Mixed methods are administered to analyse the data with greater emphasis on the qualitative ones. Measures administered include the Beck Depression & Anxiety Inventories; the Rosenberg Self Esteem Scale; the Dysfunctional Attitudes Scale; the Multidimensional Perfectionism Scale by Frost and the Perfectionistic Self Presentation Scale. 8 semi-structured interviews are analysed utilising Interpretative Phenomenological Approach (IPA). Results: from the analysis of data it is evident that perfectionism is a multidimensional construct with strong interpersonal features that affect several different life domains. The proposed treatment protocol appears significantly effective in reducing perfectionism and Axis 1 disorder symptomatology. Additionally, there is a significant increase in self- esteem. Interventions that appear most helpful are behavioural experiments, assertiveness training, compassionate mind training, continuum and positive logging.