Perfectionism unbound: An integrated individual and group intervention for those hiding imperfections

Abstract

The tendency to hide and mask suffering and one's perceived imperfections is one of the biggest obstacles in treating those with prominent perfectionistic traits. In this single case, we present an integrative form of psychotherapy for patients with recurrent strategies aimed at neither displaying nor disclosing their perfectionism. Emily was a 26‐year‐old woman diagnosed with Major Depressive Disorder and reported a personality pathology as diagnosed through the Alternative Model of Personality Disorders. The intervention comprised of a 4‐month individual therapy and 2‐month group therapy. The former is based on Metacognitive Interpersonal Therapy protocol for personality disorders. The latter is a protocol that integrates the Dynamic Relational Treatment for Perfectionism and Compassion Focused Therapy. At the end of this integrative treatment, Emily remitted from Major Depressive Disorder and personality pathology. Further studies should confirm our promising results in larger samples.

Structured group psychotherapies: Advantages, challenges, and possibilities

“…Structured group treatments can also integrate aspects of different approaches, combining more than one theory‐specific model to maximize pathways of therapeutic action. One such innovation blends components of compassion‐focused therapy, metacognitive interpersonal therapy, and dynamic relational therapy to address multidimensional perfectionism in a combined individual and group therapy program (Cheli et al, 2022). In this treatment, a relational psychodynamic case formulation is used to guide treatment through a phase of individual metacognitive interpersonal therapy—aimed at examining core schemas—followed by group therapy focused on acceptance and mindful self‐compassion.…”

Beyond treatment modalities: Clinical decisions and relational dynamics that facilitate change in group treatments

“…1.6 | Integrating MIT and CFT: The case of Emily Cheli et al (2022) utilized an intervention that combined individual MIT (Dimaggio et al, 2020) with a group intervention based on CFT for individuals with perfectionism. The individual presented in the case study received 4 months of MIT individual therapy followed by group therapy for 2 months.…”

“…Second, once a group treatment is identified, there remains the question of how and if complementary individual sessions are helpful/needed. Patients in four of the six described group treatments in this issue also participated in individual therapy sessions in addition to their group sessions (Cheli et al, 2022; Inchausti et al, 2022; Juul et al, 2022; Straarup et al, 2022). The individual sessions were typically conducted at the beginning of treatment to develop a case formulation, with a couple of additional sessions to supplement the group or help with termination (Inchausti et al, 2022; Straarup et al, 2022).…”

“…The individual sessions were typically conducted at the beginning of treatment to develop a case formulation, with a couple of additional sessions to supplement the group or help with termination (Inchausti et al, 2022; Straarup et al, 2022). In one case, several months of individual sessions were conducted before the start of the group (Cheli et al, 2022) or individual sessions were interspersed with group sessions every other week (Juul et al, 2022). Notably, one treatment that did not incorporate individual sessions actively discouraged seeking individual treatment immediately following the course of group therapy, as they argued that therapy gains may continue after the treatment ends (Lorentzen, 2022).…”

“…Another clinical decision that was touched on in the six described group treatments is whether to strive for a group with patients with homogeneous or heterogeneous presenting problems. In the case examples presented, three of the studies reported on recruitment for therapy groups based on specific symptom presentations: borderline personality disorder, avoidant personality disorder, and clinical levels of perfectionism (Cheli et al, 2022; Inchausti et al, 2022; Juul et al, 2022). One group, GST, was designed for individuals with anxiety disorders who may share common traits but do not necessarily have the same disorder (Straarup et al, 2022).…”