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

## TL;DR

An online therapy program successfully reduced perfectionism and related issues in South Korea, offering a scalable mental health solution.

## Contribution

First randomized controlled trial of internet-based CBT for perfectionism in South Korea.

## Key findings

- ICBT significantly reduced perfectionistic strivings and anxiety in participants.
- Participants in the ICBT group showed increased life satisfaction compared to the control group.
- The unguided ICBT program demonstrated efficacy comparable to guided interventions.

## Abstract

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.

This study evaluated the effectiveness of an ICBT program specifically designed to reduce perfectionistic strivings.

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.

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]).

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.

•Internet-based CBT (ICBT) effectively reduced perfectionistic strivings and associated distress.•The study is the first RCT of ICBT for perfectionism conducted in South Korea.•Participants in the ICBT group showed significant improvements in anxiety and life satisfaction.•An unguided ICBT program demonstrated efficacy comparable to guided interventions.•Findings highlight ICBT's potential as a scalable, accessible treatment for perfectionism.

Internet-based CBT (ICBT) effectively reduced perfectionistic strivings and associated distress.

The study is the first RCT of ICBT for perfectionism conducted in South Korea.

Participants in the ICBT group showed significant improvements in anxiety and life satisfaction.

An unguided ICBT program demonstrated efficacy comparable to guided interventions.

Findings highlight ICBT's potential as a scalable, accessible treatment for perfectionism.