Are Perfectionist Therapists Perfect? Addressing Therapist Schemas in CBT

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    Abstract

    Research has largely focussed on establishing how client perfectionism relates to psychopathology, how it may impede outcomes in
    cognitive-behavioural therapy (CBT) and how it might be understood and treated. Less attention has been given to how therapist
    perfectionism may impact upon the therapeutic process within CBT treatment. The importance of therapists reflecting upon their own
    schema has featured little in the CBT literature until more recently (Haarhoff, 2006), with the emphasis traditionally being on
    implementing model-driven interventions (Leahy, 2008). Recent work has given more attention to the benefits of therapists reflecting
    upon the potential impact of their own schema upon their therapeutic work (Leahy 2001; Young, Klosko and Weishar, 2003; Haarhoff,
    2006) and the use of supervision, self-reflection and self-practice is now being more strongly encouraged (Bennet-Levy, 2006; Pretorius,
    2006). Perfectionism has been identified as a common therapist schema, with Haarhoff (2006) finding rates of 75-87% amongst trainee
    CBT therapists. Whilst multidimensional explanations of perfectionism acknowledge adaptive components of the construct which may
    enhance therapist effectiveness (e.g. organisation, positive striving for achievement, orderliness), the potential detrimental effect of more
    maladaptive components remains. Indeed, a recent study found a number of significant negative associations were observed between
    aspects of therapist perfectionism, treatment efficacy and client retention in treatment (Presley, Jones and Newton, 2017). More
    specifically, therapist factors such as having high standards for others, striving for excellence, being concerned about making mistakes,
    rumination and planfulness were all associated with lesser treatment outcomes for depression and/or anxiety disorders. This skills class
    therefore provides an opportunity for participants to consider how and why these therapist factors might impede CBT treatment, consider
    how such effects might be reduced, and reflect on any personal challenges/changes related to this.
    The skills class aims to:
    1. To consider both client and therapist factors which contribute to therapeutic relationships and outcomes in psychotherapy
    2. To reflect upon the impact of our own schema on our work with our clients
    3. To consider the impact of therapist perfectionism specifically
    4. To discuss and interpret research outcomes in this area
    5. To consider ways in which we can manage and minimise any detrimental effect of our schema on our therapeutic work with clients
    References:
    Haarhoff, B. A. (2006) The Importance of Identifying Therapist Schema in Cognitive Therapy Training and Supervision. New Zealand Journal
    of Psychology, 35 (3): 126-131.
    Presley, V. L., Jones, C. A., & Newton, E. K. (2017). Are Perfectionist Therapists Perfect? The Relationship between Therapist Perfectionism
    and Client Outcomes in Cognitive Behavioural Therapy. Behavioural and Cognitive Psychotherapy , 45 (3): 225-237.
    Original languageEnglish
    Title of host publicationCBT Back to the Future
    Subtitle of host publicationCelebrating 50 years of CBT in Europe
    Publication statusPublished - 2021
    EventEuropean Association for Behavioural and Cognitive Psychotherapies Annual Congress 2021 - Belfast, United Kingdom
    Duration: 8 Sept 202111 Sept 2021

    Conference

    ConferenceEuropean Association for Behavioural and Cognitive Psychotherapies Annual Congress 2021
    Country/TerritoryUnited Kingdom
    CityBelfast
    Period8/09/2111/09/21

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