Cognitive Behavioral Model Of Clinical Perfectionism (Shafran, Cooper, Fairburn, 2002)

People with perfectionism pursue high standards in one or more areas of their life and base their self-worth on their ability to achieve these standards, even though this has negative consequences (Shafran, Egan, & Wade, 2010). Perfectionism can arise in domains including: work, appearance, bodily hygiene, social and romantic relationships, eating habits, health, time management, hobbies and leisure activities, sports, orderliness, and several others (Stoeber, J., & Stoeber, F., 2009). 

Working with perfectionism is complicated by the overlap between positive perfectionism (sometimes referred to as normal, adaptive, or healthy perfectionism) and negative perfectionism (sometimes referred to neurotic, maladaptive, or unhealthy perfectionism). Shafran, Cooper & Fairburn (2002) suggest that perfectionism found in clinical groups (which they refer to as ‘clinical' perfectionism) is distinguishable from the functional pursuit of excellence (positive perfectionism) by an “overdependence of self-evaluation on the detrimental pursuit of personally demanding, self-imposed standards in at least one highly salient domain,

“It would be helpful if we could explore and understand how your perfectionism has developed and what is keeping it going. Could we explore some of your thoughts, feelings, and behaviors, to see what kind of pattern they follow?” 

1. Set standards. 

Help the client identify one or two life domains in which they set high standards for themselves. If the client struggles to do this, explore some of the general areas in their life where high standards might exist (such as work, relationships, appearance, weight, finances, etc.) or where difficulties are reported. Next, help the client specify some of their high standards in each domain. Perfectionistic standards usually take the form of strict and inflexible ‘should’ or ‘must’ rules related to achievement and performance.

• Can you tell me about one or two areas of your life where you set yourself high standards?
• In what situations does your perfectionism seem strongest?
• Do you set yourself

• Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 31, 203-212.
• Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014). Cognitive-behavioral treatment of perfectionism. Guilford Press.
• Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
• Lee, M., Roberts-Collins, C., Coughtrey, A., Phillips, L., & Shafran, R. (2011). Behavioral expressions, imagery and perfectionism. Behavioural and Cognitive Psychotherapy, 39, 413-425.
• Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2017). The relationship between perfectionism and psychopathology: A meta-analysis. Journal of Clinical Psychology, 73, 1301-1326.
• Maloney, G. K., Egan, S. J., Kane, R. T., Rees, C. S. (2014). An etiological model of perfectionism. PloS One, 9, e94757.
• Riley, C., & Shafran, R. (2005). Clinical perfectionism: A preliminary qualitative analysis. Behavioural and Cognitive Psychotherapy, 33, 369-374.
• Shafran, R., Cooper, Z., &