Comparative Effectiveness of Face-to-Face Cognitive-Behavioral Therapy and Combined Cognitive-Behavioral Therapy (Face-to-Face + Web-Based Application) on Maladaptive Perfectionism in College Students: A Randomized Controlled Trial.

Abstract

Background: The effectiveness of integrating a self-help training application with cognitive behavioral therapy (CBT) for treating maladaptive perfectionism remains unclear. This study evaluated the impact of combining CBT with a web-based program versus CBT alone on psychological outcomes in college students with maladaptive perfectionism.

Methods: This study involved 52 participants randomized to a 10-week intervention of either CBT or CBT combined with a web-based application. Outcomes assessed included perfectionism, depression, anxiety, stress, psychological well-being, procrastination, and life satisfaction, measured through self-reporting at baseline, posttreatment, and 3 follow-ups. Data analyses utilized independent t tests, chi-square tests for preintervention differences, and repeated mixed analysis of variance (ANOVA) to evaluate intervention effects over time, with effect sizes calculated using η².

Results: Participants had a mean age of 27.85 years (SD, 4.94), were predominantly female (n = 34; 74%), mostly single (n = 29; 73.9%), and held a master's degree (n = 20; 43.5%). Overall, 52 participants were randomized into 2 groups, with 26 participants in each group. Of these, 23 participants from each group completed the treatment and follow-up periods. The CBT combined with an App group demonstrated superior effectiveness in addressing perfectionism and improving interpersonal sensitivity, striving for excellence, and high standards for others compared with CBT alone. In addition, this combined treatment was significantly better than CBT in reducing stress, increasing psychological well-being, and improving life satisfaction.

Conclusion: Integrating a web-based self-help application with CBT effectively reduces maladaptive perfectionism and associated psychopathology, highlighting the potential benefits of combining digital tools with traditional therapeutic approaches.