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

ElsevierVolume 41, September 2025, 100851Internet InterventionsAuthor links open overlay panel, , , , , , , Highlights•

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

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

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

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An unguided ICBT program demonstrated efficacy comparable to guided interventions.

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

AbstractBackground

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.

Objectives

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

Methods

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.

Results

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]).

Conclusions

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.

Keywords

Internet interventions

Internet-based cognitive-behavioral therapy

Perfectionism

© 2025 The Authors. Published by Elsevier B.V.

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