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Perfectionism and therapy relationship quality in psychodynamic-interpersonal group psychotherapy Zhang, Lisa


Perfectionism has been identified as a core vulnerability and maintenance factor in myriad psychopathologies and additionally appears to obstruct the course of improvement from the treatment of that psychopathology. The Perfectionism Social Disconnection Model posits that perfectionism is related to various negative outcomes through the mediating effects of social disconnection. When applied to the therapy realm, one would expect that perfectionism impedes the formation and growth of therapy relationships and that this then leads to worse outcomes from psychotherapy (e.g. less symptomatic improvement). Much of what is known about perfectionism in the context of psychotherapy comes from a series of papers stemming from a single study, the Treatment of Depression Collaborative Research Program (TDCRP, Elkin et al., 1989). These papers support the notion that perfectionism impairs both therapeutic alliance and therapeutic outcomes. This dissertation seeks to evaluate the Perfectionism Social Disconnection Model in the context of psychotherapy and to extend what is known about the relationships between perfectionism, therapy relationship quality, and therapy outcomes beyond the context of individual group treatment of depression using contemporary, empirically validated multidimensional measures of perfectionism. Furthermore, previous studies addressing these issues have mostly conceptualized perfectionism as a static measure. It is unknown if treatments that lead to decreases in perfectionism also improve therapy relationship quality and if those changes account for better therapeutic outcomes. The current paper addresses these questions in a group of 71 patients taking part in a group psychodynamic-interpersonal psychotherapy treatment designed to address issues related to perfectionism. Hypotheses were that 1) pre-treatment perfectionism would be negatively related to initial therapy relationship quality, 2) decreases in perfectionism would be accompanied by increases in therapy relationship quality, and 3) that changes in therapy relationship quality would account for the relationship between decreases in perfectionism and better therapy outcomes. In the current study, these hypotheses were not supported. These null results are discussed in the context of a literature that suggests that perfectionism is related to both worse treatment outcomes and to interpersonal difficulties both in therapy and non-therapy contexts.

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