Comprehensive Assessment of Perfectionism in Clinical Practice

Abstract

Perfectionism is known as a transdiagnostic process which leads to the onset, persistence and resistance to treatment of various types of psychopathologies such as anxiety disorders, depression, eating disorders and obsessive-compulsive spectrum conditions. High perfectionism is often accompanied by shame, fear of negative judgment and defensiveness, which might slow down the help-seeking process and make it difficult to engage in therapy. With its ubiquitous presence in all forms of diagnosis, it is necessary to perform a functionally informed assessment of perfectionism that will be vital in clinical practice. In this paper, a multidimensional approach to the evaluation of perfectionism will be presented that will combine diagnostic assessment, functional analysis, psychometric assessment, and situational understanding. Based on cognitive-behavioural and Relational Frame Theory (RFT) approaches, it highlights the necessity to go beyond the measurement of traits to investigate the relational patterns, rule-based behaviour, and self-evaluation that maintain perfectionistic patterns. Extensive evaluation involves structured and semi-structured interviews, standardized perfectionism measures, broad-spectrum symptom measures and personality measures to detect comorbidities and measure general distress and functioning. Assessment objectives are not restricted to symptoms identification but informed collaborative case conceptualization, directed treatment planning, tracking the therapeutic progress, and outcomes assessment. Instead of removing the striving for high standards, the aim of intervention is to minimize strict self-assessment and cognitive fusion to perfectionistic rules, facilitating psychological flexibility and goal adaptive actions.