{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:12:01Z","timestamp":1790791921255,"version":"4.1.0"},"reference-count":39,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["RES PSYCHOTHER-PSYCH"],"abstract":"<jats:p>The interest in treating underlying core vulnerability factors or transdiagnostic processes has been a focus of much attention. In this paper we describe our application of group dynamic- relational psychotherapy to the treatment of perfectionism, a core personality vulnerability factor associated with various forms and types of dysfunction and disorders that have profound costs to the individual both socially and subjectively. Over the course of the past three decades, we developed an evidence-based integrative group treatment that targets the psychodynamic and relational underpinnings of perfectionism. The treatment is based on an integration of psychodynamic and interpersonal perspectives and therapeutic approaches. In this paper we present our model of perfectionism and describe our group dynamic-relational therapy for the treatment of its pernicious outcomes. By drawing on illustrative case material, we describe the approach as applied to one such group as it progresses through four phases of group development that we have termed engagement and pseudo attachment, pattern interruption, self-redefinition\/painful authenticity, and termination. Finally, we present some of the accumulating evidence of the effectiveness and efficacy of dynamic-relational therapy.<\/jats:p>","DOI":"10.4081\/ripppo.2022.635","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T14:41:05Z","timestamp":1662043265000},"source":"Crossref","is-referenced-by-count":11,"title":["Group dynamic-relational therapy for perfectionism"],"prefix":"10.4081","author":[{"given":"Samuel F.","family":"Mikail","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Hewitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon L.","family":"Flett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0156-015X","authenticated-orcid":false,"given":"Sabrina","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"20494","doi-asserted-by":"crossref","unstructured":"Armusewicz, K., Steele, M., Steele, H., & Murphy, A. (2022). Assessing therapist and clinician competency in parent-infant psychotherapy: The REARING coding system (RCS) for the group attachment based intervention (GABI). Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1), 23-37. https:\/\/doi.org\/10.4081\/ripppo.2022.562","DOI":"10.4081\/ripppo.2022.562"},{"key":"20495","doi-asserted-by":"crossref","unstructured":"Blatt, S. J. (1995). The destructiveness of perfectionism: Implications for the treatment of depression. The American Psychologist, 50(12), 1003-1020. https:\/\/doi.org\/10.1037\/0003-066X.50.12.1003","DOI":"10.1037\/0003-066X.50.12.1003"},{"key":"20496","unstructured":"Bruch, H. (1988). Conversations with anorexics (D. Czyzewski & M. A. Suhr, Eds.). New York: Basic Books."},{"key":"20497","doi-asserted-by":"crossref","unstructured":"Cheek, J., Kealy, D., Hewitt, P. L., Mikail, S. F., Flett, G. L., Ko, A., & Jia, M. (2018). Addressing the complexity of perfectionism in clinical practice. Psychodynamic Psychiatry, 46(4), 457\u2013489. https:\/\/doi.org\/10.1521\/pdps.2018.46.4.457","DOI":"10.1521\/pdps.2018.46.4.457"},{"key":"20498","doi-asserted-by":"crossref","unstructured":"Flett, G. L., & Hewitt, P. L. (2022). Perfectionism in childhood and adolescence: A developmental approach. American Psychological Association. https:\/\/doi.org\/10.1037\/0000289-000","DOI":"10.1037\/0000289-001"},{"key":"20499","doi-asserted-by":"crossref","unstructured":"Flett, G. L., Hewitt, P. L., Blankstein, K. R., & Gray, L. (1998). Psychological distress and the frequency of perfectionistic thinking. Journal of Personality and Social Psychology, 75(5), 1363-1381. https:\/\/doi.org\/10.1037\/0022-3514.75.5.1363","DOI":"10.1037\/0022-3514.75.5.1363"},{"key":"20500","unstructured":"Fonagy, P. (2001). Attachment theory and psychoanalysis. New York: Other Press."},{"key":"20501","doi-asserted-by":"crossref","unstructured":"Fredtoft, T., Poulsen, S., Bauer, M., & Malm, M. (1996). Dependency and perfectionism: Short-term dynamic group psychotherapy for university students. Psychodynamic Counselling, 2.4 (November), 476-497. https:\/\/doi.org\/10.1080\/13533339608402472","DOI":"10.1080\/13533339608402472"},{"key":"20502","doi-asserted-by":"crossref","unstructured":"Handley, A. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2015). A randomized controlled trial of group cognitive behavioural therapy for perfectionism. Behaviour Research and Therapy, 68, 37-47. https:\/\/doi.org\/10.1016\/j.brat.2015.02.006","DOI":"10.1016\/j.brat.2015.02.006"},{"key":"20503","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., & Flett, G. L. (1991a). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456-470. https:\/\/doi.org\/10.1037\/0022-3514.60.3.456","DOI":"10.1037\/0022-3514.60.3.456"},{"key":"20504","unstructured":"Hewitt, P. L., Flett, G. L., & Mikail, S. F. (2017). Perfectionism: A relational approach to conceptualization, assessment, and treatment. New York: Guilford Press."},{"key":"20505","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Flett, G. L., Mikail, S. F., Kealy, D., & Zhang, L. (2018). Perfectionism in the Therapeutic Context: The Perfectionism Social Disconnection Model and Clinical Process and Outcome. In J. Stoeber (Ed.) The Psychology of Perfectionism: Theory, Research, Applications. New York: Routledge.","DOI":"10.4324\/9781315536255-20"},{"key":"20506","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Flett, G. L., Sherry, S.B., & Caelian, C. (2006). Trait perfectionism dimensions and suicidal behavior. In T.E. Ellis (Ed.). Cognition and suicide: Therapy, research, and therapy (pp. 215-235). Washington, DC: American Psychological Association. https:\/\/doi.org\/10.1037\/11377-010","DOI":"10.1037\/11377-010"},{"key":"20507","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Flett, G. L., Sherry, S. B., Habke, M., Parkin, M., Lam, R., McMurtry, B., Ediger, E., Fairlie, P., Stein, M. B. (2003). The interpersonal expression of perfection: Perfectionistic self-presentation and psychological distress. Journal of Personality and Social Psychology, 84(6), 1303-1325. https:\/\/doi.org\/10.1037\/0022-3514.84.6.1303","DOI":"10.1037\/0022-3514.84.6.1303"},{"key":"20508","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Flett, G. L., Turnbull-Donovan, W., & Mikail, S. F. (1991b). The multidimensional perfectionism scale: Reliability, validity, and psychometric properties in psychiatric samples. Psychological Assessment, 3(3), 464-468. https:\/\/doi.org\/10.1037\/1040-3590.3.3.464","DOI":"10.1037\/1040-3590.3.3.464"},{"key":"20509","unstructured":"Hewitt, P. L., Kealy, D., Mikail, S. F., Smith, M. M., Chen, C., Sochting, I., Ge, S., Tasca, G."},{"key":"20510","unstructured":"A., Flett, G. L., Ko, A. (under review). The Efficacy of Group Psychotherapy for Adults with Perfectionism: A Randomized Controlled Trial of Dynamic-Relational versus Psychodynamic Supportive Treatment."},{"key":"20511","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Mikail, S. F., Dang, S. S., Kealy, D., & Flett, G. L. (2020). Dynamic\u2010relational treatment of perfectionism: An illustrative case study. Journal of Clinical Psychology, 76(11), 2028-2040. https:\/\/doi.org\/10.1002\/jclp.23040","DOI":"10.1002\/jclp.23040"},{"key":"20512","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Mikail, S. F., Flett, G. L., & Dang, S. S. (2018). Specific formulation feedback in Dynamic-relational group psychotherapy of perfectionism. Psychotherapy, 55(2), 179-185. https:\/\/doi.org\/10.1037\/pst0000137","DOI":"10.1037\/pst0000137"},{"key":"20513","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Mikail, S. F., Flett, G. L., Tasca, G. A., & Flynn, C. A. (2015). Psychodynamic and Interpersonal Group Psychotherapy for Perfectionism: Evaluating the Effectiveness of a Short-Term Treatment. Psychotherapy, 52(2), 205-217. https:\/\/doi.org\/10.1037\/pst0000016","DOI":"10.1037\/pst0000016"},{"key":"20514","unstructured":"Hewitt, P. L., Smith, M. M., Molnar, D. S., & Flett, G. L., Lang, T. (in preparation). Automatic Self Recriminations: Development and validation of a measure of self-critical internal dialogue."},{"key":"20515","doi-asserted-by":"crossref","unstructured":"Hewitt, P. L., Qiu, T., Flynn, C. A., Flett, G. L., Wiebe, S. A., Tasca, G. A., & Mikail, S. F. (2019). Dynamic-relational group treatment for perfectionism: Informant ratings of patient change. Psychotherapy (Chicago, Ill.), 57(2), 197-205. https:\/\/doi.org\/10.1037\/pst0000229","DOI":"10.1037\/pst0000229"},{"key":"20516","doi-asserted-by":"crossref","unstructured":"Hollender, M. H. (1965). Perfectionism. Comprehensive Psychiatry, 6, 94-103.","DOI":"10.1016\/S0010-440X(65)80016-5"},{"key":"20517","unstructured":"Horney, K. (1950). Neurosis and human growth. New York, NY: Norton."},{"key":"20518","doi-asserted-by":"crossref","unstructured":"Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12-19. https:\/\/doi.org\/10.1037\/0022-006X.59.1.12","DOI":"10.1037\/0022-006X.59.1.12"},{"key":"20519","doi-asserted-by":"crossref","unstructured":"Miller, R., Hilsenroth, M. J., & Hewitt, P. L. (2017). Perfectionism and therapeutic alliance: A review of the clinical research. Research in Psychotherapy: Psychopathology, Process and Outcome, 20(1), 19-29. https:\/\/doi.org\/10.4081\/ripppo.2017.264","DOI":"10.4081\/ripppo.2017.264"},{"key":"20520","doi-asserted-by":"crossref","unstructured":"Norcross, J. C., VandenBos, G. R., Freedheim, D. K. (Eds.). (2011). History of psychotherapy: Continuity and change (2nd ed). American Psychological Association. https:\/\/doi.org\/10.1037\/12353-000","DOI":"10.1037\/12353-000"},{"key":"20521","doi-asserted-by":"crossref","unstructured":"Pacht, A. R. (1984). Reflections on perfection. American Psychologist, 39(4), 386\u2013390. https:\/\/doi.org\/10.1037\/0003-066X.39.4.386","DOI":"10.1037\/0003-066X.39.4.386"},{"key":"20522","doi-asserted-by":"crossref","unstructured":"Paquin, J. D., Abegunde, C., Hahn, A., & Fassinger, R. E. (2021). A brief history of group therapy as a field and the representation of women in its development. International Journal of Group Psychotherapy, 71(1), 13-80. https:\/\/doi.org\/10.1080\/00207284.2020.1798176","DOI":"10.1080\/00207284.2020.1798176"},{"key":"20523","doi-asserted-by":"crossref","unstructured":"Popolo, R., MacBeth, A., Brunello, S., Canfora, F., Ozdemir, E., Rebecchi, D., Toselli, C., Venturelli, G., Salvatore, G., & Dimaggio, G. (2018). Metacognitive interpersonal therapy in group: A feasibility study. Research in Psychotherapy: Psychopathology, Process and Outcome, 21(3), 155-163. https:\/\/doi.org\/10.4081\/ripppo.2018.338","DOI":"10.4081\/ripppo.2018.338"},{"key":"20524","doi-asserted-by":"crossref","unstructured":"Qanbari Alaee, E., Saed, O., Khakpoor, S., Ahmadi, R., Ali Mohammadi, M., Yoosefi Afrashteh, M., & Morovati, Z. (2022). The efficacy of transdiagnostic cognitive behavioural therapy on reducing negative affect, anxiety sensitivity and improving perceived control in children with emotional disorders - a randomized controlled trial. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(1), 127-144. https:\/\/doi.org\/10.4081\/ripppo.2022.588","DOI":"10.4081\/ripppo.2022.588"},{"key":"20525","doi-asserted-by":"crossref","unstructured":"Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. The American Psychologist, 65(2), 98-109. https:\/\/doi.org\/10.1037\/a0018378","DOI":"10.1037\/a0018378"},{"key":"20526","unstructured":"Smith, M. M., Hewitt, P. L., Sherry, S. B., Flett, G. L., Kealy, D., Tasca, G., Ge, S., Ying, F., & Bakken, K. (under review). A meta-analytic review of the effectiveness of cognitive-behavioral therapy for perfectionism: Redux. Clinical Psychology & Psychotherapy."},{"key":"20527","doi-asserted-by":"crossref","unstructured":"Sorotzkin, B. (1985). The quest for perfection: Avoiding guilt or avoiding shame? Psychotherapy: Theory, Research, Practice, Training, 22(3), 564\u2013571. https:\/\/doi.org\/10.1037\/h0085541","DOI":"10.1037\/h0085541"},{"key":"20528","unstructured":"Strupp, H. H., Binder, J. L. (1984). Psychotherapy In A New Key. New York: Basic Books."},{"key":"20529","doi-asserted-by":"crossref","unstructured":"Tasca. G. A, Mikail, S. F., & Hewitt, P. L. (2021). Group Psychodynamic Interpersonal","DOI":"10.1037\/0000213-000"},{"key":"20530","unstructured":"Psychotherapy. Washington, D.C.: American Psychological Association."},{"key":"20531","doi-asserted-by":"crossref","unstructured":"Winston, A., Rosenthal, R. N., & Roberts, L. W. (2019). Learning supportive psychotherapy: An illustrated guide. American Psychiatric Association Publishing.","DOI":"10.1176\/appi.books.9781615371501.lr34"},{"key":"20532","unstructured":"Yalom, I. D., & Leszcz, M. (2020). The Theory and Practice of Group Psychotherapy. New York: Basic Books."}],"container-title":["Research in Psychotherapy: Psychopathology, Process and Outcome"],"original-title":[],"link":[{"URL":"https:\/\/www.researchinpsychotherapy.org\/index.php\/rpsy\/article\/download\/635\/584","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.researchinpsychotherapy.org\/index.php\/rpsy\/article\/download\/635\/584","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T14:41:20Z","timestamp":1662043280000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchinpsychotherapy.org\/index.php\/rpsy\/article\/view\/635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,1]]},"references-count":39,"URL":"https:\/\/doi.org\/10.4081\/ripppo.2022.635","relation":{},"ISSN":["2239-8031","2499-7552"],"issn-type":[{"value":"2239-8031","type":"electronic"},{"value":"2499-7552","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9,1]]}}}