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Symposia

Technology/Digital Health

Advancing Digital ACT Interventions: Evidence-Based Strategies for Expanding Access to Care

3 - (SYM 52) A Good Enough Intervention: Testing Brief Online Self-help Treatment Modules for Clinical Perfectionism

Friday, November 21, 2025

3:48 PM - 4:09 PM CST

Location: Bolden 6, Level 2

Keywords: Technology / Mobile Health, ACT (Acceptance & Commitment Therapy), Randomized Controlled Trial
Recommended Readings: Ong, C. W., Lee, E. B., Levin, M. E., & Twohig, M. P. (2022). Online process-based training for perfectionism: A randomized trial. Behaviour Research and Therapy, 156, 104152., Arch, J. J., Mitchell, J. L., Schmiege, S. J., Levin, M. E., Genung, S. R., Nealis, M. S., Fink, R. M., Bright, E. E., Andorsky, D. J., & Kutner, J. S. (2022). A randomized controlled trial of a multi-modal palliative care intervention to promote advance care planning and psychological well-being among adults with advanced cancer: study protocol. BMC palliative care, 21(1), 198. https://doi.org/10.1186/s12904-022-01087-z, Bowers, E. M., Capel, L. K., Woolley, M. G., Barnes, A., Twohig, M. P., & Levin, M. E. (2024). Efficacy and feasibility of web-based ACT-Enhanced behavioral treatment for skin picking in adults: A randomized waitlist-controlled trial. Journal of Obsessive-Compulsive and Related Disorders, 43, 100909., Donahue, M. L., & Levin, M. E. (2024). Pilot evaluation of a prototype online acceptance and commitment therapy program for adults living with a chronic health condition. International Journal of Mental Health, 53(4), 397–419. https://doi.org/10.1080/00207411.2024.2321432, Klimczak, K. S., San Miguel, G. G., Mukasa, M. N., Twohig, M. P., & Levin, M. E. (2023). A systematic review and meta-analysis of self-guided online acceptance and commitment therapy as a transdiagnostic self-help intervention. Cognitive behaviour therapy, 52(3), 269–294. https://doi.org/10.1080/16506073.2023.2178498

Speaker(s)

Clarissa Ong, Ph.D. (she/her/hers)

Assistant Professor
University of Louisville
Louisville, KY, United States

Co-author(s)

Clarissa Ong, Ph.D. (she/her/hers)

Assistant Professor
University of Louisville
Louisville, KY, United States
Eric Lee, Ph.D. (he/him/his)

Assistant professor
Southern Illinois University
Carbondale, IL, United States
AK

Andrew Kurtz, B.A.

Graduate Student
Florida State University
Tallahassee, FL, United States
JA

Jacob S. Avendano, M.S.

Graduate Student
University of Toledo
Milan, OH, United States
Kate Sheehan, M.A. (she/her/hers)

Graduate Student
University of Toledo
Toledo, OH, United States
Estella Fox, B.A.

Graduate Student
University of Toledo
Toledo, OH, United States
AW

Andrew Wall, B.A.

Graduate Student
Southern Illinois University Carbondale
Carbondale, IL, United States
HM

Hannah Myers Johnson, B.A.

Graduate Student
Southern Illinois University Carbondale
Carbondale, IL, United States
AS

Alexa M. Skolnik, M.A.

Graduate Student
University of Toledo
Toledo, OH, United States

Abstract Body

Clinical perfectionism is defined as rigid adherence to unrealistically high standards and basing self-worth on ability to meet those standards (Shafran & Mansell, 2001). It is a known transdiagnostic risk and maintaining factor for many OCD and related presentations, including OCD, hoarding disorder, and body dysmorphic disorder (Pinto et al., 2017), suggesting a need to target perfectionism in treatment.

The current randomized controlled trial examined the effectiveness of a self-guided online intervention comprising evidence-based treatment modules for clinical perfectionism, relative to a self-help book on perfectionism (active control condition). Feedback from beta testers with minoritized identities was integrated into the online intervention development. Participants (N = 109) were given access to the study interventions for 4 weeks and assessed at baseline, weekly, postintervention, 1-month follow-up, and 6-month follow-up (only findings though 1-month follow-up are reported here).

We found that the online intervention and self-help book demonstrated significant changes in perfectionism, self-compassion, psychological flexibility, and quality of life from baseline through 4 weeks of intervention (ps < .001). These findings were maintained at follow-up (baseline to 1-month follow-up ps < .001). The only significant time × condition interaction, t(502) = -2.03, p = .043, indicated that the self-help book condition led to significantly lower perfectionism scores than the online intervention at post-intervention. No interaction was found between baseline and 1-month follow-up (p = .053). On average, participants reported similar levels of time spent using the interventions, and similar levels of satisfaction and engagement.

In summary, through 1-month follow-up, the self-guided online intervention performed similarly to the self-help book with regard to outcomes, engagement, and acceptability. Both interventions demonstrated large, significant effects in a sample of demographically diverse participants. It remains to be seen whether these effects hold up at 6 months. These additional data and results will be presented and discussed.