Perfectionism and Anxiety
High Standards Create and Maintain Worry
- A false shield from shame
- The transdiagnostic nature of perfectionism
- Pathways to pathology
- Adverse consequences of perfectionism
- Development of anxiety – stress, learning, cognitive and biological models
- Physiological basis of anxiety
- Anxiety and related disorders - classification and differential diagnosis
- Perfectionism and mental health - anxiety, OCD, hoarding, and more
- How to talk with clients about perfectionism
- Self-report, interview, and behavioral assessments
Cognitive Strategies
Help Clients Address Shoulds and Musts
- Happiness is success, and other myths
- Teach clients the levels of thinking model
- Common distorted thinking – double standards, overgeneralizations, and more
- Socratic questioning to examine beliefs
- Top perspective-shifting strategies
- Essential cognitive restructuring tools – thought records and pie charts
- Action-oriented approaches – behavioral experiments and surveys
- Mental imagery for perceived failures
- Troubleshooting for common cognitive therapy errors
- Case study
Exposure to Create New Learning
Tools to Decrease Distress by Provoking It
- Address myths about exposure therapy
- How to prepare clients for exposure
- Effective versus ineffective exposure
- Techniques – in-vivo, imaginal, interoceptive, and more
- Develop a useable exposure hierarchy
- Optimize exposure therapy with inhibitory learning principles
- When to remove client safety behaviors
- Practical issues when doing exposure therapy in person or via telehealth
- Avoid common exposure mistakes
- Case study
Mindfulness and Acceptance
Teach Clients to Drop Their Evaluating
- How to talk about mindfulness and acceptance
- Increase willingness to have internal experience
- Foster non-judgment
- Cultivate a compassionate stance
- Tools to improve psychological flexibility
- Formal and informal mindfulness practice between sessions
- Discern client values and facilitate behavioral change
- Case study
Motivational Interviewing
When Clients Maintain Rigid Standards
- Uncover both sides of ambivalence to change
- Access intrinsic reasons for change
- Facilitate change talk based in values
- Roll with resistance
- Reflections, agreements, and reframes
- Respond to discord
- Improve participation in between-session assignments
- Case study
Clinical Issues
Putting It All Together... Imperfectly
- Integrate approaches into an effective treatment plan
- Management of co-occurring depression
- Overview of transdiagnostic approaches
- When to refer for medication consultation
- How to foster a strong alliance
- Management of the therapist’s own perfectionism and anxiety
- Adaptations for children and adolescents
- Limitations of the research and potential risks


