225 The Professional Counselor | Volume 13, Issue 3 The Cognitive Behavior Therapy for Perfectionism Small Group Intervention Perfectionism has emerged as a critical vulnerability factor for a variety of maladjustments and mental health disorders (Flett & Hewitt, 2014; Speirs Neumeister, 2018). Flett and Hewitt (2014) found that interventions with an explicit focus on decreasing perfectionism were more effective in reducing negative aspects of perfectionism than general prevention programs. Further, Feiss and colleagues (2019) conducted a meta-analysis to evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems in adolescents and found that targeted programming was more effective than universal programming. Overall, interventions for Tier 2 and Tier 3 can provide additional support for at-risk students, who are more likely to access mental health treatment when referred to school-based services (Biolcati et al., 2017). When delivered in a group format, identified students are likely to find peers they can relate to and connect with (J. L. Horowitz et al., 2007). Shafran and colleagues (2002) proposed a cognitive behavioral conceptualization of perfectionism that helps to guide counselors in assessment and treatment. Specific structured protocols were outlined by the authors as an extension of the protocols developed in the treatment studies by Steele et al. (2013) and Handley et al. (2015). Despite having structured sample protocols, all cognitive behavior therapy for perfectionism (CBT-P) treatment strategies should be used flexibly and be focused on individualized formulation (Egan & Shafran, 2018). A series of clinical trials in different settings and formats evaluated the treatment efficacy of CBT-P (Egan & Shafran, 2018; Egan et al., 2014; Handley et al., 2015). Handley and colleagues (2015) conducted the first randomized control trial to determine the efficacy of CBT-P in a group format. Participants had a range of disorders, including anxiety, depression, obsessive-compulsive disorder, and eating concerns. Those in the treatment group, who received the CBT-P group protocol, demonstrated significant large effect size (Cohen’s d = 1.2) reductions in disorders compared to those in the control group. However, only a few studies have examined the efficacy of CBT-P in adolescents, and no studies have examined CBT-P on high-achieving students within a school-based setting. Purpose of the Present Study The primary purpose of this quasi-experimental, pre-post design study was to determine the effectiveness of a modified version of the CBT-P small group intervention on perfectionism, negative affectivity, and social–emotional well-being in grade 9 to 12 early college high school students. The following research questions were addressed: RQ1. Is there a decrease in the levels of perfectionism in grade 9 to 12 early college high school students after participating in the modified CBT-P group counseling intervention? RQ2. Is there a decrease in negative affectivity (anxiety, depression, stress) in grade 9 to 12 early college high school students after participating in the modified CBT-P group counseling intervention? RQ3. Is there an increase in the social–emotional well-being of grade 9 to 12 early college high school students after participating in the modified CBT-P group counseling intervention? Method Participants and Selection The study was approved by both the school district and the researchers’ university IRB. The participants represented in this study were grade 9 to 12 high school students enrolled in one diverse
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