School Based- Group Cognitive Behavioral Therapy for Maladaptive Perfectionism: Effects on Anxiety and Self Esteem- in Adolescent Girls in a Nonwestern- Cultural Context

Maladaptive perfectionism is a key cognitive vulnerability associated with elevated anxiety and low self-esteem in adolescents, particularly in academically competitive school environments. School-based group cognitive behavioral therapy (CBT) offers a potentially accessible and culturally appropriate approach for addressing these interrelated difficulties. The present study evaluated the effectiveness of a school-based group CBT program targeting maladaptive perfectionism, anxiety, and self-esteem among adolescent girls in a non-Western cultural context. A quasi-experimental pretest–posttest design with a control group was employed. Adolescents aged 12–15 years were initially screened for elevated anxiety across 18 junior high schools. From those scoring above the cutoff on the Beck Anxiety Inventory (BAI), 40 female students were purposively selected and then randomly assigned to a CBT intervention group (n = 20) or a control group (n = 20). The intervention consisted of a 10-session school-based group CBT program delivered weekly. Outcomes included maladaptive perfectionism (Hill Perfectionism Questionnaire), anxiety (BAI), and self-esteem (Rosenberg Self-Esteem Scale). Data were analyzed using ANCOVA and MANCOVA models, including interaction terms to account for baseline differences. Compared with the control group, participants who received CBT showed substantial reductions in maladaptive perfectionism and anxiety, along with significant improvements in self-esteem at posttest. Significant group × pretest interactions indicated that adolescents with higher baseline perfectionism and lower self-esteem benefited most from the intervention. The findings support the effectiveness of school-based group CBT in reducing maladaptive perfectionism and improving emotional well-being among adolescent girls. Implementing CBT within school settings may provide an effective and scalable approach for early intervention in non-Western contexts where access to mental health services is limited.