Clinical Perfectionism Model
Shafran, Cooper & Fairburn (2002) · Perfectionism (transdiagnostic)
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
Shafran, Cooper and Fairburn's clinical perfectionism model (2002) describes self-worth resting almost entirely on meeting demanding standards, with the bar rising again each time they are met.
Clinical Perfectionism Model
Shafran, Cooper & Fairburn (2002)
Self-Worth Tied to Striving & Achievement
The core of the model — over-evaluation of striving and achievement: judging self-worth predominantly, or only, in terms of meeting demanding personal standards (at work, study, sport, appearance, parenting). Everything else flows from, and feeds back into, this.
Inflexible, Demanding Standards
Inflexible, excessively high personal standards, pursued relentlessly and held to despite significant cost to wellbeing, relationships or health.
Striving, Checking or Avoidance
Performance-related behaviour driven by the standards — over-working, repeated checking, correcting and redoing — or, where failure feels likely, procrastination and avoidance. Both are attempts to manage the demand.
Dichotomous Judgement of Performance
Dichotomous (all-or-nothing) evaluation of performance, with selective attention to shortfalls: anything short of the standard is counted as failure, and successes are scrutinised for flaws.
Self-Criticism / Discounting Success
Self-criticism when standards are not met; when they are met, the achievement is discounted ('that wasn't good enough') or the standard is judged too low and raised. Both routes reinforce the over-evaluation of achievement and restart the cycle.
The published model, shown for reference. Switch to “Blank” to see the empty template you complete with a client.
Understanding the model
Having high standards isn't a problem in itself. Clinical perfectionism is different: it's when your sense of worth depends almost entirely on meeting demanding standards — and the bar keeps rising however hard you try. This model shows how that trap works.
Because so much rides on achieving, you set rigid, exacting standards and push to meet them. That can look like over-working, checking and redoing things — or, when the pressure feels too great, putting things off and avoiding them altogether.
Whatever happens then tends to be judged in black and white: anything less than the standard counts as failure.
And so it keeps itself going. Fall short, and you criticise yourself harshly. Meet the standard, and you brush it off — 'that wasn't good enough', or 'the bar must have been too low' — and raise it. Either way, the message that your worth depends on achieving is confirmed, and the cycle turns again.
Questions therapists ask about this model.
Frequently asked questions
What makes this different from having high standards?
High standards are not in themselves the difficulty. What the model describes is a sense of worth that depends almost entirely on meeting demanding standards, pursued through rigid rules and hard effort, with the bar moving however hard the client tries. The telling feature is what happens on success: the achievement is brushed aside, or the standard is judged to have been too low and is raised, so meeting it never settles the question the striving was meant to answer.
How does the cycle keep itself going?
Through both outcomes. Falling short brings self-criticism and counts as failure, because performance is judged in all-or-nothing terms with attention drawn to shortfalls. Meeting it is discounted, or treated as proof that the bar was set too low. Either way the message that worth depends on achieving is confirmed, and the behaviour serving it — over-working, checking, redoing, or putting things off altogether — continues.
How does it relate to the CBT-E model?
They are structurally alike, with a different core: CBT-E (Fairburn, Cooper and Shafran, 2003) has self-worth resting on shape, weight and eating, and here it rests on achievement. Egan, Wade and Shafran (2011) review perfectionism as a transdiagnostic process that appears across eating problems, anxiety and low mood, which is why this formulation is often drawn alongside one for another presentation.
Worksheets and reading for this model
Using this model in session — for therapists
How to introduce the model, guided-discovery questions, treatment targets and a behavioural experiment are available to signed-in therapists.
References
- Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). Clinical perfectionism: A cognitive-behavioural analysis. Behaviour Research and Therapy, 40(7), 773–791.
- Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: A clinical review. Clinical Psychology Review, 31(2), 203–212.
- Shafran, R., Egan, S., & Wade, T. (2010). Overcoming perfectionism: A self-help guide using cognitive behavioural techniques. Robinson.
This diagram is a reconstruction of the published model for clinical and educational use, grounded in the sources above.
Cite this page (APA 7)
Vermani, T. (2026). Clinical Perfectionism Model. Formulate. https://formulatetools.co.uk/tools/formulation/clinical-perfectionism
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