Trial Review

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial registered on ANZCTR


Registration number
ACTRN12621001500842
Ethics application status
Approved
Date submitted
6/09/2021
Date registered
4/11/2021
Date last updated
4/11/2021
Date data sharing statement initially provided
4/11/2021
Type of registration
Retrospectively registered

Titles & IDs
Public title
"Pobody's Nerfect": A 5-lesson perfectionism program teaching young adolescents about minimising the impact of perfectionism on well-being.
Scientific title
Examining the impact of a universal 5-lesson perfectionism program for adolescents in decreasing perfectionism
Secondary ID [1] 305236 0
Nil known
Universal Trial Number (UTN)
Trial acronym
Linked study record
Current study is a follow-up study linked to the records ACTRN12616000981426, ACTRN12618000444280, and ACTRN12621000457842

Health condition
Health condition(s) or problem(s) studied:
Depression 323514 0
Anxiety 323515 0
Stress 323516 0
Psychological Wellbeing 323517 0
Perfectionism 323518 0
Self Compassion 323519 0
Condition category
Condition code
Mental Health 321075 321075 0 0
Anxiety
Mental Health 321076 321076 0 0
Depression

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
The 5-lesson perfectionism program is based on previous studies that have been described previously in children aged 10-12 (Vekas & Wade, 2017), Trial ID: ACTRN12616000981426, and pilot tested in young gifted adolescents, Trial ID: ACTRN12618000444280, and Trial ID: ACTRN12621000457842. The intervention is delivered in an engaging format with the use of PowerPoint to describe psycho-education to the students, as well as brainstorming activities, small group and whole class discussions, and homework activities. Each participant receives a workbook for the 5 lessons in which they write down answers to questions that are posed in the program i.e., “What are the advantages of making a mistake? What are the disadvantages?”
The intervention will be delivered face-to-face by a South Australian Department for Education psychologist or provisionally registered psychologist. The program will be delivered to individual classes of students that each school have deemed may benefit from the program (up to 20 per class). The South Australian Department for Education and Child Development are now utilising this program as part of their curricula - previously named "Learning Successfully for Study and Life" to "Pobody's Nerfect". Psychologists have been formally trained by previous researchers in the trials listed above and are required to adhere to a strict protocol so the intervention is delivered evenly across classrooms.

The intervention will be delivered 1x per week for 5 weeks, with each lesson 60 minutes in length. The location of the intervention will be in the young person’s high school classroom.

Completion of homework activities and amount of time spent on this will be at the participants' discretion and this will be communicated to participants.

A brief summary of session content will now be described

Session 1: Lesson is about how to learn successfully and avoid the pitfalls of perfection.

Small group and class discussion on what they think perfectionism is. Small group and class discussion on advantages and disadvantages of perfectionism.

Education on what perfectionism is based on evidence and how it is related to poor mental and poorer academic achievement.

Students then watch a YouTube clip on JK Rowlings 10 tips for success and write down the tips in their own words. Small group discussion on what tip resonated with them most. Homework: Create a poster of favourite tip to display in classroom.

Session 2: Focuses on 3 elements of good learning.

Number 1: Taking time out will improve your performance. Usain Bolt quote is discussed (with the theme being around taking time out and importance of taking a break). Education provided with the importance of taking time out in the context of physical health, and then transferring to academic health. Group task to rate their belief on the quote: The harder you work the better you perform – true/false. Education is provided on Yerkes Dodson Law, with the emphasis on We all have our zone of optimum performance – the amount of work we need to do to do well – beyond this, performance deteriorates and we will burn out. Small group and individual work to name 5 things they like doing just because it is relaxing.

Number 2: Making mistakes is good for you. Small group and class discussion on the advantages and disadvantages of making mistakes. Education provided on the different styles of learning, with growth mindset being more advantageous and part of it is making mistakes.

Number 3: Celebrating success is good for you. Class brainstorm about how we react when we succeed. Small group activity to brainstorm activities to do to celebrate successes. Homework: Experiment – taking breaks from studying, doing one thing on list to relax, one thing on list to celebrate success, and rate productivity before and after the experiment.

Session 3: Self-compassion

Review Class discussion on experiment – what did they find? Did productivity increase when they celebrated successes and took breaks? Focus on session 3 is self-compassion.

First task: Recall a recent situation when something didn’t go so well. What were your thoughts/feelings/behaviours? Write down, relay in small groups and then ask if anyone would like to share – class discussion.

Then introduce self-compassion – class discuss on what they think self-compassion is.

Students watch a YouTube video (Power of self-compassion) and are asked to discuss in small groups what they thought and feedback to class.

Task individually in-class. Write a letter to a friend who has failed at a test to practice compassion.

Homework: Write a letter to self in a self-compassionate way when things have gone wrong, rate mood before and after.

Session 4: Review self-compassion letter as a class discussion and look at self-compassion vs. self-criticism. Introduce basketball hypothetical to class (listed below)

“Imagine that you are getting coaching sessions to learn to play basketball. This is something you have wanted to do for a long time and are excited and determined to try hard in the lessons.
Now imagine that you have lessons under two different coaches: Coach Critic, and Coach Compassion.

Coach Critic does not say anything to you when you bounce or throw the ball. However, when you drop the ball or miss a catch, Coach Critic calls you names, such as a “you’re a wimp,” “you’re pathetic,” and “you’re useless.” He says that unless you can play perfectly and unless you are the best, you are a bad person and no one in the team will like you.

Coach Compassion is different again. He does not tell you off every time you drop the ball, but instead encourages you and tells you that you are doing well when you catch the ball. He says things like “It is OK to make mistakes because it helps us to learn how to do it better.” He takes time with you at the end of practice and tells you what you did well and what skills you can work on and what can be improved. He gives each player specific skills to work on over the week to make them better.”

Ask students individually and then in small groups: Now, which coach would you choose for your friends? Why?
Which coach do you think would get a better performance out of your friends?

Discuss answers as a class and then provide education on the tripod of balance: we need achievement, threat and self-compassion to be well-rounded. Ask what happens if we remove achievement, threat or self-compassion individually and consequences of this as a class discussion.

Classroom activity: Role play. The scenario is “You spent all week studying for a maths test, but you have just received your result back and you have not done as well in the test as you had hoped. Mr/miss self-critical will start, and Mr/miss self-compassionate will be allowed to respond.

For example, self-critical voice may say “you’re a loser, you should give up on Maths, if you don’t do well no one will like you” and self-compassionate may respond “you can do it, just keep trying, you will get there, you are good at other things”. Allow classroom responses towards the end of the activity (everybody joins in).

Small group activity: Jot down things that will help when feeling self-critical and engage in small group discussion.

Homework: let’s practice what we did today in class by turning self-critical thoughts into self-compassionate thoughts by using a journal. Write down self-critical thoughts, what you did to combat them, and how you felt afterwards. There is an example in the workbook if you get stuck.

Fun clip: Awareness test YouTube video. Elicits fun with key point: we miss a lot in our lives if we are too narrowly focused and self-critical on ourselves– miss a lot of what’s good/fun; life can become a chore; we lose perspective – we are not just our achievements!

Session 5: Social Media and Perfection.
Review Homework: Changing critical thoughts into compassionate thoughts – what did people find?

Small group discussion: What impact does social media have on trying to be perfect?

Classroom to watch Social Media and Perfection video – small group and class discussion on key points elicited from that video.
• What are the main messages of the video?
• Does your real life differ from your online life? How is it different? Why?
• How can this ’perfect ideal’ on social media be problematic?

Small group activity: Review the 5 sessions: what they found most helpful and key messages that stuck. Turn into class discussion.

Homework: An activity to work on until next week when we meet again, is to take a photo of something ‘real’ that happened to you during the week and something you would never post online on social media. You can be as funny and as creative as you like! For example, a ‘post-selfie’ run, perhaps an outfit gone wrong, messy hair when you wake up in the morning but make it as personalised to your ‘real life’ as possible. Print out the photo and stick it in the Instagram template and feel free to add a funny caption. Next week, we will hang them up in the classroom to always have a reminder of funny/not so funny things that happen in our day-to-day lives and to combat the ‘perfect’ life that is projected on social media.

Strategies to monitor adherence: Facilitators go around and ensure that students fill in workbook, but participation in out of class activities (i.e., homework) is optional. Session attendance monitored by the facilitator (psychologist)

Almost all of the educational materials in this intervention were designed specifically for the study. The exception to this is that four YouTube videos are watched in-session.

JK Rowlings 10 steps to success - YouTube https://www.youtube.com/watch?v=bvMtUuedLwU&t=2s
Awareness Test - YouTube https://www.youtube.com/watch?v=ubNF9QNEQLA
Social Media and Perfection - YouTube https://www.youtube.com/watch?v=0EFHbruKEmw&t=5s
The Power of Self Compassion - YouTube https://www.youtube.com/watch?v=BTQP7XzDxjI&t=85s
Intervention code [1] 321632 0
Prevention
Intervention code [2] 322047 0
Treatment: Other
Comparator / control treatment
The control group will be a comparator control group who are on the waiting list to receive the program. Based on resource availability and the student support service program as provided by the Department of Education, there will always be at least 1 school that is on the waitlist while another school is receiving the program. They will have no formal treatment during this time period, i.e., lessons-as-usual. They will receive the intervention after the last collection of data.

Intervention will be offered to waitlist control group following the 3-month follow-up data, generally in the following semester when school curricula begins a new well-being module.
Control group
Active

Outcomes
Primary outcome [1] 328853 0
Perfectionionism, measured with:
Discrepancy and High Standards Subscale from the Almost Perfect Scale Revised (Slaney et al., 2001)
Timepoint [1] 328853 0
One week prior to the intervention, one week post intervention, 3 months after the baseline (primary endpoint)
Primary outcome [2] 328854 0
Perfectionionism, measured with: Self Oriented Perfectionism subscale from the Child and Adolescent Perfectionism Scale (Hewitt et al., 2000)
Timepoint [2] 328854 0
One week prior to the intervention, one week post intervention, 3 months after the baseline (primary endpoint)
Secondary outcome [1] 400651 0
Depression, Stress, Anxiety: DASS-21 (Lovibond & Lovibond)
Timepoint [1] 400651 0
One week prior to the intervention, one week post intervention, 3 months after the baseline
Secondary outcome [2] 400652 0
Wellbeing: The Warwick Edinburg Mental Well Being Scale (Tennant et al., 2007)
Timepoint [2]
Timepoint [2] 400652 0
One week prior to the intervention, one week post intervention, 3 months after the baseline
Secondary outcome [3] 400653 0
Self-Compassion: 17-item self-compassion scale for Youth (Neff et al., 2020)
Timepoint [3] 400653 0
One week prior to the intervention, one week post intervention, 3 months after the baseline

Eligibility
Key inclusion criteria
Schools in South Australia with year 7, year 8, year 9, year 10, year 11, and year 12 students within the catchment area for delivery of psychology services with the Noarlunga Department for Education and Child Development in South Australia. All socio economic status included.
Minimum age
12 Years
Maximum age
18 Years
Sex
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Nil

Study design
Purpose of the study
Prevention
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation was not concealed.
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable.
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
the Student Support Service (SSS) program within the Department for Education and Child Development in South Australia delivers programmes via responding to a request from a school for a service. This means it is up to schools to advise SSS if and when they wish to participate in the programme. SSS’s ability to deliver the programme will be also dependent on capacity of SSS psychologists and the competing needs of various SSS workload demands. A waitlist will thus be created if necessary, but it should be noted that all schools that have requested for delivery of the program will receive the program. Allocation of schools to waitlist control and intervention group will thus be unable to be randomised but at the discretion of the SSS.
Phase
Not Applicable
Type of endpoint/s
Statistical methods / analysis
Power analysis shows that to detect a Cohen's d effect size of 0.30 with a power level of 0.80, and attition of 5% at each time point, 127 participants per group are required (Hedeker, Gibbons, & Waternaux, 1999). Data will be fully powered, with 4 schools expected to participate. Data will be analysed via Linear Mixed Modelling, adjusting for baseline levels of each outcome variable.

Recruitment
Recruitment status
Recruiting
Date of first participant enrolment
Anticipated
Actual
21/10/2021
Date of last participant enrolment
Anticipated
12/06/2023
Actual
Date of last data collection
Anticipated
12/10/2023
Actual
Sample size
Target
508
Accrual to date
20
Final
Recruitment in Australia
Recruitment state(s)
SA

Funding & Sponsors
Funding source category [1] 309611 0
University
Name [1] 309611 0
Flinders University
Country [1] 309611 0
Australia
Primary sponsor type
University
Name
Flinders University
Address
GPO Box 2100
Adelaide SA 5001
Australia
Country
Australia
Secondary sponsor category [1] 310626 0
None
Name [1] 310626 0
Address [1] 310626 0
Country [1] 310626 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 309386 0
Social and Behavioural Sciences Research Ethics Committee, Flinders University
Ethics committee address [1] 309386 0
GPO Box 2100
Adelaide SA 5001
Ethics committee country [1] 309386 0
Australia
Date submitted for ethics approval [1] 309386 0
13/10/2020
Approval date [1] 309386 0
06/04/2021
Ethics approval number [1] 309386 0
2833
Ethics committee name [2] 309387 0
SA Department of Education and Child Development
Ethics committee address [2] 309387 0
Level 8, 31 Flinders Street
Adelaide SA 5000
Ethics committee country [2] 309387 0
Australia
Date submitted for ethics approval [2] 309387 0
03/05/2021
Approval date [2] 309387 0
05/08/2021
Ethics approval number [2] 309387 0
2018-0003

Summary
Brief summary
This study builds on pilot work testing 2-5 session perfectionism programmes with children (ACTRN12616000981426) and early adolescents (ACTRN12618000444280; ACTRN12621000457842) which found improvements in emotional problems, self-imposed perfectionistic standards (sustained at 4-week follow-up), and well-being, sustained at 3-month follow-up (Vekas & Wade, 2017).

The modified programme for the current research expands the pilot programme (ACTRN12618000444280) and subsequent 5-lesson perfectionism intervention (ACTRN12621000457842) to be led by trained psychologists which include an emphasis on the difference in pursuing excellence and pursuing perfection to high school students across Year 7 to Year 12 universally.

Research objectives
1. To examine the impact of the Pobody's Nerfect curriculum on primary (perfectionism) and secondary (anxiety, depression, wellbeing, self-compassion) outcomes.
2. To test whether improvements in certain outcome factors (anxiety, depression, well-being, self-compassion) are moderated by the following outcome factors: level of perfectionism, self-compassion and sex.

We hypothesize that the intervention group will experience significantly greater decreases in perfectionism, anxiety, and depression, and significantly greater increases in wellbeing and self-compassion at follow-up. We also hypothesize that decreases in perfectionism and increases in self-compassion between baseline and end of treatment will moderate the association between group and follow-up changes in anxiety, depression, and well-being.
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 113974 0
Prof Tracey Wade
Address 113974 0
College of Education, Psychology & Social Work
Flinders University
GPO Box 2100
Adelaide SA 5001
Country 113974 0
Australia
Phone 113974 0
+61 8 8201 3736
Fax 113974 0
Email 113974 0
[email protected]
Contact person for public queries
Name 113975 0
Prof Tracey Wade
Address 113975 0
College of Education, Psychology & Social Work
Flinders University
GPO Box 2100
Adelaide SA 5001
Country 113975 0
Australia
Phone 113975 0
+61 8 8201 3736
Fax 113975 0
Email 113975 0
[email protected]
Contact person for scientific queries
Name 113976 0
Prof Tracey Wade
Address 113976 0
College of Education, Psychology & Social Work
Flinders University
GPO Box 2100
Adelaide SA 5001
Country 113976 0
Australia
Phone 113976 0
+61 8 8201 3736
Fax 113976 0
Email 113976 0
[email protected]

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment
Sensitivity of children's data


What supporting documents are/will be available?

No Supporting Document Provided



Results publications and other study-related documents

Documents added manually
No documents have been uploaded by study researchers.

Documents added automatically
No additional documents have been identified.