Healthcare (Basel, Switzerland) · 2026
Self-Criticism in Preventive Guided Self-Help Interventions: Greater Gains or Greater Risks? Its Effect on Adherence, Treatment Success, and Working Alliance.
СтатьяНазвание и аннотация: Перевод в очереди
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Di Consiglio Micaela, D'Olimpio Francesca, Couyoumdjian Alessandro
Аннотация
BACKGROUND: Self-criticism is a transdiagnostic factor associated with psychological distress and poorer outcomes in traditional psychotherapy, yet recent evidence suggests it may facilitate change in preventive and low-intensity interventions. This study examined the role of self-criticism in adherence, working alliance, and outcomes within NoiBene, a guided self-help program designed to promote well-being and prevent psychological distress among non-clinical university students.
METHODS: A total of 455 participants (82% female; M = 23.5 years) completed measures of internalized and comparative self-criticism, and key psychological processes (e.g., emotional awareness, rumination, worry, perfectionism, psychological inflexibility, and assertiveness) were assessed before and after the intervention. Adherence and working alliance were measured only after the intervention.
RESULTS: Contrary to evidence from clinical settings, severe self-criticism was not associated with increased dropout or weaker alliance. Instead, individuals with severe self-criticism exhibited the greatest improvements across multiple domains, suggesting a higher potential for therapeutic gain. Moreover, participants with moderate levels of both internalized and comparative self-criticism showed higher dropout and lower adherence.
CONCLUSIONS: These findings indicate that, in preventive guided self-help contexts, self-criticism does not necessarily hinder engagement and outcomes and may, under certain conditions, function as a catalyst for change. Implications for tailoring digital preventive interventions and addressing dropout risk are discussed.
METHODS: A total of 455 participants (82% female; M = 23.5 years) completed measures of internalized and comparative self-criticism, and key psychological processes (e.g., emotional awareness, rumination, worry, perfectionism, psychological inflexibility, and assertiveness) were assessed before and after the intervention. Adherence and working alliance were measured only after the intervention.
RESULTS: Contrary to evidence from clinical settings, severe self-criticism was not associated with increased dropout or weaker alliance. Instead, individuals with severe self-criticism exhibited the greatest improvements across multiple domains, suggesting a higher potential for therapeutic gain. Moreover, participants with moderate levels of both internalized and comparative self-criticism showed higher dropout and lower adherence.
CONCLUSIONS: These findings indicate that, in preventive guided self-help contexts, self-criticism does not necessarily hinder engagement and outcomes and may, under certain conditions, function as a catalyst for change. Implications for tailoring digital preventive interventions and addressing dropout risk are discussed.