Design and construction of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder in Iran: A feasibility study.

BACKGROUND

Obsessive-compulsive disorder (OCD) is a debilitating mental health problem that is frequently inadequately treated in several areas owing to restricted access to specialised services, societal stigma, and elevated treatment expenses Internet-based cognitive-behavioural therapy (ICBT) offers an effective and accessible alternative. To date, no Persian-language ICBT for OCD has been rigorously established or evaluated.

OBJECTIVES

This study aimed to develop and evaluate the feasibility of a culturally adapted Persian ICBT for OCD in Iran, examining its acceptability, applicability, and preliminary clinical outcomes from the perspectives of both clinicians and clients.

METHODS

The ICBT protocol was designed and constructed based on Salkovskis's model and culturally tailored for Iran. Feasibility was evaluated by 19 CBT therapists and 15 clients using a structured feasibility scale. Clients also completed pre- and post-treatment assessments of OCD severity (Y-BOCS), satisfaction (CSQ), credibility/expectancy (CEQ), and adherence (TAAS).

RESULTS

All feasibility subscales were rated significantly above threshold (p < .001), with "Applicability/Demand" receiving the highest endorsement. Secondary exploratory outcomes demonstrated significant symptom reduction (M baseline = 27.80; M post = 18.06; Z = -3.42, p < .001), with 53% showing clinical response and 13% remission in the client group. Also, high satisfaction, credibility, and adherence were reported. Exploratory regressions did not identify significant predictors of outcome.

CONCLUSION

These findings suggested the preliminary feasibility and strong demand for ICBT for OCD in Iran. The positive evaluations from both professionals and clients, coupled with significant symptom reduction and high user satisfaction, position this program as a promising, accessible treatment alternative for OCD patients.