A randomized mixed-methods pilot feasibility trial of CBT group therapy with 4T-Integrated religious psychoeducation for religious obsessions and compulsions.

OBJECTIVE

To evaluate the feasibility, acceptability, and religious congruence of integrating the 4T religious psychoeducation model into CBT group therapy for religious OCD, with exploratory analyses of clinical change.

METHOD: Twenty-three adults with religious OCD were randomly assigned to standard CBGT or a 4T-integrated group. Assessments were conducted at pre-test, post-test, and 1-, 3-, and 12-month follow-ups using the Y-BOCS, OBQ-44, TAFS, PIOS, BDI, and BAI. Linear mixed-effects and nonparametric analyses explored within-group change. Feasibility indicators included recruitment, retention, adherence, and participant feedback. Semi-structured interviews were thematically analyzed to examine acceptability and cultural fit.

RESULTS

Both interventions were feasible and well-tolerated, with adequate recruitment and retention. Participants in both groups showed within-group improvements across symptom and cognitive measures. Exploratory trends suggested greater reductions in thought-action fusion (likelihood) and additional late-phase cognitive shifts in the 4T group. Qualitative findings highlighted positive perceptions of the 4T model's religious congruence, clearer understanding of intrusive thoughts, and enhanced motivation.

CONCLUSION

This randomized pilot feasibility trial supports the practicality and acceptability of integrating religiously grounded psychoeducation into CBGT for religious OCD. Preliminary trends suggest the need for a larger definitive trial, and qualitative data highlight the contextual relevance of religiously integrated psychoeducation for treatment engagement.