Obsessive - Compulsive Disorder
Conditions
Keywords
OCD, Obsessive compulsive disorder, Guided self-help, CBT
Brief summary
This randomised controlled trial (RCT) aims to assess the feasibility, acceptability, and preliminary efficacy of a culturally adapted, guided self-help cognitive behaviour therapy (CBT) manual specifically designed for individuals with OCD in Pakistan.
Detailed description
Obsessive-Compulsive Disorder (OCD) is a chronic and debilitating mental health condition characterised by persistent, intrusive thoughts (obsessions) and repetitive behaviours or mental acts (compulsions). These symptoms are often distressing, time-consuming, and cause significant functional impairment and reduction in quality of life. Cognitive and behavioural therapies, particularly the Exposure and Response Prevention (ERP), have consistently demonstrated efficacy as a first-line treatment for OCD. However, access to trained therapists remains limited in low- and middle-income countries (LMICs), including Pakistan. Self-help interventions rooted in CBT principles, especially when culturally adapted, represent a promising, scalable, and cost-effective alternative to conventional therapy. Previous research in Pakistan has shown the feasibility and acceptability of culturally adapted CBT (CaCBT) in treating depression and OCD within primary care and outpatient settings (Naeem et al., 2011; Aslam et al., 2015). This randomised controlled trial (RCT) aims to assess the feasibility, acceptability, and preliminary efficacy of a culturally adapted, guided self-help CBT manual specifically designed for individuals with OCD in Pakistan.
Interventions
OTHERCulturally adapted Guided Self-Help OCD Manual
Participants will receive a culturally adapted guided self-help OCD manual based on culturally adapted CBT principles, designed to be used over ten weeks. The manual includes: Psychoeducation, Exposure and Response Prevention (ERP), Thought distraction techniques, Mood tracking and thought diaries, Identifying and modifying cognitive distortions, Problem-solving and communication strategies, and Relaxation and well-being exercises. Participants will receive the self-help manual at the time of initial assessment and intake, and then will be provided with telephone support. Psychology graduates working as guides will provide weekly telephone support. Intervention will be provided flexibly over 12 weeks. The second contact will be made at the time of final assessment on the 12th week.
Sponsors
Pakistan Association of Cognitive Therapists
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
This is a rater-blind, randomised controlled trial (RCT) comparing a guided self-help CBT intervention plus Treatment as Usual (TAU) with TAU alone. Participants will be randomly assigned (1:1 allocation) to either group. Assessments will occur at baseline and 12 weeks post-intervention.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Clinical diagnosis of OCD (with or without comorbid depression) * Minimum 5 years of formal education * Residing within commuting distance of the participating sites * Ability to read and write Urdu * Provision of informed written consent
Exclusion criteria
* Current substance use or dependence (diagnosed) * Significant cognitive impairment (e.g., dementia or intellectual disability) * OCD with active psychosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Obsessive-compulsive symptoms | 12 weeks | As assessed through participants' scores on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) |
| Feasibility and acceptability | 12 weeks | Feasibility and acceptability will be assessed through trial procedure, recruitment, retention and informal feedback from participants. |
| Clients' satisfaction | 12 weeks | The client satisfaction scale will be used. At the end of the intervention, researchers will ask participants to describe their experience. They will be asked to name the sessions they found most or least helpful and to provide suggestions for improving the intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anxiety & depression | 12 weeks | As assessed through participants' scores on the Hospital Anxiety and Depression Scale (HADS) |
| Functionality | 12 weeks | As assessed through participants' scores on the WHO Disability Assessment Schedule 2 (WHODAS 2) |
Outcome results
None listed