Cultural Adaptation of Traditional Islamically Integrated Psychotherapy (TIIP) for Muslims with Obsessive Compulsive Disorder (OCD): Study Protocol for a Randomized Controlled Trial in Pakistani Population (Preprint)

BACKGROUND Obsessive-Compulsive Disorder (OCD) is a debilitating mental health condition marked by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Cultural and religious contexts significantly influence treatment, particularly in Muslim-majority countries like Pakistan, where mental health interventions often lack cultural sensitivity. Traditional Islamically Integrated Psychotherapy (TIIP) integrates Islamic teachings with contemporary psychotherapy, addressing this gap. OBJECTIVE To evaluate the efficacy of a culturally adapted TIIP module in reducing OCD severity and improving associated mental health outcomes among Pakistani Muslims. METHODS A randomized controlled trial (RCT) comparing the efficacy of TIIP against treatment-as-usual (TAU) will be conducted in an outpatient mental health setting in Pakistan, targeting a culturally representative sample. Sixty participants, aged 18-40 years, diagnosed with OCD according to DSM-5-TR and scoring ≥14 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), will be randomized into experimental (TIIP) and control (TAU) groups. The intervention will involve eight individual therapy sessions using the adapted TIIP framework. Outcomes will be assessed using Y-BOCS and secondary measures, including DASS-21, TAF, TCQ, and SQOL-9, validated in Urdu. RESULTS This is a study protocol so results are anticipated. Recruitment has started in August 2025. We expect to enroll 60 participants and complete data collection by December 2025. Primary outcome analyses (mixed-effects models) will compare changes in Y-BOCS between groups. Trial Registration Number: ClinicalTrials.gov NCT06302712; https://clinicaltrials.gov/study/NCT06302712 (registered March 15, 2024; prospectively registered). CONCLUSIONS This study aims to establish TIIP as a culturally and religiously sensitive intervention for OCD, addressing the unique needs of Pakistani Muslims. Findings will provide a foundation for integrating culturally adapted psychotherapies into broader mental health frameworks in low- and middle-income countries. CLINICALTRIAL ClinicalTrials.gov NCT06302712; https://clinicaltrials.gov/study/NCT06302712 (registered March 15, 2024; prospectively registered).