Effective factors in the psychotherapy of religious obsessive-compulsive disorder: A qualitative study.

BACKGROUND: Religious obsessive-compulsive disorder (religious OCD; scrupulosity) presents unique challenges in psychotherapy due to the interaction between religious beliefs and obsessive-compulsive symptoms. Understanding how individuals benefit from psychotherapy in this context can inform more effective and culturally sensitive treatment approaches. AIMS: This study aimed to explore the factors that make psychotherapy effective for individuals experiencing religious obsessions and compulsions. METHOD: A qualitative design based on a phenomenological approach was employed. In-depth semi-structured interviews were conducted with nine participants diagnosed with religious OCD. The collected data were analysed using thematic analysis to identify the core themes that contribute to therapeutic benefit. RESULTS: The findings revealed several dimensions that enhanced the therapeutic process. The therapist's competence in religious knowledge and ability to apply this knowledge meaningfully contributed to treatment effectiveness. Participants emphasized that the therapist's religiosity fostered trust and a sense of being understood. Additionally, evidence-based psychotherapeutic methods, such as normalization and psychoeducation, added value to the process. A key finding was that an integrative approach combining religious and scientific psychotherapy knowledge substantially improved outcomes. The therapist's non-judgemental, empathetic and sincere attitude further facilitated clients' sense of safety and engagement in therapy. CONCLUSIONS: Effective psychotherapy for religious OCD requires a holistic approach that integrates religious sensitivity with evidence-based therapeutic skills. Such integration plays a crucial role in enhancing client trust, understanding and overall recovery.