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.
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
Current substance use or dependence (diagnosed)
Significant cognitive impairment (e.g., dementia or intellectual disability)
OCD with active psychosis
Parallel
Culturally adapted Guided Self-Help OCD Manual
Other interventionParticipants 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.
Obsessive-compulsive symptoms
As assessed through participants' scores on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS)
Feasibility and acceptability
Feasibility and acceptability will be assessed through trial procedure, recruitment, retention and informal feedback from participants.
Clients' satisfaction
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.
Anxiety & depression
As assessed through participants' scores on the Hospital Anxiety and Depression Scale (HADS)
Functionality
As assessed through participants' scores on the WHO Disability Assessment Schedule 2 (WHODAS 2)
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