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)

<sec> <title>BACKGROUND</title> 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. </sec> <sec> <title>OBJECTIVE</title> To evaluate the efficacy of a culturally adapted TIIP module in reducing OCD severity and improving associated mental health outcomes among Pakistani Muslims. </sec> <sec> <title>METHODS</title> 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. </sec> <sec> <title>RESULTS</title> 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). </sec> <sec> <title>CONCLUSIONS</title> 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. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT06302712; https://clinicaltrials.gov/study/NCT06302712 (registered March 15, 2024; prospectively registered). </sec>