Treatment of scrupulous obsessions and compulsions using exposure and response prevention: A case report

Cognitive-behavioral therapy by exposure and response prevention (EX/RP) is an effective treatment for obsessive-compulsive disorder (OCD). However, p atients who have religious obsessions and compulsions (scrupulosity) introd uce concerns not commonly encountered when treating individuals with other types of OCD symptoms. The present case history describes the successful us e of EX/RP for a patient with scrupulosity. Behavioral and cognitive sympto ms of OCD responded to treatment and remained improved at 6-month follow-up . Special considerations in presenting the rationale for using exposure-bas ed interventions, and in developing exposure exercises for these types of s ymptoms, are discussed in detail.