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, patients who have religious obsessions and compulsions (scrupulosity) introduce concerns not commonly encountered when treating individuals with other types of OCD symptoms. The present case history describes the successful use of EX/RP for a patient with scrupulosity. Behavioral and cognitive symptoms of OCD responded to treatment and remained improved at 6-month follow-up. Special considerations in presenting the rationale for using exposure-based interventions, and in developing exposure exercises for these types of symptoms, are discussed in detail.