Uncorrected Proof Iran J Psychiatry Behav Sci. 2022 June; 16(2):e118186. Published online 2022 July 3. doi: 10.5812/ijpbs-118186. Case Report Effectiveness of Technology-Based Interventions for Scrupulous Obsessions and Compulsions: A Case Report Sepideh Soltanmohammadlou 1 , Abbas Ramezani Farani 1, * , Seyed Vahid Shariat 1 and Mojtaba Habibi 2 1 Department of Behavioral Science and Mental Health, Iran University of Medical Science, Tehran, Iran 2 Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Psychiatric Institute), Iran University of Medical Sciences, Tehran, Iran * Corresponding author: Department of Behavioral Science and Mental Health, Iran University of Medical Science, Tehran, Iran. Email: ramezanifarani@gmail.com Received 2021 July 25; Revised 2022 April 26; Accepted 2022 May 28. Abstract Introduction: Cognitive-behavioral therapy (CBT) is one of the most important well-known treatments for obsessive-compulsive disorder (OCD), including the scrupulosity type. Technology-based interventions can increase the effects of CBT by different meth- ods. The aim of this study was to examine the effectiveness of online cognitive therapy in a Muslim patient with scrupulosity em- ploying in-vivo exposure, with the therapist virtually present and using a treatment application. Case Presentation: The patient was a 37-year-old female diagnosed with scrupulosity in OCD by a psychiatrist. The patient’s symp- toms were measured at baseline for 6 weeks then underwent 12 sessions of CBT with the therapist present via video call. All the exposure sessions were conducted in real situations triggering thoughts and compulsions. The therapy application was also used between sessions as an assistive treatment tool. Conclusions: The results of this treatment model showed a decrease in obsessive symptoms and beliefs and anxiety and depression symptoms at the end of treatment and after a 3-month follow-up. Moreover, the quality of life was improved in the patient. Keywords: Remote Therapy, Scrupulosity, Technology-Based Cognitive-Behavioral Therapy, Treatment Application 1. Introduction Obsessive-compulsive disorder (OCD) is one of the most prevalent and debilitating psychiatric disorders (1). The symptoms of OCD are extremely broad and varied. Scrupulosity is a type of this disorder in which there is an obsessional fear of thinking and behaving against reli- gious beliefs and God’s commandments (2). The OCD treatment guidelines and research have intro- duced cognitive-behavioral therapy (CBT) with an empha- sis on exposure and response prevention (ERP) as the psy- chological intervention of choice for OCD, including the scrupulosity type (2, 3). However, the nature of treatments received by OCD patients does not fulfill the minimum re- quirements for CBT treatment, and many sessions do not include exposure, with an emphasis on homework (4). In addition, it has been shown that 18% - 30% of patients re- ceived treatment with exposure techniques (in 2 years) (4). Furthermore, treatment barriers, including the patients’ feeling of shame, fear of being labeled, and the lack of ac- cess to mental health professionals, can contribute to not seeking appropriate treatments (5). According to these findings and due to the discrepancy between the preva- lence of this disorder and the number of individuals re- ceiving treatment, mental health services are still inappro- priate and insufficient despite abundant knowledge about OCD treatment (4). Technology-based interventions can greatly decrease the limitations mentioned above. For instance, we hope different evidence-based treatments become remotely available to patients using these treatments (6). In addi- tion, technology-based interventions, especially those us- ing applications, provide objective feedback for the client about contribution to problems and also a response to treatment and raise ERP treatment success and the qual- ity of CBT with an emphasis on ERP (7). The effect of technology-based interventions on OCD has also been ex- amined. These studies have pointed out the limitations of the literature and the need for further examining the ef- ficacy of these types of interventions for OCD treatment (8). However, there have been no studies on the impact of technology-based interventions on scrupulous patients. According to our previous investigations, only limited re- search has confirmed the influence of CBT on reducing the symptoms of scrupulosity patients (9, 10). Farhood et al. demonstrated that although CBT re- duced obsessive symptoms in both groups of patients with Copyright © 2022, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.