The Effectiveness of Reality Therapy on Obsessive Beliefs and Cognitive Ability in Patients with Obsessive Beliefs: Tehran, Iran

Abstract

Background: Obsessive-compulsive disorder (OCD) is a mental disorder in which a person has intrusive thoughts and feels the need to perform specific tasks repeatedly to relieve the distress caused by the obsessions, to the point that it disrupts their overall functioning. Objectives: The present study aimed to investigate the effectiveness of reality therapy (RT) on obsessive beliefs and cognitive ability in individuals with obsessive beliefs. Based on the principles of cognitive and humanistic psychology, this study seeks to explain the role of RT-based interventions in reducing obsessive symptoms and improving individuals' psycho-emotional functioning. Methods: This quasi-experimental study was conducted with a pretest-posttest design with a control group. The statistical population included people with obsessive beliefs who referred to psychiatric clinics in Tehran in 2025. For this, 30 individuals with formal, clinician-administered diagnosis of OCD were selected using purposive sampling and randomly assigned to two experimental and control groups (15 people in each group). The research tools included the Obsessional Beliefs Questionnaire (OBQ-44) and the Cognitive Ability Questionnaire (CAQ). The experimental group underwent RT intervention in ten 90-minute sessions, and the control group did not receive any intervention. The data were analyzed using the multivariate analysis of covariance (MANCOVA) test by SPSS (version 23) software. Results: The findings showed that the total score of the variable "obsessive beliefs" in the pre-test phase for the control and experimental groups was 209.5 ± 16.2 and 207.2 ± 8.9, respectively, and for the variable "cognitive ability" was 47.1 ± 3.9 and 46.5 ± 4.7, respectively. For both variables, there was no significant difference between the two values obtained in pre-test phase. While, after the intervention (post-test phase), the total score of the variable "obsessive beliefs" for the control and experimental groups was 206.00 ± 14.95 and 186.0 ± 8.4, respectively, and for the variable "cognitive ability" was 46.7 ± 3.5 and 61.8 ± 5.0, respectively. Based on obtained results, there was a significant difference between the two values obtained for both variables in post-test phase. The results showed that the effect of RT on all components related to the variables "obsessional beliefs" and "cognitive ability" was significant (P < 0.05). Conclusions: The findings of this study indicate that RT, as an approach based on individual choice and responsibility, can be effective in modifying dysfunctional beliefs, especially obsessive beliefs and cognitive abilities. The findings of the present study, can provide a basis for designing clinical interventions and training therapists in the field of cognitive psychology.