The Effects of ‘RehaCom’-Based Cognitive Rehabilitation and Exposure-Response Prevention Behavioral Therapy (ERP) on Neuropsychological and Clinical Indices in Patients with Obsessive-Compulsive Disorder

Kahani, ُُShamsoddin; Naziri, Ghasem; Mohamadi, Masoud; Aminimanesh, Sajad

doi:10.22054/jcps.2026.89383.3301

The Effects of ‘RehaCom’-Based Cognitive Rehabilitation and Exposure-Response Prevention Behavioral Therapy (ERP) on Neuropsychological and Clinical Indices in Patients with Obsessive-Compulsive Disorder

Document Type : Research Paper

Authors

¹ Ph.D. student in Clinical Psychology, Islamic Azad University, Shiraz Branch, Department of Clinical Psychology, Shiraz, Iran.

² Assistant Professor, Department of Clinical Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.

10.22054/jcps.2026.89383.3301

Abstract

Abstract
Introduction: Numerous theoretical and empirical findings have confirmed the effectiveness of behavioral therapy in treating obsessive–compulsive disorder (OCD). However, the anxiety induced by exposure and response prevention (ERP) and the lack of response in some patients highlight the need for a deeper understanding of the neural mechanisms underlying OCD.
Objective: Focusing on the common paradigm of prefrontal dysfunction, the present study examined the effects of cognitive rehabilitation and ERP on neuropsychological and clinical indices in patient with OCD.
Method: A single-case experimental design with multiple nonconcurrent baselines was employed. The study population consisted of patients aged 17–48 years selected through purposive sampling. Six patients meeting inclusion criteria were randomly assigned to two intervention groups (cognitive rehabilitation and behavioral therapy). Each intervention comprised 24 individual sessions with a two-month follow-up. Assessment tools included the Tower of London, Wisconsin Card Sorting, Stroop, and n-back tests, as well as the Yale–Brown Obsessive–Compulsive Scale and Beck Depression Inventory. Data were analyzed using visual analysis, percentage improvement, effect size, reliable change index, and Ingram’s clinical efficiency indices.
Results: Both interventions led to significant reductions in OCD and depression symptoms. However, cognitive rehabilitation showed greater clinical effectiveness in neuropsychological indices during the intervention and at two-month follow-up (Z > 1.96, p < 0.05). Furthermore, in Ingram’s indices—generalization, comprehensiveness, acceptability, safety, and data stability- cognitive rehabilitation outperformed behavioral therapy.
Discussion: Cognitive rehabilitation, by enhancing executive brain functions, can lead to significant improvement and reduction in obsessive-compulsive and depressive symptoms, in line with the response inhibition–exposure approach. Accordingly, it can be considered an effective complementary treatment in clinical programs.

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