Effectiveness of Thought Stopping in Treating Obsessive-Compulsive and Compulsive

Effectiveness of Thought Stopping in Treating Obsessive-Compulsive and Compulsive | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effectiveness of Thought Stopping in Treating Obsessive-Compulsive and Compulsive Basim Aldahadha, Ala Shdouh, Mubin Alnawiseh This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4277175/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The present study aimed to identify the effectiveness of a counseling program based on thought stopping among female students suffering from obsessive-compulsive disorder (OCD) and compulsive hoarding disorder (CHD). The sample consisted of 40 students distributed equally and randomly to the treatment group and waiting list group. OCD and CHD scales and a program based on cognitive behavioral therapy in thought stopping were applied. The results showed that there were significant differences between the treatment and waiting list groups in OCD and CHD in favor of the treatment group on the post measurements. The results also showed the effectiveness of the program in thought stopping on the post measurements and at follow-up a month after program termination. There is the effectiveness of thought-stopping in alleviating the symptoms of OCD and HCD. Attention should be given to early intervention of thought-stopping to reduce CHD by raising awareness of the roles of nurturing and the environment in which this disorder grows and how to prevent it. thought stopping obsessive-compulsive compulsive hoarding and female students Figures Figure 1 Introduction Some individuals have a love for shopping, buying for many different purposes, and staying there for long years in their homes, and they take up many space in the place where they live (Yamada, et al., 2018 ) a desire to love possession, and these things are linked to emotional aspects, and if they are directed by others to get rid of them (Himle, et al., 2006 ; Saxena & Maidment, 2004 ); they are worthless, and cause distress and tension for all who refuse to respond to them; believing that they will bind them later (David, Frost, & Steketee, 2007 ). They do not realize that they are suffering from a disorder, and this disorder exists in the high school community, but it is not taken into consideration due to a lack of awareness of it and consequently the inability to diagnose it (American Psychiatric Association, 2013 ; Fusco, 2021 ). Most studies have attributed the cause of OCD in adolescence to the beginning of physical and sexual changes and therefore the accompaniment of a feeling of personal hygiene (Abdel-Khaleq, 2002 ; Aldahadha, 2018a ). OCD is one of the anxiety disorders, with which it shares symptoms. A small degree of anxiety increases alertness, attention and improvement in the performance of the individual, but if the anxiety exceeds a certain limit, the performance of the individual will decrease and thus hinder achievement, and his or her interest becomes only obsessive thoughts, rituals and practices (Saxena & Sumner, 2014 ; Frost, et al., 2000 ). OCD is characterized by extremely repetitive ideas and behaviors that interfere in daily life, and this disorder gives rise to anomalous situations in which the individual focuses on an idea, risk, or impulsive image that is often ridiculous and trivial but imposes itself on him or her and continues to be reconsidered by the individual in these cases (Abramowitz et al., 2003 ; Faure & Forbes, 2021 ). Ownership love appears in individuals in childhood; it is an innate tendency that can be stripped from any benefit or purpose, and it can be illogical and exaggerated, causing individuals to perform strange behaviors. This stage is called CHD, and it was classified in the DSM 5 among the areas of OCD (Steketee et al., 2003 ; Tolin & Gilliam, 2010 ). CHD is no less important than other mental disorders in terms of its prevalence and the problems it causes; its prevalence in the United States is estimated at 1–2%, (i.e., ranging between 3 and 6 million American people), and it affects 129 million people worldwide, impacting the psychological, family, social and health lives of individuals (Storch et al., 2007 ). CHD is defined as "excessive accumulation, collection of holdings, and the great difficulty in deciding to dispose of unnecessary personal property, due to the ongoing feeling of the need to use these objects later" (Gilliam & Tolin, 2010 . 14). Among the age groups that have CHD are high school students because in this stage there arises difficulties in decision making, health and psychological problems, lack of organization, the inability to set goals, low self-confidence, lack of time organization, and difficulty in solving problems (Fenske & Schwenk, 2009 ; Rimawi, 2003 ). The thought stopping method is considered one of the therapeutic methods for addressing obsessive thoughts, and it has a role in stopping them (Hollon & DiGiuseppe, 2011 ). It includes focusing on an unwanted, annoying or painful idea for a short period of time and then suddenly stopping it and emptying the mind of it (Saxena, 2008 ; Saxena, 2007 ). It is used in launching the firm command to stop or snapping a rubber band around the wrist to cause pain, an old technique developed to treat obsessive and fear-provoking ideas, and it has proved effective with a long list of obsessive and fear-provoking ideas (i.e., preoccupations about health, disturbing or painful thoughts or fears) (Aldahadha, 2018 b; Beck, 2000 ). High school students with hoarding disorder do not realize the seriousness of the problems caused by the symptoms of this disorder, and treatment cannot begin to address the symptoms of hoarding until the student has conscious insight (Aldahadh, 2020; Sadiq & Marwa, 2013 ). Since it is punitive it thus reduces the likelihood of an idea recurring, and the command's to stop distracts attention, which is incompatible with the unwanted idea (Suñol, et al., 2020 ). Following the command stands as an alternative idea to help ensure that unwanted thoughts do not return (Frost et al., 2004 ; Grisham & Barlow, 2005 ). Several studies have been conducted related to the subject of the current study. Frost et al. ( 2008 ) found that more than 95% of respondents complained of excessive hoarding. Sadiq and Marwa ( 2013 ) conducted a study entitled “The effect of stopping thoughts in reducing sleep disturbance” among a group of students from Diyala University. The results favored the treatment group. Wilson and Chambless ( 2005 ) conducted a study entitled "The effectiveness of the behavioral cognitive program with OCD”, aiming to determine the extent of the program's impact on OCD patients. The study showed the effectiveness of the applied program in reducing OCD regarding obsessive thoughts about hygiene, closing doors, and disease. As a result of the repetition of compulsive behaviors and the impact of repeated compulsive thinking, CHD has become part of the lives of many high school students and has an impact on important decision making, goal setting, problem solving, social interaction and academic achievement. Some studies have also indicated the existence of this problem (Rachman, 2002 ; Storch, et al., 2007 ), aiming to determine the prevalence of CHD and to reveal the relationship between it and OCD in some demographic variables, with one study finding that the prevalence 41.5% among sample members was 15.5%. Through follow-up with the counseling records at the schools, the counselor’s advice, and the notes of the female students’ parents, cases of isolation emerged due to excessive collection and storage of things, including school books over many years, games since childhood, magazines containing pictures of actors, and school files. The students had difficulty discarding things despite their being useless, leading to the emergence of chaos, disorganization, and feelings of distress and anxiety; and the cases are repeated in different situations that indicate them. Accordingly, the problem of this study was to build and test the effectiveness of a counseling program in stopping compulsive thoughts among high school students who suffer from CHD. Hence, the study sought to answer the following questions: 1-Are there statistically significant differences between the means on the posttest for OCD scales and CHD measurements among female secondary school students attributable to treatment? 2- Are there statistically significant differences between the means on the follow-up test of the OCD scales and the CHD measurements attributable to treatment? This study attempts to add a new benefit to studies conducted among Arabs with both OCD and CHD since it attempts to test the effectiveness of a counseling program based on thought stopping in reducing the disorders of OCD and CHD within a sample of high school students in Southern Mazar Brigade schools. This study is the first at the local level to study these variables. It could even be used as a frame of reference or an introduction to upcoming research and studies that the researcher hopes will address other problems for professionals. The practical importance of this study is that it provides a counseling program based on thought stopping to stop both OCD and CHD among high school students and opens the way for other researchers in the future to research this topic and study it from other aspects. It could open new horizons for studies and topics that approximate perspectives and support scientific research, in addition to providing a theoretical and conceptual framework of concepts, data, information, and instructional methods and providing counselors with a counseling program from which they can benefit in treating similar cases. The current study aims to reveal the effectiveness of a counseling program based on thought stopping in both OCD and CHD in female high school students. Method Participants and procedures Al-Jaafariya Vocational Secondary School (N = 205) for Girls was chosen randomly from all-girls schools in Karak governorate. The participants agreed to attend the program five days per week and one session per day. The names of the students were monitored in lists according to the vocational and academic branches. Each student was provided with a copy of two scales for OCD and CHD, and they were asked to answer the items on the two scales. Subsequently, the questionnaires bearing the female students’ answers were corrected, and the female students who obtained the highest scores on the two scales were maintained; and they are estimated at 80 and greater on the OCD scale, and they scored 58 and greater on the CHD scale. Thirty students were selected randomly from 60 who wished to participate in the counseling program. In further step of participants psychotherapy, they were interviewed in the zero-intake interview session. In the first session, it was ascertained that there were no medical problems that might be a cause of OCD or HCD, and the signs, symptoms and events that caused him to have these symptoms were discussed. Additionally, the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) were used. It has been confirmed that most of these symptoms are present in all selected participants. According to the DSM-5-TR, the diagnose based on specific factors: The person has obsessions, compulsions, or both. The obsessions or compulsions take up a lot of time (more than an hour per day). The obsessions or compulsions cause distress or affect participation in social activities, work responsibilities or other life events. The symptoms aren’t caused by drugs, alcohol, medications, or another medical problem. The symptoms aren’t explained by another mental disorder (e.g., generalized anxiety disorder, eating disorder or body image disorder). For diagnosing the HCD, we also used the criteria listed in the DSM-5-TR. Finally. The sample was randomly divided into two groups (Treatment and Waiting list), with 15 eligible students in each group from those who had the highest levels of OCD, CHD and continued intervention. This study was approved by the Scientific Research Committee at Mutah University on May 23, 2021, and was conducted in accordance with the instructions of the American Psychological Association and the Ethics of Scientific Research and the Helsinki declaration of Ethical Principles for Medical Research Involving Human Subjects. All participants agreed to overcome their problems and they sign a written consent to the publication of his data. See figure (1) the consort flow diagram of participants through trial. Procedure Counseling program The counseling program aims to stop the actions and obsessive thoughts of the CHD sample from female high school students, and in this way, the program includes achieving the following goals (Tolin, et al., 2002 ): 1- A cognitive goal by enlightening the students about their problems and identifying the concept of CHD, its causes and its effects, its behavioral and psychological manifestations and its causes. 2- An emotional goal by training the students to waiting list their emotions, training them to confront obsessive symptoms, and training in the technique of stopping thoughts; and 3- A behavioral goal through a behavioral intervention and helping the students to replace negative thoughts and beliefs with positive thoughts and beliefs and to modify their behaviors in a positive way. The procedures used when implementing the program begin with discussion and dialog, review of the previous session, learning and training in new skills, a final evaluation at the end of the session, and homework. To ensure that the content of the program fits the study sample, through the validity of the program, it was presented to 9 arbitrators from among specialized faculty members. Thought stopping exercises Step (1) Make a list of your stressful thoughts, which include stressful stimuli, irrational thoughts, and silly thoughts, which have become habitual and difficult to stop. Write these thoughts down on a piece of paper. At every thought that raises your anxiety and tension and you write it down on the paper, ask yourself the following questions: Is the idea irrational? Is the idea an unexpected or unusual outcome? Is the idea a defensive method? Is it difficult to tune in to the idea? Does the thought affect my ability to focus and what I need to do? Is it causing me a lot of discomfort? Do I want to be happier, calmer, and more relaxed without these thoughts? If you answered yes to those questions related to the idea that causes you stress and pressure, then the thinking stopping tactic will be effective and very appropriate for you. Step 2: Visualize the thought. Close your eyes, then imagine the stressful situation or thought as it really is. Try to be as natural as if you were actually thinking about the obsessive behavior. In the meantime, you can cut out that obsessive thought that triggers stress and allow normal, healthy thinking to continue. Step (3) Cut the idea, this step can be applied through the following two methods (1) set the alarm clock or time for three minutes and then it rings, look away, then close your eyes, then prepare yourself as I explained in the previous step. And when you hear the sound of the alarm shout, saying stop. You can put an elastic band on your wrist so that you tighten that rubber to cause a feeling of pain. Empty your mind of all neutral thoughts that don't cause anxiety. Set a desired goal for your life for (30) seconds after stopping or saying the word stop, and during a period when your mind is free of stimuli. If the obsessive thoughts return during that time, shout again, "Stop!" (2) Record to yourself, out loud, the word “stop” for intermittent periods, such as after every three minutes, after two minutes, after one minute, and so on. You may find it useful to re-listen to the recording so that you hear the word stop again several times and at short intervals ranging from about five seconds less or more, apply the same method to the alarm clock, or to situations that cause anxiety or obsessive-invasive situations or others. Make sure that the recorded audiotape restores the process of forming, emerging, and controlling your thoughts so that it prolongs the period of absence of obsessive thoughts. Step (4) Cut off the non-purposeful idea. You have to set the stopping of the idea without using the voice recorder. During that, if you feel the presence of an unwanted idea, shout, “Stop,” then lift the rubber to cause some kind of tension and pain on the wrist, when you succeed in distinguishing and noticing the idea. In different situations and occasions, you have to pronounce the word “stop” normally and naturally to stop and cut off intrusive thoughts. After succeeding in stopping the thought using your normal tone of voice, try to start cutting off the unhealthy extraneous thought through special gestures you make or special movements such as hitting lightly on the table or the floor or any other sign indicating the word stop. When that signal is enough to cut off the bossy thoughts, use the subvocal technique. Imagine hearing the word "stop" and then try to move your tongue as if you were pronouncing that word, but in a subtle, inaudible manner. Being successful in this phase means that you will stop the thoughts when alone or with others, without making sounds, making movements or hitting the floor but only by focusing attention on yourself. Step (5) Thought substitution. The last step of stopping thoughts involves replacing the obsessive thought with a neutral, natural, non-obsessive thought. Develop some positive, self-affirming statements or fantasies that may be appropriate for the target situation. For example: If you are afraid of flying, you might say: Do yourself a few sentences such as: Traveling by airline is a safe means of transportation. I could be relaxed, and then develop other sentences that indicate a sense of confidence while you are talking to yourself, because the alternative obsessive response may fade with the repetition of the alternative strong thought, and then imagine yourself having reached the place you are headed towards, and you have obtained positive results and achieved the goal that you traveled for him. Instruments Obsessive-compulsive disorder The OCD Scale was developed by reviewing a number of studies and theoretical writings in the field of OCD (Abu Hindi, 2003 ; Abdel-Khaleq, 1992; Al-Miqdadi, 2008 ). The OCD scale developed by Al-Humairi ( 2014 ) was used; the scale in its original form has psychometric properties that qualify it for use in the current study. The validity and reliability of the scale were checked in its original form, and then the internal consistency between the items was calculated by the method of correlation between the degree of the item and the overall degree of the scale. The results showed that the correlation ranged between r = 0.57 and r = 0.84 , and all were significant at the level of 0.01. The validity of the scale ( r = 92.0 ), which was significant at the level of 0.01, reached the coefficient of stability of the scale through reapplication ( r = 90.0 ), thus enjoying a measure of persistence. For the purposes of this study, the content validity of the scale was verified in its initial form by presenting it to a number of people experienced in and specializing in the field of psychological and educational guidance at Mutah University and Al-Balqa Applied University, with the aim of acquiring their views about the accuracy of the scale content and its validity in terms of the degree of item measurement, its clarity and linguistic wording, and its appropriateness to measure what it was designed for, as well as to add, amend or delete what they deemed appropriate. Proposed amendments were made to the OCD scale, in light of the arbitrators’ notes, and they related to paraphrasing the items to become clearer. The criterion that was adopted in accepting or excluding items was that the items obtained a consensus of 80% of the arbitrators; thus, the number of items after arbitration was 32 items. The scale was also applied to a survey sample consisting of 42 students from outside the study sample from Al-Mazar Girls’ Secondary School. To verify the validity indicators of the scale, construction validity indicators were calculated using the Pearson’s correlation coefficient to determine the values of the item correlation coefficient with the total score for the scale. It was found that the values of the coefficients of correlations of the OCD scales ranged between 0.79 and 0.48, and the criterion for accepting the item was adopted when its correlation coefficient was no less than 0.40, according to Hattie ( 1985 ); thus, all of items on the scale were accepted. To estimate the internal consistency of the OCD scale, it was calculated using Cronbach's alpha formula using the data of the first application in the prospective sample of 42 subjects from outside the study sample. For the scale and its dimensions, using the test-retest method with a time difference of two weeks, it was found that the stability of the internal consistency of the scale as a whole was 0.91, and the stability of the test-retest of the scale as a whole was 0.93. The OCD scale in its final form included 32 items, which were answered with a five-point scale including the following option: always − 5 points; often – 4 points; sometimes − 3 points; rarely − 2 degrees; and never – 1 point. These points apply to all items on the scale because they are formulated in a positive direction; and thus, the score on the scale as a whole range from 32 to 160 points. Compulsive hoarding scale The CHD scale (Frost et al., 2004 ) was used to detect the level of CHD. The validity of the test was verified by content validity, concomitant validity, validity of internal consistency, and discriminatory validity. Its preliminary version is characterized by a high degree of stability since the Cronbach’s alpha stability was .94, showing a high stability. For the purposes of this study, the scale was translated in its original form from the English language to the Arabic language; appropriate adjustments were made to the translation so that the examiners cold avoid any difficulties resulting from a misunderstanding of the meaning, which would hinder responses. Then, the items were translated into English again to ensure that the items retained their meaning. After presenting the translation to four specialists in the English language, the scale was also presented to specialists in the Arabic language to verify the wording of the items, and then it was presented to a group of arbitrators from Mutah University, and the necessary adjustments were made based on the opinions of the arbitrators. Additionally, the scale was applied in 42 female students to ensure their understanding of the scale terms, and the students were asked to take notes on the scale, especially with regard to formulating and understanding the provisions. The content validity of the scale was also verified by presenting it in its initial form to a number of people experienced in and specializing in the field of psychology and counseling at Mutah University and Al-Balqa Applied University to determine its suitability to measure what it was designed for, and material was added, amended or deleted based on what they deemed appropriate. In light of the arbitrators’ observations, proposed amendments were made to the CHD scale related to paraphrasing the items to become clearer, and the criterion that was adopted in accepting or excluding the items was that the items obtained a consensus of 80% of the arbitrators; thus, the total number of items after arbitration was 23 items. The scale was also applied to an exploratory sample consisting of 42 female students from outside the study sample, and the construction validity indicators were calculated using the Pearson’s correlation coefficient to determine the values of the correlation coefficient of the overall degree of the scale; it was found that the values of the correlation coefficients for items on the CHD scale were statistically significant at the level of significance of α = 0.01, they ranged between 0.73 and 0.46 with the overall degree of the scale, and the correlation coefficient of all items with the overall degree of the scale was greater than 0.40, so the acceptance criterion for the item was adopted. Its correlation coefficient was less than 0.40, according to Hattie ( 1985 ). It is also clear from the foregoing quality of the items on the CHD scale; thus, the scale obtained its final form, consisting of 23 items. To estimate the internal consistency of the CHD scale, it was calculated using Cronbach's alpha formula using the data of the first application in the 42 exploratory sample students from outside the study sample. To verify the stability of the test-retest method, with a time difference of two weeks, the Pearson’s correlation coefficient was calculated between the first and second applications in the sample, and it was found that the stability of the internal consistency of the scale for the whole was 0.89, and the test-retest constant for the scale as a whole was 0.92. The CHD scale in its final form included 23 items. These items apply to all of the positive scale items, while the grades are reflected in Items 10, 12, 14, 21, and 4 since they are formulated in negative form. Thus, the scale ranged as a whole from 23 to 115 degrees. The higher that the degree is, the more indicative that it is of a high level of CHD. Data analysis The Pearson’s correlation coefficient, means, standard deviations, ANCOVA, and the paired sample t test were used. Levene's test for equality of variances was used to verify the homogeneity of the regression slope scores of the waiting list and treatment groups on the OCD scale and the OHD pretest scale. The p values of homogeneity for the OCD and HCD scales were 0.095 and 0.187, respectively, which are nonsignificant values (0.05), indicating the use of associated analysis of covariance (ANCOVA). Results Initially, the analysis of variance assumptions were investigated: random and independent sample selection of the population, normal sample distribution, independence of the groups to be compared, and homogeneity of variance between groups. To test the first hypothesis, the means and the standard deviations were calculated on the two scales, OCD and CHD, on the posttest; Table (1) shows these values. To ensure the equivalence of the different study groups regarding the pretest for the OCD scale, the means and standard deviations were calculated, and the t test for the sample using the OCD scale was calculated on the pretest; Table 1 shows these values. It is noted that there were no differences between the treatment and waiting list groups on the pretest measurement, indicating equivalence of the two groups. Table 1 Means and standard deviations of the OCD and CHD on the posttest Variable Group Pretest Post test Sig. T df M SD M SD OCD CHD Waiting List 3.25 0.92 3.27 0.78 0.94 .066 28 Experimental 3.22 0.90 2.42 0.58 Waiting List 3.61 0.88 3.27 1.09 0.59 .539 28 Experimental 3.40 1.22 2.28 0.75 Note: OCD = Obsessive compulsive disorder; CHD = Compulsive hoarding disorder; N = 15 To verify the significance of the apparent differences, analysis of covariance ANCOVA was performed for the posttest of the OCD and HCD scales according to group after neutralizing the effect of the pretest, as shown in Table (2). Table 2 shows that there were statistically significant differences between the means of the total scores for OCD F (11.441 ) = P < 0.01 and CHD F (9.337) = P < 0.01 and the waiting list group in favor of the OCD and CHD scales with high effects, respectively, of . 298 and . 257 . Table 2 Analysis of covariance (ANCOVA) of the OCD and CHD scales by group at the pretest Source Variables Sum of square df Means of square f Sig. Eta square Pretest OCD 0.160 1 0.160 0.326 0.57 .012 HCD 1.835 1 1.835 2.159 0.15 .075 Group OCD 5.615 1 5.615 11.441 0.00 .298 HCD 7.935 1 7.935 9.337 0.00 .257 Total OCD 19.049 29 HCD 32.037 29 Note: OCD = Obsessive compulsive disorder; CHD = Compulsive hoarding disorder; * P < 0. To test the hypothesis of the second study, results show that there are statistically significant differences between the two measures of pretest and follow-up among members of the treatment group on the OCD t (3.22) = 2.575, p = 0.02 and CHD t (3.40) = 2.539, p = 0.02 , indicating the continuity of the impact of the program beyond the follow-up period. Discussion The effectiveness of the indicated program was demonstrated by the presence of a statistically significant difference between the mean scores of the pre- and post-test measurements of the two treatment groups on the OCD and CHD scales in favor of postapplication. The results of this study were consistent with the results of many studies that have been conducted in this field, so a remarkable improvement emerged in the performance of female students and their ability to address compulsive ideas and actions by learning new skills, such as stopping ideas, relaxation, and problem-solving methods. The results of the current study are consistent with the study of Al-Douri ( 2003 ). The results of this study showed positive changes due to the method of thought stopping, including the technique of stopping ideas, which rendered the program effective (Wilson & Chambless, 2005 ). The study used a set of techniques that made the program effective, including cognitive reconstruction, relaxation, exposure, response prevention, and stopping thoughts. Al-Bajari ( 2007 ) used stopping ideas to modify the future trends of university students; the cognitive behavioral program was effective for the treatment group. Sadiq and Marwa ( 2013 ) and Goody (2006) used a method of relaxation, exposure, response prevention, and self-dialog, which played a role in treating the cognitive distortions causing OCD. The effectiveness of the indicated program as applied to the treatment group was also attributed to the fact that it helped to modify the behavior of female students, such as setting lists of tasks, homework and life activities, attention to healthy food, and setting priorities when setting goals related to public life situations. The results clearly revealed the positive impact of the indicative practice in which they participated and from which they learned and trained in the instructional sessions, and they generalized it in similar situations at the level of social and study life. Based on the above, the results of the current study confirmed the effectiveness of the CBT program in stopping compulsive thoughts and actions. Thus, the results of the current study are consistent with many studies (Al-Douri, 2003 ; Al-Miqdadi, 2008 ; McLean et al., 2001 ; Tolin et al., 2007 ; Willner & Goody, 2006; Wilson & Chambless, 2005 ). These studies focused on the use of CBT programs in treating OCD. The training program had a clear impact on stopping compulsive thoughts and actions in people with CHD. The cognitive behavioral approach links the methods and techniques of these two approaches and focuses on how the individual learns about behavior and emotions and cognitive communication through different patterns. The general feature of this theory is its direct intervention through rules and directed goals, its reliance on homework and application skills and its focus on problems by learning a set of skills that include looking at problem solving objectively as a fact of life. Regarding the changes that were observed in female students after applying the therapeutic program, within the framework of the current study, the members of the treatment group received intensive psychological treatment combined with relaxation and repeated and multiple attempts to train in the techniques of cognitive behavioral therapy to stop the thoughts and compulsions and to alleviate the students’ pain and distress due to OCD and CHD through several group sessions. Where the student was participating in all of the activities of the session from the beginning to the end, the agreement was activated between the researcher and the student on the importance of active participation in all of the various tasks during the program, with an emphasis also on them when at home. Among these techniques are reinforcement (so that members of the group are encouraged to exercise these roles) and homework (so that they are trained to practice these roles in life through the family at home and through their colleagues and peers in society). In particular, obsessive thoughts and compulsive acts are suddenly characterized by the insistence with which they invade the person when alone since they are invasive during school and among people. The patient has the opportunity to be able to stop them and return to normal life; they are trained on this skill in various ways, sometimes using stopping thoughts and sometimes using dialog and debate (Corey, 2013 ). The sessions took place with all of the procedures in an atmosphere of familiarity, with calm discussions conducted. The students recorded this activity in their reports, in which they recorded what happened to them after the end of the session and until the next session, and these reports were used for the topics of the new sessions. It was important to review them to achieve the goals, principles, foundations and steps of CBT and to ensure the continuity and extent of the students’ ability to understand what happened in the sessions and how to implement the skills outside of the sessions. The students benefited from the program by considering individual differences, by helping the students to improve in a specific framework for each individual case, and according to the individual case of each student separately. Thus, each member of the sample participated in carrying out the training assigned to her and according to the technique that suited her alone. The program relied on specific points, which are the procedural goals that researchers have previously focused on, such as overcoming obsessive thoughts and compulsive actions related to CHD. The program considers the principles of cognitive behavioral therapy in stopping compulsive thoughts and actions, especially the stage of building the therapeutic relationship, stimulating active participation, understanding students from the beginning of the session with an agenda, clarifying specific points that will be accomplished, training with them and repeating training, and continuing throughout the session. Consequently, the program used has achieved one of the main goals of programs to modify obsessive thoughts in general. The goal of conducting behavior modification programs is not to bring about temporary changes in the various aspects of the personality and then to soon extinguish them as if they were nothing. Rather, what is required in these programs is that their effect remains even after the training that individuals received during the sessions of those programs has stopped and even after their training links have been discontinued. It is essential to conduct these programs to ensure their continuity and effectiveness with the members of the treatment group after the sessions of the application have stopped, instilling confidence that the sample members have used in their life situations the different strategies that they learned and giving a justification for trying to implement these programs on large groups of female students, particularly those who suffer from anxiety disorders in general and from OCD and CHD specifically, because of the distress, distress and hardship that they cause and the social misalignment and psychological and academic problems they cause. In addition, the work of a researcher as a principal at the same school and the students' knowledge of and confidence in the research also helped in the success of the counseling program. This study is also, to the best of our knowledge, one of the first studies conducted in an Arab population to address an indicative program addressing CHD through a cognitive behavioral program using the technique of stopping thoughts. Conclusions Considering the results of this study, the following recommendations can be made. More studies should be conducted on the topic of stopping thought and CHD in different age groups and in male students and discovering the differences between them. In addition, the program was implemented to stop compulsive thoughts and actions in school students. There is the need to link CHD with other variables, such as social isolation and academic achievement. Finally, attention should be given to early intervention to reduce CHD by raising awareness of the roles of nurturing and the environment in which this disorder grows and how to prevent it. Abbreviations OCD Obsessive-Compulsive Disorder CHD Compulsive Hoarding Disorder Declarations Ethics approval and consent to participate. Approval for the study was granted by Counseling and Special Education Research Ethics Committee. When providing consent, participants agreed that anonymized survey responses could be used for research. The study was performed in accordance with relevant guidelines and regulations including the Declaration of Helsinki for research with human participants. Informed consent was obtained from all participants. Funding This research was unfunded. Data availability The datasets analyzed during the current study are not publicly available due to patient confidentiality. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Availability of data and materials The data will be available upon reasonable request. Corresponding author : Basim Aldahadha Authors Contributions A.B (Apply the treatment, study problem, rote the body manuscript, documentation 7th edition, and review the statistical analysis) A. S. (support the funding, review the language writing prepare figures and tables) M. A. (assets in applying the procedures, helping students, approving the writing, and supporting funding) affiliation for authors Aff1, (Karak); Aff2, (Abo-Dabi); Aff3; (Karak) References Abdel-Khaleq & Mayasa, A. (1990). Obsessions and their relationship to both anxiety, fears and depression. Journal of the Faculty of Arts, Alexandria University, 5(3), 38-54. Abdel-Khaleq, A. (2002). Obsessive-compulsive disorder Diagnosis and treatment. Kuwait University: Scientific Publishing Council. Abramowitz, J., Whiteside, S., Kalsy, S. & Tolin, D. (2003). Thought Waiting list strategies in obsessive-compulsive disorder: a replication and ex tension. Journal of Behavior Research and Therapy, 41(5), 529-540. https://pubmed.ncbi.nlm.nih.gov/12711262/ Abu Hindi, Wael. ( 2003 ). Obsessive-compulsive disorder from an Arab-Islamic perspective. Kuwait: Knowledge World . The National Council for Culture, Arts and Letters. Al-Bajari, A. (2007). The effectiveness of the method of stopping ideas in modifying the future trends of university students. Annual Scientific Conference of the Faculty of Basic Education, University of Mosul, 5(2), 38-50. Aldahadha, B. (2020). Metacognition and Mindfulness Attention Awareness and their Relationships with Depression and Anxiety level. Journal of Rational-Emotive Cognitive-Behavior Therapy, 39 , 183–200. https://link.springer.com/article/10.1007/s10942-020-00367-y Aldahadha, B. (2018a). The psychometric properties of perfectionism scale and its relation to depression and anxiety, Cogent Psychology, 5: 1, https://doi.org/10.1080/23311908.2018.1524324 Aldahadha, B. (2018,b). Disputing Irrational Beliefs Among Convicted Terrorists and Extremist Beliefs. Journal of Rational-Emotive Cognitive-Behavior Therapy , 36 (4), 404-416. https://doi.org/10.1007/s10942-018-0293-7. Al-Douri, Wisal Muhammad. ( 2003 ) . The effectiveness of a cognitive behavioral therapy program in mental health of gifted students . Unpublished Ph.D. thesis, College Education, University of Baghdad. Al-Humairi, Abdo Farhan. (2014). Obsessive-compulsive disorder in adolescence. Journal for Studies and Research, 5 (1), 3-20. Al-Miqdadi, Y. (2008). The effectiveness of a high behavioral counseling program to reduce obsessive-compulsive disorder among a sample of Al-Bayt University students. Journal of Umm Al-Qura University for Educational and Psychological Sciences, 20 , (2), 45-62. American Psychiatric Association. (2013 ). Diagnostic and statistical manual of mental disorders: DSM-5 . Washington, D. C: American Psychiatric Association Beck, A. (2000). Cognitive therapy and emotional disorders. Translation: Adel Mustafa, p. 1, Cairo: Arab Horizons House. Corey , G. (2013). Theory and Practice of Counseling and Psychotherapy , (9 ed), USA: Belmont, Calif: Wadsworth. David, F., Frost, R. O & Steketee, G. (2007). Buried in treasure: Help for compulsive Acquiring, saving and hoarding . New York: Oxford UniversityPress. Faure, K., & Forbes, K. (2021). Clarifying the Placement of Obsessive-Compulsive Disorder in the Empirical Structure of Psychopathology. J. Psychopathology Behaviors Assess 43 , 671–685 . https://doi.org/10.1007/s10862-021-09868-1 Fenske, J. N, Schwenk , T. L. (2009). "Obsessive compulsive disorder: diagnosis and management". Am Fam Physician. 80 ( 3), 239–4 5 . https://pubmed.ncbi.nlm.nih.gov/19621834/ Frost, R. O., Tolin, D. F., Steketee, G., Fitch, K. & Bruns, A. (2008). Excessive acquisition in hoarding. Journal of Anxiety disorder, 23 , 632 – 639. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735347/ Frost, R. O., Steketee, G., & Williams, L. (2000). Hoarding: A community health problem. Health and Social Care in the Community, 8 , 229-234. https://pubmed.ncbi.nlm.nih.gov/11560692/ Frost, R.O., Steketee, G., & Grisham, J. (2004). Measurement of compulsive hoarding: saving inventory revised. Behavior Research and Therapy, 42 , 11631182. https://pubmed.ncbi.nlm.nih.gov/15350856/ Gilliam, C. M., & Tolin, D, F. (2010). Compulsive Hoarding. Bulletin of Menninger Clinic, 74 (2), 93–121. https://pubmed.ncbi.nlm.nih.gov/20545491/ Grisham, J. & Barlow, D. (2005). Compulsive hoarding: Current research and Therapy . Behavior Research and Therapy, 27 , 45-52. https://link.springer.com/article/10.1007/s10862-005-3265-z Hattie, J. (1985) Methodology Review: Assessing Unidimensionality of Tests and Items. Applied Psychological Measurement, 9 , 139-164. http://dx.doi.org/10.1177/014662168500900204 Himle JA, Fischer DJ, Muroff JR, Van Etten ML, Lokers LM, Abelson JL, Hanna GL. (2006). Videoconferencing-based cognitive-behavioral therapy for obsessive-compulsive disorder . Behavior Research and Therapy, 44, 1821–1829 . https://pubmed.ncbi.nlm.nih.gov/16466688/ Hollon, S. D., & DiGiuseppe, R. (2011). Cognitive theories of psychotherapy. In History of psychotherapy: Continuity and change, 2nd ed. (pp. 203-241). American Psychological Association. Saxena, S., & Sumner, J. (2014). Venlafaxine extended-release treatment of hoarding disorder. International clinical psychopharmacology, 29 (5), 266–273. https://doi.org/10.1097/YIC.0000000000000036 Storch EA, Lack CW, Merlo LJ, Geffken GR, Jacob ML, Murphy TK, Goodman WK. (2007). Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms. Comprehensive Psychiatry, 48 (4), 313-8. https://pubmed.ncbi.nlm.nih.gov/17560950/ McLean PD, Whittal ML, Thordarson DS, Taylor S, Söchting I, Koch WJ, Paterson R, Anderson KW. (2001). Cognitive versus behavior therapy in the group treatment of obsessive-compulsive disorder. Journal of consult psychology. 14 , 205-219. https://pubmed.ncbi.nlm.nih.gov/11393598/ Rachman, S. (2002). A cognitive theory of compulsive checking. Behavior Research and Therapy, 40 (6), 625-39. https://pubmed.ncbi.nlm.nih.gov/12051482/ Rimawi, M. (2003). Childhood and adolescence growth psychology. Amman: Al Massira Publishing House. Sadiq, S. and Marwa, S. (2013). The Effect of Cessation of Counseling in Reducing Sleep Disorder among Students of Diyala University. Al-Farahidi Literature Journal , No. 17. Saxena, S. & Maidment, M. (2004). Treatment of compulsive hoarding . Clinical psychology, 60 , 1143-1145. https://www.researchgate.net/publication/8324874_Treatment_of_Compulsive_Hoarding Saxena, S. (2007). Is compulsive hoarding a genetically and neurobiological discrete syndrome? Implications for diagnostic classification. American Journal of Psychiatry, 164, 380–384. https://ajp.psychiatryonline.org/doi/10.1176/ajp.2007.164.3.380 Saxena S. (2008). Recent advances in compulsive hoarding. Current Psychiatry Rep. Aug;10 (4):297-303. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294597/ Steketee, G., Frost, R. O. & Kyrios, M. (2003). Cognitive Aspects of Compulsive Hoarding. Cognitive Therapy and Research 27 , 463–479. https://doi.org/10.1023/A:1025428631552 Suñol, M., Martínez-Zalacaín, I., Picó-Pérez, M., López-Solà, C., Real, E., Fullana, M., . . . Soriano-Mas, C. (2020). Differential patterns of brain activation between hoarding disorder and obsessive-compulsive disorder during executive performance. Psychological Medicine, 50 (4), 666-673. https://pubmed.ncbi.nlm.nih.gov/30907337/ Tolin, D. F., Frost, R. O. & Steketee, G. (2007). An open trial of cognitive-behavioral therapy for compulsive hoarding . Behavior Research and Therapy, 45, 1461–1470. https://pubmed.ncbi.nlm.nih.gov/17306221/ Tolin, D. F., Abramowitz, J. S., Przeworski, A., & Foa, E. B. (2002). Thought suppression in obsessive-compulsive disorder. Behaviour Research and Therapy, 40 (11), 1255–1274. https://doi.org/10.1016/S0005-7967(01)00095-X Willner, P. & Goodey, R. A. (2006). Interaction of Cognitive Distortions and Cognitive Deficits in the Formulation and Treatment of Obsessive–Compulsive Behaviors in a Woman with an Intellectual Disability , Journal of Applied Research in Intellectual Disabilities, 19 , 67–73. https://doi.org/10.1111/j.1468-3148.2005.00279.x Wilson KA, & Chambless DL. (2005). Cognitive therapy for obsessive-compulsive disorder. Behav Res Ther. 43 (12), 1645-54. doi: https://pubmed.ncbi.nlm.nih.gov/16239156/ Yamada S, Nakao T, Ikari K, Kuwano M, Murayama K, Tomiyama H, et al. (2018) A unique increase in prefrontal gray matter volume in hoarding disorder compared to obsessive-compulsive disorder. PLoS ONE 13 (7): e0200814. https://doi.org/10.1371/journal.pone.0200814 Fusco, K. (2021 ). Are you a digital hoarder ? Retrieved 9 December 2021 from https://www.headspace.com/articles/digital-hoarding Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4277175","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":294072317,"identity":"b503daab-ec8e-4c1a-9df2-710375b2f082","order_by":0,"name":"Basim Aldahadha","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIiWNgGAWjYBACAyA+wMBgwdggwcAgzcBgA+QzNh4gQosETEsaSEsDQS0MSFoOg7l4tZizH3946EaNhGz/7OaHtwtqztutbT8MtKXGJhqXFsueHIPDOcckjGfcOWZsPePY7eRtZxKBWo6l5TbgctiBHIbDOWwSiQ03EsykedhuJ5sdAGphbDiMW8v55w8O5/yTSJx/I/2bNM+/c8lm5x8S0HIjweBwbptE4oYbOWbSvG0H7MxuELDFcsYboJY+CeONN3KKrXn7khPMbgBtScDjF3P+9Mefc77ZyM67kb7xNs83O3uz8+kPH3yoscGpBQMkglUmEKscBOxJUTwKRsEoGAUjAwAA46Vq18TGGCkAAAAASUVORK5CYII=","orcid":"","institution":"Mutah University","correspondingAuthor":true,"prefix":"","firstName":"Basim","middleName":"","lastName":"Aldahadha","suffix":""},{"id":294072318,"identity":"5439ba3e-00e3-4497-a5d9-4a6365d9cf7f","order_by":1,"name":"Ala Shdouh","email":"","orcid":"","institution":"Rabdan Academy","correspondingAuthor":false,"prefix":"","firstName":"Ala","middleName":"","lastName":"Shdouh","suffix":""},{"id":294072319,"identity":"ffda49a2-2d7a-48b6-93d4-d2ed6ef9fb0b","order_by":2,"name":"Mubin Alnawiseh","email":"","orcid":"","institution":"Mutah University","correspondingAuthor":false,"prefix":"","firstName":"Mubin","middleName":"","lastName":"Alnawiseh","suffix":""}],"badges":[],"createdAt":"2024-04-16 15:48:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4277175/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4277175/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":55161797,"identity":"558ff092-50f9-4823-8770-d21609ab8bca","added_by":"auto","created_at":"2024-04-23 13:11:14","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":18397,"visible":true,"origin":"","legend":"\u003cp\u003eThe consort flow diagram of participants through trial.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4277175/v1/79bd5ac8bcfc0840acaf28c7.png"},{"id":74221470,"identity":"f5938836-ecf5-486f-9a48-7677b81dc432","added_by":"auto","created_at":"2025-01-20 06:39:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":663116,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4277175/v1/78c1b846-f0e8-49d6-922f-e3208f6b0f50.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effectiveness of Thought Stopping in Treating Obsessive-Compulsive and Compulsive","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSome individuals have a love for shopping, buying for many different purposes, and staying there for long years in their homes, and they take up many space in the place where they live (Yamada, et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) a desire to love possession, and these things are linked to emotional aspects, and if they are directed by others to get rid of them (Himle, et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2006\u003c/span\u003e; Saxena \u0026amp; Maidment, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2004\u003c/span\u003e); they are worthless, and cause distress and tension for all who refuse to respond to them; believing that they will bind them later (David, Frost, \u0026amp; Steketee, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). They do not realize that they are suffering from a disorder, and this disorder exists in the high school community, but it is not taken into consideration due to a lack of awareness of it and consequently the inability to diagnose it (American Psychiatric Association, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Fusco, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMost studies have attributed the cause of OCD in adolescence to the beginning of physical and sexual changes and therefore the accompaniment of a feeling of personal hygiene (Abdel-Khaleq, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2002\u003c/span\u003e; Aldahadha, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2018a\u003c/span\u003e). OCD is one of the anxiety disorders, with which it shares symptoms. A small degree of anxiety increases alertness, attention and improvement in the performance of the individual, but if the anxiety exceeds a certain limit, the performance of the individual will decrease and thus hinder achievement, and his or her interest becomes only obsessive thoughts, rituals and practices (Saxena \u0026amp; Sumner, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Frost, et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2000\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOCD is characterized by extremely repetitive ideas and behaviors that interfere in daily life, and this disorder gives rise to anomalous situations in which the individual focuses on an idea, risk, or impulsive image that is often ridiculous and trivial but imposes itself on him or her and continues to be reconsidered by the individual in these cases (Abramowitz et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Faure \u0026amp; Forbes, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOwnership love appears in individuals in childhood; it is an innate tendency that can be stripped from any benefit or purpose, and it can be illogical and exaggerated, causing individuals to perform strange behaviors. This stage is called CHD, and it was classified in the DSM 5 among the areas of OCD (Steketee et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Tolin \u0026amp; Gilliam, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCHD is no less important than other mental disorders in terms of its prevalence and the problems it causes; its prevalence in the United States is estimated at 1\u0026ndash;2%, (i.e., ranging between 3 and 6\u0026nbsp;million American people), and it affects 129\u0026nbsp;million people worldwide, impacting the psychological, family, social and health lives of individuals (Storch et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCHD is defined as \"excessive accumulation, collection of holdings, and the great difficulty in deciding to dispose of unnecessary personal property, due to the ongoing feeling of the need to use these objects later\" (Gilliam \u0026amp; Tolin, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2010\u003c/span\u003e. 14). Among the age groups that have CHD are high school students because in this stage there arises difficulties in decision making, health and psychological problems, lack of organization, the inability to set goals, low self-confidence, lack of time organization, and difficulty in solving problems (Fenske \u0026amp; Schwenk, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Rimawi, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2003\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe thought stopping method is considered one of the therapeutic methods for addressing obsessive thoughts, and it has a role in stopping them (Hollon \u0026amp; DiGiuseppe, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). It includes focusing on an unwanted, annoying or painful idea for a short period of time and then suddenly stopping it and emptying the mind of it (Saxena, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; Saxena, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). It is used in launching the firm command to stop or snapping a rubber band around the wrist to cause pain, an old technique developed to treat obsessive and fear-provoking ideas, and it has proved effective with a long list of obsessive and fear-provoking ideas (i.e., preoccupations about health, disturbing or painful thoughts or fears) (Aldahadha, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2018\u003c/span\u003eb; Beck, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2000\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHigh school students with hoarding disorder do not realize the seriousness of the problems caused by the symptoms of this disorder, and treatment cannot begin to address the symptoms of hoarding until the student has conscious insight (Aldahadh, 2020; Sadiq \u0026amp; Marwa, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Since it is punitive it thus reduces the likelihood of an idea recurring, and the command's to stop distracts attention, which is incompatible with the unwanted idea (Su\u0026ntilde;ol, et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Following the command stands as an alternative idea to help ensure that unwanted thoughts do not return (Frost et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Grisham \u0026amp; Barlow, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2005\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSeveral studies have been conducted related to the subject of the current study. Frost et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2008\u003c/span\u003e) found that more than 95% of respondents complained of excessive hoarding. Sadiq and Marwa (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) conducted a study entitled \u0026ldquo;The effect of stopping thoughts in reducing sleep disturbance\u0026rdquo; among a group of students from Diyala University. The results favored the treatment group.\u003c/p\u003e \u003cp\u003eWilson and Chambless (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2005\u003c/span\u003e) conducted a study entitled \"The effectiveness of the behavioral cognitive program with OCD\u0026rdquo;, aiming to determine the extent of the program's impact on OCD patients. The study showed the effectiveness of the applied program in reducing OCD regarding obsessive thoughts about hygiene, closing doors, and disease. As a result of the repetition of compulsive behaviors and the impact of repeated compulsive thinking, CHD has become part of the lives of many high school students and has an impact on important decision making, goal setting, problem solving, social interaction and academic achievement. Some studies have also indicated the existence of this problem (Rachman, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2002\u003c/span\u003e; Storch, et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), aiming to determine the prevalence of CHD and to reveal the relationship between it and OCD in some demographic variables, with one study finding that the prevalence 41.5% among sample members was 15.5%.\u003c/p\u003e \u003cp\u003eThrough follow-up with the counseling records at the schools, the counselor\u0026rsquo;s advice, and the notes of the female students\u0026rsquo; parents, cases of isolation emerged due to excessive collection and storage of things, including school books over many years, games since childhood, magazines containing pictures of actors, and school files. The students had difficulty discarding things despite their being useless, leading to the emergence of chaos, disorganization, and feelings of distress and anxiety; and the cases are repeated in different situations that indicate them. Accordingly, the problem of this study was to build and test the effectiveness of a counseling program in stopping compulsive thoughts among high school students who suffer from CHD. Hence, the study sought to answer the following questions:\u003c/p\u003e \u003cp\u003e1-Are there statistically significant differences between the means on the posttest for OCD scales and CHD measurements among female secondary school students attributable to treatment?\u003c/p\u003e \u003cp\u003e2- Are there statistically significant differences between the means on the follow-up test of the OCD scales and the CHD measurements attributable to treatment?\u003c/p\u003e \u003cp\u003eThis study attempts to add a new benefit to studies conducted among Arabs with both OCD and CHD since it attempts to test the effectiveness of a counseling program based on thought stopping in reducing the disorders of OCD and CHD within a sample of high school students in Southern Mazar Brigade schools. This study is the first at the local level to study these variables. It could even be used as a frame of reference or an introduction to upcoming research and studies that the researcher hopes will address other problems for professionals.\u003c/p\u003e \u003cp\u003eThe practical importance of this study is that it provides a counseling program based on thought stopping to stop both OCD and CHD among high school students and opens the way for other researchers in the future to research this topic and study it from other aspects. It could open new horizons for studies and topics that approximate perspectives and support scientific research, in addition to providing a theoretical and conceptual framework of concepts, data, information, and instructional methods and providing counselors with a counseling program from which they can benefit in treating similar cases. The current study aims to reveal the effectiveness of a counseling program based on thought stopping in both OCD and CHD in female high school students.\u003c/p\u003e"},{"header":"Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants and procedures\u003c/h2\u003e \u003cp\u003eAl-Jaafariya Vocational Secondary School (N\u0026thinsp;=\u0026thinsp;205) for Girls was chosen randomly from all-girls schools in Karak governorate. The participants agreed to attend the program five days per week and one session per day. The names of the students were monitored in lists according to the vocational and academic branches. Each student was provided with a copy of two scales for OCD and CHD, and they were asked to answer the items on the two scales. Subsequently, the questionnaires bearing the female students\u0026rsquo; answers were corrected, and the female students who obtained the highest scores on the two scales were maintained; and they are estimated at 80 and greater on the OCD scale, and they scored 58 and greater on the CHD scale. Thirty students were selected randomly from 60 who wished to participate in the counseling program.\u003c/p\u003e \u003cp\u003e In further step of participants psychotherapy, they were interviewed in the zero-intake interview session. In the first session, it was ascertained that there were no medical problems that might be a cause of OCD or HCD, and the signs, symptoms and events that caused him to have these symptoms were discussed. Additionally, the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) were used. It has been confirmed that most of these symptoms are present in all selected participants.\u003c/p\u003e \u003cp\u003eAccording to the DSM-5-TR, the diagnose based on specific factors: The person has obsessions, compulsions, or both. The obsessions or compulsions take up a lot of time (more than an hour per day). The obsessions or compulsions cause distress or affect participation in social activities, work responsibilities or other life events. The symptoms aren\u0026rsquo;t caused by drugs, alcohol, medications, or another medical problem. The symptoms aren\u0026rsquo;t explained by another mental disorder (e.g., generalized anxiety disorder, eating disorder or body image disorder). For diagnosing the HCD, we also used the criteria listed in the DSM-5-TR. Finally. The sample was randomly divided into two groups (Treatment and Waiting list), with 15 eligible students in each group from those who had the highest levels of OCD, CHD and continued intervention. This study was approved by the Scientific Research Committee at Mutah University on May 23, 2021, and was conducted in accordance with the instructions of the American Psychological Association and the Ethics of Scientific Research and the Helsinki declaration of Ethical Principles for Medical Research Involving Human Subjects.\u003c/p\u003e \u003cp\u003eAll participants agreed to overcome their problems and they sign a written consent to the publication of his data. See figure (1) the consort flow diagram of participants through trial.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eProcedure\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003eCounseling program\u003c/h2\u003e \u003cp\u003eThe counseling program aims to stop the actions and obsessive thoughts of the CHD sample from female high school students, and in this way, the program includes achieving the following goals (Tolin, et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2002\u003c/span\u003e):\u003c/p\u003e \u003cp\u003e1- A cognitive goal by enlightening the students about their problems and identifying the concept of CHD, its causes and its effects, its behavioral and psychological manifestations and its causes.\u003c/p\u003e \u003cp\u003e2- An emotional goal by training the students to waiting list their emotions, training them to confront obsessive symptoms, and training in the technique of stopping thoughts; and\u003c/p\u003e \u003cp\u003e3- A behavioral goal through a behavioral intervention and helping the students to replace negative thoughts and beliefs with positive thoughts and beliefs and to modify their behaviors in a positive way.\u003c/p\u003e \u003cp\u003eThe procedures used when implementing the program begin with discussion and dialog, review of the previous session, learning and training in new skills, a final evaluation at the end of the session, and homework. To ensure that the content of the program fits the study sample, through the validity of the program, it was presented to 9 arbitrators from among specialized faculty members.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003eThought stopping exercises\u003c/h2\u003e \u003cp\u003eStep (1) Make a list of your stressful thoughts, which include stressful stimuli, irrational thoughts, and silly thoughts, which have become habitual and difficult to stop. Write these thoughts down on a piece of paper. At every thought that raises your anxiety and tension and you write it down on the paper, ask yourself the following questions: Is the idea irrational? Is the idea an unexpected or unusual outcome? Is the idea a defensive method? Is it difficult to tune in to the idea? Does the thought affect my ability to focus and what I need to do? Is it causing me a lot of discomfort? Do I want to be happier, calmer, and more relaxed without these thoughts? If you answered yes to those questions related to the idea that causes you stress and pressure, then the thinking stopping tactic will be effective and very appropriate for you.\u003c/p\u003e \u003cp\u003eStep 2: Visualize the thought. Close your eyes, then imagine the stressful situation or thought as it really is. Try to be as natural as if you were actually thinking about the obsessive behavior. In the meantime, you can cut out that obsessive thought that triggers stress and allow normal, healthy thinking to continue.\u003c/p\u003e \u003cp\u003eStep (3) Cut the idea, this step can be applied through the following two methods (1) set the alarm clock or time for three minutes and then it rings, look away, then close your eyes, then prepare yourself as I explained in the previous step. And when you hear the sound of the alarm shout, saying stop. You can put an elastic band on your wrist so that you tighten that rubber to cause a feeling of pain. Empty your mind of all neutral thoughts that don't cause anxiety. Set a desired goal for your life for (30) seconds after stopping or saying the word stop, and during a period when your mind is free of stimuli. If the obsessive thoughts return during that time, shout again, \"Stop!\" (2) Record to yourself, out loud, the word \u0026ldquo;stop\u0026rdquo; for intermittent periods, such as after every three minutes, after two minutes, after one minute, and so on. You may find it useful to re-listen to the recording so that you hear the word stop again several times and at short intervals ranging from about five seconds less or more, apply the same method to the alarm clock, or to situations that cause anxiety or obsessive-invasive situations or others. Make sure that the recorded audiotape restores the process of forming, emerging, and controlling your thoughts so that it prolongs the period of absence of obsessive thoughts.\u003c/p\u003e \u003cp\u003eStep (4) Cut off the non-purposeful idea. You have to set the stopping of the idea without using the voice recorder. During that, if you feel the presence of an unwanted idea, shout, \u0026ldquo;Stop,\u0026rdquo; then lift the rubber to cause some kind of tension and pain on the wrist, when you succeed in distinguishing and noticing the idea. In different situations and occasions, you have to pronounce the word \u0026ldquo;stop\u0026rdquo; normally and naturally to stop and cut off intrusive thoughts. After succeeding in stopping the thought using your normal tone of voice, try to start cutting off the unhealthy extraneous thought through special gestures you make or special movements such as hitting lightly on the table or the floor or any other sign indicating the word stop. When that signal is enough to cut off the bossy thoughts, use the subvocal technique. Imagine hearing the word \"stop\" and then try to move your tongue as if you were pronouncing that word, but in a subtle, inaudible manner. Being successful in this phase means that you will stop the thoughts when alone or with others, without making sounds, making movements or hitting the floor but only by focusing attention on yourself.\u003c/p\u003e \u003cp\u003eStep (5) Thought substitution. The last step of stopping thoughts involves replacing the obsessive thought with a neutral, natural, non-obsessive thought. Develop some positive, self-affirming statements or fantasies that may be appropriate for the target situation. For example: If you are afraid of flying, you might say: Do yourself a few sentences such as: Traveling by airline is a safe means of transportation. I could be relaxed, and then develop other sentences that indicate a sense of confidence while you are talking to yourself, because the alternative obsessive response may fade with the repetition of the alternative strong thought, and then imagine yourself having reached the place you are headed towards, and you have obtained positive results and achieved the goal that you traveled for him.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eInstruments\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eObsessive-compulsive disorder\u003c/strong\u003e \u003cp\u003eThe OCD Scale was developed by reviewing a number of studies and theoretical writings in the field of OCD (Abu Hindi, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Abdel-Khaleq, 1992; Al-Miqdadi, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). The OCD scale developed by Al-Humairi (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) was used; the scale in its original form has psychometric properties that qualify it for use in the current study.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eThe validity and reliability of the scale were checked in its original form, and then the internal consistency between the items was calculated by the method of correlation between the degree of the item and the overall degree of the scale. The results showed that the correlation ranged between \u003cem\u003er\u0026thinsp;=\u0026thinsp;0.57\u003c/em\u003e and \u003cem\u003er\u0026thinsp;=\u0026thinsp;0.84\u003c/em\u003e, and all were significant at the level of 0.01. The validity of the scale (\u003cem\u003er\u0026thinsp;=\u0026thinsp;92.0\u003c/em\u003e), which was significant at the level of 0.01, reached the coefficient of stability of the scale through reapplication (\u003cem\u003er\u0026thinsp;=\u0026thinsp;90.0\u003c/em\u003e), thus enjoying a measure of persistence.\u003c/p\u003e \u003cp\u003eFor the purposes of this study, the content validity of the scale was verified in its initial form by presenting it to a number of people experienced in and specializing in the field of psychological and educational guidance at Mutah University and Al-Balqa Applied University, with the aim of acquiring their views about the accuracy of the scale content and its validity in terms of the degree of item measurement, its clarity and linguistic wording, and its appropriateness to measure what it was designed for, as well as to add, amend or delete what they deemed appropriate. Proposed amendments were made to the OCD scale, in light of the arbitrators\u0026rsquo; notes, and they related to paraphrasing the items to become clearer. The criterion that was adopted in accepting or excluding items was that the items obtained a consensus of 80% of the arbitrators; thus, the number of items after arbitration was 32 items.\u003c/p\u003e \u003cp\u003eThe scale was also applied to a survey sample consisting of 42 students from outside the study sample from Al-Mazar Girls\u0026rsquo; Secondary School. To verify the validity indicators of the scale, construction validity indicators were calculated using the Pearson\u0026rsquo;s correlation coefficient to determine the values of the item correlation coefficient with the total score for the scale. It was found that the values of the coefficients of correlations of the OCD scales ranged between 0.79 and 0.48, and the criterion for accepting the item was adopted when its correlation coefficient was no less than 0.40, according to Hattie (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e1985\u003c/span\u003e); thus, all of items on the scale were accepted. To estimate the internal consistency of the OCD scale, it was calculated using Cronbach's alpha formula using the data of the first application in the prospective sample of 42 subjects from outside the study sample. For the scale and its dimensions, using the test-retest method with a time difference of two weeks, it was found that the stability of the internal consistency of the scale as a whole was 0.91, and the stability of the test-retest of the scale as a whole was 0.93.\u003c/p\u003e \u003cp\u003eThe OCD scale in its final form included 32 items, which were answered with a five-point scale including the following option: always \u0026minus;\u0026thinsp;5 points; often \u0026ndash; 4 points; sometimes \u0026minus;\u0026thinsp;3 points; rarely \u0026minus;\u0026thinsp;2 degrees; and never \u0026ndash; 1 point. These points apply to all items on the scale because they are formulated in a positive direction; and thus, the score on the scale as a whole range from 32 to 160 points.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompulsive hoarding scale\u003c/strong\u003e \u003cp\u003eThe CHD scale (Frost et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2004\u003c/span\u003e) was used to detect the level of CHD. The validity of the test was verified by content validity, concomitant validity, validity of internal consistency, and discriminatory validity. Its preliminary version is characterized by a high degree of stability since the Cronbach\u0026rsquo;s alpha stability was .94, showing a high stability. For the purposes of this study, the scale was translated in its original form from the English language to the Arabic language; appropriate adjustments were made to the translation so that the examiners cold avoid any difficulties resulting from a misunderstanding of the meaning, which would hinder responses. Then, the items were translated into English again to ensure that the items retained their meaning. After presenting the translation to four specialists in the English language, the scale was also presented to specialists in the Arabic language to verify the wording of the items, and then it was presented to a group of arbitrators from Mutah University, and the necessary adjustments were made based on the opinions of the arbitrators.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eAdditionally, the scale was applied in 42 female students to ensure their understanding of the scale terms, and the students were asked to take notes on the scale, especially with regard to formulating and understanding the provisions. The content validity of the scale was also verified by presenting it in its initial form to a number of people experienced in and specializing in the field of psychology and counseling at Mutah University and Al-Balqa Applied University to determine its suitability to measure what it was designed for, and material was added, amended or deleted based on what they deemed appropriate. In light of the arbitrators\u0026rsquo; observations, proposed amendments were made to the CHD scale related to paraphrasing the items to become clearer, and the criterion that was adopted in accepting or excluding the items was that the items obtained a consensus of 80% of the arbitrators; thus, the total number of items after arbitration was 23 items.\u003c/p\u003e \u003cp\u003eThe scale was also applied to an exploratory sample consisting of 42 female students from outside the study sample, and the construction validity indicators were calculated using the Pearson\u0026rsquo;s correlation coefficient to determine the values of the correlation coefficient of the overall degree of the scale; it was found that the values of the correlation coefficients for items on the CHD scale were statistically significant at the level of significance of α\u0026thinsp;=\u0026thinsp;0.01, they ranged between 0.73 and 0.46 with the overall degree of the scale, and the correlation coefficient of all items with the overall degree of the scale was greater than 0.40, so the acceptance criterion for the item was adopted. Its correlation coefficient was less than 0.40, according to Hattie (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e1985\u003c/span\u003e). It is also clear from the foregoing quality of the items on the CHD scale; thus, the scale obtained its final form, consisting of 23 items.\u003c/p\u003e \u003cp\u003eTo estimate the internal consistency of the CHD scale, it was calculated using Cronbach's alpha formula using the data of the first application in the 42 exploratory sample students from outside the study sample. To verify the stability of the test-retest method, with a time difference of two weeks, the Pearson\u0026rsquo;s correlation coefficient was calculated between the first and second applications in the sample, and it was found that the stability of the internal consistency of the scale for the whole was 0.89, and the test-retest constant for the scale as a whole was 0.92.\u003c/p\u003e \u003cp\u003eThe CHD scale in its final form included 23 items. These items apply to all of the positive scale items, while the grades are reflected in Items 10, 12, 14, 21, and 4 since they are formulated in negative form. Thus, the scale ranged as a whole from 23 to 115 degrees. The higher that the degree is, the more indicative that it is of a high level of CHD.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eThe Pearson\u0026rsquo;s correlation coefficient, means, standard deviations, ANCOVA, and the paired sample t test were used. Levene's test for equality of variances was used to verify the homogeneity of the regression slope scores of the waiting list and treatment groups on the OCD scale and the OHD pretest scale. The \u003cem\u003ep\u003c/em\u003e values of homogeneity for the OCD and HCD scales were 0.095 and 0.187, respectively, which are nonsignificant values (0.05), indicating the use of associated analysis of covariance (ANCOVA).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eInitially, the analysis of variance assumptions were investigated: random and independent sample selection of the population, normal sample distribution, independence of the groups to be compared, and homogeneity of variance between groups. To test the first hypothesis, the means and the standard deviations were calculated on the two scales, OCD and CHD, on the posttest; Table\u0026nbsp;(1) shows these values.\u003c/p\u003e \u003cp\u003eTo ensure the equivalence of the different study groups regarding the pretest for the OCD scale, the means and standard deviations were calculated, and the t test for the sample using the OCD scale was calculated on the pretest; Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows these values. It is noted that there were no differences between the treatment and waiting list groups on the pretest measurement, indicating equivalence of the two groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMeans and standard deviations of the OCD and CHD on the posttest\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eVariable\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eGroup\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cem\u003ePretest\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u003cem\u003ePost test\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eSig.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eT\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eOCD\u003c/p\u003e \u003cp\u003eCHD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWaiting List\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWaiting List\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e.539\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003e\u003cem\u003eNote: OCD\u0026thinsp;=\u0026thinsp;Obsessive compulsive disorder; CHD\u0026thinsp;=\u0026thinsp;Compulsive hoarding disorder; N\u0026thinsp;=\u0026thinsp;15\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTo verify the significance of the apparent differences, analysis of covariance ANCOVA was performed for the posttest of the OCD and HCD scales according to group after neutralizing the effect of the pretest, as shown in Table\u0026nbsp;(2).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows that there were statistically significant differences between the means of the total scores for OCD \u003cem\u003eF (11.441\u003c/em\u003e)\u0026thinsp;=\u0026thinsp;\u003cem\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/em\u003e and CHD \u003cem\u003eF (9.337)\u0026thinsp;=\u0026thinsp;P\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/em\u003e and the waiting list group in favor of the OCD and CHD scales with high effects, respectively, of .\u003cem\u003e298\u003c/em\u003e and .\u003cem\u003e257\u003c/em\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnalysis of covariance (ANCOVA) of the OCD and CHD scales by group at the pretest\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSource\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eVariables\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eSum of square\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eMeans of square\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ef\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eSig.\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eEta square\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePretest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.326\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.835\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.835\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.075\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.615\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.615\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11.441\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.298\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.257\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.049\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cem\u003eNote: OCD\u0026thinsp;=\u0026thinsp;Obsessive compulsive disorder; CHD\u0026thinsp;=\u0026thinsp;Compulsive hoarding disorder; * P\u0026thinsp;\u0026lt;\u0026thinsp;0.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTo test the hypothesis of the second study, results show that there are statistically significant differences between the two measures of pretest and follow-up among members of the treatment group on the OCD \u003cem\u003et (3.22)\u0026thinsp;=\u0026thinsp;2.575, p\u0026thinsp;=\u0026thinsp;0.02\u003c/em\u003e and CHD \u003cem\u003et (3.40)\u0026thinsp;=\u0026thinsp;2.539, p\u0026thinsp;=\u0026thinsp;0.02\u003c/em\u003e, indicating the continuity of the impact of the program beyond the follow-up period.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe effectiveness of the indicated program was demonstrated by the presence of a statistically significant difference between the mean scores of the pre- and post-test measurements of the two treatment groups on the OCD and CHD scales in favor of postapplication. The results of this study were consistent with the results of many studies that have been conducted in this field, so a remarkable improvement emerged in the performance of female students and their ability to address compulsive ideas and actions by learning new skills, such as stopping ideas, relaxation, and problem-solving methods. The results of the current study are consistent with the study of Al-Douri (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). The results of this study showed positive changes due to the method of thought stopping, including the technique of stopping ideas, which rendered the program effective (Wilson \u0026amp; Chambless, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). The study used a set of techniques that made the program effective, including cognitive reconstruction, relaxation, exposure, response prevention, and stopping thoughts. Al-Bajari (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) used stopping ideas to modify the future trends of university students; the cognitive behavioral program was effective for the treatment group. Sadiq and Marwa (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) and Goody (2006) used a method of relaxation, exposure, response prevention, and self-dialog, which played a role in treating the cognitive distortions causing OCD.\u003c/p\u003e \u003cp\u003eThe effectiveness of the indicated program as applied to the treatment group was also attributed to the fact that it helped to modify the behavior of female students, such as setting lists of tasks, homework and life activities, attention to healthy food, and setting priorities when setting goals related to public life situations. The results clearly revealed the positive impact of the indicative practice in which they participated and from which they learned and trained in the instructional sessions, and they generalized it in similar situations at the level of social and study life.\u003c/p\u003e \u003cp\u003eBased on the above, the results of the current study confirmed the effectiveness of the CBT program in stopping compulsive thoughts and actions. Thus, the results of the current study are consistent with many studies (Al-Douri, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2003\u003c/span\u003e; Al-Miqdadi, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; McLean et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2001\u003c/span\u003e; Tolin et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Willner \u0026amp; Goody, 2006; Wilson \u0026amp; Chambless, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). These studies focused on the use of CBT programs in treating OCD. The training program had a clear impact on stopping compulsive thoughts and actions in people with CHD. The cognitive behavioral approach links the methods and techniques of these two approaches and focuses on how the individual learns about behavior and emotions and cognitive communication through different patterns. The general feature of this theory is its direct intervention through rules and directed goals, its reliance on homework and application skills and its focus on problems by learning a set of skills that include looking at problem solving objectively as a fact of life.\u003c/p\u003e \u003cp\u003eRegarding the changes that were observed in female students after applying the therapeutic program, within the framework of the current study, the members of the treatment group received intensive psychological treatment combined with relaxation and repeated and multiple attempts to train in the techniques of cognitive behavioral therapy to stop the thoughts and compulsions and to alleviate the students’ pain and distress due to OCD and CHD through several group sessions. Where the student was participating in all of the activities of the session from the beginning to the end, the agreement was activated between the researcher and the student on the importance of active participation in all of the various tasks during the program, with an emphasis also on them when at home.\u003c/p\u003e \u003cp\u003eAmong these techniques are reinforcement (so that members of the group are encouraged to exercise these roles) and homework (so that they are trained to practice these roles in life through the family at home and through their colleagues and peers in society). In particular, obsessive thoughts and compulsive acts are suddenly characterized by the insistence with which they invade the person when alone since they are invasive during school and among people. The patient has the opportunity to be able to stop them and return to normal life; they are trained on this skill in various ways, sometimes using stopping thoughts and sometimes using dialog and debate (Corey, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe sessions took place with all of the procedures in an atmosphere of familiarity, with calm discussions conducted. The students recorded this activity in their reports, in which they recorded what happened to them after the end of the session and until the next session, and these reports were used for the topics of the new sessions. It was important to review them to achieve the goals, principles, foundations and steps of CBT and to ensure the continuity and extent of the students’ ability to understand what happened in the sessions and how to implement the skills outside of the sessions.\u003c/p\u003e \u003cp\u003eThe students benefited from the program by considering individual differences, by helping the students to improve in a specific framework for each individual case, and according to the individual case of each student separately. Thus, each member of the sample participated in carrying out the training assigned to her and according to the technique that suited her alone.\u003c/p\u003e \u003cp\u003eThe program relied on specific points, which are the procedural goals that researchers have previously focused on, such as overcoming obsessive thoughts and compulsive actions related to CHD. The program considers the principles of cognitive behavioral therapy in stopping compulsive thoughts and actions, especially the stage of building the therapeutic relationship, stimulating active participation, understanding students from the beginning of the session with an agenda, clarifying specific points that will be accomplished, training with them and repeating training, and continuing throughout the session.\u003c/p\u003e \u003cp\u003eConsequently, the program used has achieved one of the main goals of programs to modify obsessive thoughts in general. The goal of conducting behavior modification programs is not to bring about temporary changes in the various aspects of the personality and then to soon extinguish them as if they were nothing. Rather, what is required in these programs is that their effect remains even after the training that individuals received during the sessions of those programs has stopped and even after their training links have been discontinued. It is essential to conduct these programs to ensure their continuity and effectiveness with the members of the treatment group after the sessions of the application have stopped, instilling confidence that the sample members have used in their life situations the different strategies that they learned and giving a justification for trying to implement these programs on large groups of female students, particularly those who suffer from anxiety disorders in general and from OCD and CHD specifically, because of the distress, distress and hardship that they cause and the social misalignment and psychological and academic problems they cause. In addition, the work of a researcher as a principal at the same school and the students' knowledge of and confidence in the research also helped in the success of the counseling program. This study is also, to the best of our knowledge, one of the first studies conducted in an Arab population to address an indicative program addressing CHD through a cognitive behavioral program using the technique of stopping thoughts.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eConsidering the results of this study, the following recommendations can be made. More studies should be conducted on the topic of stopping thought and CHD in different age groups and in male students and discovering the differences between them. In addition, the program was implemented to stop compulsive thoughts and actions in school students. There is the need to link CHD with other variables, such as social isolation and academic achievement. Finally, attention should be given to early intervention to reduce CHD by raising awareness of the roles of nurturing and the environment in which this disorder grows and how to prevent it.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOCD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eObsessive-Compulsive Disorder\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCHD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCompulsive Hoarding Disorder\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval for the study was granted by Counseling and Special Education Research Ethics\u003c/p\u003e\n\u003cp\u003eCommittee. When providing consent, participants agreed that\u003c/p\u003e\n\u003cp\u003eanonymized survey responses could be used for research. The study was\u003c/p\u003e\n\u003cp\u003eperformed in accordance with relevant guidelines and regulations including\u003c/p\u003e\n\u003cp\u003ethe Declaration of Helsinki for research with human participants. Informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was unfunded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets analyzed during the current study are not publicly available due\u003c/p\u003e\n\u003cp\u003eto patient confidentiality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data will be available upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e: Basim Aldahadha\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.B (Apply the treatment, study problem, rote the body manuscript, documentation 7th edition, and review the statistical analysis)\u003c/p\u003e\n\u003cp\u003eA. S. (support the funding, review the language writing prepare figures and tables)\u003c/p\u003e\n\u003cp\u003eM. A. (assets in applying the procedures, helping students, approving the writing, and supporting funding)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;affiliation for authors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Aff1, (Karak); Aff2, (Abo-Dabi); Aff3; (Karak)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbdel-Khaleq \u0026amp; Mayasa, A. (1990). Obsessions and their relationship to both anxiety, fears and depression. \u003cem\u003eJournal of the Faculty of Arts,\u003c/em\u003e Alexandria University, 5(3), 38-54.\u003c/li\u003e\n\u003cli\u003eAbdel-Khaleq, A. (2002). \u003cem\u003eObsessive-compulsive disorder Diagnosis and treatment. \u003c/em\u003eKuwait University: Scientific Publishing Council.\u003c/li\u003e\n\u003cli\u003eAbramowitz, J., Whiteside, S., Kalsy, S. \u0026amp; Tolin, D. (2003). 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(2021\u003cstrong\u003e). \u003c/strong\u003e\u003cem\u003eAre you a digital hoarder\u003cstrong\u003e?\u003c/strong\u003e \u003c/em\u003eRetrieved 9 December 2021 from https://www.headspace.com/articles/digital-hoarding\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"thought stopping, obsessive-compulsive, compulsive hoarding, and female students","lastPublishedDoi":"10.21203/rs.3.rs-4277175/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4277175/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe present study aimed to identify the effectiveness of a counseling program based on thought stopping among female students suffering from obsessive-compulsive disorder (OCD) and compulsive hoarding disorder (CHD). The sample consisted of 40 students distributed equally and randomly to the treatment group and waiting list group. OCD and CHD scales and a program based on cognitive behavioral therapy in thought stopping were applied. The results showed that there were significant differences between the treatment and waiting list groups in OCD and CHD in favor of the treatment group on the post measurements. The results also showed the effectiveness of the program in thought stopping on the post measurements and at follow-up a month after program termination. There is the effectiveness of thought-stopping in alleviating the symptoms of OCD and HCD. Attention should be given to early intervention of thought-stopping to reduce CHD by raising awareness of the roles of nurturing and the environment in which this disorder grows and how to prevent it.\u003c/p\u003e","manuscriptTitle":"Effectiveness of Thought Stopping in Treating Obsessive-Compulsive and Compulsive","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-23 13:11:09","doi":"10.21203/rs.3.rs-4277175/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3015681d-a081-4e83-9d02-5e03f4cbbb35","owner":[],"postedDate":"April 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-20T06:38:24+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-23 13:11:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4277175","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4277175","identity":"rs-4277175","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}