Investigating the effectiveness of an online religiously-integrated cognitive behavioral therapy-based intervention on death anxiety

Death anxiety (DA) is a constant and illogical state of anxiety accompanied by thoughts, anxieties, and feelings related to death. DA was described as a mechanism underlying the development of various anxiety disorders. Although Cognitive Behavioral Therapy (CBT) is successful in reducing anxiety, and religious beliefs correlated with lower levels of DA, no previous research has examined the impact of religiously integrated CBT (RCBT) on DA. RCBT recognizes the significance of the client's religiosity and aims to integrate these beliefs within the framework of evidence-based CBT. Therefore, the current study aimed to develop a novel RCBT-based intervention for DA in individuals who received a diagnosis of an anxiety disorder and to compare its effectiveness with CBT. This study is an experimental, randomized controlled trial with pre-test, post-test, and three-month follow-up measurements. 42 participants were randomly allocated to the RCBT group (n = 21) or the CBT group (n = 21). Both CBT and RCBT effectively reduced DA, general anxiety, and depression in a clinical sample with comorbid diagnoses; these gains were maintained at the three-month follow-up. The findings show that RCBT is as effective as classical CBT in reducing DA and related clinical symptoms, supporting its use as a viable alternative treatment approach for individuals with religious or spiritual needs. This is the first study to create and evaluate both an RCBT-based and a CBT-based intervention for DA using a randomized controlled trial in a clinical sample, and the first to examine their effects on co-occurring clinical symptoms, including anxiety disorders. Future research is recommended to include measures specific to sub-dimensions of positive psychological outcomes, such as well-being, hope, and functioning, and to identify which religious content is most effective through qualitative methods and intersession follow-up. This can increase participation, treatment adherence, and treatment success in RCBT.