Inference-Based Cognitive Behavioral Therapy for Latter-day Saints with Scrupulosity

Understanding the Struggle

For active Latter-day Saints, faith is at the heart of life—shaping our values, relationships, and purpose in this life. But when Obsessive-Compulsive Disorder (OCD) targets that faith, it can create a painful cycle of doubt, guilt, and fear.

People with scrupulosity, a form of OCD centered on religious and moral themes, often find themselves asking questions that never seem to resolve:

  • What if I’m not truly worthy to take the sacrament, attend the temple or serve a mission?

  • What if I’ve committed unpardonable sins or haven’t sufficiently repented?

  • What if I’m not a good person after all?

  • What if I’m not who I appear and am actually deceiving myself or others?

These thoughts can become constant, overwhelming, and spiritually confusing. You might try to pray more, confess more, or analyze every word and feeling—yet the uncertainty only grows. At Mountain Home Center for Religious and Moral OCD, we specialize in helping Latter-day Saints break that cycle through a compassionate, structured treatment approach called Inference-Based Cognitive Behavioral Therapy (I-CBT).

Unlike traditional exposure-based methods, I-CBT does not involve exposures. Instead, it helps clients understand how OCD creates these fears, teaches them to recognize false reasoning patterns, and empowers them to become experts in managing their own minds—so they can live their faith with confidence and peace.

Why Scrupulosity?

Scrupulosity is a subtype of OCD in which obsessions center on morality, sin, and spirituality. Compulsions may include excessive prayer, confession, mental review, or seeking reassurance from ecclesiastical leaders, family members, or friends.

In the Latter-day Saint context, scrupulosity often looks like:

  • Repeatedly confessing to a bishop or family members about minor or imagined transgressions

  • Anxiously reviewing past events to ensure perfect honesty or purity

  • Feeling distress during temple recommend interviews or ordinances

  • Obsessing over the “rightness” of prayers, scripture study, or other spiritual activities

  • Avoiding spiritual activities out of fear of hypocrisy or feelings of unworthiness

Although these behaviors may sometimes appear like efforts to live in higher and holier ways, they are driven by anxiety, not faith. Scrupulosity hijacks good intentions and turns spiritual life into a series of mental traps that makes you feel further away from Heavenly Father and Jesus Christ.

When Traditional Exposure Therapy Isn’t a Good Fit

The gold standard for OCD treatment has long been Exposure and Response Prevention (ERP). In ERP, clients gradually face feared situations while refraining from compulsions, allowing their anxiety to decrease naturally over time.

While ERP is highly effective for many OCD themes (such as contamination or checking), it can feel confusing or even morally uncomfortable for religious scrupulosity. For example, an exposure such as “pray incorrectly” or “don’t attend the temple” might feel irreverent or incompatible with spiritual values.

Moreover, ERP can be difficult to apply when fears are internal, abstract, moral or spiritual—for example, “What if I’m not truly a good person?” There’s no concrete behavior to “expose” oneself to, because the distress lies in the imagination and reasoning process itself.

That’s where Inference-Based Cognitive Behavioral Therapy offers an alternative path—one that honors faith, protects conscience, and directly addresses the core cognitive issues that drive OCD.

What Is Inference-Based Cognitive Behavioral Therapy?

Inference-Based Cognitive Behavioral Therapy (I-CBT) is an evidence-based approach that targets the reasoning patterns that lead to obsessional thinking. I-CBT focuses not on what you fear, but on how your mind arrives at the fear in the first place.

OCD begins with inferential confusion—a process where your brain begins to rely more on imaginary stories generated by your OCD than what is actually happening in reality. For example, even though you know that you love your husband and are consistently happy in your marriage, you may begin to question whether those feelings are real.

Even though nothing in the present moment supports the story, it feels plausible. Soon, anxiety takes hold, and compulsions follow: confessing, analyzing, or replaying memories to try to manage your anxiety and achieve certainty about your concerns.

I-CBT teaches you to step back and recognize the mental process that produced the obsession. You learn to see how the mind slipped from normal reasoning into obsessional reasoning—and how to restore confidence in what is actually happening and what you know to be true without performing compulsions.

How I-CBT Differs from Traditional Treatment Approaches

1. No Exposures Required

I-CBT does not rely on confrontation or “getting used to” anxiety. Instead, it focuses on understanding. With I-CBT, you never have to worry about being asked to do something that is not consistent with your values or outside of LDS cultural norms as part of treatment.

2. Addresses Hard-to-Treat Themes

Some OCD fears—like fears of being immoral, unworthy, or spiritually lost—don’t translate well to exposure tasks. I-CBT directly targets these internal fears by examining the reasoning behind them, making it ideal for themes that are primarily cognitive or moral in nature.

3. Empowers Clients as Experts

One of the greatest strengths of I-CBT is that it teaches clients to become experts in their own OCD. Rather than relying indefinitely on a therapist or external reassurance, clients learn the structure of their disorder, how to spot its reasoning errors, and how to correct them in daily life. 

Common LDS-Specific Fear Themes Addressed in I-CBT

Fear of Being “Unworthy”

OCD often convinces clients that they might not meet God’s standards, even when there’s no evidence of wrongdoing. I-CBT helps you see how OCD confuses normal human imperfection with moral failure. You learn to interpret uncertainty as part of life, not proof of unworthiness, and you understand how to find joy and freedom in repentance instead of experiencing it as a never-ending punishment.

Fear About the Strength of Your Testimony or if the Church is True

Some individuals worry that they’ve deceived themselves about their faith or testimony. They worry that the Church might not actually be true in spite of a lifetime of meaningful spiritual experiences and Church service. I-CBT teaches that these thoughts stem from anxiety, not revelation. By learning to trust their experiences and true feelings about the gospel, clients are able to overcome their anxiety and reconnect with genuine spiritual experiences.

Fear of Sinning Without Knowing

Clients sometimes fear that they’ve sinned unintentionally or forgotten a critical detail in repentance. I-CBT helps separate realistic moral responsibility from OCD’s impossible demand for omniscience. Clients learn to live peacefully within human limits and appreciate the mercy of our Savior and the gift of his Atonement.

Becoming the Expert in Your Own OCD through our Specialized Program

One of the defining features of I-CBT is that it turns clients into experts in their own OCD.

Through our structured 7 week program developed specifically for Latter-day Saints with scrupulosity, you will learn how to recognize, understand, challenge and eventually overcome your obsessive thoughts.  You can identify OCD logic in real time, respond with grounded reasoning, and prevent compulsions before they start.

This sense of mastery brings profound relief and self-respect. You learn to trust yourself again by understanding that, while it is not always possible to prevent intrusive thoughts, you can learn how to manage and respond to them in ways that minimize anxiety and allow you to move closer to your values and goals. 

Why I-CBT is Ideal for Scrupulosity

Many OCD themes—particularly those involving worthiness, morality, or spiritual identity—don’t easily lend themselves to traditional exposure exercises. Exposing yourself to  the idea that you might not be a good person can quickly feel convoluted and inefficient. Trying to pray in a way that feels “off” or insincere can feel sacrilegious. 

I-CBT is uniquely suited for these complex, internal fears because it targets the reasoning patterns behind them. You don’t have to intentionally violate beliefs or provoke distress. Instead, you understand the logic error that makes the fear seem real.

By shifting focus from behavioral exposure to cognitive insight, clients can address even the most abstract or spiritually sensitive themes safely and effectively.

How Healing Feels in Practice

As clients move through I-CBT, they often notice gradual but powerful changes:

  • Peaceful participation in spiritual activities such as prayer, scripture study, and attending church meetings and the temple

  • Less mental checking of thoughts, motives, and prayers

  • Increased trust in their own discernment and conscience

  • More balanced perspective about mistakes and repentance

  • Stronger sense of spiritual connection unclouded by anxiety

The goal is not to erase uncertainty—it’s to live meaningfully in its presence, grounded in truth rather than fear.

Respecting Faith While Restoring Freedom

At Mountain Home Center for Religious and Moral OCD, we understand and honor the sacred nature of your beliefs. Our approach never asks you to compromise your faith or adopt practices that feel irreverent. Instead, we help you live your beliefs more fully—without OCD’s interference.

You’ll learn that spiritual peace doesn’t come from perfect certainty but from clarity, trust, and compassion for your human experience. I-CBT helps you reconnect with the love and freedom at the heart of the gospel, moving beyond anxious obligation toward authentic discipleship.

Begin Your Journey Toward Peace

If you feel overwhelmed by doubt and feelings that your are not worthy, I-CBT therapy can provide hope. With I-CBT, you can learn to understand your OCD, dismantle its reasoning errors, and overcome your anxiety.

Reach out today to schedule a consultation or learn more about how this approach can help you reclaim your confidence, your testimony and your life.

Work through Your Religious OCD with I-CBT in Provo, Orem, Salt Lake City, and throughout Utah

If you or a loved one are struggling with religious OCD, you don't have to face it alone. At the Mountain Home Center for Religious and Moral OCD, I offer specialized treatment tailored to help you find peace and regain control over your life. As a religious OCD therapist, I understand the unique challenges religious OCD brings. I am dedicated to providing the support and tools you need to manage your symptoms effectively through I-CBT in Provo, UT. Don't let OCD define your spiritual journey. Discover a path to wellness and spiritual harmony by following the steps below:

Reach out to schedule a free, 15-minute consultation.

Speak with a compassionate I-CBT therapist.

Break free from OCD for a happier life.=