Yes, the interface between religious beliefs and OCD can be quite complex. I had a client who used compulsive prayer as a ritual to reduce anxiety anytime he believed there was a risk of failure (i.e. before college exams and before tennis matches) and to forestall danger to family members (illness, motor vehicle accidents). Initially he spent several hours a day praying for divine intervention and felt quite anxious if he postponed prayer.
"Exposure and response-prevention" worked quite well (i.e. having him face anxiety-eliciting situations, refrain from his anxiety-reducing ritual, and tolerate the anxiety). However, a fairly detailed examination of his religious beliefs was needed to reach the point where he was willing to proceed with this approach, at first he was convinced that he was literally risking the wrath of God. Acceptance and respect is crucial, especially when the client's beliefs are different from the therapists' (he was Jewish, I'm not).
It is also useful to be fairly knowledgeable about the beliefs in question. For example, the ability to cite relevant scripture is often useful with fundamentalist Christians. However, one cannot be familiar with every religion and every sect thereof. When I am unfamiliar with the client's religious beliefs, I usually ask them for an explanation.
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