Obessive-Compulsive Disorder (OCD) is frequently treatment-refractory and imposes a substantial burden on affected individuals. Although Exposure and Response Prevention (ERP) is widely regarded as the first-line intervention, its inherently distressing nature contributes to treatment refusal and premature dropout in a subset of patients. The present study aims to develop and validate a novel intervention, Mindfulness-Based Exposure Therapy (MBET).

In contrast to existing protocols that incorporate mindfulness as an adjunct to ERP and have yielded mixed or limited benefits, this study seeks a theoretically grounded integration of mindfulness and exposure-based principles. We hypothesize that mindfulness training improves emotion regulation, thereby producing a synergistic effect that enhances patients' capacity to engage in and complete exposure tasks.

From a clinical perspective, MBET is intended to offer a more tolerable and acceptable alternative to standard ERP, with the potential to improve treatment adherence and clinical outcomes among patients who experience traditional exposure procedures as excessively distressing.

Inclusion Criteria:

• Have a primary diagnosis of Obsessive-Compulsive Disorder (OCD) according to DSM-5 criteria
• Are between 16 and 55 years of age (inclusive)
• Have a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score ≥ 16
• Have an education level of junior high school or above
• Are medication-free or have been stabilized on psychotropic medication for at least 8 weeks
• Have sufficient visual and auditory capabilities to complete study assessments
• Are willing to participate and provide written informed consent

Exclusion Criteria:

• Meet DSM-5 criteria for any other psychiatric disorder besides OCD
• Have severe OCD symptoms that prevent completion of assessments
• Exhibit active suicidal ideation or high suicide risk
• Have a serious somatic disease, central nervous system disease, or substance abuse history
• Are pregnant, breastfeeding, or planning pregnancy
• Have metal implants contraindicated for MRI (e.g., pacemakers, intracranial clips, metal dentures, arterial stents, joint fixations)