Death AnxietyRCBT-DANCT06876103
Effectiveness of an Online Religiously-integrated Cognitive Behavioral Therapy-based Intervention on Death Anxiety
A study testing Religiously-integrated Cognitive Behavioral Therapy and Classical Cognitive Behavioral Therapy in people with Death Anxiety, run by Ibn Haldun University at 1 site in Turkey (Türkiye).
Trial summary
There has been growing awareness of the importance of death anxiety (DA) in pathological anxiety. DA is defined as a persistent and unreasonable fear of death and thoughts, fears, and emotions associated with the end of life. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Death Anxiety
- What is being tested?
- Religiously-integrated Cognitive Behavioral Therapy and Classical Cognitive Behavioral Therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jun 2025to 1 Dec 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Aged 18-65
- A score of > 26 on the Turkish Death Anxiety Scale
- Diagnosed with one of the anxiety disorders
- Believing in life after death
Who cannot join
- Diagnosed with schizophrenia, schizophreniform disorder, schizoaffective disorder, and delusional disorder
- Being in an active manic episode
- Possessing a mental disorder that interferes with completing measures or understanding the exercises conducted during sessions
- Extreme symptoms of depression (score of > 20 on the Patient Health Questionnaire (PHQ-9), and >1 on the item assessing suicidality)
- Currently receiving therapy.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Investigating the Effectiveness of an Online Religiously-integrated Cognitive Behavioral Therapy-based Intervention on Death Anxiety
There has been growing awareness of the importance of death anxiety (DA) in pathological anxiety. DA is defined as a persistent and unreasonable fear of death and thoughts, fears, and emotions associated with the end of life. DA has been suggested as a core fear that underpins the emergence and perseverance of numerous anxiety disorders. However, previous DA-based treatment studies focus on the elderly, the patients, or health professionals who care for the terminally ill. Therefore, there is a need to examine the effect of psychological interventions on DA and current disorder symptoms in a clinical sample through randomized controlled trials. The current study aims to develop a novel Religiously Integrated Cognitive Behavioral Therapy (RCBT)-based intervention on DA in individuals diagnosed with an anxiety disorder and to compare the effectiveness of RCBT-based intervention with classical CBT-based intervention.
Read the detailed description
Religion facilitates the pursuit of symbolic immortality by providing individuals with purpose and hope in both life and death. Those who believe in an afterlife also see their world as fairer, which results in lower levels of psychiatric symptoms. Previous CBT-based death anxiety interventions did not consider the assumption of an afterlife. RCBT is an approach that integrates spiritual or religious beliefs into the therapeutic process. RCBT is an approach that recognizes the importance of spirituality or religion in a client's life and aims to use these beliefs and practices positively within the context of evidence-based CBT. Briefly, no intervention studies have investigated the effect of RCBT on DA. This will be the first study to develop an RCBT-based intervention for DA.
- Conditions
- Death Anxiety
- Being tested
- Religiously-integrated Cognitive Behavioral Therapy, Classical Cognitive Behavioral Therapy
- Keywords
- death anxiety, religiously integrated cognitive behavioral therapy, classical cognitive behavioral therapy, randomized control study
- Medical subject headings
- Necrophobia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Religiously-integrated Cognitive Behavioral TherapyOther
This study aims to assess the efficacy and feasibility of a newly developed online intervention for death anxiety based on Religiously Integrated Cognitive Behavioral Therapy (RCBT). Building upon the framework of Furer and Walker's 2008 intervention protocol, this adaptation incorporates beliefs in an afterlife, aligning with Turkish society's cultural and religious values.
The RCBT intervention consists of seven structured group therapy sessions, each lasting 90 minutes. The program is designed to help participants identify and challenge unhelpful thoughts related to death anxiety while integrating religious resources to promote cognitive restructuring. Key components of the intervention include psychoeducation, cognitive restructuring, exposure exercises, the concept of repentance in the context of trust and belief in the afterlife, gratitude, and value-oriented behaviors.
Classical Cognitive Behavioral TherapyOther
The standard CBT intervention follows the structured protocol developed by Furer and Walker (2008), which targets cognitive distortions, avoidance behaviors, and excessive safety-seeking behaviors contributing to death anxiety. The researcher has adapted the session content to fit the protocol's core components while maintaining fidelity to the original intervention model. Sessions last 90 minutes and are conducted in an online group format.
Session Structure: Session 1: Treatment Rationale, Session 2: Reducing Excessive Checking, Reassurance Seeking, and Safety Behaviors, Session 3: Exposure, Session 4: Cognitive Reappraisal, Session 5: Enhancing Enjoyment of Life, Session 6: Healthy Lifestyle, and Session 7: Relapse Prevention.
| Study group | Role | What they receive |
|---|---|---|
| Religiously Integrated CBT Group | Experimental | Participants will receive a novel online RCBT-based intervention consisting of 7 weekly 90-minute sessions in a group format. Receives: Other: Religiously-integrated Cognitive Behavioral Therapy |
| Classical CBT Group | Active comparator | Participants will receive an online CBT intervention based on Furer and Walker's (2008) protocol, consisting of 7 weekly 90-minute sessions in a group format. Receives: Other: Classical Cognitive Behavioral Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Turkish Death Anxiety Scale (TDAS)
The Turkish Death Anxiety Scale consists of 20 items that are divided into three subscales: (a) ambiguity of death, (b) exposure to death, and (c) agony of death. These subscales exhibit strong internal consistency, with Cronbach's alpha values of .91, .94, .76 respectively, adding up to a total of .95). It consists of a five-point Likert (0 = Never to 4 = Always). Subscale scores are determined by summing the individual item scores, and the total scale score is determined by summing the subscale scores. Total scale scores can be between 0 and 80, and the higher the score, the greater the level of DA. A score range of 0-7 indicates very low-level DA, 8-25 indicates low-level DA, 26-44 indicates medium-level DA, 45-63 indicates high-level DA, and 64-80 indicates very high-level DA.
Measured: Baseline (pretest), Week 7 (posttest), 3-month follow-up
Abdel-Khalek's Death Anxiety Scale (ASDA)
Abdel-Khalek's Death Anxiety Scale is a 20-item questionnaire that measures DA. The scale is one-dimensional. Higher scores indicate a greater degree of DA. It consists of a five-point Likert (1 = No to 5 = Very much). The Turkish reliability and validity of the scale were conducted by Sarıçiçek-Aydoğan et al. in 2015 (Cronbach's alpha = .86).
Measured: Baseline (pretest), Week 7 (posttest), 3-month follow-up
Secondary outcomes (2)
Generalized Anxiety Disorder-7 (GAD-7)
Generalized Anxiety Disorder-7 consists of a four-point Likert (0 = never to3 = almost every day) and 7 items that assess anxiety symptoms. The highest score that can be attained ranges up to 21. A score range of 0-4 indicates mild anxiety, 5-9 indicates moderate anxiety, 10-14 indicates high anxiety, and 15-21 indicates severe anxiety. A cut-off point of 10 points was determined for the total score. The Turkish reliability and validity of the scale were conducted by Konkan et al. in 2013 (Cronbach's alpha = .85).
Measured: Baseline (pretest), Week 7 (posttest), 3-month follow-up
Patient Health Questionnaire (PHQ-9)
Patient Health Questionnaire consists of a four-point Likert and nine items that screen depressive symptoms. Each of these items is rated on a scale of 0 (never) to 3 (almost every day). The highest score that can be attained ranges up to 27. A score range of 1-4 indicates low depressive symptoms, 5-9 indicates mild depressive symptoms, 10-14 indicates moderate depressive symptoms, 15-19 indicates partially severe depressive symptoms, and 20-27 indicates severe depressive symptoms. The Turkish reliability and validity of the scale were conducted by Sarı et al. (2016) (Cronbach's alpha = .84).
Measured: Baseline (pretest), Week 7 (posttest), 3-month follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Mar 2025
- Study start1 Jun 2025 (estimated)
- Primary completion1 Jul 2025 (estimated)
- Study completion1 Dec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Death AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study employs a parallel assignment design, where participants are randomly allocated to either the intervention or control group to compare treatment effects.
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ibn Haldun University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Büşra Kavla, Ibn Haldun University
- Investigators
- Büşra Kavla, PhD Student, Principal investigator, Ibn Haldun UniversityBurcu Uysal, Associate Professor, Study chair, Ibn Haldun University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06876103
- Sponsor's protocol ID
- 2024/04-14
- Acronym
- RCBT-DA
- Status last verified
- Mar 2025
- First submitted
- 5 Mar 2025
- Last updated
- 3 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared due to confidentiality concerns and ethical considerations.
Publications
Saricicek Aydogan A, Gulseren S, Ozturk Sarikaya O, Ozen C. Reliability and Validity of the Turkish Version of Abdel-Khalek's Death Anxiety Scale among College Students. Noro Psikiyatr Ars. 2015 Dec;52(4):371-375. doi: 10.5152/npa.2015.8820. Epub 2015 Dec 1.
PubMed 28360742Abdel-Khalek AM. A general factor of death distress in seven clinical and non-clinical groups. Death Stud. 2004 Nov;28(9):889-98. doi: 10.1080/07481180490491040.
PubMed 15493083
Study at a glance
From the registry record, last updated by the sponsor on 3 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Investigating the Effectiveness of an Online Religiously-integrated Cognitive Behavioral Therapy-based Intervention on Death Anxiety
- ClinicalTrials.gov ID
- NCT06876103
- Acronym / sponsor ID
- RCBT-DA / 2024/04-14
- Conditions
- Death Anxiety
- Keywords
- death anxiety, religiously integrated cognitive behavioral therapy, classical cognitive behavioral therapy, randomized control study
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 44 participants (estimated)
- Lead sponsor
- Ibn Haldun UniversityUniversity, hospital or other
- Study start
- 1 Jun 2025 (estimated)
- Primary completion
- 1 Jul 2025 (estimated)
- Study completion
- 1 Dec 2025 (estimated)
- First posted
- 14 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
There has been growing awareness of the importance of death anxiety (DA) in pathological anxiety. DA is defined as a persistent and unreasonable fear of death and thoughts, fears, and emotions associated with the end of life. DA has been suggested as a core fear that underpins the emergence and perseverance of numerous anxiety disorders. However, previous DA-based treatment studies focus on the elderly, the patients, or health professionals who care for the terminally ill. Therefore, there is a need to examine the effect of psychological interventions on DA and current disorder symptoms in a clinical sample through randomized controlled trials. The current study aims to develop a novel Religiously Integrated Cognitive Behavioral Therapy (RCBT)-based intervention on DA in individuals diagnosed with an anxiety disorder and to compare the effectiveness of RCBT-based intervention with classical CBT-based intervention.
Detailed description
Religion facilitates the pursuit of symbolic immortality by providing individuals with purpose and hope in both life and death. Those who believe in an afterlife also see their world as fairer, which results in lower levels of psychiatric symptoms. Previous CBT-based death anxiety interventions did not consider the assumption of an afterlife. RCBT is an approach that integrates spiritual or religious beliefs into the therapeutic process. RCBT is an approach that recognizes the importance of spirituality or religion in a client's life and aims to use these beliefs and practices positively within the context of evidence-based CBT. Briefly, no intervention studies have investigated the effect of RCBT on DA. This will be the first study to develop an RCBT-based intervention for DA.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- This study employs a parallel assignment design, where participants are randomly allocated to either the intervention or control group to compare treatment effects.
| Arm | Type | Receives |
|---|---|---|
| Religiously Integrated CBT Group | Experimental | Other: Religiously-integrated Cognitive Behavioral TherapyParticipants will receive a novel online RCBT-based intervention consisting of 7 weekly 90-minute sessions in a group format. |
| Classical CBT Group | Active comparator | Other: Classical Cognitive Behavioral TherapyParticipants will receive an online CBT intervention based on Furer and Walker's (2008) protocol, consisting of 7 weekly 90-minute sessions in a group format. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Aged 18-65
- A score of > 26 on the Turkish Death Anxiety Scale
- Diagnosed with one of the anxiety disorders
- Believing in life after death
Key exclusion criteria (5 listed)
- Diagnosed with schizophrenia, schizophreniform disorder, schizoaffective disorder, and delusional disorder
- Being in an active manic episode
- Possessing a mental disorder that interferes with completing measures or understanding the exercises conducted during sessions
- Extreme symptoms of depression (score of > 20 on the Patient Health Questionnaire (PHQ-9), and >1 on the item assessing suicidality)
- Currently receiving therapy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Religiously-integrated Cognitive Behavioral TherapyThis study aims to assess the efficacy and feasibility of a newly developed online intervention for death anxiety based on Religiously Integrated Cognitive Behavioral Therapy (RCBT). Building upon the framework of Furer and Walker's 2008 intervention protocol, this adaptation incorporates beliefs in an afterlife, aligning with Turkish society's cultural and religious values. The RCBT intervention consists of seven structured group therapy sessions, each lasting 90 minutes. The program is designed to help participants identify and challenge unhelpful thoughts related to death anxiety while integrating religious resources to promote cognitive restructuring. Key components of the intervention include psychoeducation, cognitive restructuring, exposure exercises, the concept of repentance in the context of trust and belief in the afterlife, gratitude, and value-oriented behaviors. | Other | Religiously Integrated CBT Group |
| Classical Cognitive Behavioral TherapyThe standard CBT intervention follows the structured protocol developed by Furer and Walker (2008), which targets cognitive distortions, avoidance behaviors, and excessive safety-seeking behaviors contributing to death anxiety. The researcher has adapted the session content to fit the protocol's core components while maintaining fidelity to the original intervention model. Sessions last 90 minutes and are conducted in an online group format. Session Structure: Session 1: Treatment Rationale, Session 2: Reducing Excessive Checking, Reassurance Seeking, and Safety Behaviors, Session 3: Exposure, Session 4: Cognitive Reappraisal, Session 5: Enhancing Enjoyment of Life, Session 6: Healthy Lifestyle, and Session 7: Relapse Prevention. | Other | Classical CBT Group |
Primary outcome
Turkish Death Anxiety Scale (TDAS)
Time frame: Baseline (pretest), Week 7 (posttest), 3-month follow-up
The Turkish Death Anxiety Scale consists of 20 items that are divided into three subscales: (a) ambiguity of death, (b) exposure to death, and (c) agony of death. These subscales exhibit strong internal consistency, with Cronbach's alpha values of .91, .94, .76 respectively, adding up to a total of .95). It consists of a five-point Likert (0 = Never to 4 = Always). Subscale scores are determined by summing the individual item scores, and the total scale score is determined by summing the subscale scores. Total scale scores can be between 0 and 80, and the higher the score, the greater the level of DA. A score range of 0-7 indicates very low-level DA, 8-25 indicates low-level DA, 26-44 indicates medium-level DA, 45-63 indicates high-level DA, and 64-80 indicates very high-level DA.
Abdel-Khalek's Death Anxiety Scale (ASDA)
Time frame: Baseline (pretest), Week 7 (posttest), 3-month follow-up
Abdel-Khalek's Death Anxiety Scale is a 20-item questionnaire that measures DA. The scale is one-dimensional. Higher scores indicate a greater degree of DA. It consists of a five-point Likert (1 = No to 5 = Very much). The Turkish reliability and validity of the scale were conducted by Sarıçiçek-Aydoğan et al. in 2015 (Cronbach's alpha = .86).
2 secondary outcomes
Generalized Anxiety Disorder-7 (GAD-7)
Time frame: Baseline (pretest), Week 7 (posttest), 3-month follow-up
Patient Health Questionnaire (PHQ-9)
Time frame: Baseline (pretest), Week 7 (posttest), 3-month follow-up
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jun 2025.
- Background: PubMed 28360742Saricicek Aydogan A, Gulseren S, Ozturk Sarikaya O, Ozen C. Reliability and Validity of the Turkish Version of Abdel-Khalek's Death Anxiety Scale among College Students. Noro Psikiyatr Ars. 2015 Dec;52(4):371-375. doi: 10.5152/npa.2015.8820. Epub 2015 Dec 1.
- Background: PubMed 15493083Abdel-Khalek AM. A general factor of death distress in seven clinical and non-clinical groups. Death Stud. 2004 Nov;28(9):889-98. doi: 10.1080/07481180490491040.
- Individual participant dataSharing planned: No. Individual participant data will not be shared due to confidentiality concerns and ethical considerations.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Büşra Kavla, PhD Student principal investigator
Ibn Haldun University
Burcu Uysal, Associate Professor study chair
Ibn Haldun University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Religiously-integrated Cognitive Behavioral Therapy and Classical Cognitive Behavioral Therapy in people with Death Anxiety, run by Ibn Haldun University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 3 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Büşra Kavla, PhD Student (00905435978136, busra.kavla@stu.ihu.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Turkish Death Anxiety Scale (TDAS) (time frame: Baseline (pretest), Week 7 (posttest), 3-month follow-up). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06876103, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Jun 2025.