Online Exposure Therapy for Obsessive-Compulsive Disorder
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Miami
Must not be taking: Psychotropic medications
Disqualifiers: Severe mental illness, Hoarding, others
No Placebo Group
Approved in 1 jurisdiction
Trial Summary
What is the purpose of this trial?The overarching goal of this protocol is to investigate mechanisms that influence symptom outcomes of exposure and response prevention (ERP) therapy for OCD. Mechanisms may include affective processes, learning factors, cognitive factors, or other constructs that could influence treatment outcomes. The study team will conduct this research within the context of an effective online treatment for OCD called OCD-NET. OCD-NET is bibliotherapy with coaching and its content is reflective of standard care for OCD.
Will I have to stop taking my current medications?
The trial does not require you to stop taking your current medications, but you must have been on a stable dose of any psychotropic medication for at least 4 weeks and not have started any new psychotropic medication in the last 12 weeks.
What data supports the effectiveness of the treatment OCD-NET, Online Exposure Therapy for OCD, OCD-NET Bibliotherapy with Coaching?
Research shows that internet-based cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) can be effective for treating obsessive-compulsive disorder (OCD). Studies found that online CBT programs led to significant improvements in OCD symptoms, with many participants completing the treatment and finding it acceptable.
12345Is online exposure therapy for OCD safe for humans?
Research suggests that exposure-based cognitive-behavioral therapy (CBT), including online versions, does not lead to negative effects like dropping out of treatment or dissatisfaction compared to other treatments. This indicates that it is generally safe for humans.
36789How is the OCD-NET treatment different from other treatments for OCD?
OCD-NET is unique because it offers online exposure therapy, which allows patients to receive cognitive behavioral therapy with exposure and response prevention (ERP) over the internet, overcoming barriers like geographical location and access to trained therapists.
13101112Eligibility Criteria
This trial is for individuals with Obsessive-Compulsive Disorder (OCD) or Compulsive Personality Disorder who are interested in an online therapy program. Specific eligibility criteria details were not provided, so it's best to contact the study team for more information.Inclusion Criteria
English-speaking
Able to provide consent
Located within the United States
+2 more
Exclusion Criteria
I am under the age of 18.
Participants currently located outside of the United States
Prisoners
+6 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive the OCD-NET intervention, which includes bibliotherapy with coaching, for up to 12 months
12 months
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The study tests OCD-NET, an online bibliotherapy with coaching that reflects standard care for OCD. It aims to understand how different factors like emotions, learning, and cognition can affect treatment outcomes.
1Treatment groups
Experimental Treatment
Group I: OCD-NET GroupExperimental Treatment1 Intervention
Participants will receive the OCD-NET intervention for up to 12 months.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of MiamiMiami, FL
Loading ...
Who Is Running the Clinical Trial?
University of MiamiLead Sponsor
References
No talking, just writing! Efficacy of an Internet-based cognitive behavioral therapy with exposure and response prevention in obsessive compulsive disorder. [2022]Many patients with obsessive-compulsive disorder (OCD) do not receive first-line treatment according to the current guidelines (cognitive behavioral therapy with exposure and response prevention, CBT with ERP) due to barriers to treatment. Internet-based therapy is designed to overcome these barriers. The present study evaluates the efficacy of an Internet-based writing therapy with therapeutic interaction based on the concept of CBT with ERP for patients with OCD.
Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial. [2023]Adherence to internet-based cognitive-behavioral therapy (iCBT) is often low, possibly reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fixed order).
Home-based behavior therapy for obsessive-compulsive disorder: a case series with data. [2019]The effectiveness of "home-based" exposure and response prevention was assessed in a series of 11 subjects with obsessive-compulsive disorder (OCD). Patients received 24 treatment sessions in a range of natural settings and situations. Sixty-four percent of the patients responded to behavior therapy in these settings, and 36% achieved lasting improvements in their OCD symptoms. Implications for the impact on consumers of this seldom-used application of behavior therapy are discussed and some recommendations for future research are made.
An Internet administered treatment program for obsessive-compulsive disorder: a feasibility study. [2018]The present study evaluates efficacy of a new Internet-administered cognitive behavioral therapy (CBT) protocol, The OCD Program, designed to treat obsessive-compulsive disorder (OCD) remotely. This protocol comprises 8 online lessons delivered over 8 weeks and incorporates cognitive and behavioral techniques. Twenty-two individuals with a principal diagnosis of OCD received CBT-based online lessons, homework assignments, twice weekly contact from a clinical psychologist, and automated emails. Eighty-one percent of participants completed the lessons within the 8-week program. Post-treatment and 3-month follow-up data were collected from 21/21 (100%) and 19/21 (91%) participants, respectively. Participants improved significantly on the primary outcome measures, the Yale-Brown Obsessive Compulsive Scale and Obsessive Compulsive Inventory-Revised, with within-groups effect sizes (Cohen's d) at follow-up of 1.28 and 0.60, respectively. Participants rated the procedure as highly acceptable despite receiving an average of only 86min (SD=54.4min) telephone contact with the therapist over the 8 weeks. These results provide preliminary support for efficacy of Internet-administered treatment for obsessive-compulsive disorder.
Self-help with minimal therapist contact for obsessive-compulsive disorder: a review. [2022]Though there are effective psychological and drug treatments for obsessive-compulsive disorder (OCD), many patients remain inadequately treated or untreated. Making effective self-treatment guidance available may increase the number of patients being helped. In this review, database and manual literature searches were performed of case studies, open and randomised controlled trials (RCTs) of bibliotherapy, self-help groups, telecare and computer-aided self-help for OCD. We found no RCTs of bibliotherapy or self-help groups for OCD. Three open studies showed the efficacy of brief exposure and ritual prevention (ERP) instructions delivered by a live therapist by phone. A vicarious ERP computer program was effective in a small open study. Fully interactive computer-aided self-help by ERP for OCD was efficacious in two open studies and a large multicentre RCT, and in a small RCT compliance and outcome with that program was enhanced by brief scheduled support from a clinician. Although more research is needed, self-help approaches have the potential to help many more patients who would otherwise remain inadequately treated or untreated. Their dissemination could save resources used by health care providers. We propose a stepped care model for the treatment of OCD.
Editorial Perspective: Exposures in cognitive behavior therapy for pediatric obsessive-compulsive disorder: addressing common clinician concerns. [2019]Professional organizations and expert consensus recommend the use of exposure-based cognitive-behavioral therapy (CBT) to treat pediatric obsessive-compulsive disorder (OCD), but a sizable proportion of clinicians possess hesitancy regarding the use of exposures in treatment. Most notably, this hesitancy relates to concerns about negative patient and parent reactions to exposures. Accordingly, we examine three commonly reported clinician concerns regarding negative patient/parent reactions (e.g. treatment attrition, therapeutic relationship, and treatment satisfaction) among youths receiving exposure-based CBT compared to a nonexposure-based treatment. Based on our findings, there is no empirical support that exposure-based CBT precipitates adverse consequences in treatment (e.g. treatment attrition, poor therapeutic relationship, low treatment satisfaction) relative to nonexposure-based interventions. These results corroborate existing OCD expert recommendations for the use of exposure-based CBT and provide information to mitigate clinicians' concerns about the potentially iatrogenic impact of exposures when treating pediatric OCD. We briefly present best practice recommendations for implementing exposure-based CBT in pediatric OCD patients.
Adverse events in cognitive behavioral therapy and relaxation training for children and adolescents with obsessive-compulsive disorder: A mixed methods study and analysis plan for the TECTO trial. [2023]Knowledge on adverse events in psychotherapy for youth with OCD is sparse. No official guidelines exist for defining or monitoring adverse events in psychotherapy. Recent recommendations call for more qualitative and quantitative assessment of adverse events in psychotherapy trials. This mixed methods study aims to expand knowledge on adverse events in psychotherapy for youth with OCD.
Internet cognitive behavioural treatment for obsessive compulsive disorder: A randomised controlled trial. [2018]Internet-based cognitive behaviour therapy (iCBT) is becoming increasing accepted as an efficacious and effective treatment for the anxiety and depressive disorders. However few studies have examined the efficacy of iCBT for obsessive compulsive disorder (OCD). This randomised controlled trial compared technician-administered iCBT (n = 32) to a treatment as usual (TAU) control group (n = 35) in patients with OCD. The primary outcome measures were the Dimensional Obsessive-Compulsive Scale (DOCS) and the Obsessional Beliefs Questionnaire (OBQ-20) administered at pre- and post-treatment (or matched time points). The iCBT group was followed-up at 3-months post-treatment when diagnostic status was assessed at clinical interview. The iCBT program was more efficacious than TAU in reducing maladaptive OC beliefs as well as symptoms of OCD, distress, and depression, with large within- and between-groups effect sizes found (>.78). Adherence was high (75%) and gains were maintained at 3 month-follow-up with 54% of treatment completers no longer meeting diagnostic criteria for OCD at follow-up. These results are comparable to outcomes obtained by clinician-administered face-to-face and internet-based programs and suggest that iCBT for OCD is efficacious when administered by a clinically-supervised technician. Future research is now needed to evaluate how effective iCBT for OCD is in routine clinical settings.
An open trial of videoconference-mediated exposure and ritual prevention for obsessive-compulsive disorder. [2018]The gold-standard treatment for OCD is exposure and ritual prevention (ERP), yet despite its well-established efficacy, only a small percentage of OCD patients have access to this treatment. Remote treatments (e.g., videoconferencing) are becoming increasingly popular avenues for treatment delivery and show promise in increasing patient access to evidence-based mental health care. The current pilot study utilized an open trial to examine the feasibility and preliminary efficacy of videoconference-mediated, twice weekly, ERP for adults (n=15) with OCD. Results revealed that ERP was associated with significant improvements in OCD symptoms and large within-group effect sizes. Among the 10 individuals who completed a 3-month follow-up assessment, 30% of participants no longer met DSM-IV-TR criteria for OCD and 80% of participants were rated as very much or much improved on the CGI. This study adds to the growing body of literature suggesting that videoconference-based interventions are viable alternatives to face-to-face treatment.
Internet-based cognitive behavior therapy for obsessive compulsive disorder: a pilot study. [2021]Cognitive behavior therapy (CBT) is widely regarded as an effective treatment for obsessive compulsive disorder (OCD), but access to CBT therapists is limited. Internet-based CBT (ICBT) with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD.
Videoconference- and cell phone-based cognitive-behavioral therapy of obsessive-compulsive disorder: a case series. [2018]For most patients with obsessive-compulsive disorder (OCD) the availability of exposure-based therapy is limited. In our study six outpatients with obsessive-compulsive disorder (OCD) received 15 sessions of therapy delivered only over teleconference (six sessions) and cell phones (nine sessions) over a 3-month period of time. Five of the patients were women and the average age of the participants was 31.5 (SD=8.1). Patients presented a variety of OCD symptoms which were treated with standard exposure and response prevention exercises both during treatment sessions and as a part of homework exercises. All patients rated the treatment format as acceptable and rated the quality of the working alliance as high. At the end of therapy four of the six patients were highly improved and no longer met diagnostic criteria for OCD according to the Anxiety Disorders Interview Schedule for DSM-IV and the Yale-Brown Obsessive Compulsive Scale. The same was true at 3-month follow-up although some small increases in OCD symptoms had occurred. The innovative treatment format shows promise as a method of delivery that may make treatment accessible for patients with poor access to specialty clinics.
Online Video Teletherapy Treatment of Obsessive-Compulsive Disorder Using Exposure and Response Prevention: Clinical Outcomes From a Retrospective Longitudinal Observational Study. [2022]Exposure and response prevention, a type of cognitive-behavioral therapy, is an effective first-line treatment for obsessive-compulsive disorder (OCD). Despite extensive evidence of the efficacy of exposure and response prevention (ERP) from clinical studies and in real-world samples, it is still underused as a treatment. This is likely due to the limits to access to care that include the availability of adequately trained therapists, as well as geographical location, time, and cost barriers. To address these, NOCD created a digital behavioral health treatment for OCD using ERP delivered via video teletherapy and with technology-assisted elements including app-based therapy tools and between-session therapist messaging.