Online versus in‐person delivery of cognitive behaviour therapy for obsessive compulsive disorder: An examination of effectiveness

Abstract

Cognitive behavioural therapy (CBT) including exposure and response prevention is the first‐line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in‐person delivery, few studies have assessed the role of therapist‐guided, manual‐based CBT for OCD delivered in real‐time via videoconferencing methods. The present study sought to fill this gap by comparing in‐person and online delivery of group‐based CBT for the treatment of OCD. A convenience sample of participants with moderate to severe OCD (n = 144) were recruited from a naturalistic database from two large OCD specialty assessment and treatment centres. Patients received group‐based CBT that was provided in‐person (pre‐COVID‐19 pandemic; March 2018 to March 2020) or online via videoconferencing (during the COVID‐19 pandemic; March 2020 to April 2021). In both delivery methods, treatment consisted of 2‐h weekly sessions led by trained clinicians. Analyses revealed that, regardless of treatment modality, both in‐person and online groups demonstrated significant, reliable, and statistically equivalent improvements in OCD symptoms post‐treatment. Videoconferenced, clinician‐led CBT may be a promising alternative to in‐person delivery for those with moderate to severe OCD symptoms.

Actualising the psychologist role in an academic health sciences centre: Reflections on the journey.

“…Part way into the pandemic, we were able to use our data to determine that group CBT by video platform was equivalent to in-person group CBT and may have slight benefit in lower dropout and increased patient engagement (see Milosevic et al, 2022). We replicated this finding specifically in an obsessive-compulsive disorder (OCD) sample using data from the ATRC and another major OCD centre in Toronto (Lisi et al, 2024). These results were consistent with our subsequent meta-analysis and systematic review, showing virtually no difference between in-person CBT and remote CBT on primary outcomes across a range of mental health conditions (Zandieh et al, 2024).…”

Effectiveness of One Videoconference-Based Exposure and Response Prevention Session at Home in Adjunction to Inpatient Treatment in Persons With Obsessive-Compulsive Disorder: Nonrandomized Study

“…The first option is telephone-supported ERP, which was shown to be effective in 2 studies [29,30]. With advancing technologies, the second option is videoconference-based ERP, which can also be considered an adequate tool that comes with significant reductions in obsessive-compulsive symptoms, especially in persons with moderate OCD symptoms [27,[31][32][33]. Videoconference-based psychotherapy has several advantages over in-person psychotherapy.…”

Internet‐Based Cognitive Behavioural Treatments for Obsessive–Compulsive Disorder: A Systematic Review and Meta‐Analysis

“…Studies indicate high consumer satisfaction rates with technology-delivered CBT (T-CBT) (Andrews et al 2018). In the last decade, internet, telehealth, and smartphone treatment interventions show considerable promise for improving treatment dissemination by creating low-cost and efficient alternatives to traditional face-toface therapy, allowing flexibility in self-pacing, anonymity and appeal to individuals who prefer not to connect with the therapists via face-to-face (G. Andersson and Titov 2014;Cuijpers, van Straten, and Andersson 2008;Lisi et al 2023).…”