Therapist-Guided, Internet-Delivered Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Trial

Abstract

Therapist-guided ICBT is a promising low-intensity intervention for adolescents with OCD and has the potential to increase access to CBT. It might be particularly useful in a stepped-care approach, in which a large proportion of patients with moderately severe OCD could first be offered ICBT, thus freeing limited resources for more complex cases. Clinical trial registration information-Internet-Delivered CBT for Adolescents With OCD: A Randomized Controlled Study (BiPOCD); http://clinicaltrials.gov; NCT02191631.

Prediction of outcome in internet‐delivered cognitive behaviour therapy for paediatric obsessive‐compulsive disorder: A machine learning approach

“…Sixty‐seven adolescents with OCD (12–17 years) participated in a RCT (Lenhard et al, ) and had received either immediate or delayed (12 weeks) ICBT. Six participants in the delayed ICBT group dropped out before commencing treatment.…”

“…Rather, it may be implemented as a first‐line, low‐cost intervention in a stepped care model, freeing resources for more complex cases that require individualized face‐to‐face CBT or additional treatments (Mataix‐Cols & Marks, ). The earlier mentioned paediatric OCD trials have indicated responder rates of about 30 to 70% at the three‐month follow‐up (Lenhard et al, , ), possibly somewhat lower than in face‐to‐face CBT, where on average 68% of patients respond to treatment (McGuire et al, ). Consequently, all patients are not expected to benefit from ICBT, and some might need or prefer face‐to‐face CBT.…”

“…Critically, research on ICBT for the paediatric population has been lagging behind significantly and a recent review found only 19 RCTs of ICBT for children and adolescents (Vigerland et al, ). In the field of paediatric OCD, two open trials (Lenhard et al, ; Rees, Anderson, Kane, & Finlay‐Jones, ) and a recent RCT (Lenhard et al, ) have demonstrated promising effects of ICBT with significant symptom reductions in clinical relevant samples.…”

“…The aim of this study was to investigate predictors of treatment response in ICBT for paediatric OCD. We used outcome data from a recent RCT (Lenhard et al, ) and applied several machine learning approaches, as well as a traditional linear regression approach, for comparison purposes.…”

How can technology enhance cognitive behavioral therapy: the case of pediatric obsessive compulsive disorder

“…The treatment contains E/RP (main component), cognitive restructuring, coping with stress, and family accommodation. The program consists of eight modules with separate content for adolescents and for parents.8 weeksOpen trialUnder studyIncreasing treatment availability and accessibility, and improving cost-effectivity (stepped care model)Lenhard et al (2014; 2017) [60, 61]Web-based CBT reduced therapist contactAdolescents 12–17 yearsThe program (12 chapters for adolescents and 5 for parents) contains educative texts, interactive elements, animations, films and exercises, addressing psychoeducation, E/RP, cognitive elements, relapse prevention, family accommodation and parental coping strategies. Participants can have regular contact with a therapist through e-mails, phone calls and standardized forms.The treatment is supported by a smartphone app offering the possibility to add and edit exposure tasks and set reminders for ERP.12 weeksRCT N  = 67Results of the RCT showed a moderate effect size (CYBOCS effect size d  = 0.69) for the web-based CBT compared to a waiting list.…”