Researchers from the Karolinska Institutet in Stockholm, Sweden  investigated the efficacy of internet-based cognitive behavioral therapy (ICBT) with therapist support for obsessive compulsive disorder. CBT is widely regarded as an effective treatment for OCD, but access to CBT therapists is limited – thus the internet-based program as an intermediate solution.
This pilot was an open trial where 23 patients received a 15-week ICBT program with therapist support, consisting of psycho-education, cognitive restructuring and exposure with response prevention.

The primary measure of outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment.

All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen's d = 1.56). At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression.

This pilot demonstrated the impressive promise of ICBT, combined with therapist support, for reducing OCD symptoms, depressive symptoms and improving general functioning.  Follow-up with randomized, controlled trials are needed to confirm the effectiveness of this new treatment format.

Citation:  Andersson E, Enander J, Andrén P, Hedman E, Ljótsson B, Hursti T, Bergström J, Kaldo V, Lindefors N, Andersson G, Rück C. Internet-based cognitive behavior therapy for obsessive compulsive disorder: a pilot study. BMC Psychiatry. 2011 Aug 3;11:125. [email protected]