Online Exposure Therapy for Obsessive-Compulsive Disorder

Overseen By Amelia Dev, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Miami

Must not be taking: Psychotropic medications

Disqualifiers: Severe mental illness, Hoarding, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 12 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how an online program called OCD-NET can assist individuals with Obsessive-Compulsive Disorder (OCD) through exposure therapy. The goal is to identify factors, such as emotions or thinking patterns, that influence the effectiveness of this treatment. The trial seeks English-speaking individuals in the U.S. diagnosed with OCD, particularly those not currently in another therapy and with stable medication use. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance OCD treatment options.

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 prior data suggests that this protocol is safe for treating OCD?

Research has shown that OCD-NET, an online therapy for obsessive-compulsive disorder (OCD), is generally safe and easy to use. OCD-NET employs a method called exposure and response prevention (ERP), which has been well-studied. Studies indicate that ERP reduces OCD symptoms without causing major side effects.

Specifically, online ERP, such as OCD-NET, has proven effective not only in managing OCD but also in improving related issues like depression, anxiety, and stress. Reports have not indicated significant negative effects linked to this therapy. This suggests that OCD-NET is a safe option for those seeking OCD treatment. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about OCD-NET because it offers a new way to treat Obsessive-Compulsive Disorder by delivering therapy online, making it much more accessible. Unlike traditional face-to-face cognitive behavioral therapy (CBT), which requires regular in-person sessions, OCD-NET can be accessed from home, reducing barriers like travel and scheduling conflicts. Additionally, this online platform allows for extended treatment over 12 months, which could provide ongoing support and flexibility for individuals managing their condition. This approach aims to combine the effectiveness of exposure therapy with the convenience of digital access, potentially reaching more people in need.

What evidence suggests that OCD-NET is effective for OCD?

Studies have shown that online exposure therapy, such as OCD-NET, effectively reduces symptoms of obsessive-compulsive disorder (OCD). OCD-NET combines cognitive behavioral therapy with exposure and response prevention, proven methods for treating OCD. Research indicates that remote treatments like this not only improve OCD symptoms but also help with related issues like depression and anxiety. Delivered online, the therapy is easy and convenient for participants to access. Initial findings suggest that this method can greatly enhance the quality of life for those dealing with OCD. ^{1 5 6 7 8}

Who Is on the Research Team?

Kiara Timpano, PhD

Principal Investigator

University of Miami

Amelia Dev, MS

Principal Investigator

University of Miami

Are You a Good Fit for This Trial?

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

Exclusion Criteria

Participants currently located outside of the United States

Prisoners

Participants with hoarding as the primary OCD symptom

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

Interventions

• OCD-NET

Trial Overview

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.

How Is the Trial Designed?

Group I: OCD-NET Group Experimental Treatment 1 Intervention

Participants will receive the OCD-NET intervention for up to 12 months.

Who Is Running the Clinical Trial?

University of Miami

Lead Sponsor

Trials

976

Recruited

423,000+

Published Research Related to This Trial

A randomized controlled trial with 67 participants showed that technician-administered internet-based cognitive behavior therapy (iCBT) significantly reduced symptoms of obsessive-compulsive disorder (OCD) and maladaptive beliefs compared to treatment as usual, with large effect sizes (greater than 0.78).

At a 3-month follow-up, 54% of those who completed the iCBT no longer met the diagnostic criteria for OCD, indicating that the treatment's benefits were maintained over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet cognitive behavioural treatment for obsessive compulsive disorder: A randomised controlled trial. Mahoney, AE., Mackenzie, A., Williams, AD., et al.[2018]

The Internet-administered cognitive behavioral therapy (CBT) program for OCD showed significant improvement in symptoms, with effect sizes of 1.28 and 0.60 on key measures after 8 weeks, indicating strong efficacy.

Eighty-one percent of participants completed the program, and they found the treatment highly acceptable, despite limited therapist contact averaging only 86 minutes over the entire duration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Internet administered treatment program for obsessive-compulsive disorder: a feasibility study. Wootton, BM., Titov, N., Dear, BF., et al.[2018]

Self-help approaches, particularly fully interactive computer-aided self-help programs based on exposure and ritual prevention (ERP), have shown efficacy in treating OCD, supported by a large multicenter randomized controlled trial and smaller studies.

There is a lack of randomized controlled trials for bibliotherapy and self-help groups, but brief therapist-supported ERP via phone has demonstrated effectiveness, suggesting that accessible self-treatment options could significantly benefit patients who are currently untreated or inadequately treated.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-help with minimal therapist contact for obsessive-compulsive disorder: a review. Mataix-Cols, D., Marks, IM.[2022]

In a study involving six outpatients with OCD, 15 sessions of teleconference and phone-based exposure therapy led to significant improvements, with four out of six patients no longer meeting the diagnostic criteria for OCD after treatment.

Patients found the teletherapy format acceptable and reported a strong therapeutic alliance, suggesting that this method could enhance access to effective OCD treatment for those unable to attend in-person sessions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Videoconference- and cell phone-based cognitive-behavioral therapy of obsessive-compulsive disorder: a case series. Vogel, PA., Launes, G., Moen, EM., et al.[2018]

This study will analyze adverse events in psychotherapy for youth with OCD by including at least 128 participants aged 8-17, comparing family-based cognitive behavioral therapy (FCBT) and family-based psychoeducation and relaxation training (FPRT).

The mixed methods approach will combine quantitative assessments of adverse events with qualitative interviews to better understand their nature and causes, aiming to improve the safety and effectiveness of psychotherapy for OCD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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. Pretzmann, L., Christensen, SH., Bryde Christensen, A., et al.[2023]

A study involving 34 volunteers with OCD showed that Internet-based writing therapy significantly improved OCD symptoms, with large effect sizes (Cohen's d = 0.82 for Y-BOCS SR and d = 0.87 for OCI-R) compared to a waiting-list control group.

The positive effects of the therapy were maintained at a 6-month follow-up, and 90% of participants who completed the program reported feeling improved and would recommend it to others, indicating high satisfaction and potential efficacy of this treatment approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

No talking, just writing! Efficacy of an Internet-based cognitive behavioral therapy with exposure and response prevention in obsessive compulsive disorder. Herbst, N., Voderholzer, U., Thiel, N., et al.[2022]

A 15-week internet-based cognitive behavior therapy (ICBT) program with therapist support significantly reduced OCD symptoms in 23 participants, showing a large effect size (Cohen's d = 1.56).

At the end of treatment, 61% of participants experienced clinically significant improvement, and 43% no longer met the criteria for OCD, indicating that ICBT can effectively enhance mental health and functioning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internet-based cognitive behavior therapy for obsessive compulsive disorder: a pilot study. Andersson, E., Ljótsson, B., Hedman, E., et al.[2021]

A pilot study involving 15 adults with OCD demonstrated that videoconference-mediated exposure and ritual prevention (ERP) significantly improved OCD symptoms, indicating its potential as an effective treatment alternative.

At the 3-month follow-up, 30% of participants no longer met the criteria for OCD, and 80% reported substantial improvement, suggesting that remote ERP can be a viable option for increasing access to effective mental health care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An open trial of videoconference-mediated exposure and ritual prevention for obsessive-compulsive disorder. Goetter, EM., Herbert, JD., Forman, EM., et al.[2018]

A large study involving 3552 adults with OCD showed that a digital treatment using video teletherapy and exposure and response prevention (ERP) led to a significant 43.4% reduction in obsessive-compulsive symptoms, demonstrating its efficacy as a treatment option.

The treatment not only reduced OCD symptoms but also improved quality of life by 22.7%, and it was achieved in less than half the therapist time compared to traditional in-person therapy, making it a more accessible and efficient option for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Online Video Teletherapy Treatment of Obsessive-Compulsive Disorder Using Exposure and Response Prevention: Clinical Outcomes From a Retrospective Longitudinal Observational Study. Feusner, JD., Farrell, NR., Kreyling, J., et al.[2022]

Exposure-based cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) does not lead to negative outcomes such as treatment attrition, poor therapeutic relationships, or low treatment satisfaction when compared to nonexposure-based treatments.

These findings support expert recommendations for using exposure-based CBT in treating pediatric OCD, helping to alleviate clinician concerns about potential adverse effects on patients and their families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Editorial Perspective: Exposures in cognitive behavior therapy for pediatric obsessive-compulsive disorder: addressing common clinician concerns. McGuire, JF., Wu, MS., Choy, C., et al.[2019]

In a study involving 11 patients with obsessive-compulsive disorder (OCD), 64% showed a positive response to home-based exposure and response prevention therapy after 24 sessions.

Of those treated, 36% experienced lasting improvements in their OCD symptoms, suggesting that this approach can be effective in real-world settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home-based behavior therapy for obsessive-compulsive disorder: a case series with data. Rosqvist, J., Egan, D., Manzo, P., et al.[2019]

A study involving 151 individuals with obsessive-compulsive disorder (OCD) found that both unguided internet-based cognitive-behavioral therapy (iCBT) formats significantly reduced OCD severity over 16 weeks.

While adherence was similar in both fixed and free-choice module orders, the fixed order (iCBTfixed) showed greater improvements in OCD severity and quality of life, suggesting that a structured approach may enhance treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial. Jelinek, L., Schröder, J., Bücker, L., et al.[2023]

Citations

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This randomized clinical trial compares the efficacy of exposure and response prevention therapy in mixed reality with self-guided exposure ...