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Efficacy of Technology-delivered Cognitive Behavioural Therapy for OCD Versus Control Conditions, and in Comparison with Therapist-Administered CBT: Meta-Analysis of Randomized Controlled Trials
University of Florence, Italy; Miller Institute Behav and Cognit Psychotherapy, Italy.
Miller Institute Behav and Cognit Psychotherapy, Italy; University of Florence, Italy.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.ORCID iD: 0000-0003-4753-6745
2015 (English)In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 44, no 3, 190-211 p.Article, review/survey (Refereed) Published
Abstract [en]

Cognitive behavioural therapy (CBT) is a well-established treatment for obsessive-compulsive disorder (OCD). However, few patients receive CBT, due to factors such as geographic limitations, perceived stigmatization, and lack of CBT services. Technology-delivered cognitive behavioural therapy (T-CBT) could be an effective strategy to improve patients access to CBT. To date, a meta-analysis on the effectiveness of T-CBT for OCD has not been conducted. This study used meta-analytic techniques to summarize evidence on the efficacy of T-CBT for OCD versus control conditions and therapist-administered CBT. A meta-analysis according to Prisma guidelines was conducted on randomized controlled trials (RCTs) of T-CBT for OCD. Treatment was classified as T-CBT if evidence-based CBT active ingredients for OCD were included (psychoeducation, ERP, and cognitive restructuring), delivered through health technologies (e.g. self-help books, leaflets, and other forms of bibliotherapy) or remote communication technologies (e.g. the Internet, web-cameras, telephones, telephone-interactive voice response systems, and CD-ROMS). Studies using validated outcomes for OCD or depression were included. Eight trials were included (N=420). Two trials were classified as at high risk of bias. T-CBT seemed to be superior to control conditions on OCD symptom outcomes at post-treatment (d=0.82, 99% CI=0.55-1.08, p=0.001), but not on comorbid depression (d=0.33, 99% CI=-0.01-0.67, p=0.020). Difference in the efficacy on OCD symptoms between T-CBT and therapist-administered CBT was not significant, despite a trend favouring therapist-administered CBT emerged (d=0.45, 95% CI=0.03-0.87, p=0.033). Directions for research are discussed. Further RCTs are warranted to examine the efficacy of T-CBT for OCD.

Place, publisher, year, edition, pages
Taylor andamp; Francis (Routledge): STM, Behavioural Science and Public Health Titles , 2015. Vol. 44, no 3, 190-211 p.
Keyword [en]
meta-analysis; technology-delivered cognitive-behavioural therapy; obsessive-compulsive disorder; treatment outcome; cognitive behavioural therapy
National Category
Basic Medicine
Identifiers
URN: urn:nbn:se:liu:diva-115806DOI: 10.1080/16506073.2015.1005660ISI: 000350283600002PubMedID: 25705787OAI: oai:DiVA.org:liu-115806DiVA: diva2:796876
Available from: 2015-03-20 Created: 2015-03-20 Last updated: 2017-12-04

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Andersson, Gerhard

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