Exploring experiences of online group cognitive behavioural therapy for obsessive compulsive disorder

Background-Exposure response prevention with or without cognitive strategies (CBT) is the recommended intervention for obsessive compulsive disorder (OCD) including delivered online. Engagement has not been explored for remote CBT for OCD. This meta-analysis explored the efficacy of this intervention delivered online either for individual or group based therapy. Post-intervention outcome measures, drop-out rates, ERP task completion and therapy sessions completed with the following moderators: remote intervention type, control group and therapist qualification were analysed.

Methods: A systematic search of 5 databases was carried out, identifying randomised controlled trials that evaluated remote CBT for OCD. The PRISMA protocol was followed. The Cochrane Risk of Bias Tool was used.

Results: 24 studies were included. A medium effect size was found, favouring remote CBT to control groups at post-intervention (k=24, n=2264, Hedge’s g= -0.44, 95% CI [-0.73- -0.14] p=0.004). Moderating effects were not found.

Discussion: Remote CBT is an effective intervention for OCD, but moderators were not apparent. There was insufficient research on ERP task completion and session completion to explore this aspect of engagement. There was a lack of research on remote CBT for OCD groups. Future research should therefore explore facilitators and barriers to engagement with remote CBT for OCD in general and with remote CBT for OCD groups in particular.