Implementing Internet-Based Cognitive Behavioral Therapy for Obsessive Compulsive Disorder: A Case Report - Abstract
Objective: Cognitive-behavioral therapy (CBT) incorporating exposure and ritual prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD) (citation). This case study outlines treatment of a 30-year-old female diagnosed with OCD and no psychiatric comorbidities using an internet-based CBT intervention (I-CBT) and therapist phone support.
Methods: Treatment involved completing CBT homework assignments on an internet platform, platform messaging with an assigned therapist, conducting patient-guided exposures with response prevention, and phone support for treatment planning and implementation. Patient evaluations were conducted prior to week one of treatment and during week 13, following termination of therapist contact. Additionally, weekly self-report forms were administered to monitor patient symptoms. The primary outcome measure for OCD symptoms was the Yale-Brown Obsessive Compulsive Scale (YBOCS) severity score.
Results: Mrs. X’s YBOCS severity score decreased from a 25 (severe) pre-treatment to a 12 (mild) post-treatment. Additionally, Her Hamilton Depression Scale (HAM-D17) score remained in the range of no depression symptoms and her Obsessive Compulsive Inventory-Revised severity score decreased from 23 (above cutoff of 21 for clinical impairment) to 10.
Conclusion: Over the course of a 13-week I-CBT intervention, patient OCD symptoms reduced significantly. This case illustrates the utility of an internet-based CBT intervention for OCD and factors that contribute to its efficacy.