iCBT for Adult Obsessive-Compulsive Disorder

Taking Psychiatry Online: Developing a Platform to Provide Internet-Delivered Cognitive-Behavior Therapy and Testing It in Obsessive-Compulsive Disorder

The goal of the study is to assess the feasibility, acceptability, and potential effects of therapist-guided internet-delivered cognitive-behavior therapy (iCBT) for adult obsessive-compulsive disorder, using a recently developed digital platform.

Although cognitive-behavior therapy (CBT) is a well-established first-line treatment for many mental disorders, very few patients receive it due to the shortage of trained professionals, the costs of face-to-face therapy, and geographic barriers. Therapist-guided internet-delivered CBT (iCBT) is a potential solution to this problem but is not generally available in our context.

The investigators plan to:

1. Develop a digital platform for the treatment of mental disorders using therapist-guided iCBT;
2. Assess the feasibility, acceptability, and potential effects of therapist-guided iCBT for adult obsessive-compulsive disorder (OCD) using the platform developed in Objective 1.

Inclusion Criteria:

• Age between 18 and 75
• Internet access
• Principal diagnosis of OCD, based on DSM-5
• Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) Total Severity Score > 16
• Ability to communicate in Spanish
• For participants taking psychotropic medication for OCD: at least eight weeks on stable medication and willingness to stay on the same medication/doses for the 12 weeks of the study

Exclusion Criteria:

• Estimated IQ < 70, as per the Vocabulary subtest of the Wechsler Adults Intelligence Scale for Children (WISC)
• Eight or more previous sessions of CBT for OCD with an experienced therapist during the last 12 months
• Ongoing psychological treatment for OCD
• Diagnosis of organic brain disorder, intellectual disability, autism spectrum disorder, psychosis, bipolar disorder, low-weight anorexia nervosa, or alcohol/substance dependence
• Immediate risk to self or others (e.g., suicidality)
• Inability to communicate in Spanish
• Low motivation to participate (i.e., the patient does not believe the therapy will be helpful at all)
• Insufficient time to work on the treatment (about 30 minutes per day)