Effectiveness of Video Teletherapy in Treating Child and Adolescent Obsessive-Compulsive Disorder with Exposure and Response Prevention: a Retrospective Longitudinal Observational Study

Abstract

AbstractExposure and response prevention (ERP), a form of cognitive-behavioral therapy, stands as an effective primary treatment for obsessive-compulsive disorder (OCD) for children and adolescents as well as adults. However, despite strong evidence supporting ERP’s effectiveness from clinical research and real-world applications, its utilization remains limited. This underuse is often attributed to access barriers such as the scarcity of properly trained therapists, geographical constraints, and costs. Some of these barriers may be addressed with virtual behavioral health, providing ERP for OCD through video teletherapy and supplemented by app-based therapeutic tools and messaging support between sessions. While studies in adults with OCD have shown research efficacy and real-world effectiveness of teletherapy ERP, less is known about outcomes in youth. This study reports on the effectiveness of teletherapy ERP for OCD in the largest sample (N=2173) of child and adolescent patients to date, across the U.S., Canada, Australia, and the UK. Treatment resulted in a median 37.3% decrease in OCD symptoms and 53.4% of youth met full response criteria. Further, there were significant reductions in the severity of concurrent depression, anxiety, and stress symptoms. These outcomes were achieved in a relatively small amount of therapist time (median of 13 appointments and 11.5 hours). The observed effect size was substantial and comparable to in-person ERP outcomes. This remote treatment, assisted by technology, is easily accessible to patients and represents a significant advancement in spreading effective and efficient evidence-based care for OCD.