Smart Sensory Technology in Psychotherapy for Pediatric OCD
Condition: Obsessive-Compulsive Disorder
MeSH terms: Compulsive Personality Disorder; Obsessive-Compulsive Disorder
Study type: Interventional

Summary: 
      Telemedicine interventions enable the improvement of behavioral state-of-the-art treatment of
      OCD, as therapy can be delivered in the patients' immediate home environment, allowing for
      more valid symptom actualization. In addition, access to experts is made possible even in
      rural areas, and the inhibition to seek therapy can be reduced. In a preliminary study, our
      research group was able to demonstrate the efficiency of using telemedical access. SSTeP-KiZ
      aims at the further development of telemedical treatment of children with OCD by using sensor
      technology in the home setting, where most symptoms occur. In this context, relevant
      emotional states of the patients such as anxiety and stress reactions shall be quantified
      reliably during the therapy session with exposures by combining different sensor modalities.
      As a result, the therapy procedure can be immediately and individually adapted to the patient
      and the situation, thus optimizing the success of the treatment.

      Methods: It is planned to establish the therapy system on a sample of 10 healthy children and
      5-10 patients with OCD treated at University Hospital of Tübingen. Afterwards we will recruit
      26 children with obsessive-compulsive disorder aged 12-18 years to conduct therapy with them.
      There are 14 weekly therapy sessions via teleconferencing with the children and parents.
      During the sessions and exposures, patients' field of view is recorded via eye trackers,
      measures of stress responses via heart rate and pupillometry, and movement measures for
      approach-avoidance behaviors. Using an AI approach, these indicators are integrated and
      reported back to the therapist online to optimize the therapy process. Accompanying app-based
      daily symptoms will also be collected by the children and parents and processed for use in
      the therapy process. We expect a good feasibility and significant symptom reduction by this
      therapeutic approach and the chance to make this system usable for broad clinical
      application.
    

Detailed description: 
      The main goal of SSTeP-KiZ is the implementation of sensors in the existing
      telepsychotherapeutic treatment of children and adolescents with obsessive-compulsive
      disorder. SSTeP-KiZ aims to significantly improve the telepsychotherapeutic treatment options
      for this group of patients through the use of sensors that can be worn during symptom
      triggering situations at home in patients' everyday lives, and an analysis and incorporation
      of the multimodal sensor data into the therapeutic process.

      In the medium term, SSTeP-KiZ should enable the use of real-time data on anxiety and stress
      levels (pupillometry, heart rate, eye tracking) obtained during therapy sessions by the
      therapist while the patient is still in the therapy session. Thus, even under the conditions
      of telepsychotherapy, despite the physical absence of the therapist, the individual intensity
      of the therapy sessions can be directly adjusted. In addition, the compliance and
      satisfaction of the patients during the accompanied therapy tasks can be directly promoted.
      Furthermore, the data obtained within the framework of SSTeP-KiZ should also be suitably
      prepared concerning the children and adolescents and their relatives and, in the sense of
      therapeutic feedback, suitably visualized to form an additional component of the therapy.

      Goals:

      A. Development of a prototype for a multisensory therapy system in healthy children and
      adaptation to mentally ill children with an obsessive-compulsive disorder.

      B. Evaluation of the prototype in the context of an internet-based psychotherapy for mentally
      ill children with an obsessive-compulsive disorder C: Preparations for the introduction of
      the multisensory therapy system into broad clinical application in the health care system

      Sample I: 10 healthy children:

      Sample II: 5-10 patients of University Hospital Tübingen with OCD.

      Sample III&IV: 6 & 20 children with OCD.
    

Intervention name(s): Online-based Cognitive-behavioral Therapy for OCD
Intervention type(s): Behavioral
Intervention description(s): 26 patients with obsessive-compulsive disorder (OCD) receive treatment with cognitive-behavioral therapy. 14 sessions will take place via the internet.
Other intervention name(s): Online-based Psychotherapy
Intervention model: Single Group Assignment
Intervention model description: All participants will be treated with cognitive behavioural therapy during our feasibility study.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Obsessive-compulsive Disorder; Children and Adolescents; Cognitive-behavioral therapy; Digital sensory device