Clinical trial NCT01522287: Computer Assisted Cognitive Behavior Therapy for Obsessive Compulsive Disorder: A Comprehensive Stepped-Care Approach
Official title: Computer Assisted CBT for OCD: A Comprehensive Stepped-Care Approach
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Obsessive Compulsive Disorder
Keywords: Obsessive Compulsive Disorder
Computer Assisted Therapy
Cognitive Behavior Therapy
Cognitive Therapy
Lead sponsor: Center for Psychological Consultation
Sponsor class: OTHER
First posted: 2012-01-31
Enrollment: 88
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The goal of this project is to improve access to effective treatments for obsessive compulsive disorder (OCD) through the use of web-based cognitive behavioral therapy (CBT) treatment. There intervention involves both a computer program (BT Steps) and human interaction via telephone. The investigators will test the efficacy and feasibility of computer therapy alone (n=35), computer plus a non-therapist coach (n=35), and computer plus a CBT therapist coach (n=35

Detailed description: The need for evidence-based mental health treatments i.e., 'treatment based on the best available science or research evidence"1, has been stressed from scientific, ethical, and marketing perspectives. While empirical evidence supports both the efficacy and effectiveness of cognitive behavior therapy (CBT) for Obsessive-Compulsive Disorder (OCD), demand for clinicians trained in these approaches far exceeds supply. New technologies provide the opportunity to facilitate access to this specialized treatment. A growing body of research has found that web-based self-administered psychotherapy is highly effective, cost-efficient, and can achieve clinical improvements similar to those obtained with clinician administered therapy. The long-term goal of this project is to improve clinical and occupational functioning and decrease disability associated with OCD by improving access to effective treatments through the use of web-based CBT treatment. The intervention involves a computer program (BT STEPS) and human interaction via telephone. The inclusion of human interaction for coaching and encouragement has been found to significantly increase compliance and success rates in computerized self-help. Whether treatment outcomes differ when this coaching is done by a therapist versus when done by a trained non-therapist has not been studied. This is the first program to examine a hybrid model involving different levels of remote clinician coaching in combination with an on-line self-help tutorial. In Phase I the investigators will test the efficacy and feasibility of computer therapy alone (n=35), computer plus nontherapist coach (n=35) and computer plus CBT therapist coach. In phase II the investigators will do a fully powered study comparing our model to traditional face-to-face therapy.

Eligibility criteria: Inclusion Criteria:

* Age 18 or above
* Have clinically significant OCD
* YBOCS score of 16-32

Exclusion Criteria:

* Significant comorbid depression
* Serious suicide risk
* Psychosis or psychotic disorder

Primary outcomes:
measure: Yale Brown Obsessive Compulsive Scale (YBOCS)
timeFrame: Change from Baseline on YBOCS at 12 weeks
Secondary outcomes:
measure: PHQ-9
timeFrame: Change from baseline on PHQ9 at 12 weeks
measure: Work and Social Adjustment Scale (WSA)
timeFrame: Change from baseline on WSA at 12 weeks
Other outcomes:
Locations:
city: Madison
country: United States
facility: Center for Psychological Consultation
state: Wisconsin
Study officials:
References:
citation: Greist JH, Marks IM, Baer L, Kobak KA, Wenzel KW, Hirsch MJ, Mantle JM, Clary CM. Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control. J Clin Psychiatry. 2002 Feb;63(2):138-45. doi: 10.4088/jcp.v63n0209.