Therapist-guided, internet-delivered cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: a randomized controlled trial
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OBJECTIVE: Cognitive-behavioral therapy (CBT) is the first-line treatment for young people with obsessive-compulsive disorder (OCD), but most patients do not have access to this treatment. Thus, innovative ways to increase the accessibility of CBT are needed. The objective of this trial was to evaluate the efficacy of therapist-guided internet-based CBT (ICBT) for adolescents with OCD. METHOD: Sixty-seven adolescents (12-17 years old) with OCD were randomly assigned to a 12-week clinician- and parent-supported ICBT program (BiP OCD) or a waitlist condition. The primary outcome was the Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS) administered by blinded assessors before and after the intervention. All patients were followed up 3 months after the intervention. RESULTS: In intention-to-treat analyses, BiP OCD was superior to waitlist on the CY-BOCS (time-by-group interaction, B = -4.53, z = -3.74, p < .001; Cohen's d = 0.69; 95% CI 0.19-1.18) and on most secondary outcome measurements. Patients randomized to BiP OCD also showed further improvement from post-treatment to 3-month follow-up, with a within-group pretreatment to follow-up effect size (Cohen's d) equal to 1.68 (95% CI 1.00-2.36). Patient satisfaction with BiP OCD was high. There were no relevant adverse events. Average clinician support time was 17.5 minutes per patient per week. CONCLUSION: Therapist-guided ICBT is a promising low-intensity intervention for adolescents with OCD and has the potential to increase access to CBT. It might be particularly useful in a stepped-care approach, in which a large proportion of patients with moderately severe OCD could first be offered ICBT, thus freeing limited resources for more complex cases. Clinical trial registration information-Internet-Delivered CBT for Adolescents With OCD: A Randomized Controlled Study (BiPOCD); http://clinicaltrials.gov; NCT02191631.
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In a single-blinded randomized controlled trial with sixty-seven adolescents (aged 12-17) suffering from obsessive-compulsive disorder (OCD), a 12-week clinician and parent supported ICBT-intervention proved superior to wait-list controls on the Children's Yale-Brown Obsessive-Compulsive Scale with an effect-size of d = 0.69 (p < 0.001).
“Most recently, Lenhard et al. (2017) reported results from a single-blinded randomized controlled trial with sixty-seven adolescents (aged 12–17) suffering from obsessive-compulsive disorder (OCD). In this trial, a 12-week clinician and parent supported ICBT-intervention proved superior to wait-list controls on the semi-structured clinician-administered interview Children's Yale-Brown Obsessive-”
From Internet-based cognitive behavioral therapy for adolescents with anxiety disorders: A feasibility study (2018) · cites this paper as Lenhard et al., 2017
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- Authors
- Lenhard, F., Andersson, E., Mataix-Cols, D., Rück, C., Vigerland, S., Högström, J., Hillborg, M., Brander, G., Ljungström, M., Ljótsson, B., & Serlachius, E.
- Affiliations
- Region Stockholm (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Lenhard, Fabian
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 56
- Issue
- 1
- Pages
- 10-19.e2
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2538766504
- Cited by
- 146
- References
- 43
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 15 · 2023: 11 · 2022: 19 · 2021: 27 · 2020: 11 · 2019: 19 · 2018: 14 · 2017: 9 · 2016: 2
- FWCI
- 22.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Karolinska Institutet
- Stockholms Läns Landsting (20120167, 20140085)
- Vetenskapsrådet (K2013‐61P‐22168, 2014-04052)
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd (2014-4052)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, adolescents, internet-based cognitive behavioral therapy, therapist-guided intervention, treatment accessibility, stepped care, low-intensity intervention, parental support, treatment efficacy, patient satisfaction
- MeSH terms
- Adolescent, Child, Female, Follow-Up Studies, Humans, Male, Obsessive-Compulsive Disorder, Cognitive Behavioral Therapy, Single-Blind Method, Outcome Assessment, Health Care, Internet
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