Self-guided internet–delivered cognitive behavior therapy (ICBT) for obsessive-compulsive symptoms: A randomized controlled trial
Abstract
Internet-delivered cognitive behavior therapy (ICBT) for obsessive-compulsive disorder (OCD) has been demonstrated to be efficacious across multiple clinical trials. However, most of these interventions include clinician support, and many individuals with OCD prefer to manage their own symptoms. Self-guided ICBT overcomes this problem, but to date the efficacy of self-guided interventions has only been studied in uncontrolled trials. The present study aims to examine the efficacy and acceptability of ICBT for OCD symptoms when delivered in a self-guided format using a randomized controlled trial design. In the present study, 190 participants were randomized to either a self-guided ICBT condition or a waitlist control group. 140 participants completed the baseline assessment, initiated treatment, and were included in the analyses. The between-group effect size at post-treatment was large on the self-report version of the Yale-Brown Obsessive-Compulsive Scale (d = 1.05; 95% CI 0.89-1.21). Twenty-seven percent of the ICBT condition met conservative criteria for clinically significant change at post-treatment, which increased to thirty-eight percent at three-month follow-up. Participants rated the program as highly acceptable. The results indicate that self-guided ICBT may be a viable treatment option for some individuals with OCD symptoms.
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The Acceptability Questionnaire is a 10-item measure of acceptability of remote treatments and has been used in other remote treatments.
“The AQ is a 10-item measure of acceptability of remote treatments. The questionnaire has been used in other remote treatments [55].”
From Internet videoconferencing delivered cognitive behavior therapy for generalized anxiety disorder: protocol for a randomized controlled trial (2022) · cites this paper as [55]
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Self-citationTrenoska Basile, V., Newton-John, T., & Wootton, B. M. (2022) · Trials · doi:10.1186/s13063-022-06520-5 · Cited by 2 · see citing works
Self-citationBrief remote cognitive behaviour therapy for generalized anxiety disorder: An open trial
Basile, V. T., Newton-John, T. R. O., McDonald, S., & Wootton, B. M. (2024) · British Journal of Clinical Psychology · doi:10.1111/bjc.12516 · Cited by 2 · see citing works
Self-citationReasons for seeking internet-delivered treatment for individuals with obsessive-compulsive disorder.
Melkonian, M., McDonald, S., Karin, E., Titov, N., Dear, B., & Wootton, B. M. (2024) · British Journal of Clinical Psychology · doi:10.1111/bjc.12524 · Cited by 2 · see citing works
Self-citationKohls, E., Baldofski, S., Scholl, J., Flygare, O., Lundström, L., Beyrich-Kolbus, U., Steinbrecher, M., Rück, C., & Rummel‐Kluge, C. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06519-7 · Cited by 3 · see citing works
“Differently, self-guided interventions do not involve clinician or therapist support during the treatment [36].”
Imagery rescripting for social anxiety disorder via internet videoconferencing: An open trial
Winter, H. R., Norton, A. R., & Wootton, B. M. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104914 · Cited by 2 · see citing works
Self-citationCognitive behavior therapy for COVID-19 related distress
Moses, K., & Wootton, B. M. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-824289-6.00007-6 · Cited by 2 · see citing works
Self-citationTechnological Interventions for Obsessive–Compulsive Disorder Management
Borgnis, F., & Pedroli, E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00096-0 · Cited by 2 · see citing works
Fernández, S., & Roussos, A. (2024) · Praxis Psy · doi:10.32995/praxispsy.v24i40.254 · Cited by 2 · see citing works
Dunn, I. B. J. M. D., Power, E., Casey, L. J., & Wootton, B. M. (2025) · PLoS ONE · doi:10.1371/journal.pone.0316857 · Cited by 1 · see citing works
Self-citation杨, 晨. (2024) · Advances in Psychology · doi:10.12677/ap.2024.144232 · Cited by 1 · see citing works
Yorulmaz, E. G., Sütcü, S. T., Tunçel, Ö. K., Akkeçili, Y., & Pırıldar, Ş. (2023) · Current Psychology · doi:10.1007/s12144-023-05570-5 · Cited by 1 · see citing works
“Mahoney et al., 2014 ; Wootton et al., 2019).”
Bisby, M. A., Wootton, B. M., & Dear, B. F. (2025) · British Journal of Clinical Psychology · doi:10.1111/bjc.12543
“All participants in the current study received the OCD Course, an 8-week digital cognitive-behavioural treatment for adults with obsessive–compulsive disorder (Wootton et al., 2014, 2019).”
Self-citationInternet psychoeducation and psychotherapy for obsessive-compulsive disorder - review
Pasztor, J., Praško, J., Vaněk, J., Višňovský, J., Zaťková, M., Šlepecký, M., Sollár, T., & Nesnídal, V. (2025) · Psychiatrie pro praxi · doi:10.36290/psy.2025.018
Hoppen, L., Kuck, N., Bürkner, P.-C., Karin, E., Wootton, B. M., & Buhlmann, U. (2021) · Figshare · doi:10.6084/m9.figshare.14889693
Self-citationSkoko, A., Hlynsson, J. I., Čihařová, M., Berger, T., Carlbring, P., Krieger, T., Bergström, J., Daele, T. V., van Klaveren, C., Cornelisz, I., et al. (2026) · doi:10.2196/preprints.103262
Lee, J. H., & Wootton, B. M. (2026) · British Journal of Clinical Psychology · doi:10.1111/bjc.70080
Self-citationSkoko, A., Hlynsson, J. I., Čihařová, M., Berger, T., Carlbring, P., Krieger, T., Bergström, J., Daele, T. V., van Klaveren, C., Cornelisz, I., et al. (2026) · JMIR Research Protocols · doi:10.2196/103262
- Authors
- Wootton, B. M., Karin, E., Titov, N., & Dear, B. F.
- Affiliations
- University of Technology Sydney (AU)
- Macquarie University (AU)
- Corresponding author
- Wootton, Bethany M.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 66
- Pages
- 102111
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2953853892
- Cited by
- 51
- References
- 58
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 14 · 2023: 11 · 2022: 5 · 2021: 8 · 2020: 1
- FWCI
- 3.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Funders
- Australian Government
- 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
- internet-based cognitive behavioral therapy, self-guided treatment, obsessive-compulsive symptoms, obsessive-compulsive disorder, treatment acceptability, treatment efficacy, waitlist control, Yale-Brown Obsessive Compulsive Scale
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Self Care, Therapy, Computer-Assisted, Waiting Lists, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Young Adult, Self Report
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