A pilot open trial of video telehealth-delivered exposure and response prevention for obsessive-compulsive disorder in rural Veterans
Open accessAbstract
Exposure and response prevention (ERP) is the gold-standard, evidence-based psychotherapy for obsessive-compulsive disorder (OCD), but few receive it. Video telehealth can increase access to ERP for OCD and may enhance the salience of exposures. This study examined the feasibility, acceptability, and preliminary effectiveness of video telehealth-delivered ERP. We conducted a pilot open trial with 11 Veterans, using mixed quantitative and qualitative methods. Treatment completers (n = 9) had significantly reduced OCD and posttraumatic stress disorder symptoms posttreatment. Patients expressed greater comfort in engaging in ERP at home than in clinics. Therapists reported that seeing patients’ home environments helped them understand their symptoms and identify relevant OCD exposures. Results suggest that video telehealth-delivered ERP is feasible and acceptable to patients and therapists and promising for reducing OCD symptoms. Future research should compare its effectiveness to usual care and evaluate patients’ preferences for treatment delivery.Abbreviations: ERP: exposure and response prevention; GAD-7: Generalized Anxiety Disorder-7 scale; OCD: obsessive-compulsive disorder; OCI-R: Obsessive-Compulsive Inventory, Revised; PCL-5: PTSD Checklist; PHQ-9: Patient Health Questionnaire; PTSD: posttraumatic stress disorder; VA: epartment of Veterans Affairs; Y-BOCS: Yale-Brown Obsessive Compulsive Scale, self report form.
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Internet-based delivery of exposure with response prevention leads to a clinically significant decrease in symptoms.
“Different studies found that internet-based delivery of exposure with response prevention leads to a clinical significant decrease in symptoms [11–13].”
From Personalized exposure and experience sampling method feedback versus exposure as usual for obsessive–compulsive disorder: a study protocol for a randomized controlled trial (2024) · cites this paper as [13]
The Video delivery and Quantitative outcomes sections show that ERP was delivered by live video and that six of nine treatment completers had clinically significant improvement in OCD symptoms. But this was a small, uncontrolled pilot trial in rural Veterans; its Conclusions call the effectiveness preliminary, so the broader causal claim that internet-based ERP leads to such improvement overstates the evidence. (LLM, conf=0.84)
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- Authors
- Fletcher, T. L., Boykin, D. M., Helm, A., Dawson, D. B., Ecker, A. H., Freshour, J., Teng, E., Lindsay, J., & Hundt, N. E.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- Corresponding author
- Fletcher, Terri L.
- ORCID
- Venue
- Military Psychology
- Publisher
- Informa UK Limited
- Published
- 2021-10-28
- Volume
- 34
- Issue
- 1
- Pages
- 83-90
- ISSN
- 0899-5605 (ISSN-L)
- 1532-7876
- PMC
- PMC10013345
- OpenAlex
- W3209799088
- Cited by
- 19
- References
- 25
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 8 · 2023: 4 · 2022: 1
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Military Psychology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- South Central MIRECC Pilot
- HSR&D Career Development Award (CDA 13-264)
- VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety (CIN# 13-413)
- South Central Mental Illness Research, Education and Clinical Center (Pilot Grant)
- U.S. Department of Veterans Affairs (CDA 13-264)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- video telehealth, exposure and response prevention, obsessive-compulsive disorder, veterans, rural veterans, treatment feasibility, acceptability, home-based psychotherapy, post-traumatic stress disorder, access to mental health care
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