Internet-based cognitive behavioral therapy in children and adolescents with obsessive compulsive disorder: a feasibility study

Karsten Hollmann, Katharina Allgaier, Carolin S Hohnecker, Heinrich Lautenbacher, Verena Bizu, Matthias Nickola, Gunilla Wewetzer, Christoph Wewetzer, Tord Ivarsson, Norbert Skokauskas, Lidewij H Wolters, Gudmundur Skarphedinsson, Bernhard Weidle, Else de Haan, Nor Christan Torp, Scott N Compton, Rosa Calvo, Sara Lera-Miguel, Anna Haigis, Tobias J Renner, Annette Conzelmann, Karsten Hollmann, Katharina Allgaier, Carolin S Hohnecker, Heinrich Lautenbacher, Verena Bizu, Matthias Nickola, Gunilla Wewetzer, Christoph Wewetzer, Tord Ivarsson, Norbert Skokauskas, Lidewij H Wolters, Gudmundur Skarphedinsson, Bernhard Weidle, Else de Haan, Nor Christan Torp, Scott N Compton, Rosa Calvo, Sara Lera-Miguel, Anna Haigis, Tobias J Renner, Annette Conzelmann

Abstract

Cognitive behavioral therapy (CBT) is the first choice of treatment of obsessive-compulsive disorder (OCD) in children and adolescents. However, there is often a lack of access to appropriate treatment close to the home of the patients. An internet-based CBT via videoconferencing could facilitate access to state-of-the-art treatment even in remote areas. The aim of this study was to investigate feasibility and acceptability of this telemedical approach. A total of nine children received 14 sessions of CBT. The first session took place face-to-face, the remaining 13 sessions via videoconference. OCD symptoms were recorded with a smartphone app and therapy materials were made accessible in a data cloud. We assessed diagnostic data before and after treatment and obtained measures to feasibility, treatment satisfaction and acceptability. Outcomes showed high acceptance and satisfaction on the part of patients with online treatment (89%) and that face-to-face therapy was not preferred over an internet-based approach (67%). The majority of patients and their parents classified the quality of treatment as high. They emphasized the usefulness of exposures with response prevention (E/RP) in triggering situations at home. The app itself was rated as easy to operate and useful. In addition to feasibility, a significant decrease in obsessive-compulsive symptoms was also achieved. Internet-based CBT for pediatric OCD is feasible and well received by the patients and their parents. Furthermore, obsessive-compulsive symptomatology decreased in all patients. The results of this study are encouraging and suggest the significance of further research regarding this technology-supported approach, with a specific focus on efficacy.Trial registration number: Clinical trials AZ53-5400.1-004/44.

Keywords: App; Children; Cognitive behavioral therapy; Internet-based psychotherapy; Obsessive–compulsive disorder.

Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose. The authors have no conflicts of interest to declare that are relevant to the content of this article. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. The authors have no financial or proprietary interests in any material discussed in this article.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Study flow; iCBT internet-delivered cognitive-behavioral therapy

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