Effectiveness and acceptability of Internet-based Cognitive Behavioral Therapy for individuals with Obsessive Compulsive Disorder in Singapore

Abstract

Background

Obsessive Compulsive Disorder (OCD) is the third-most prevalent mental health disorder in Singapore, with an increasing treatment delay and a high level of burden.

Objective

Given the potential for therapist-guided Internet-based Cognitive Behavioral Therapy (I-CBT) to provide accessible, time- and cost-effective treatment, this study aims to evaluate the efficacy and acceptability of I-CBT among Singaporeans with OCD.

Methods

Twenty-five participants underwent a 10-week therapist-guided I-CBT program that was adapted to suit the Singaporean context. It consists of psychoeducation, cognitive restructuring, exposure and response prevention as well as relapse prevention. Participants’ OCD, depressive and anxiety symptoms as well as level of functioning and quality of life (QoL) were assessed at three time points: pre-treatment, post-treatment and one-month follow-up. Therapist time and participants’ satisfaction with the program were measured.

Results

All participants completed the I-CBT program. Significant reductions were found in OCD symptoms, with large within-group effect sizes at post-treatment (p <.001, Cohen’s d = 2.64) and at one-month follow-up (p <.001, Cohen’s d = 2.23). A total of 40 % had their OCD symptoms in remission. I-CBT also resulted in clinically significant improvements in depressive (p <.001) and anxiety symptoms (p <.001) as well as improvements in functioning (p <.001) and QoL (p <.001). The program required a mean of 129 (SD = 89.8) minutes of therapist time and was regarded as acceptable by OCD sufferers in Singapore.

Conclusions

This study demonstrated that therapist-guided I-CBT is promising in reducing OCD symptoms. However, randomized control trials are needed to confirm the effectiveness of this innovative treatment delivery method.