Lisi Diana M, Hawley Lance L, McCabe Randi E, Rowa Karen, Cameron Duncan H, Richter Margaret A, Rector Neil A
Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Clin Psychol Psychother. 2023 Sep 12. doi: 10.1002/cpp.2908.
Cognitive behavioural therapy (CBT) including exposure and response prevention is the first-line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in-person delivery, few studies have assessed the role of therapist-guided, manual-based CBT for OCD delivered in real-time via videoconferencing methods. The present study sought to fill this gap by comparing in-person and online delivery of group-based CBT for the treatment of OCD. A convenience sample of participants with moderate to severe OCD (n = 144) were recruited from a naturalistic database from two large OCD specialty assessment and treatment centres. Patients received group-based CBT that was provided in-person (pre-COVID-19 pandemic; March 2018 to March 2020) or online via videoconferencing (during the COVID-19 pandemic; March 2020 to April 2021). In both delivery methods, treatment consisted of 2-h weekly sessions led by trained clinicians. Analyses revealed that, regardless of treatment modality, both in-person and online groups demonstrated significant, reliable, and statistically equivalent improvements in OCD symptoms post-treatment. Videoconferenced, clinician-led CBT may be a promising alternative to in-person delivery for those with moderate to severe OCD symptoms.
认知行为疗法（CBT），包括暴露与反应预防，是强迫症（OCD）的一线心理治疗方法。鉴于临床情况的变化，人们越来越努力评估其在网络环境中的有效性。与传统的面对面治疗类似，很少有研究评估通过视频会议实时提供的、由治疗师指导的、基于手册的强迫症认知行为疗法的作用。本研究旨在通过比较面对面和在线提供的团体认知行为疗法对强迫症的治疗效果来填补这一空白。从两个大型强迫症专科评估和治疗中心的自然数据库中招募了144名中重度强迫症患者作为便利样本。患者接受了团体认知行为疗法，该疗法在疫情前（2018年3月至2020年3月）以面对面的方式提供，或在新冠疫情期间（2020年3月至2021年4月）通过视频会议在线提供。在两种治疗方式中，治疗均由训练有素的临床医生主持，每周进行2小时的疗程。分析显示，无论治疗方式如何，面对面组和在线组在治疗后强迫症症状均有显著、可靠且在统计学上相当的改善。对于有中重度强迫症症状的患者，由临床医生通过视频会议提供的认知行为疗法可能是面对面治疗的一个有前景的替代方案。
