Shorter communication A pilot randomized controlled trial of videoconference-assisted treatment for obsessive-compulsive disorder Patrick A. Vogel a, * , Stian Solem a, b , Kristen Hagen b , Erna M. Moen c , Gunvor Launes d , Åshild T. Håland d , Bjarne Hansen e , Joseph A. Himle f a Norwegian University of Science and Technology, Department of Psychology, 7491, Trondheim, Norway b St. Olavs University Hospital, Pb 7002, 7441 Trondheim, Norway c Oslo University Hospital, Aker, 0372 Oslo, Norway d Sørlandet Hospital, 4604 Kristiansand, Norway e Haukeland University Hospital, 5021 Bergen, Norway f University of Michigan, Department of Psychiatry, Ann Arbor, MI 48105, USA article info Article history: Received 20 June 2014 Received in revised form 24 October 2014 Accepted 26 October 2014 Available online 30 October 2014 Keywords: OCD CBT Videoconference Self-help ERP Telepsychology abstract Evidence-based exposure and response prevention (ERP) treatment for obsessive-compulsive disorder (OCD) is not always easily accessible. Long distances from specialist treatment and other practical or motivational difficulties can interfere with ERP access and outcome. Delivery of ERP through tele- psychology can help “fill the gap”. The current study included 30 patients with OCD who were ran- domized to 12 weeks of either videoconference-assisted ERP (VCT; N ¼ 10), self-help ERP (SeH, N ¼ 10), or a wait-list condition (W-L, N ¼ 10). The VCT format included use of tablet-based videoconferencing sessions (N ¼ 6) or studio-based videoconference (N ¼ 4), as well as telephone calls. Patients rated the VCT format as natural and reported strong working alliances with their therapists. VCT treatment pro- duced significantly greater reductions in obsessive-compulsive symptoms compared to the two control conditions. Treatment outcomes were similar to that of regular face-to-face ERP and improvements in symptom scores remained stable at follow-up. The study indicated that ERP for OCD can be delivered efficiently with videoconferencing technology along with telephone calls. The use of such technology in psychological treatment is likely to become more common in the future and it holds promise as a method to make evidence-based treatment more accessible. © 2014 Elsevier Ltd. All rights reserved. Several meta-analytic studies and expert consensus guidelines indicate that serotonin reuptake inhibiting medication and cognitive-behavioral therapies including exposure and response prevention (ERP) are effective treatments for OCD (Hofmann & Smits, 2008). The effect sizes (ES, Cohens d, pooled) in controlled studies of CBT for OCD are large (.97) and 48% of patients with intention to seek treatment show clinically significant improve- ment ( € Ost, 2008). Medication treatment is widely available, but many patients in routine clinical settings refuse medication treat- ment (Himle et al., 2006). There are several important barriers to accessing guideline- concordant ERP-based care for OCD and several methods have been developed to help address this challenge. Perhaps the simplest and lowest cost method is the self-help book focused on the CBT treatment of OCD. But a controlled trial (Tolin et al., 2007) found that an unguided self-help book for OCD yielded only a 17% reduction in symptoms. Among the first attempts to improve upon book-directed CBT involved the use of a telephone voice interac- tive approach known as BT-STEPS (Greist et al., 2002). BT-STEPS yielded modest results when delivered without clinician involve- ment, but outcomes improved when clinician support was added to this model (Gega, Marks, & Mataix-Cols, 2004). However, even with clinician involvement, effect sizes are smaller than typical face-to-face CBT and many people with OCD do not adhere to BT- STEPS and drop out (Gega et al., 2004). CBT delivered with a combination of face-to-face and telephone calls has also shown promise as a way to deliver CBT effectively, especially for those who live far from trained therapists (Lovell et al., 2006). Limita- tions with telephone treatment include concerns about treating patients with co-occurring depression and difficulties judging progress and tailoring exposure exercises without visual feedback (Taylor et al., 2003). * Corresponding author. Tel.: þ47 73 55 04 25. E-mail address: patrickv@svt.ntnu.no (P.A. Vogel). Contents lists available at ScienceDirect Behaviour Research and Therapy journal homepage: www.elsevier.com/locate/brat http://dx.doi.org/10.1016/j.brat.2014.10.007 0005-7967/© 2014 Elsevier Ltd. All rights reserved. Behaviour Research and Therapy 63 (2014) 162e168