Effectiveness of an online interpretation training as a pre-treatment for cognitive behavioral therapy for obsessive-compulsive disorder in youth: A randomized controlled trial

Lidewij H Wolters,Annelieke Hagen,Vivian Op De Beek,Pascalle Dol,Else De Haan,Elske Salemink

doi:10.1016/j.jocrd.2021.100636

Abstract

BackgroundCognitive behavioral therapy (CBT) is the treatment of choice for pediatric obsessive-compulsive disorder (OCD), but not all patients profit sufficiently. Long waitlists and wide variations in improvement rates ask for new interventions. We examined the effectiveness of a Cognitive Bias Modification–Interpretation (CBM-I) training that was offered during the waiting period for CBT. We tested 1) whether the CBM-I training is an effective intervention during a waitlist period for CBT, and 2) whether augmenting CBT with CBM-I improves treatment effect. MethodsParticipants (74 children with OCD, 8–18 years) were randomly assigned to either a CBM-I training or a waitlist, both followed by CBT. Resultsindicated that compared to the waitlist, the CBM-I training was effective in reducing OCD severity, with a medium effect size. Patients in the CBM-I training condition started subsequent CBT with less severe OCD, and this advantage was maintained during CBT. However, the CBM-I training did not result in a faster decline of symptoms during subsequent CBT. ConclusionThese findings indicate that CBM-I training could be an easy to implement, helpful intervention during a waitlist period. However, replications in larger samples and comparisons to active control conditions are needed.

Highlights

Cognitive behavioral therapy (CBT) is recommended as first line treatment for pediatric obsessive-compulsive disorder (OCD) (National Institute for Health and Care Excellence, 2005; Geller et al, 2012)
We examined if augmenting CBT with an adapted Cognitive Bias Modification of interpretation (CBM-I) training for pediatric OCD during the waitlist period could improve treatment effect
We tested the effect of the CBM-I training during the waitlist period, and second, we examined if the pretreatment CBM-I training enhanced treatment effect of subsequent CBT

Summary

Introduction

CBT is an effective treatment for OCD, not all children profit sufficiently. CBM-I could be offered already during the waiting period for CBT, and CBM-I and CBT may mutually reinforce each other which may improve treatment effect. Cognitive behavioral therapy (CBT) is the treatment of choice for pediatric obsessive-compulsive disorder (OCD), but not all patients profit sufficiently. We examined the effectiveness of a Cognitive Bias Modification–Interpretation (CBM-I) training that was offered during the waiting period for CBT. We tested 1) whether the CBM-I training is an effective intervention during a waitlist period for CBT, and 2) whether augmenting CBT with CBM-I improves treatment effect. Patients in the CBM-I training condition started subsequent CBT with less severe OCD, and this advantage was maintained during CBT. Replications in larger samples and comparisons to active control conditions are needed

Methods

Results

Conclusion