Online OCD Therapy Provides Relief For A Neglected Condition

Obsessive hand-washing is one of the more famous symptoms of OCD, but it's seldom recognized how common and devastating the condition can be. r.classen/Shutterstock

Obsessive-Compulsive Disorder (OCD) is often not taken very seriously, with a preference for neatness and order often casually referred to as “being a little OCD”. This perception hides the often devastating impact on the lives of 1-3 percent of the population. In 1996 the World Health Organisation (WHO) – rated OCD as the ninth largest cause of disability in the world. So confirmation of the effectiveness of a treatment program that could reach those who can’t access existing support has much greater implications than might appear.

Professor Mike Kyrios of Australia’s Flinders University has spent years developing an online program for people with OCD, accessible at Mentalhealthonline. The system involves a combination of treatment strategies, videos made by people with OCD describing their experiences, and downloadable resources. The treatment applies Cognitive-Behavioral Therapy (CBT) techniques and is known as iCBT. Ideally, but not necessarily, it is supported through email contact with a therapist who provides motivation and clarifying information.

In the Journal of Medical Internet Research, Kyrios reports on a trial that demonstrated iCBT's effectiveness, by comparing outcomes for OCD sufferers randomly assigned to iCBT or therapist-assisted online relaxation therapy.

Trial participants had suffered OCD symptoms of varying severity for an average of 14 years, and many were on medications with limited success. A third of those given iCBT were considered to have made a reliable recovery, compared to just 11 percent who had the relaxation therapy. Half experienced significant improvement (29 percent for relaxation). Moreover, when participants were followed up months after the trial, those who had been in the iCBT maintained their much better outcomes.

Kyrios argued the treatment's potential is huge. “The largest problem for OCD sufferers seeking help is shame,” he told IFLScience. Those with the condition who do see therapists often take many sessions to open up about their symptoms out of fear of judgment. In this context, a program that can be accessed anonymously could attract many people unwilling to try face-to-face treatment.

OCD is often accompanied by fears of going out in public, either from agoraphobia or anxiety about contamination, creating another pool of people for whom online treatment is better than in person.

Moreover, there is a shortage of qualified therapists with skills in the area, and publicly funded treatment programs are often woefully short, even in wealthy nations. Kyrios told IFLScience that, while the nature of the symptoms varies by culture, OCD appears at similar rates around the world, yet the need for affordable therapy in low-income countries has been barely addressed.

The most recent WHO report grouped OCD with anxiety, rather than considering it alone, but ranked the combination as the 6th largest cause of global disability. Kyrios' work may end the neglect of such a serious condition.

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