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

Abstract

Background: Cognitive 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. Methods: Participants (74 children with OCD, 8–18 years) were randomly assigned to either a CBM-I training or a waitlist, both followed by CBT. Results: indicated 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. Conclusion: These 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.