Video-based treatment with ERP therapy significantly reduced OCD symptoms


Feusner reports personal fees from NOCD Inc. during the course of the study. Smith is employed by NOCD. Please see the study for all other authors’ relevant financial disclosures.

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Exposure and response prevention treatment through video teletherapy showed effectiveness in reducing obsessive-compulsive symptoms while improving quality of life, per a study published in the Journal of Medical Internet Research.

“Exposure and response prevention (ERP) is a type of cognitive behavioral therapy that consistently demonstrates efficacy for [obsessive compulsive disorder] in numerous controlled trials and is also effective in less controlled clinical settings,” Jamie D. Feusner, MD, of the department of psychiatry at the University of Toronto, and colleagues wrote.

Source: Adobe Stock.

Source: Adobe Stock.

Despite extensive evidence of the efficacy of ERP from clinical studies and in real-world samples, it is still underutilized as a treatment. Therefore, Feusner and fellow researchers at NOCD, a company that provides telehealth for patients with OCD, sought to address these treatment gaps by creating a digital behavioral health treatment for OCD using ERP delivered via video teletherapy and examining subsequent treatment outcomes.

The retrospective, longitudinal observational study included 3,552 individuals with a diagnosis of OCD, who were treated with live twice-weekly Zoom teletherapy ERP for 3 weeks, followed by 6 weeks of once-weekly brief video teletherapy check-ins for 30 minutes. Participants also completed ongoing ERP homework assignments for the duration.

Assessments were made through the 20-item self-report Dimensional Obsessive-Compulsive Scale, DIAMOND severity scale, and Depression, Anxiety and Stress Scales (DASS-21) and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form, conducted at treatment initiation, after completion of 3 weeks of twice-weekly sessions, and at the end of 6 weeks of brief check-ins. Longitudinal assessments were also obtained at 3-, 6-, 9-, and 12-month intervals following treatment conclusion.

Results showed treatment resulted in a 43.4% mean reduction in obsessive-compulsive symptoms (g = 1; 95% CI, 0.93-1.03) and a 62.9% response rate. Treatment also resulted in a 44.2% mean reduction in depression, a 47.8% mean reduction in anxiety, and a 37.3% mean reduction in stress symptoms.

Quality of life improved by a mean of 22.7%. Reduction in OCD symptoms and response rates were similar for those with mild, moderate or severe symptoms. Improvements were maintained at the 3, 6, 9 and 12-month follow-up intervals.

“This breakthrough study provides strong clinical evidence that behavioral telehealth works as well as traditional in-office visits, with faster time-to-relief at a significantly lower cost for consumers, employers, and health plans,” Stephen Smith, chief executive officer of NOCD, said in a release that accompanied the study.


  • Business Wire. Industry’s largest peer-reviewed longitudinal study on behavioral telehealth reveals levels of treatment effectiveness, duration, and cost compared to traditional treatment. Accessed June 17, 2022.


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