Integrating Videoconferencing Into Treatment for Obsessive-Compulsive Disorder: Practical Strategies With Case Examples

Abstract

Obsessive-compulsive disorder (OCD), a disabling psychiatric illness, creates substantial societal burden. Evidencebased treatments, including psychopharmacology and exposure with response/ritual prevention (EX/RP), are often inaccessible. Digital health technologies, including videoconferencing, may increase access, but the best way to integrate them with current treatments remains unclear. This column describes the experiences of faculty at the Center for OCD and Related Disorders with videoconferencing-assisted treatment. Through a case series, the authors describe five ways to incorporate videoconferencing into OCD treatment: hybrid in-person/remote EX/RP; fully remote EX/ RP; and videoconferencing-assisted psychopharmacology, support groups, and clinical supervision. For each strategy, the authors highlight advantages, challenges, clinical considerations, and avenues needing further research.

To Proceed Via Telehealth or Not? Considerations for Pediatric Anxiety and Related Disorders Beyond COVID-19

“…T he availability and accessibility of telehealth for mental healthcare changed dramatically in the wake of the COVID-19 pandemic, which accelerated a widespread shift to telehealth among mental health professionals to prioritize both providers’ and clients’ safety ( Gilbert et al, 2020 ). As COVID-19 restrictions relaxed, many providers returned to offering at least some in-person services, with “hybrid” (telehealth and in-person) services also available ( Kayser et al, 2021 ). While there is some uncertainty about how well-supported telehealth will remain by regulations and payers following the expiration of emergency orders ( Haque, 2021 ), mental health services via telehealth are likely here to stay, given their many benefits ( Frank et al, 2021 , Madigan et al, 2021 , Riley et al, 2022 ).…”

Editorial: Digital cognitive behavior therapy for obsessive-compulsive disorder

“…The studies by this group show how the outcomes of digital treatments can be enhanced by innovative digital solutions for problems such as non-adherence that hinder the large-scale implementation of digital treatments for OCD. They also demonstrate the usefulness of hybrid care, which includes the blending of digital and in-person treatment as well as the use of multiple modes of digital technology in the treatment of OCD (Kayser et al, 2021 ; Feusner et al, 2022 ). A similar digital treatment using hybrid and enhanced care was examined by Wang et al in their open trial of videoconferencing-based ERP in 25 children and adolescents.…”

Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic

“…Unlike in other modes of talk therapy, ERP’s emphasis on therapist-supervised exposures presents unique opportunities and challenges to delivering treatment entirely via a virtual platform. Prior studies have demonstrated the effectiveness of remotely delivered treatment for OCD ( Wootton, 2016 ), and Kayser et al (2021) outlined general strategies for integrating videoconferencing into different models of pharmacotherapy/psychotherapy for OCD and clinical supervision, noting both potential benefits and limitations. The current paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021.…”