Stepped care offering internet-delivered cognitive behavioral therapy with in-person CBT if necessary noninferior to in-person CBT only
TUESDAY, May 11, 2021 (HealthDay News) — Stepped care offering internet-delivered cognitive behavioral therapy (CBT) followed by in-person CBT if necessary is noninferior to in-person CBT for children and adolescents with obsessive compulsive disorder (OCD), according to a study published in the May 11 issue of the Journal of the American Medical Association.
Kristina Aspvall, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues conducted a randomized clinical noninferiority trial to examine whether internet-delivered CBT implemented in a stepped-care model is noninferior to in-person CBT. One hundred fifty-two individuals aged 8 to 17 years with OCD were enrolled and randomly assigned to the stepped-care group (74 participants), who received internet-delivered CBT for 16 weeks with face-to-face treatment for nonresponders at three-month follow-up, or a control group (78 participants), who received in-person CBT for 16 weeks.
The researchers found that at three-month follow-up, 46 and 30 percent in the stepped-care and control groups, respectively, were nonresponders. At six-month follow-up, the Children’s Yale-Brown Obsessive-Compulsive Scale score was 11.57 and 10.57 points in the stepped-care and control groups, respectively, corresponding to an estimated mean difference of 0.91 points (one-sided 97.5 percent confidence interval, −∞ to 3.28; P for noninferiority, 0.02). In both groups, the most frequently reported adverse events were increased anxiety (30 to 36 percent) and depressive symptoms (20 to 28 percent).
“Such blended approaches to mental health technology continue to gain traction given advantages for both safety and engagement,” write the authors of an accompanying editorial.
One author disclosed financial ties to the medical technology and publishing industries.
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