Obsessive-compulsive disorder (OCD) can be successfully treated with cognitive behaviour therapy (CBT). However, as few patients have access to CBT, there is a strong push to develop and evaluate scalable and cost-effective internet-delivered interventions. BIP OCD is a therapist-guided online CBT intervention for pediatric OCD that has shown promise in trials conducted at a single site in Stockholm, Sweden. In this study, we evaluated if BIP OCD is an acceptable, feasible, and effective treatment in other countries and clinical contexts. Thirty-one patients were recruited at three different sites; a specialist OCD clinic in Gothenburg (Sweden), a specialist OCD clinic in London (United Kingdom), and a university-based clinic in Brisbane (Australia). Acceptability and feasibility measures included treatment adherence and feedback from therapists. Clinician assessments were conducted at baseline, post-treatment, and 3-month follow-up. The average module completion for the participants was 8.1/12 (SD = 3.2) and the majority of patients completed the BIP OCD treatment (100% in Gothenburg, and 55.6% in both London and Brisbane). Pooling data from the three sites, the within-group effect sizes from baseline to post-treatment on the Children's Yale-Brown Obsessive-Compulsive Scale were in the expected range (bootstrapped Cohen's d = 1.78; 95% CI 1.18–2.39), with an additional symptom reduction to the 3-month follow-up (bootstrapped Cohen's d = 0.27; 95% CI 0.02–0.51). Participating therapists identified both advantages and difficulties supporting patients in this digital format. The results of this study suggest that the treatment effects obtained in the original BIP OCD trials can be generalized to other clinical contexts nationally and internationally. Lessons learned provide important information for successful implementation of BIP OCD in regular healthcare contexts.

中文翻译：

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对儿科强迫症实施互联网认知行为疗法：瑞典、英国和澳大利亚诊所的经验教训。


强迫症（OCD）可以通过认知行为疗法（CBT）成功治疗。然而，由于很少有患者能够获得 CBT，因此迫切需要开发和评估可扩展且具有成本效益的互联网干预措施。 BIP OCD 是一种由治疗师指导的针对儿科强迫症的在线 CBT 干预措施，在瑞典斯德哥尔摩的一个站点进行的试验中显示出了前景。在这项研究中，我们评估了 BIP OCD 在其他国家和临床环境中是否是可接受的、可行的和有效的治疗方法。在三个不同地点招募了 31 名患者；哥德堡（瑞典）的强迫症专科诊所、伦敦（英国）的强迫症专科诊所以及布里斯班（澳大利亚）的大学诊所。可接受性和可行性措施包括治疗依从性和治疗师的反馈。临床医生在基线、治疗后和 3 个月随访时进行评估。参与者的平均模块完成率为 8.1/12 (SD = 3.2)，大多数患者完成了 BIP OCD 治疗（哥德堡为 100%，伦敦和布里斯班为 55.6%）。汇集三个中心的数据，儿童耶鲁布朗强迫量表从基线到治疗后的组内效应大小在预期范围内（自举科恩 d = 1.78；95% CI 1.18–2.39）， 3 个月随访后症状进一步减轻（自举 Cohen's d = 0.27；95% CI 0.02–0.51）。参与的治疗师发现了以这种数字格式支持患者的优点和困难。这项研究的结果表明，在最初的 BIP OCD 试验中获得的治疗效果可以推广到国内外的其他临床环境。 经验教训为在常规医疗保健环境中成功实施 BIP OCD 提供了重要信息。