HIT-OCD: A 5-Week Integrative CBT/ERP/ACT Protocol With In-Context (Home/Personal-Space) Exposure Support via Videoconferencing

Obsessive-compulsive disorder (OCD) is a chronic and disabling disorder for which Exposure and Response Prevention (ERP) is the first line of psychological treatment. However, when practicing there are a number of barriers to implementation. For instance, distress, inadequate adherence and limited to minimal support between sessions. This study evaluated the efficacy of the 5-week, High Intensive Training (HIT)- OCD combining ERP, inhibitory learning principles, Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) & Solution- Focused Brief Therapy (SFBT) elements in a sample of adults with OCD. 32 individuals with symptoms of OCD received ERP based HIT protocol through online sessions and daily Whatsapp-based updates & check-ins. Severity of OCD was measured using the Obsessive-Compulsive Inventory-Revised (OCD-R) at beginning (Week 1) and the end (Week 5) of the protocol. Descriptive statistics and Shapiro-Wilk test was conducted, a paired-samples t-test & the Wilcoxon signed rank test were used to evaluate symptom change, and Cohen’s d was calculated as a measure of effect size. The clinically meaning change at individual level was calculated using the Reliable Change Index ( RCI). A statistically significant reduction in OCI-R total scores from pre- to post-treatment was obtained t(31) = 7.29, p < .001, d = 1.29. For than 50% of the data met the criteria for reliable and clinically significant change. At the individual level (53.1%) met criteria for reliable improvement and (46.9%) achieved significance in terms of crossing from clinical to non-clinical range. In terms of numbers, the proportion of participants scoring from clinical range fell from 68.8% at pre-test to 21.9% at post-test. The data showed no reliable deterioration. The outcomes of HIT-OCD are an acceptable and considered potentially effective protocol of OCD. Replication with controlled designs, larger samples and long-term follow-up can be considered in future studies.