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An interactive computer-administered self-assessment and self-help program for behavior therapy

L Baer1, J H Greist

  • 1Department of Psychiatry, Harvard Medical School, Boston, Mass., USA.

The Journal of Clinical Psychiatry
|January 1, 1997
PubMed
Summary
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Behavior therapy for obsessive-compulsive disorder (OCD) is effective but inaccessible. A computer program, BT STEPS, offers self-help behavior therapy via telephone, showing significant symptom reduction and improved quality of life for patients.

Area of Science:

  • Psychiatry
  • Behavioral Science
  • Health Technology

Background:

  • Behavior therapy, including exposure and ritual prevention (E & RP), is highly effective for obsessive-compulsive disorder (OCD).
  • Limited availability and high cost restrict access to essential behavior therapy for many OCD sufferers.
  • Digital health solutions are needed to improve accessibility and adherence to evidence-based OCD treatments.

Purpose of the Study:

  • To evaluate the efficacy and patient acceptance of BT STEPS, a computer-assisted self-help behavior therapy program for OCD.
  • To determine if BT STEPS can provide substantial reductions in OCD symptom severity.
  • To assess the potential of BT STEPS to increase access to effective OCD treatment.

Main Methods:

  • A computer program (BT STEPS) was developed, incorporating nine clinical steps and interactive voice response (IVR) telephone calls.

Related Experiment Videos

  • BT STEPS utilizes digitized voice files and patient-reported progress to guide self-assessment and E & RP.
  • Two trials involving 65 patients were conducted across three sites to assess the program's effectiveness.

    • Main Results:

    • Patients using BT STEPS demonstrated substantial reductions in OCD severity, measured by the Yale-Brown Obsessive Compulsive Scale.
    • Approximately two-thirds of patients completing two or more E & RP sessions reported significant improvement.
    • The program was well-liked by patients, with 71% reporting an improved quality of life.

    Conclusions:

    • BT STEPS offers a potentially widely accessible and effective method for delivering behavior therapy to individuals with OCD.
    • The program can be used under clinical supervision and in conjunction with pharmacotherapy.
    • This technology-driven approach may overcome barriers to accessing crucial OCD treatment.