Does videoconference-based exposure and response prevention at home enhance the effects of inpatient treatment in persons with obessive-compulsive disorder?

Therapist-guided exposure and response prevention (ERP) for the treatment of obsessive–compulsive disorder (OCD) is frequently conducted within clinical settings but rarely at places where patients are usually confronted with OCD symptom-provoking situations in daily life (e.g., at home). Therefore, the aim of this study was to investigate patients’ views on ERP sessions at home via videoconference and its impact on treatment outcome. Sixty-four inpatients with OCD received therapist-guided videoconference-based ERP at home adjunctive to a multimodal inpatient treatment between 2015 and 2020. Compared to sixty-four age- and sex-matched controls who received a multimodal inpatient treatment without videoconference-based ERP at home, patients who received videoconference-based ERP in adjunction to a multimodal inpatient treatment showed stronger reductions in OCD symptom severity from admission to discharge. Before videoconference-based ERP, patients reported high rationale credibility and treatment expectancy. After videoconference-based ERP, patients reported medium-to-high positive mood as well as depth and smoothness of the session and they perceived the working alliance as high. Results highlight the importance of administering therapist-guided ERP in patients’ natural environment to enhance treatment response in OCD. Videoconference-based ERP as add-on to treatment as usual is, therefore, a promising approach to facilitate the application of ERP in patients’ natural environment and foster the generalization of ERP conducted in clinical settings.