Telephone and Online Therapy for OCD and Related Conditions

Effectiveness of Telephone and Online Therapy

When initially considering telephone or online therapy for OCD and anxiety, many clients may at first question the efficacy of psychotherapy conducted via these non-traditional methods. While this is certainly a reasonable concern, a brief internet search will uncover literally hundreds of research studies supporting the use of telephone and internet-based treatment for such varied conditions as Obsessive Compulsive Disorder (OCD), Panic Disorder, Social Anxiety, Phobias, and others. For example:

• A 2006 study at the University of Michigan found webcam-based Cognitive Behavioral Therapy to be consistently successful for the treatment for Obsessive Compulsive Disorder (OCD). Additionally, all study participants reported having a strong therapeutic alliance with their treatment provider, and a uniformly high level of satisfaction with the treatment.

• A 2014 study at the Karolinska Institute in Sweden found online therapy using CBT to as effective as traditional face-to-face treatment for Health Anxiety. Researchers also found online therapy to sometimes be more effective, as more clients were willing and able to participate in online treatment as compared to traditional office-based treatment, especially those who otherwise had no access to treatment providers with expertise in CBT.

• A 2011 University of Michigan study examined Exposure and Response Prevention (ERP) for OCD delivered by a combination of online therapy and telephone therapy.  All study participants had a reduction of at least 50% of their symptoms.  66% of the participants “were highly improved, and no longer met the diagnostic criteria for OCD”.

• A 2000 study at the University of Quebec in Canada found significant improvement in study participants who received Cognitive Behavioral Therapy via webcam for Panic Disorder and Agoraphobia. Furthermore, researchers found that most participants reported that they established a strong therapeutic alliance with their therapist within one session.

• A 2013 study conducted by researchers at Curtin University in Australia compared Cognitive Behavioral Therapy (CBT) for mood and anxiety disorders administered using online therapy (via webcam) versus traditional in-person therapy. Researchers found that CBT was effective in significantly reducing symptoms of depression and anxiety using both in-person and online therapy, with “no significant differences being observed between the two”.

• A 2014 study conducted by researchers at Brown University, Drexel University, the University of Tampa, and Massachusetts General Hospital examined online Exposure and Response Prevention (ERP) for OCD.  80% of participants were “much improved” or “very much improved” at 3-month follow-up, with 30% of participants no longer meeting diagnostic criteria for OCD.

• A 2010 study at the Karolinska Institute in Sweden found that clients receiving online Cognitive Behavioral Therapy (CBT) for Panic Disorder improved as much as those receiving traditional office-based CBT. Study participants reported that their improvement was strong following treatment, and that it remained strong six months later.

• A 2014 study conducted by researchers at Florida International University, Brown University, Boston University and the University of Pennsylvania found online CBT for children with OCD to be effective.
• And a 2008 meta-analysis of 92 studies of online therapy found that these studies “provide strong support for the adoption of online psychological interventions”.  

Legality of Telephone and Online Therapy

Some people also worry about the legality of telephone and online therapy. It is important to emphasize that the State of California initially authorized telemedicine in 1997, and formally extended that law in 2000 to specifically include telephone and online therapy provided by psychologists, marriage and family therapists, and social workers. Current California law explicitly allows for both telephone and online therapy. 

The issue of providing telephone and online counseling to clients in other US states and in other countries is more complicated. All staff therapists at the OCD Center of Los Angeles are licensed or registered to practice in the State of California. In terms of providing counseling to residents of other US states, the key issue is the law of the state in which the client lives.