Self-treatment of obsessive-compulsive disorder guided by manual and computer conducted telephone interview

While on a waiting list for treatment by therapist-guided exposure and ritu al prevention (ERP), patients with obsessive-compulsive disorder (OCD) did self-treatment at home guided by a manual plus a computer-driven telephone interview system (BT STEPS). Of 21 patients who used the system for at leas t three weeks while on the waiting list, one improved so much that subseque nt therapist-guided ERP was unnecessary. Progress of the rest with the syst em predicted later progress with therapist-guided ERP. Improvement after us ing the system was similar to that of 20 matched historical controls who ha d had therapist-guided ERP without the prior use of BT STEPS. Outpatient us ers of BT STEPS needed less subsequent clinician-guided time than did their matched controls. in this pilot study, patients with OCD improved nearly a s much with home self-treatment guided by a manual plus computer, as with t reatment guided by a behaviour therapist.