Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Could virtual ERP be the new standard of treatment for OCD? The largest OCD treatment study to date shows that outpatient virtual ERP is highly effective and efficient

7 min read
Stephen Smith
By Stephen Smith
Reviewed by Dr. Jamie Feusner, MD

Executive Summary:

  • A new peer-reviewed study validated by the Journal of Medical Internet Research (JMIR), one of the most respected journals in healthcare research, examined the treatment outcomes of virtual exposure and response prevention (ERP) therapy for OCD. 
  • The 1.5 year-long study analyzed a cohort of over 3500 NOCD Therapy members, with an average treatment time under 12 weeks and subsequent follow-up assessments conducted at 3, 6, 9, and 12 months.
  • The findings are remarkable: members experienced an average decrease in OCD symptoms, resulting in dramatic improvements in depression, anxiety, stress, and overall quality of life. 
  • These results were achieved in under half the therapy time needed for traditional ERP therapy in an outpatient setting, resulting in substantial monetary and time savings.
  • The significant improvements achieved with this treatment, combined with overcoming geographical barriers,  suggests that virtual ERP therapy for many people with OCD may be  more effectively delivered in a face-to-face virtual setting than an in-person one. The implications of this is that virtual-first therapy may shift from the “alternative” to the “standard.”
  • This new research study suggests that treatment with NOCD Therapy can result in significant improvements after 11 hours of therapy. This is less than half the time on average, than standard therapy.

Obsessive-compulsive disorder (OCD) is one of the most debilitating conditions and prevalent conditions in the world, affecting more than 2.3% of the population in their lifetime. As a chronic condition, OCD is characterized by intrusive, distressing thoughts and repetitive behaviors aimed at reducing that distress. With OCD, a person’s compulsions only temporarily relieve discomfort and actually makes their distress worse in the long run. As such, OCD typically significantly affects a person’s quality of life—but OCD is also highly treatable and manageable with exposure and response prevention (ERP) therapy.

As a gold standard OCD treatment, ERP is an evidence-based, specialized therapy that has consistently demonstrated excellent outcomes in the treatment of OCD. ERP works by having people purposely face situations that provoke their obsessions, then helps them resist doing compulsions in response to the resulting distress.

As people habituate to the distress brought on by their obsessions and reduce their reliance on compulsions, they spend less time and energy avoiding distress. That is the ultimate goal of ERP therapy: to free people from the cycle of obsessions and compulsions so they can live better.

Despite the extensive evidence of the efficacy of ERP from clinical studies and in real-world samples, it’s still an underused treatment. The reasons have historically been related to limitations in the access to care for the majority of individuals with OCD and related conditions, including the scarcity of adequately trained ERP therapists, the lack of geographical locations with OCD specialists, and time and cost barriers. 

NOCD was built specifically to address these barriers to treatment. NOCD Therapy offers a digital behavioral health treatment platform for OCD that delivers ERP via live, face-to-face video therapy and provides between-session support from self-help tools, peer communities, and therapist messaging functionality. 

Our mission at NOCD is to put an end to the suffering caused by OCD around the globe by providing effective, affordable, and convenient treatment that’s available to anyone who needs it, no matter where they live. We have developed the world’s largest network of OCD specialists, all of whom are specialty-trained in treating OCD with ERP therapy, and our team works side by side with OCD experts and researchers who designed some of the world’s top OCD treatment programs. 

In order to pursue our mission, we rigorously research our members’ treatment outcomes to continuously optimize the services we offer the OCD community. Now we’re proud to announce that a new, peer-reviewed research study validates the effectiveness of NOCD Therapy for people with OCD, representing the largest study of OCD treatment ever recorded. 

The study was published by the Journal of Medical Internet Research (JMIR), the leading, and largest, peer-reviewed journal for digital medicine and healthcare. JMIR is a pioneering open-access eHealth journal, the top-ranked journal in medical informatics, and is one of the most respected healthcare research journals globally.

The JMIR validates the effectiveness of NOCD Therapy in the largest study of OCD treatment ever recorded 

The study found that treatment at NOCD Therapy resulted in clinically and statistically significant improvements, including a median reduction of over 43% in OCD symptoms, as well as dramatic improvements in depression, anxiety, stress, and overall quality of life due to treating the root problem of OCD. The study further proved that people receiving our video teletherapy treatment achieved meaningful results in less than half the total time in treatment with their therapists, compared with standard once-weekly outpatient treatment—representing potentially substantial monetary savings not only for the people receiving treatment, but also for health insurers. 

In its most common format of once-weekly in-person, outpatient therapy, people in ERP therapy typically require over 25 hours of therapist time—which could take 6 or more months—to achieve meaningful results. With NOCD Therapy, the timeframe to witness clinically significant improvements was less than 12 weeks requiring less than 11 total therapist hours, on average.

One of the vital advantages of remote treatment is that therapists can readily interact with people in the specific settings that most trigger their obsessional thoughts, images, or urges. This allows for administering in-session exposures that otherwise could be difficult or impossible to reproduce in an office setting. This is why in many cases, ERP therapy for OCD can actually be more effectively delivered virtually than in person for many people.

The NOCD Therapy treatment model highlighted in this study consisted of twice-weekly 60-minute remote ERP video sessions for three weeks. After that timeframe, members had six weeks of once-weekly 30-minute video “check-in” sessions to guide ongoing ERP homework assignments. Members also had access to the NOCD platform for between-session support throughout their treatment journey. 

Rigorous, peer-reviewed studies have allowed us to consistently provide our members with the best available care for OCD and related conditions. This recent study validated that ERP delivered in our technology-assisted video teletherapy treatment format results in clinically significant symptom and quality of life improvements in a real-world sample, on a large scale. With our offerings, NOCD Therapy has made effective and affordable evidence-based treatment for OCD and related conditions easier to access than ever before, while reducing the time of treatment needed on average for our members to experience life-changing results.

Some key findings from the peer-reviewed study

This study published in the JMIR documented the treatment outcomes of over 3500 people over the course of their NOCD Therapy journey, representing the largest reported treated cohort of people with OCD to date. The effect size was large and similar to studies of in-person ERP.

For many people with OCD, ERP therapy is actually more effectively delivered in a face-to-face virtual setting than an in-person one. This is because virtual treatment overcomes a major barrier that many people with OCD have to start, and follow through with, therapy, since in-person treatment is not widely available in most geographic areas. Another important reason is because therapists can more easily help their members manage their fears in the environment where they are most bothered, as opposed to in an office, where it may not generalize to real-world settings. The implications of this is that virtual-first therapy may shift from the “alternative” to the “standard.”

Here are some key findings from the study:

  • The study analyzed a cohort of 3552 adults with OCD, and we did follow-up assessments with them at 3, 6, 9, and 12 months. Treatment resulted in clinically and statistically significant improvements, with a 43.4% mean reduction in obsessive-compulsive symptoms and a 62.9% response rate.
  • We were able to show that by effectively treating OCD at NOCD Therapy, we could also significantly reduce anxiety, depression, and stress as well as improve quality of life. This is significant because it shows that treating the whole person effectively often starts with treating the root issue of OCD. Treating only the anxiety and depression likely wouldn’t have the same outcome. Treatment also resulted in a 44.2% mean reduction in depression, a 47.8% mean reduction in anxiety, and a 37.3% mean reduction in stress symptoms. Quality of life improved by a mean of 22.7%.
  • Members in the study achieved their reduction in severity in less than half the time on avg, in comparison to standard ERP Therapy. The total time was less than 12 hours of therapy (the mean duration of treatment was 11.5 weeks, and the mean total therapist time was 10.6 hours).
  • Reduction in OCD symptoms and response rates were similar for those with mild, moderate, or severe symptoms. 
  • Our NOCD Therapy members in the study maintained their outcomes across 3, 6, 9 and 12 months. 

You can read the entire study and the full results in the Journal of Medical Internet Research.

Effective, specialized OCD therapy is here

Learn more

If you think you or someone you know may be struggling with OCD, NOCD can help. We provide convenient, affordable, and effective treatment anywhere in the US and now outside of the US. Our therapy is 100% online, and all NOCD therapists are licensed and specialty-trained to treat OCD using ERP therapy through live face-to-face video sessions. We provide evidence-backed, rigorously researched therapy, and tailor treatment plans to each member’s individual needs. People can get better in half the time compared to standard ERP treatment, while also reducing anxiety, depression, and stress by treating the root problem of OCD, and improving their overall quality of life. 

You can book a free 15-minute call with our team to get matched with a NOCD Therapist and get started with OCD treatment.

Stephen Smith

Stephen founded NOCD after feeling frustrated with a lack of treatment resources and support during his own OCD recovery. He enjoys running hill sprints, listening to audiobooks, and eating breakfast no matter the time of day.

NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Licensed Therapist, MA

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Madina Alam

Madina Alam

Licensed Therapist, LCMHC

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Tamara Harrison

Tamara Harrison

Licensed Therapist, MA

I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.

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