Developing a smartphone app to enchance CBT for OCD. Looking for your feedback

Dr Ramesh Perera-Delcourt, Clinical Psychologist, Centre for Anxiety Disorders and Trauma is seeking your feedback on Developing a smartphone app to enhance CBT for OCD

What is the purpose of this research?

Obsessive-Compulsive Disorder (OCD) is a common anxiety disorder. People with OCD are affected by repetitive, upsetting thoughts (referred to as ‘obsessions’) and/or distressing actions they feel they have to repeat (‘compulsions’). OCD can have a very negative impact on those diagnosed with it. It can affect the ability to work, socialise and have a family life. Cognitive-Behavioural Therapy (CBT) is an effective talking therapy for OCD. However, CBT does not help everyone with OCD. Up to half of patients do not fully recover after treatment, and up to a third stop treatment before the final session.

Therefore, it is important to improve CBT for OCD. Improving treatment could benefit around 15,000 people with OCD in the UK per year who seek treatment, and perhaps also some of the three quarters of a million who do not seek treatment. Experts have suggested that a key way to improve CBT for OCD is to help patients engage better with tasks between therapy sessions.

The Aim of this research is to find out if a smartphone app could help patients with OCD engage with between-session tasks.

The particular task the app will aim to help people with is called a ‘behavioural experiment’. This involves the person with OCD doing something to test out their fear, find out what happens when they test that fear, and learn to tolerate anxiety. Because these tasks involve facing fear, they are understandably challenging.

Some apps have already been developed but these are for other types of between-session tasks.

This makes the apps less relevant to therapy in the UK. Another problem is that these apps do not use any methods to make it easier to engage with the difficult tasks.

The app developed by this research will draw on what is called ‘gamification’. Gamification involves applying game-like elements to things that aren’t games. This increases motivation to carry out tasks by making them more fun and rewarding. Gamification techniques include:

* making use of levels and challenges;

* rewards;

* a narrative;

* sharing accomplishments with others.

Gamification and apps have shown promise for some other disorders. Applying this to OCD could improve recovery rates and reduce the number of sessions required.

Design and Methods

I will review the research literature to find out how therapy tasks for OCD could be made more fun and easier to engage with. Clinicians and service users will be interviewed or take part in focus groups to find out how they think a gamified app could be beneficial.

Based on these ideas, a plan for an app would be given to a developer. Because this is the first study of its kind, only a basic app would be developed. I would use the app with 8 patients with OCD at different points in their therapy.

The study would assess how many people were willing to be recruited to trial the app. It would also look at whether using the app made it any easier for those individuals to engage with therapy.

Next Steps

If the findings are positive, future research would develop a more sophisticated app and test it with a larger group of patients. The finished app would make it easier for patients to follow their therapy plan, so more people would get better, and be easy for clinicians to use within the NHS.

This would also save the NHS money on therapist time.

Sharing the Findings

The findings would be shared in academic journals and conferences, as well as workshops for clinicians, OCD charities and the app industry.

Please read this proposal and give me feedback at: https://goo.gl/forms/bg6TGEWo73soaUNz2

Thank you for helping me with this.

Dr Ramesh Perera-Delcourt, Clinical Psychologist, Centre for Anxiety Disorders and Trauma, SLaM Ramesh.perera-delcourt@slam.nhs.uk / ramesh@perera-delcourt.co.uk