Online computer-aided vicarious exposure for OCD symptoms: A pilot study

Background and objectives: Computer-aided vicarious exposure (CAVE) for obsessive-compulsive disorder (OCD) is an intervention in which participants learn and rehearse exposure with response prevention (ERP) by directing a character around a virtual world. This study aimed to pilot an online CAVE program for OCD in a community sample with high OCD symptomatology.

Methods: Participants (n = 78) were allocated to an intervention group (three 45-min weekly CAVE sessions) or to a waitlist control group. The treatment group were asked to complete three 45-min sessions over a four week period.

Results: Those who completed at least one CAVE session showed greater improvement on measures of OCD symptomatology at one-month post-treatment (d = 0.49–0.81) compared to waitlist (d = 0.01–0.1). Older age, past treatment and higher symptom severity were associated with non-adherence.

Limitations: These findings should be considered preliminary due to sample size limitations and an absence of an active control group. However, the findings suggest that further development and evaluation of the program is warranted.

Conclusions: Preliminary findings suggest that online CAVE programs have potential to bridge treatment gaps among those reluctant to attend treatment or engage with in vivo exposure exercises. These programs may also have potential applications as an adjunct to face-to-face or online cognitive behavioural therapy.