Think different: effectiveness of an online training for children with obsessive-compulsive disorder

The aim of the present study is to improve treatment for children with OCD by adding an online Cognitive Bias Modification–Interpretation (CBM-I) training to cognitive behavioural therapy (CBT). The CBM-I training is offered as the first step in treatment, followed by CBT. CBM-I is compared with a waitlist condition also followed by CBT. Advantages of CBM-I compared with existing interventions are: the CBM-I training is relatively short (4 weeks), it can start during a natural waitlist that usually exists (before a therapist is available), CBM-I is motivating for the patient, can be completed at home, is cheap and easy to implement.
The first research question is: Does CBM-I result in a decrease of obsessive-compulsive complaints compared to the waitlist condition? The second research question is: Is there a favourable effect of the CBM-I training (compared to the waitlist condition) on subsequent CBT?
If CBM-I leads to a significant improvement in OCD severity and/or if CBM positively affects the effect of CBT, than adding a pre-treatment CBM-I training to CBT may result in more effective treatment for children with OCD, an early start of treatment (no/shorter waitlist period), and a reduction of the costs of treatment.

The aim of the present study is to improve treatment for children with OCD by adding an online Cognitive Bias Modification-Interpretation (CBM-I) training as a pre-treatment to cognitive behavioural therapy (CBT). CBM-I is compared with a waitlist condition also followed by CBT.
The first hypothesis is that CBM-I results in a decrease of obsessive-compulsive complaints compared to the waitlist condition.
The second hypothesis is that CBM-I has a favourable effect (compared to the waitlist condition) on subsequent CBT.

Assessment T0: pre-CBM / pre-waitlist (week 0)
- OCD severity (CY-BOCS)
- Interpretation bias (OBQ-CV; recognition task)
- Comorbidity (CBCL, YSR, CDI)
- General functioning (CGAS)

Assessment T1: post-CBM / post-waitlist & start CBT (week 4)

- OCD severity (CY-BOCS)

- Interpretation bias (OBQ-CV; recognition task)

- OCD severity (CY-BOCS)

- Interpretation bias (OBQ-CV; recognition task)

- Comorbidity (CBCL, YSR, CDI)

- General functioning (CGAS)

Assessment T2: CBT, 4th session (week 8)
- OCD severity (CY-BOCS)

Assessment T3: CBT, 8th session (week 12)
- OCD severity (CY-BOCS)

Assessment T4: CBT, 12th session (week 16)
- OCD severity (CY-BOCS)

Assessment T5: post-CBT, 16th session (week 20)
- OCD severity (CY-BOCS)
- Comorbidity (CBCL, YSR, CDI)
- General functioning (CGAS)

A Cognitive Bias Modification – Interpretation (CBM-I) training (12 sessions in 4 weeks) is compared with a waitlist control condition (4 weeks without treatment). The CBM-I procedure (Mathews & Mackintosh, 2000) is adapted for children with OCD.
After the CBM-I training / waitlist period, all participants receive cognitive behavioural treatment (16 weekly sessions, protocol ‘Bedwing je dwang’/‘Control your OCD’, De Haan & Wolters, 2009).