Although there have yet to be any e-health interventions developed specifically for comorbid OCD and AOD use, there have been several e-health interventions developed for OCD as a single disorder. Research examining computerised CBT programs for OCD have found evidence of effectiveness [790-794], with effects similar to those found in clinician-delivered CBT sustained to three and four months [790, 793, 795, 796]. There is also evidence to suggest a dose-response relationship in regards to computerised CBT programs, with greater symptom improvements found among those who have completed more homework [792]. However, studies have found that clinician-assisted programs with limited contact are associated with better outcomes than completely computerised programs with no human contact, and the addition of a therapist coach has been linked to treatment adherence and lower dropout rates [797].
A small number of e-health programs based on ERP have also been developed. It has been suggested that the complex nature of OCD coupled with the exposure-based intervention may have deterred researchers from translating treatments into online interventions [798]. Furthermore, the findings from studies examining the efficacy of computerised ERP interventions have been mixed. A computerised ERP intervention called BT Steps/OC Fighter was found to be less efficacious in reducing OCD symptoms than a more expensive clinician-delivered ERP, but more efficacious than relaxation training [792]. The findings from this study suggest that the primary benefit of having a clinician was to ensure people maintain their engagement in the exposure process [769]. Given these findings, the UK NICE Guidelines recommend that BT Steps/OC Fighter should not be used in the treatment of OCD [444].
Another ERP program, ICBT, has been found to be more efficacious in reducing OCD and depressive symptoms, and improving general functioning compared to active control (online, non-directive supportive therapy) [793]. Although encouraging, further research is needed in the area of ICBT and OCD [798].