Can OCD therapy work over the phone?

Specialist treatment for obsessive-compulsive disorder (OCD) is not evenly spread. Families in regional areas, or those without a specialist clinic nearby, often face long drives or long waits — or simply go without. So a reasonable question is whether the treatment that works in a clinic still works when it is delivered at a distance, over the phone, rather than in the room.

What the research looked at

This trial set out to test that directly. Seventy-two adolescents aged 11 to 18 with OCD, and their parents, were randomly assigned to receive cognitive behavioural therapy (CBT) either over the telephone or face-to-face in a specialist clinic. Everything else was held the same: both groups received up to fourteen sessions of the same treatment, built around exposure with response prevention, delivered by experienced therapists. The only difference was how the sessions were delivered. Independent assessors, who did not know which group each young person was in, measured symptoms during and after treatment and at follow-ups out to twelve months.

This was designed as a non-inferiority trial — the question was not whether telephone therapy was better, but whether it was no worse than the established face-to-face version.

What it found

Telephone CBT was not inferior to face-to-face CBT at the end of treatment and at the three- and six-month follow-ups. The gains young people made during treatment held over time. On every secondary measure, telephone delivery held up. Young people in both groups reported high satisfaction with the treatment they received.

The authors were precise about one limit. At the twelve-month follow-up, the results no longer clearly met the strict statistical bar for non-inferiority — so the firm conclusion was that telephone CBT is effective and not inferior at least in the medium term. They framed it as a way of making a specialist treatment reachable for many more young people, rather than a wholesale replacement for in-person care.

What this means for your family

The practical takeaway is encouraging: where getting to a clinic is the barrier, the evidence supports delivering this treatment remotely without giving up its core. The active ingredients of OCD treatment — facing feared situations and resisting the rituals, with a therapist's guidance — can be done over a distance.

At The Moore Centre, treatment is available in person at the Annerley rooms, by telephone, or by Zoom, so where you live does not have to decide whether you get specialist help. If a child or young person's OCD is affecting daily life, get in touch and we will explain the options.

Reference Turner, C. M., Mataix-Cols, D., Lovell, K., Krebs, G., Lang, K., Byford, S., & Heyman, I. (2014). Telephone cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: A randomized controlled non-inferiority trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53(12), 1298–1307. Trial registration ISRCTN27070832.

Led by Dr Cynthia Turner, Clinical Psychologist, The Moore Centre.

This article is general information, not a substitute for individual assessment. If OCD is affecting a young person's day-to-day life, get in touch — we see children, adolescents and adults in person at the Annerley rooms, by telephone, or by Zoom.