The treatment was based on established CBT methods for treating OCD, including psychoeducation, cognitive restructuring, exposure with response prevention (ERP), and a relapse prevention programme (Abramowitz, 2006 , 2009 ). The treatment consisted of text material (about 100 pages) and worksheets divided into 10 modules (i.e. chapters). The material was also accessible as an mp3 file (about 5 h of total listening) that the participant could download to their computer. All participants read the same texts relating to general psychoeducation and rationale for the treatment, but tailored examples of obsessions and compulsions were given according to participants' subtype of OCD (washing, checking, symmetry, forbidden thoughts). Modules 1–4 consisted of psychoeducation, cognitive restructuring of meta-cognitions, and of establishing an individual ERP hierarchy. Participants were encouraged to spend no more than 1 week on each of the first four modules. All participants had to proceed through modules 1–4 consecutively in order to access the ERP treatment. Modules 5–10 focused on doing daily in vivo ERP exercises. These modules were not fixed in a predetermined order but were opened by the therapist depending on the kind of OCD subtype the patient had. Worksheets, self-rating assessments, text material, mp3 files, and therapist e-mail contact were integrated in one single treatment platform that required username and password authentication to be accessed. Detailed information about the treatment content is presented elsewhere (Andersson et al.2011 (link)).
The ICBT programme lasted 10 weeks. The therapists had no face-to-face contact with the participants during treatment and their main role was to provide feedback on homework assignments, grant consecutive access to the modules, and to support the participants in doing ERP. The therapists replied to the participants within 24 h on weekdays, and participants were encouraged to contact the therapist if they needed support or clarification. Participants were notified by a short mobile text message (SMS) whenever they received a new message from their therapist in the treatment platform. An SMS was also sent to participants if they had not logged on to the treatment platform for 7 days. If the participant had not logged on within a few days after this SMS, the therapist telephoned the participant to check their status and to remind him/her to log on as soon as possible.
The therapists were all clinical psychology students in their final year of the 5-year psychology programme and had access to on-demand supervision from a licensed psychologist and received scheduled supervision with a psychotherapist on six occasions during the treatment period. Participants interacted with same therapist throughout the whole treatment. Both the psychologist and the psychotherapist had extensive clinical experience in CBT for OCD. To ensure treatment integrity, the psychologist monitored treatment adherence in the treatment platform each day during the entire treatment period.
The ICBT programme lasted 10 weeks. The therapists had no face-to-face contact with the participants during treatment and their main role was to provide feedback on homework assignments, grant consecutive access to the modules, and to support the participants in doing ERP. The therapists replied to the participants within 24 h on weekdays, and participants were encouraged to contact the therapist if they needed support or clarification. Participants were notified by a short mobile text message (SMS) whenever they received a new message from their therapist in the treatment platform. An SMS was also sent to participants if they had not logged on to the treatment platform for 7 days. If the participant had not logged on within a few days after this SMS, the therapist telephoned the participant to check their status and to remind him/her to log on as soon as possible.
The therapists were all clinical psychology students in their final year of the 5-year psychology programme and had access to on-demand supervision from a licensed psychologist and received scheduled supervision with a psychotherapist on six occasions during the treatment period. Participants interacted with same therapist throughout the whole treatment. Both the psychologist and the psychotherapist had extensive clinical experience in CBT for OCD. To ensure treatment integrity, the psychologist monitored treatment adherence in the treatment platform each day during the entire treatment period.
