New wine in an old bottle? Evaluation of myMCT as an integrative bibliotherapy for obsessive-compulsive disorder.

Objective: Many individuals with obsessive-compulsive disorder (OCD) do not receive proper treatment due to limited access to or active avoidance of the psychological/medical healthcare system. Self-help may alleviate some of the burden inflicted by OCD. However, the efficacy of most self-help interventions has not been tested. Research is increasingly concerned with often sophisticated Internet self-help interventions, but bibliotherapy using eBooks may reach individuals at a larger scale. The present study examined the efficacy of the myMCT (short for “my metacognitive training”), an integrative transtherapeutic self-help manual for OCD. A secondary aim was to identify factors moderating treatment response. Method: A total of 70 individuals with self-reported OCD were assessed at baseline and subsequently randomized to either myMCT or a wait-list control condition. Six weeks later, post-assessment was carried out. Scores on the self-rating version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) served as the primary outcome. Secondary outcomes included scores on OCD symptom dimensions (Obsessive-Compulsive Inventory-Revised; OCI-R), depression (Patient Health Questionnaire for Depression; PHQ-9), and a cognitive biases questionnaire. Results: The retention rate was 80% (treatment group: 74%, control group: 86%). Participants who received myMCT showed a significant decline in both obsessive and compulsive symptoms on the Y-BOCS at a large effect size relative to wait-list controls. Moreover, the myMCT intervention group showed larger decreases on the OCI-R, PHQ-9, and the cognitive biases questionnaire. Poor insight predicted a worse outcome in the treatment group. Conclusions: MyMCT led to symptom improvement in individuals with OCD for both the primary and secondary outcomes at a medium to large effect size. Still, many still displayed substantial symptom severity post intervention. In a next step, it remains to be determined. whether culturally adapted translations are feasible and efficacious in nonindustrialized countries where evidence-based treatments are rarely available and self-help often represents the only treatment option.