Efficacy of remote cognitive-behavior therapy for obsessive-compulsive disorder: An updated systematic review and meta-analysis

J Anxiety Disord. 2026 Nov 5;124:103257. doi: 10.1016/j.janxdis.2026.103257. Online ahead of print.

ABSTRACT

Obsessive-compulsive disorder (OCD) is a common psychiatric condition. Several factors limit individuals from receiving evidence-based treatment, and remote treatments have been developed to improve access. The aim of this study was to synthesize the existing literature on remote treatment for OCD using a meta-analytic approach. Twenty-three studies (n = 1897; Mage range = 11.00 – 41.10 years; % female range = 38.00 – 93.30%) were included in the meta-analysis. The pooled within-group effect size was large across all remote treatments from pre-treatment to post-treatment (k = 29; g = 1.13; 95% CI [0.95, 1.30]) and from pre-treatment to follow-up (k = 17; g = 1.19; 95% CI [0.99, 1.38]). The pooled between-group effect size was small at post-treatment (k = 27; g = 0.43; 95% CI [0.17, 0.69]), favoring the remote treatment group. While the pooled between-group effect size was also small at follow-up (k = 8; g = -0.21; 95% CI [-0.41, -0.01]), it favored the control condition. Moderator analyses indicated that remote treatments were more efficacious than passive control groups (k = 12; g = 1.05; 95% CI [0.76, 1.34]) and active control groups (k = 6; g = 0.45; 95% CI [0.12, 0.79]) at post-treatment. However, face-to-face treatment was more efficacious than remote treatment at post-treatment (k = 9; g = -0.32; 95% CI [-0.63, -0.02]). However, moderator analyses were not significant at follow-up. These findings add to the growing body of literature examining the efficacy of remote treatment for OCD and demonstrate potential for remote stepped care treatment.

PMID:43033778 | DOI:10.1016/j.janxdis.2026.103257