Predictors of treatment outcome for internet‐delivered cognitive‐behavioural therapy for individuals with obsessive‐compulsive disorder: A systematic review

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Abstract
Objectives: Internet‐delivered cognitive‐behavioural therapy (ICBT) is demonstrated to be an effective treatment for obsessive‐compulsive disorder (OCD). However, not all individuals who commence ICBT respond well to treatment and thus understanding predictors of outcome is crucial for informing best‐practice treatment planning. The aim of this study was to provide a preliminary synthesis of predictors of treatment outcomes of ICBT for OCD. Methods: Eight studies ( n = 1010; mean age range 30.05–37.08 years; 54.0%–78.3% female) were included in this review. Predictors of 1) post‐treatment severity, 2) post‐treatment change score and 3) post‐treatment remission were examined. Results: Based on the available data, significant predictors of post‐treatment severity included age, baseline OCD severity, baseline responsibility/checking symptoms, baseline ordering/symmetry symptoms, baseline avoidance, working alliance, past psychological treatment, disgust severity and change in depressive symptoms. For post‐treatment change score, significant predictors were baseline OCD severity, motivation to reduce avoidance, baseline incompleteness, working alliance, engagement with a clinician, baseline depression severity, pharmacotherapy use and disgust severity. Finally, for responder status, significant predictors included age, motivation to reduce compulsions, engagement with a clinician and past psychological treatment. Conclusions: While preliminary, these findings contribute to the emerging literature on predictors of ICBT treatment outcomes for individuals with OCD. However, given the limited literature, future research is necessary to replicate and build on these findings.

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