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Table 2 Summary of the content of the OCD treatment manual

From: Internet-based cognitive behavior therapy for obsessive compulsive disorder: A pilot study

Module 1
CBT and OCD explained
Treatment rationale is presented, including a description of OCD symptoms (obsessions and compulsions), prevalence, and main principles of conducting an online CBT treatment. Different fictional patient characters are introduced (each example represents a specific OCD symptom dimension). The participant has the opportunity to follow one or all four characters (washing, checking, symmetry, or violent thoughts). Homework: Register OCD symptoms in the Internet platform diary.
Module 2
Assessing OCD symptoms with
the CBT model
The autonomic nervous system and its interaction with OCD symptoms is explained. Participants begin to link obsessions and compulsions to the OCD circle and learn how to conduct a functional analysis of their OCD problems. Each OCD circle is presented visually for each example character.
Homework: Continue OCD diary registrations and apply these to the OCD circle.
Module 3
Cognitive restructuring
Common OCD metacognitions are explained, such as inflated responsibility, absolute need for certainty, thought-action fusion and exaggerated need to control. The focus is to register and discuss meta cognitions with the psychologist from a functional perspective.
Homework: Continue OCD diary registrations and use these registrations to analyze meta cognitions associated with obsessions.
Module 4
Establish treatment goals and exposure hierarchy
Introduction to Exposure with response prevention (ERP). Different strategies for conducting ERP are explained and examples given of treatment goals and different ways of constructing exposure hierarchies for each example character.
Homework: register treatment goals and then construct an exposure hierarchy with the information from these goals.
Module 5
Exposure with response prevention (ERP)
Different aspects of ERP are highlighted, along with common obstacles associated with ERP and how to overcome them. The participant then chooses an ERP exercise at the bottom of the exposure hierarchy.
Homework: Start ERP and report to the psychologist after two days.
Modules 6 - 11
ERP exercises
Each module focuses on certain ERP exercises with examples from each treatment character. The text for each module is short (1-2 pages), as the focus is reporting and planning the weekly exposures.
Homework: Conduct daily ERP and report to the psychologist at least once per week.
Modules 12 - 13
ERP exercises. Establishing valued directions for further improvements
The modules focus on daily ERP with further exercises added that are adopted from acceptance and commitment therapy. These include establishing valued based goals and how they are applied in daily exposure tasks.
Homework: Continue ERP. Establish valued based goals and applying them in daily exposure exercises.
Modules 14 - 15
Establishing relapse prevention plan
The treatment is summarized, and the participant learns the distinction between relapse and setback and further treatment strategies. The participant establishes a relapse prevention program based on his/her valued based goals.
Homework: Continue ERP. Sum the treatment and establish a relapse prevention plan.