Chakrabarti S, Kathiravan S, Sarah N. Videoconferencing-delivered psychotherapy for obsessive-compulsive disorder in low-resource settings: A pilot study from India. World J Psychiatry 2026; 16(2): 111577 [DOI: 10.5498/wjp.v16.i2.111577]
Corresponding Author of This Article
Subho Chakrabarti, MD, Professor, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, 12 Sector, Chandigarh 160012, India. subhochd@yahoo.com
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Psychiatry
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Observational Study
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Feb 19, 2026 (publication date) through Feb 2, 2026
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World Journal of Psychiatry
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Chakrabarti S, Kathiravan S, Sarah N. Videoconferencing-delivered psychotherapy for obsessive-compulsive disorder in low-resource settings: A pilot study from India. World J Psychiatry 2026; 16(2): 111577 [DOI: 10.5498/wjp.v16.i2.111577]
World J Psychiatry. Feb 19, 2026; 16(2): 111577 Published online Feb 19, 2026. doi: 10.5498/wjp.v16.i2.111577
Videoconferencing-delivered psychotherapy for obsessive-compulsive disorder in low-resource settings: A pilot study from India
Subho Chakrabarti, Sanjana Kathiravan, Sarah N
Subho Chakrabarti, Sanjana Kathiravan, Sarah N, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Chakrabarti S, Kathiravan S, and Sarah N were involved in analyzing the data, preparing the initial draft of the manuscript the study protocol and reviewing the literature; Chakrabarti S prepared the final version of the manuscript; Kathiravan S and Sarah N approved the final version and collected the data about patient treatment; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Postgraduate Institute of Medical Education and Research, approval No. INT/IEC/2020/SPL-990.
Informed consent statement: The approval allowed recorded verbal informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at subhochd@yahoo.com. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Subho Chakrabarti, MD, Professor, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, 12 Sector, Chandigarh 160012, India. subhochd@yahoo.com
Received: July 4, 2025 Revised: August 1, 2025 Accepted: November 7, 2025 Published online: February 19, 2026 Processing time: 211 Days and 1.4 Hours
Abstract
BACKGROUND
Psychological treatments such as exposure and response prevention (ERP) or cognitive behavioral therapy are effective in obsessive-compulsive disorder (OCD), either on their own or in combination with medications. However, very few patients receive ERP or cognitive behavioral therapy. Digital-delivered psychotherapy can surmount many obstacles associated with conventional psychotherapy, but there are very few trials of videoconferencing (VC) delivered ERP for OCD, particularly from low-resource settings.
AIM
To examine the VC-delivered ERP’s feasibility, acceptability, efficacy, and long-term outcomes and compare its efficacy with inpatient ERP.
METHODS
This study compared VC ERP’s pre- and post-intervention efficacy (n = 20) with a matched group of patients who had undergone inpatient ERP (n = 17). The Yale-Brown Obsessive-Compulsive Scale (YBOCS) scores rated the efficacy of ERP. The feasibility outcomes for VC-delivered ERP included the operational capacity, treatment utilization, treatment engagement, use of other services, and adverse events. Treatment satisfaction and preferences among users determined acceptability. Long-term follow-up determined whether patients were in remission based on the YBOCS scores and other criteria.
RESULTS
The sample had 97 patients with OCD. The patients had severe (YBOCS score 27) and chronic (6 years) OCD with psychiatric comorbidity (51%). The refusal rate for VC-ERP was 11%, and the dropout rate was 19%. VC-ERP failed in 29% with treatment-resistant OCD. The 20 patients who completed VC-ERP had 85% reductions in the YBOCS scores and recovered completely. The two groups did not differ in the change in YBOCS scores with the treatment. Gains from VC-ERP persisted for more than 2 years. The VC platform could deliver ERP despite the fluctuating network connectivity and variable patient motivation. The VC treatment improved access to ERP for many more patients. Users found VC-ERP acceptable and appreciated its advantages over inpatient ERP.
CONCLUSION
Despite its methodological limitations, this study suggests that VC-delivered ERP is feasible, acceptable, and as efficacious as in-person ERP for OCD in the resource-constrained settings of low- and middle-income countries.
Core Tip: Videoconferencing (VC) delivered exposure and response prevention (ERP) may be suitable for the treatment of obsessive-compulsive disorder (OCD) in low-resource settings, but there are no trials. This study examined the feasibility, acceptability, efficacy, and long-term outcomes of VC-delivered ERP in 97 patients with OCD and compared its efficacy with inpatient ERP. Despite its methodological limitations, this study suggests that VC-delivered ERP was feasible, acceptable, and as efficacious as in-person ERP. Gains from VC-ERP persisted for more than 2 years. VC-delivered ERP is a viable treatment option for OCD in the resource-constrained settings of low- and middle-income countries.
