Long-term efficacy of Internet-based cognitive behavior therapy for obsessive-compulsive disorder with or without booster: a randomized controlled trial.

BACKGROUND: As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program. METHOD: A total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT. RESULTS: The entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58-2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan-Meier analysis also indicated a significantly slower relapse rate in the booster group. CONCLUSIONS: The results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.

Experiences of parents of children surviving brain tumour: a happy ending and a rough beginning.

Despite a large number of studies reporting distress in parents after successfully completed cancer treatment of a child, few have explored the influence of current matters. The objective of this study was to explore parents' perceptions of post-treatment influence of childhood brain tumour. Semi-structured individual interviews were performed with the parents of seven children who had completed treatment for various types of brain tumour. Through inductive thematic analysis five key themes were derived, including 16 sub-themes. The key themes relate to: (1) survivor needs related to training and everyday life activities, where parents invested a large amount of time and commitment; (2) the everyday family life was restricted: family life in focus; (3) parenting role and routines had become more demanding; (4) for the parent as an individual daily routine as well as the view of life had changed; and (5) parental concerns and worries regarding the survivor's current and future well-being were amplified. Findings of the study suggest that the parents in the study struggle with the consequences of tangible strain, as well as existential challenges. Follow-up support should include updated information about the child's present state, and how it can be improved, as well as coaching when assisting and supporting the child.