Smartphone App Offers Effective and Accessible Treatment for Obsessive-Compulsive Disorder

In a randomized clinical trial, Mass General Brigham researchers found that smartphone-based cognitive behavioral therapy significantly improved OCD symptoms in 65% of participants, with 91% saying they’d recommend the app to a friend.

Obsessive compulsive disorder (OCD) is a severe and chronic disorder that impacts around 3% of people worldwide. Cognitive behavior therapy (CBT) is the gold-standard treatment for OCD, teaching patients about their condition and helping them identify and change unhelpful thought and behavior patterns via strategies such as exposure therapy. CBT reduces symptoms in around 60- 80% of patients, but many don’t receive it because of its high cost, time-consuming nature, and a lack of trained CBT clinicians.

To address this barrier to care, a new study led by researchers at Mass General Brigham shows that CBT delivered via smartphone app (i.e., app-based CBT) could be an effective, scalable, and affordable alternative to traditional in-person therapy. The randomized control trial, published in npj Digital Medicine, found that symptoms significantly improved in 65% of participants with OCD who completed 12 weeks of app-based CBT with support from a digital coach, and 26% went into remission.

“This study highlights the potential of app-based CBT as an effective treatment option for individuals with OCD,” said lead author Sabine Wilhelm, PhD, chief of Psychology and director of the Center for Digital Mental Health and the Center for OCD and Related Disorders in the Mass General Brigham Department of Psychiatry. “Smartphone-delivered CBT addresses obstacles to accessing traditional CBT and could reduce the amount of clinical support required from 12 hours or more to less than 1.5 hours per patient.”

The researchers conducted a trial of 120 participants, half of whom used a CBT app called Perspectives (made by Koa Health in collaboration with Wilhelm, her team, and a group of individuals with OCD), while the other half used HealthWatch, an online wellness program that does not involve CBT. Participants in both groups also had access to non-specialist coaches who were available for motivation and support via text or phone conversations.

After 12 weeks, both groups showed reduced OCD symptoms, but those using Perspectives saw greater improvements. Participants who used app CBT were also more satisfied and had higher expectations that the treatment would work. In fact, 91% of Perspectives users said they would recommend the app to a friend versus 53% of HealthWatch users. Finally, dropout during treatment was significantly lower in Perspectives (5%) than in HealthWatch (23%).

“App-based CBT could work as a supplementary or standalone intervention for OCD in remote or underserved settings, single-practice clinics, and situations where geographical or financial barriers limit access to care,” said Wilhelm.

The researchers said that future research should focus on further improving the efficacy of app-based CBT by testing it in real-world settings and in more diverse populations.

Authorship: In addition to Wilhelm, Mass General Brigham authors include Jennifer L. Greenberg, Ryan J. Jacoby, Hilary Weingarden, Susanne S. Hoeppner, Dalton Klare, Ivar Snorrason, Adam C. Jaroszewski, Thomas H. McCoy. Additional authors include Oliver Harrison.

Disclosures: Wilhelm is on the Scientific Advisory Board for Koa Health, Inc. and for Noom, Inc. Wilhelm has received research support from Koa Health, Inc and is on the Scientific Advisory Board of Koa Health. Greenberg, Jacoby, Weingarden, and McCoy have received research support from Koa Health. Harrison is Founder/CEO of Koa Health, a digital mental health company that collaborated with Wilhelm and her team at MGH to build Perspectives. Additional disclosures can be found in the paper.

Funding: Research was supported by Koa Health (formerly Telefonica Alpha) and an anonymous donor (Principal Investigator: Wilhelm). Investigators from MGH developed the Perspectives app in collaboration with technologists and designers from Koa Health and a group of individuals with OCD via a user-centered, iterative design approach. The investigators from MGH were responsible for the study design and for the execution of the study; Koa Health supported the technical activities related to the development and deployment of the app and provided funding for the project. The sponsor (Koa Health) had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or decision to submit the manuscript for publication. The sponsor (Koa Health) was able to make minor edits in the preparation, review, and approval of the manuscript. Weingarden was supported in part by the National Institute of Mental Health of the National Institutes of Health under Award Number K23MH119372 (Weingarden). Jacoby is supported in part by the National Institute of Mental Health of the National Institutes of Health under award number K23MH120351 (Jacoby). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Paper cited: Wilhelm, S et al. “A Randomized Clinical Trial of App Cognitive Behavior Therapy vs. HealthWatch for Obsessive Compulsive Disorder” npj Digital Medicine DOI: https://doi.org/10.1038/s41746-025-02230-9