Managing Compulsive Symptoms and Contamination Fears Better with a Smartphone App: A Study on Self-Help with Augmented Reality

Summary description of the study

Obsessive-Compulsive Disorders (OCD) are among the most burdensome mental illnesses. A particularly common issue is the fear of contamination, which can lead to compulsive washing or checking behaviors. Although established therapies such as Cognitive Behavioral Therapy (CBT) exist, many affected individuals do not receive adequate treatment – due to long waiting times, costs, shame, or lack of access to specialized professionals. This study investigates a newly developed app-based self-help program called ZeroOCD, which is based on CBT and utilizes Augmented Reality (AR). The app allows users to expose themselves to anxiety-provoking situations in their real environment – for example, by displaying virtual germs on door handles – thereby specifically reducing avoidance behavior. The aim is to provide affected individuals with an effective, flexible, and low-threshold treatment option that can be conveniently conducted via smartphone. The app includes nine modules and is supplemented by three video calls with a psychological professional. The effectiveness of ZeroOCD will be tested in an international study with three groups: (1) use of the ZeroOCD app, (2) traditional CBT via video conference, and (3) waitlist (the app will be provided later). Among other things, the study will examine the reduction of OCD symptoms, quality of life, treatment costs, and user satisfaction. The study will be conducted in Switzerland, the Netherlands, and Sweden – with 63 participants planned for Switzerland. The goal of the study is to determine whether an app-based treatment represents an effective and cost-efficient alternative to conventional therapy – thereby potentially reaching more people with OCD symptoms in the long term.

(BASEC)

Intervention under investigation

ZeroOCD is an app for AR-Cognitive Behavioral Therapy (AR-CBT) aimed at offering exercises for AR-Exposure Therapy (ARET) to alleviate the severity of OCD symptoms in general, with a particular focus on contamination fear. For example, the user's smartphone can be transformed into a magnifying glass through which germs and viruses become visible. The app-based intervention ZeroOCD includes nine modules that allow users flexibility in the pace of their progress while still completing the intervention within a period of 10 weeks. Therefore, the ZeroOCD intervention requires only limited contact with therapeutic professionals; during the RCT, three video calls with a therapeutic professional are scheduled (i.e., one at the beginning of treatment, one in the middle of treatment, and one towards the end of treatment). The ZeroOCD intervention can be fully conducted on a smartphone without additional devices. The nine consecutive modules of the ZeroOCD intervention are estimated to take between 5 and 20 minutes each.

(BASEC)

Disease under investigation

Contamination fear associated with Obsessive-Compulsive Disorders

(BASEC)

Sponsor

Institut für Psychologie, Universität Bern

(BASEC)

Name of the authorising ethics committee (for multicentre studies, only the lead committee)

Ethics Committee Bern

(BASEC)

Date of authorisation

16.07.2025

(BASEC)

Results of the trial