Real-World Implementation of CBT for OCD: Access, Adaptation, and Digital Innovations Across Care Settings

Dear Colleagues,

Cognitive behavioral therapy (CBT) is a first-line treatment for obsessive–compulsive disorder (OCD), with robust evidence supporting its efficacy under controlled conditions. However, translating this efficacy into real-world clinical effectiveness remains a major challenge due to barriers related to accessibility, treatment intensity, and healthcare system constraints. In routine clinical practice, CBT for OCD is delivered in diverse formats that often differ from standard protocols. These include low-intensity approaches (e.g., reduced session frequency, guided self-help, and digital interventions), high-intensity treatments (e.g., intensive outpatient or inpatient programs), and hybrid models adapted to specific healthcare systems. Digital innovations—including internet-delivered CBT (iCBT), app-based interventions, and blended care models combining digital and face-to-face approaches—are increasingly central to improving access and scalability. As mental healthcare systems increasingly adopt implementation-oriented frameworks, such as stepped and matched care, there is a growing need to examine not only whether CBT works but also how it can be effectively delivered, adapted, and sustained in real-world settings. This Special Issue focuses on the real-world implementation of CBT for OCD, with particular emphasis on accessibility, adaptation, and system-level integration. We invite original research and reviews addressing:

• Implementation strategies and service models (e.g., stepped care, matched care);
• Low-intensity and high-intensity CBT in routine clinical settings;
• Digital and remote CBT interventions, including iCBT and app-based approaches;
• Therapist-, service-, and system-level factors influencing outcomes.

Rather than focusing solely on efficacy under controlled conditions, this Special Issue aims to advance understanding of how CBT for OCD can be translated into sustainable, accessible, and scalable care in real-world clinical contexts.

Dr. Keiichiro Mukai
Prof. Dr. Bethany May Wootton
Guest Editors

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• obsessive–compulsive disorder (OCD)
• cognitive behavioral therapy (CBT)
• implementation
• real-world effectiveness
• digital CBT
• Internet-based CBT (iCBT)
• app-based interventions
• blended care
• stepped care
• low-intensity CBT
• high-intensity CBT
• access to care
• health systems