Tuesday, June 5, 2012

Live OCD Free: An interview with Dr. Kristen Mulcahy, developer of a mobile app for OCD

I was recently contacted by a representative of Teak Media Communications, LLC about a new mobile application that has been developed by a psychologist, Dr. Kristen Mulcahy, to help adults and children with obsessive-compulsive disorder.
I was asked to consider featuring the app and Dr. Mulcahy on this blog and was given an opportunity to interview her.
According to a press release that was also emailed to me, Dr. Mulcahy specializes in OCD treatment. She is the director of the Cognitive Behavioral Institute in Falmouth, Mass.
She has a blog called OCD: Real Stories, Real Help.
She created the application through her company, Pocket Therapist, LLC. The app costs $79.99 and is available in the iTunes store.
I was fascinated by the idea of a mobile app for OCD, and I thought you would be interested in finding out more about it. I interviewed Dr. Mulcahy by email, and her responses to my questions are below.
Note: I don’t have the app and have not tried it out.

How does the Live OCD Free mobile application help people with OCD?
  Live OCD Free guides users through the only evidence-based treatment for OCD, called Exposure and Response Prevention (ERP). It interactively helps users set up an exposure hierarchy, which consists of the exercises they will need to practice in order to overcome their fears and worries.
  Once their hierarchy is set up, users can set reminders to practice on a regular basis, goals to try to meet on a weekly basis, and rewards for meeting those goals. There are specific tools, including motivational messages and relaxation/meditation recordings, to help users manage their anxiety and stay motivated.
  The app will also give specific guidance if you are struggling with an obsession or have just given in to a compulsion. Live OCD Free will also create progress reports that may be emailed directly to the user's therapist.

How does the app work for adults and children with OCD?
  The children's version functions the same as the adult version, but it is much more game-like. It is based on an illustrated audiobook housed within the app about the "Worry Wizard." With the help of their coach, Sage the Owl, kids battle the “Worry Wizard.” Every time they master a challenge (or exposure), the Worry Wizard loses a piece of his costume and they get closer to revealing his true identity.

How did you first get the idea for the Live OCD Free app?
  A friend of mine, who struggles with trichotillomania, called me one day and said there really needed to be an app for hair pulling.    
Right away, I started thinking about how the smartphone technology could be applied to create a therapeutic tool for trichotillomania and also for OCD, which is more my specialty.
  That idea launched a nearly two-year journey of creating Live OCD Free.

Why did you want to create something like the Live OCD Free app?
  For several reasons. The first is the fact that there are 4-7 million people estimated to have OCD in the U.S. alone with relatively few therapists specifically trained and experienced in treating the disorder. It is a very underserved population as many sufferers are unable to afford treatment or find someone to treat them in their area. If you do not have access to a therapist, I believe Live OCD Free is the next best alternative.
  I also wanted to create a tool that could potentially make treatment even more effective and efficient. Even if someone is working with a specialist, they are still doing the majority of the work on their own, in between sessions. I wanted the app to function like a therapist in your pocket, giving you the advice and guidance you need when you are struggling and don't have access to your therapist. I love the fact that I can actually record reminders and statements I want my patients to remember when they are on their own.
  I also believe the app can provide a good framework for therapists who don't have training in treating OCD so they are, at least, providing the right type of treatment.

Once they purchase the app, what steps do people take to begin using it?
  If the user is utilizing the app as a self-help tool, it is highly recommended he/she read the 30-page user's guide that comes with the app. This guide provides basic information about OCD and ERP as well as information on how the app may be used for specific symptoms.
There are also tutorial videos, which provide specific instructions on how to set up your self-help program.
The app itself is extremely user-friendly, and can probably be utilized without this support if someone has experience with ERP.

How can therapists work with patients using the app?
  Therapists can set up their patient's exposure hierarchies in the app and set times for them to practice. They can record messages or recordings for exposure purposes.
They can also see how their patients are doing throughout the week via the progress reports created by the app.

Who is the app most suitable for?
  For anyone struggling with OCD. However, for more severe cases or for less straightforward symptoms, using Live OCD Free as an adjunct to treatment with an OCD specialist is ideal.

What kinds of studies are being conducted to test the efficacy of the app? What do the studies show? Will more studies be done?
  We have collected and continue to collect data on our beta test group, looking at how effective the app is as a self-help tool and as an adjunct to treatment with a professional. We will be teaming up with some larger treatment centers, including the OCD Institute at McLean Hospital, to conduct larger, more formal studies. See information about the Live OCD Free Pilot Study below:

Pilot Study to Determine Efficacy of Live OCD Free App as Self-Help Tool

Preliminary Results:
Following a baseline period of 3-4 weeks, participants were provided the Live OCD Free app to use on their personal mobile device. With a sample size of 5 participants, average Y-BOCS scores decreased by close to 34% over a period of 8 weeks. 

Although the sample size is too small to produce any statistically significant results, this preliminary data seems indicative of some meaningful treatment effect as generally a 35% or greater decrease in Y-BOCS scores is generally deemed clinically meaningful. Of further note is the fact that participants initially scored in the severe range on the Y-BOCS but were able to reduce OCD symptoms to score within the mild to moderate range by the end of 8 weeks time.

Although these results seem very promising, additional research is needed to better understand the efficacy of the Live OCD Free app as a self-help tool.

What kind of feedback have you received from people using the app?
We have been getting excellent feedback from both therapists and sufferers. Testimonials for the app can be found here: http://liveocdfree.com/index.php#
Is the app useful for mental health disorders other than OCD?
  Yes, the app can be used for any disorders that you would create an exposure hierarchy for, including body dysmorphic disorder, hypochondriasis, hoarding, specific phobias, social phobia, and separation anxiety. There is specific information on how to use it for several of these different disorders in the User's Guide.

How can people find out more about the app?

How do people get the app?

  Readers, what do you think? Did you ever think you would see a mobile app for OCD? Do you think you would find it helpful? How do you think this new technology would help you?


  1. Thanks for stopping by and commenting!

  2. What a great idea! I like that there is a kid version too.

  3. Thanks for the info. I've actually been considering whether I want to purchase this app to help me continue working on my own with ERPs. I really have to give this some thought.

    1. Thanks, Sunny. Good luck in your decisionmaking about it.

  4. I have being researching about obsessive compulsive disorder and reading your blog, I found your post very helpful.


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