{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T10:19:04Z","timestamp":1775125144696,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Jikei University Research Fund for Graduate Students","award":["2023-501DJ"],"award-info":[{"award-number":["2023-501DJ"]}]},{"name":"Ministry of Health and Labor Science Research Fund","award":["24GC1012"],"award-info":[{"award-number":["24GC1012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Hybrid cognitive behavioral therapy (CBT), combining group and individual sessions, for treating obsessive\u2013compulsive disorder (OCD) has rarely been examined in routine clinical practice. This prospective observational study preliminarily evaluated the feasibility and acceptability of a hybrid CBT program implemented in Japan. The program consisted of one pre-treatment individual session, eight group sessions, and one post-treatment individual session. Feasibility and acceptability were assessed using dropout rates and written questionnaire feedback. Twenty-eight individuals (mean age = 36.1 \u00b1 14.0 years) participated, with two dropouts. Seven participants reported that the program duration was too short, whereas the remaining participants considered it appropriate. Nineteen participants indicated their willingness to participate in a similar program. Open-ended feedback highlighted the importance of group composition and program content. Self-Rating Yale\u2013Brown Obsessive Compulsive Scale scores decreased at Session 8 (estimate = \u22122.74, p = 0.002) and post-treatment (estimate = \u22124.16, p &lt; 0.001) according to a linear mixed-effects model. Reductions were also observed in Sheehan Disability Scale, State\u2013Trait Anxiety Inventory, and Clinical Global Impressions Scale scores, whereas Center for Epidemiologic Studies Depression Scale scores showed no significant change. These findings suggest the feasibility and acceptability of the program and may inform future program development.<\/jats:p>","DOI":"10.3390\/bs16040529","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:26:12Z","timestamp":1775121972000},"page":"529","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preliminary Feasibility and Acceptability of a Cognitive Behavioral Therapy Combining Group and Individual Sessions for Obsessive\u2013Compulsive Disorder in Clinical Practice"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7865-1603","authenticated-orcid":false,"given":"Yasue","family":"Mitamura","sequence":"first","affiliation":[{"name":"National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawa Higashi, Kodaira-shi, Tokyo 187-8511, Japan"},{"name":"Brain Bioregulatory Science, Cooperative Graduate School, Jikei University Graduate School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0719-1001","authenticated-orcid":false,"given":"Toshitaka","family":"Hamamura","sequence":"additional","affiliation":[{"name":"National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawa Higashi, Kodaira-shi, Tokyo 187-8511, Japan"},{"name":"Brain Bioregulatory Science, Cooperative Graduate School, Jikei University Graduate School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6057-1204","authenticated-orcid":false,"given":"Koki","family":"Haruguchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa Higashi, Kodaira-shi, Tokyo 187-8511, Japan"},{"name":"Department of Psychiatry, Mount Sinai Behavioral Health Center, Icahn School of Medicine at Mount Sinai, 45 Rivington St, New York, NY 10002, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumi","family":"Imamura","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa Higashi, Kodaira-shi, Tokyo 187-8511, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-1054","authenticated-orcid":false,"given":"Shinsuke","family":"Kito","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, National Center of Neurology and Psychiatry, 4-1-1 Ogawa Higashi, Kodaira-shi, Tokyo 187-8511, Japan"},{"name":"Department of Psychiatry, Jikei University of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3649-5781","authenticated-orcid":false,"given":"Hironori","family":"Kuga","sequence":"additional","affiliation":[{"name":"National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawa Higashi, Kodaira-shi, Tokyo 187-8511, Japan"},{"name":"Brain Bioregulatory Science, Cooperative Graduate School, Jikei University Graduate School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1177\/070674370605100702","article-title":"The psychological treatment of obsessive\u2014Compulsive disorder","volume":"51","author":"Abramowitz","year":"2006","journal-title":"The Canadian Journal of Psychiatry"},{"key":"ref_2","unstructured":"American Psychiatric Association (2025, July 15). American psychiatric association (APA) practice guideline for obsessive-compulsive disorder, Available online: https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/ocd.pdf."},{"key":"ref_3","unstructured":"Baer, L. (2012). Getting control: Overcoming your obsessions and compulsions, Penguin Publishing Group."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1080\/15622975.2022.2086296","article-title":"World federation of societies of biological psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders\u2014Version 3. Part II: OCD and PTSD","volume":"24","author":"Bandelow","year":"2023","journal-title":"The World Journal of Biological Psychiatry"},{"key":"ref_5","unstructured":"Bieling, P. J., McCabe, R. E., and Antony, M. M. (2022). Cognitive-behavioral therapy in groups, Guilford Press. [2nd ed.]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1007\/s41811-018-0002-4","article-title":"Stability of treatment gains 10 years after cognitive behavioral therapy for obsessive-compulsive disorder: A study in routine clinical practice","volume":"11","author":"Cabedo","year":"2018","journal-title":"International Journal of Cognitive Therapy"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/wps.20984","article-title":"Empirical severity benchmarks for obsessive-compulsive disorder across the lifespan","volume":"21","author":"Cervin","year":"2022","journal-title":"World Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e2785","DOI":"10.32872\/cpe.v2i1.2785","article-title":"Long-term stability of benefits of cognitive behavioral therapy for obsessive compulsive disorder depends on symptom remission during treatment","volume":"2","author":"Elsner","year":"2020","journal-title":"Clinical Psychology in Europe"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"McKay, D., and Storch, E. (2013). Therapist barriers to the dissemination of exposure therapy. Handbook of treating variants and complications in anxiety disorders, Springer Press.","DOI":"10.1007\/978-1-4614-6452-5"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"115963","DOI":"10.1016\/j.psychres.2024.115963","article-title":"Loneliness in OCD and its determinants","volume":"337","author":"Eikelenboom","year":"2024","journal-title":"Psychiatry Research"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Gellatly, J., Pedley, R., Molloy, C., Butler, J., Lovell, K., and Bee, P. (2017). Low intensity interventions for obsessive-compulsive disorder (OCD): A qualitative study of mental health practitioner experiences. BMC Psychiatry, 17, (1).","DOI":"10.1186\/s12888-017-1238-x"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jocrd.2012.05.002","article-title":"Common pitfalls in exposure and response prevention (EX\/RP) for OCD","volume":"1","author":"Gillihan","year":"2012","journal-title":"Journal of Obsessive-Compulsive and Related Disorders"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1001\/archpsyc.1989.01810110048007","article-title":"The yale-brown obsessive compulsive scale: I. development, use, and reliability","volume":"46","author":"Goodman","year":"1989","journal-title":"Archives of General Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Guy, W. (1976). ECDEU assessment manual for psychopharmacology.","DOI":"10.1037\/e591322011-001"},{"key":"ref_15","first-page":"152","article-title":"Development and use of the Japanese version of the self-report Yale-brown obsessive compulsive scale","volume":"101","author":"Hamagaki","year":"1999","journal-title":"Seishin Shinkeigaku Zasshi"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.psychres.2019.01.092","article-title":"Congruence and discrepancy between self-rated and clinician-rated symptom severity on the Yale\u2013brown obsessive-compulsive scale (Y-BOCS) before and after a low-intensity intervention","volume":"273","author":"Hauschildt","year":"2019","journal-title":"Psychiatry Research"},{"key":"ref_17","unstructured":"Hedges, L. V., and Olkin, I. (1985). Statistical methods for meta-analysis, Academic Press."},{"key":"ref_18","unstructured":"Hidano, T., Fukuhara, M., Iwawaki, M., Soga, S., and Spielberger, C. D. (2000). State trait anxiety inventory (form JYZ) test manual. (Japanese adaptation of STAI), Jitsumu Kyouiku Shuppan."},{"key":"ref_19","unstructured":"(2025). Quick reference table for medical procedure points: April 2025 supplement, Igakutushin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1111\/j.1600-0447.2008.01270.x","article-title":"Group cognitive behavioural therapy for obsessive-compulsive disorder: A systematic review and meta-analysis","volume":"119","author":"Jonsson","year":"2009","journal-title":"Acta Psychiatr Scand"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0887-6185(96)00033-3","article-title":"Psychometric properties and diagnostic utility of the beck anxiety inventory and the state-trait anxiety inventory with older adult psychiatric outpatients","volume":"11","author":"Kabacoff","year":"1997","journal-title":"Journal of Anxiety Disorders"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1192\/pb.bp.106.011510","article-title":"Effectiveness of group-based cognitive\u2013behavioural therapy in patients with obsessive\u2013compulsive disorder","volume":"34","author":"Kearns","year":"2010","journal-title":"The Psychiatrist"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1080\/01933929508411322","article-title":"Group behavior therapy for obsessive-compulsive disorder","volume":"20","author":"Kobak","year":"1995","journal-title":"The Journal for Specialists in Group Work"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1017\/S1754470X23000387","article-title":"Blended individual and group CBT for OCD in adolescents: Model description and a feasibility study","volume":"17","author":"Kunnari","year":"2024","journal-title":"The Cognitive Behaviour Therapist"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v082.i13","article-title":"lmerTest package: Tests in linear mixed effects models","volume":"82","author":"Kuznetsova","year":"2017","journal-title":"Journal of Statistical Software"},{"key":"ref_26","unstructured":"Lenth, R. V. (2025, August 08). Emmeans: Estimated marginal means, aka least-squares means (Version 1.10.2). Comprehensive R Archive Network (CRAN), Available online: https:\/\/CRAN.R-project.org\/package=emmeans."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/00004714-199310000-00005","article-title":"A comparison of symptom determinants of patient and clinician global ratings in patients with panic disorder and depression","volume":"13","author":"Leon","year":"1993","journal-title":"Journal of Clinical Psychopharmacology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1038\/sj.npp.1301147","article-title":"Linking the PANSS, BPRS, and CGI: Clinical implications","volume":"31","author":"Leucht","year":"2006","journal-title":"Neuropsychopharmacology"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Mukai, K., Kyosuke, Y., Ogino, S., Hosoi, Y., Hayashida, K., and Matsunaga, H. (2025). Benefits and barriers associated with using cognitive-behavioral therapy to treat obsessive-compulsive disorder: A narrative review. Front Psychiatry, 16.","DOI":"10.3389\/fpsyt.2025.1593384"},{"key":"ref_30","unstructured":"Murray, C. J. L., and Lopez, A. D. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020: Summary, World Health Organization."},{"key":"ref_31","unstructured":"National Collaborating Centre for Mental Health (2024). NHS talking therapies for anxiety and depression manual (Version 7.1), NHS England. Available online: https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2018\/06\/nhs-talking-therapies-manual-v7.1-updated.pdf."},{"key":"ref_32","unstructured":"National Institute for Health and Care Excellence (2025, October 28). Obsessive-compulsive disorder and body dysmorphic disorder: Treatment: Clinical guideline [NICE guideline CG31], Available online: https:\/\/www.nice.org.uk\/guidance\/cg31."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/j.1440-1819.2009.02003.x","article-title":"Practice-based depression screening for psychiatry outpatients: Feasibility comparison of two-types of center for epidemiologic studies depression scales","volume":"63","author":"Nishiyama","year":"2009","journal-title":"Psychiatry and Clinical Neurosciences"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.psychres.2017.09.056","article-title":"Drop-out and efficacy of group versus individual cognitive behavioural therapy: What works best for obsessive-compulsive disorder? A systematic review and meta-analysis of direct comparisons","volume":"258","author":"Pozza","year":"2017","journal-title":"Psychiatry Research"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: A self-report depression scale for research in the general population","volume":"1","author":"Radloff","year":"1977","journal-title":"Applied Psychological Measurement"},{"key":"ref_36","unstructured":"R Core Team (2024). R: A language and environment for statistical computing, R Foundation for Statistical Computing. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.jocrd.2013.10.006","article-title":"Treatment-seeking in OCD community cases and psychological treatment actually provided to treatment-seeking patients: A systematic review","volume":"2","author":"Schwartz","year":"2013","journal-title":"Journal of Obsessive-Compulsive and Related Disorders"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/YIC.0b013e3282f2b4d6","article-title":"Assessing treatment effects in clinical trials with the discan metric of the sheehan disability scale","volume":"23","author":"Sheehan","year":"2008","journal-title":"International Clinical Psychopharmacology"},{"key":"ref_39","first-page":"717","article-title":"New depressive self-rating scale","volume":"27","author":"Shima","year":"1985","journal-title":"Psychiatry"},{"key":"ref_40","first-page":"62","article-title":"Development of the Japanese edition of the spielberger state-trait anxiety inventory (STAI) for student use","volume":"29","author":"Shimizu","year":"1981","journal-title":"Japanese Journal of Educational Psychology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jocrd.2017.08.002","article-title":"Pilot study of exposure and response prevention for Japanese patients with obsessive-compulsive disorder","volume":"15","author":"Shinmei","year":"2017","journal-title":"Journal of Obsessive-Compulsive and Related Disorders"},{"key":"ref_42","unstructured":"Spielberger, C. D., Gorsuch, R. L., and Lushene, R. E. (1970). STAI manual for the state-trait anxiety inventory (\u201cself-evaluation questionnaire\u201d), Consulting Psychologists Press. Available online: https:\/\/ci.nii.ac.jp\/ncid\/BA66835301."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1176\/appi.psychotherapy.2015.69.3.269","article-title":"Intensive individual and group cognitive behavioural therapy for obsessive-compulsive disorder","volume":"69","author":"Taylor","year":"2015","journal-title":"American Journal of Psychotherapy"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1891\/0889-8391.28.4.264","article-title":"Exploring the association between obsessive-compulsive symptoms and loneliness: Consideration of specificity and gender","volume":"28","author":"Timpano","year":"2014","journal-title":"Journal of Cognitive Psychotherapy"},{"key":"ref_45","unstructured":"Torchiano, M. (2020). Effsize: Efficient effect size computation (Version 0.8.1). Comprehensive R Archive Network (CRAN), Available online: https:\/\/CRAN.R-project.org\/package=effsize."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1037\/pas0000351","article-title":"Psychometric properties of the Japanese CES-D, SDS, and PHQ-9 depression scales in university students","volume":"29","author":"Umegaki","year":"2017","journal-title":"Psychological Assessment"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1080\/00223890701885027","article-title":"The Factor structure of the state-trait anxiety inventory: An alternative view","volume":"90","author":"Vigneau","year":"2008","journal-title":"Journal of Personality Assessment"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.jocrd.2017.03.003","article-title":"The impact of poor insight on the course of obsessive-compulsive disorder in patients receiving naturalistic treatment","volume":"13","author":"Visser","year":"2017","journal-title":"Journal of Obsessive-Compulsive and Related Disorders"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/ajim.20403","article-title":"Validity of the center for epidemiologic studies depression scale as a screening instrument of major depressive disorder among Japanese workers","volume":"50","author":"Wada","year":"2007","journal-title":"American Journal of Industrial Medicine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1192\/bjp.2024.197","article-title":"Effectiveness and acceptability of cognitive\u2013behavioural therapy delivery formats for obsessive\u2013compulsive disorder: Network meta-analysis","volume":"228","author":"Wang","year":"2026","journal-title":"The British Journal of Psychiatry"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1002\/da.22720","article-title":"Behavioral avoidance predicts treatment outcome with exposure and response prevention for obsessive-compulsive disorder","volume":"35","author":"Wheaton","year":"2018","journal-title":"Depress Anxiety"},{"key":"ref_52","unstructured":"Yalom, I., and Leszcz, M. (2020). The theory and practice of group psychotherapy, Basic Books."},{"key":"ref_53","first-page":"1645","article-title":"The Japanese version of the sheehan disability scale: Development, reliability and validity","volume":"7","author":"Yoshida","year":"2004","journal-title":"Japanese Journal of Clinical Psychopharmacology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1017\/S0033291703007414","article-title":"Evaluation of the clinical global impression scale among individuals with social anxiety disorder","volume":"33","author":"Zaider","year":"2003","journal-title":"Psychological Medicine"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/4\/529\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:41:23Z","timestamp":1775122883000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/16\/4\/529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":54,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["bs16040529"],"URL":"https:\/\/doi.org\/10.3390\/bs16040529","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]}}}