A systematic review of 17 randomized controlled trials concluded that cognitive behavioral therapy (CBT) did not need to be performed in person,media reported. The study found that for depression, the treatment was as effective as face-to-face treatment when treated remotely using video conferencing, telephone and e-mail tools.
Cognitive behavioral therapy is a common psychotherapy used to treat a number of mental health disorders, including depression and anxiety. For many practitioners, the face-to-face element of psychotherapy seems to be fundamental to its efficacy, and although technological advances in recent decades have allowed for more comprehensive forms of telecommunication, CBT is still primarily available in person.
“The common understanding is that face-to-face psychotherapy has the advantage of connecting with therapists, and this connection is partly different from therapy.” Zena Samaan, the author of the new study, said.
In the largest systematic review to date, researchers from McMaster University collected data from 17 randomized controlled trials conducted over the past 20 years. The clinical trials included in this review are primarily comparing the specific efficacy of electronic delivery CBT (eCBT) with face-to-face CBT in the treatment of severe depression (MDD).
The study defines eCBT as any form of electronic media therapy conference. This includes video conferencing, e-mail, text, or other types of web-based applications. Amazingly, the data suggest that eCBT may be more effective than face-to-face CBT. The meta-analysis concluded that there was “appropriate evidence” that teletherapy improved symptoms better than face-to-face therapy. However, Samaan points out that the heterogeneity of clinical studies means a more cautious general conclusion that eCBT is at least as effective as traditional CBT.
“Although this study began before the current COVID-19 pandemic, it was timely to ensure that treatment spent electronically was as effective as face-to-face treatment, and that the quality of care received by patients during this stressful period would not be affected,” Samaan said.
The researchers speculate that some factors may be the basis on which remote management therapy can be effective. Despite the counterintuitive findings, Samaan says the ease of remote acceptance of CBT seems to outweigh the loss of any benefit from therapists and patients in the same room.
“…… It’s not surprising that electronic interventions help because they provide flexibility, privacy, and no travel time, off-hours, traffic or parking costs,” she added. “It makes sense to get care from their own comfort space, especially mental health care, when people need it.”
Given the unique isolation nature of the COVID-19 pandemic, its associated immediate mental health effects, and the established efficacy of teletherapy, the study recommends widespread use of eCBT if patients and therapists like it. “Consideration should be given to implementing electronic options to provide treatment to patients,” Samaan said. “This could significantly improve patient access, especially in rural areas and in areas with inadequate services, as well as during epidemics.”
The new study was published in the Lancet sub-journal EClinical Medicine.