Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Adults With Psychiatric Disorders: Systematic and Meta-Analytic Review

Abstract

Background Cognitive behavioral therapy (CBT) is the gold standard of psychotherapy for psychiatric disorders. However, the format of delivering CBT in person limits access to the intervention. The advancements in information and communication technology, especially the internet, present an opportunity for cognitive behavioral therapists to service patients or clients in remote areas through videoconferencing. Although many randomized controlled trials of videoconference-delivered cognitive behavioral therapy (VCBT) have already been conducted, the overall estimated effect size of VCBT for psychiatric disorders has not been examined by systematic reviews and meta-analyses. Objective This study attempts to evaluate the effectiveness of VCBT for psychiatric disorders through a systematic and meta-analytic review. Methods A systematic review and meta-analysis of studies in which VCBT was directly compared to control groups (such as treatment as usual, attention control, wait-list control, and other minimal supports) was carried out. To identify previous studies that meet our study objective, 2 independent reviewers undertook a systematic search through seven databases: MEDLINE (via PubMed), Web of Science, Science Direct, PsycINFO, CINAHL, LILACS, and SciELO. Other databases (ClinicalTrials.gov and Cochrane Central Resister of Controlled Trials) were also checked. All studies included in the review were assessed using the quality criteria of the Cochrane Collaboration. Statistical analysis was performed by using Cochrane Review Manager (RevMan, version 5.4.0). Standardized mean difference was used in major meta-analyses where a P value of .05 or less was the threshold for statistical significance. A heterogeneity test and the chi-square test were performed to assess the presence and extent of statistical heterogeneity with significance set at P<.10. Funnel plots were visually inspected to assess the risk of bias. Subgroup analyses were conducted for each disorder to estimate intervention effects. Results The systematic search resulted in 16 studies (total N=1745) that met the criteria for this study and were included in the review. There were 10 studies on depressive symptoms, 3 on chronic pain, 1 on generalized anxiety disorder, 1 on obsessive-compulsive disorder, and 1 on hypochondriasis. The quality and risk of bias was also assessed. Results showed a pooled effect size (Hedge g) post treatment of −0.49 (95% CI –0.68 to –0.29), indicating that VCBT is effective for clients with psychiatric disorders. Study quality did not affect outcomes. Conclusions While the overall results indicate the effectiveness of VCBT, there are still only a limited number of studies on specific psychiatric and somatic conditions. Therefore, more randomized controlled trials are needed to establish the effectiveness of VCBT for different disorders. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42021224832; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=224832

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“…Cognitive-behavioral therapy is a highly effective psychotherapy for major depressive disorder, anxiety disorders, and PTSD [ 55 , 56 ]. Internet-Based CBT (ICBT) via videoconference or web-based program also is as effective as face-to-face CBT [ 57 – 59 ]. Remote treatment such as ICBT does not require people to visit the hospital and may help reduce the risk of SARS-CoV-2 infection.…”

Rapid transition from in‐person to videoconferencing psychotherapy in a counselor training clinic: A safety and feasibility study during the COVID‐19 pandemic

“…For example, systematic reviews of randomized, quasi‐experimental, and uncontrolled clinical trials indicate that VCP may be associated with medium to large effects on depressive symptoms (Berryhill, Culmer, et al., 2019 ) and small to large effects on symptoms of anxiety (Berryhill, Halli‐Tierney, et al., 2019 ). Similarly, a meta‐analysis of 16 studies evaluating the effectiveness of cognitive behavioral VCP further demonstrated that, relative to various control conditions, VCP appears to produce moderate effects across multiple outcome measures and presenting concerns (Matsumoto et al., 2021 ). Finally, data from a recent multilevel meta‐analysis additionally reported no significant differences in outcomes between clients receiving either IP or VCP services (Batastini et al., 2021 ).…”

Neural Effects of Cognitive Behavioral Therapy in Psychiatric Disorders: A Systematic Review and Activation Likelihood Estimation Meta-Analysis

“…Many studies have demonstrated the efficacy of CBT in psychiatric disorders ( Butler et al, 2006 ; Hofmann et al, 2012 ; Van Dis et al, 2020 ; Matsumoto et al, 2021 ). 269 quantitative meta-analyses were identified in a review to verify the effectiveness of CBT for psychiatric disorders.…”

“…And CBT demonstrated superior efficacy as compared to other forms of psychotherapies in personality disorders, bulimia, positive symptoms in schizophrenia ( Hofmann et al, 2012 ). A study showed that a pooled effect size (Hedge g) post-treatment of −0.49 (95% CI −0.68 to −0.29), which indicated CBT had a significant effect on psychiatric disorders ( Matsumoto et al, 2021 ). Moreover, much evidence addressed that CBT produced long-term persistence of therapeutic effects following the termination of treatment ( Butler et al, 2006 ; Van Dis et al, 2020 ).…”