Face-to-face versus Video Teleconference Group Cognitive Behavioural Therapy for Anxiety and Related Disorders: A Preliminary Comparison

Abstract

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.

Higher Acceptance of Videotelephonic Counseling Formats in Psychosomatic Medicine in Times of the COVID-19 Pandemic

“…Regarding "assessment of therapeutic contact" general acceptance and high satisfaction were found with all the counseling formats also in line with similar studies that report the "evaluation of the therapeutic contact" in both telecounseling and face-to-face contact as satisfactory, trusting and appreciative (23,24). Here it should be noted that the majority of the sessions in the study, were individual sessions and did not take place in the context of therapy.…”

“…In consideration of the fact that there is already some evidence for the acceptance and effectiveness of video-based and phone counseling formats (10,13,22,23,27), this exploratory study was able to show that especially in psychosomatic counseling, videotelephonic counseling can represent an essential and effective support function. As possible limitations, it should be noted that the present study was based on a single time point exploratory online survey in psychosomatic patients without follow up and without healthy control group.…”

Terapia cognitivo-conductual grupal por videoconferencia para el trastorno obsesivo-compulsivo: Estudio piloto.

“…Estos resultados están en consonancia con la investigación en TCCG, que muestra que puede tener menos tasas de abandono que la TCC individual (Leeuwerik et al, 2019). Asimismo, los incipientes resultados sobre la TCCG por videoconferencia apuntan que podría propiciar una mayor asistencia que la psicoterapia presencial (Milosevic et al, 2021). Sin embargo, debido al bajo número de participantes en este estudio y las circunstancias en las que se desarrolló (momento excepcional en el que el curso de la pandemia limitaba la realización de algunas actividades) habría que tomar los resultados con cautela.…”

“…Recientemente se han aplicado grupos de apoyo y psicoeducativos por videoconferencia para pacientes que sufren TOC (Kayser et al, 2021;Scholl et al, 2021). Milosevic et al (2021) compararon los resultados terapéuticos de la TCCG en formato presencial realizada antes de la pandemia con la TCCG aplicada mediante videoconferencia para varios trastornos de ansiedad, entre ellos el TOC. Los resultados apuntan que la TCCG por videoconferencia es viable y con una eficacia similar a la presencial.…”

Group early intervention eye movement desensitization and reprocessing therapy as a video-conference psychotherapy with frontline/emergency workers in response to the COVID-19 pandemic in the treatment of post-traumatic stress disorder and moral injury—An RCT study

“…To date, several research studies indicate that psychological treatment, delivered remotely though video-conference platforms, are both safe and feasible. Furthermore, that they offer greater flexibility, and improve equity of access ( Appleton et al, 2021 ; Broadbear et al, 2021 ; Cantone et al, 2021 ; Cataldo et al, 2021 ; Dharwadkar et al, 2021 ; Oudshoorn et al, 2021 ; Puspitasari et al, 2021 ; Shklarski et al, 2021a , b ; Vera San Juan et al, 2021 ; Milosevic et al, 2022 ). Smith et al (2022) , however, considers that although the evidence-base is promising further interrogation and research is needed to further explore the ethical and moral dimensions of video-conference psychotherapy.…”