Digital psychiatry: Study finds virtual therapy more effective than face-to-face meetings

HAMILTON, Ontario — Therapy is an incredibly private, personal process between a patient and their therapist, which is why the findings of a new study are so surprising. One would assume that trying to make legitimate psychological progress via remote therapy would be a fool’s errand. After all, how can anyone really connect with their therapist through a video screen? Despite this, researchers from McMaster University have concluded that electronically delivered cognitive behavioral therapy for depression is actually more helpful than traditional, face-to-face sessions.

One of the most common forms of psychotherapy, cognitive behavioral therapy (CBT) is based on the idea that anyone can develop healthier patterns of thought and do away with self-destructive and unhelpful ways of thinking and reacting to the world.

After analyzing a series of randomized control trials, the research team noted that patients who connected with their therapists solely through apps, video chats, or emails and texts enjoyed greater depression relief than patients who met with their therapists face-to-face. Study authors used standardized mood symptom scales to measure each patient’s level of depression.

The study notes that both virtual and in-person patients reported about the same level of satisfaction regarding their treatment.

“Although this study started before the current COVID-19 pandemic, it is timely and assuring that treatment delivered electronically works as well if not better than face to face and there is no compromise on the quality of care that patients are receiving during this stressful time,” says corresponding author Zena Samaan in a university release.

Making therapy an on-demand service

In all, the Canadian team reviewed 17 randomized control trials focused on virtual versus in-person CBT. All of those trials had taken place between 2003 and 2018. They also spanned numerous nations including the United States, Sweden, Australia, Switzerland, the Netherlands, and the United Kingdom.

The study’s authors say their findings challenge some long-held beliefs regarding what makes therapy effective in the first place.

“The common understanding was that face to face psychotherapy has the advantage of the connection with the therapist and this connection is in part what makes the difference in treatment,” Samaan, an associate professor of psychiatry and behavioral neurosciences at McMaster and a psychiatrist at St. Joseph’s Healthcare Hamilton explains.

“However, it is not surprising that electronic interventions are helpful in that they offer flexibility, privacy and no travel time, time off work, transport or parking costs. It makes sense that people access care, especially mental health care, when they need it from their own comfort space.”

Professor Samaan and her team believe electronic CBT should be made more widely available.

“Electronic options should be considered to be implemented for delivering therapy to patients,” she concludes. “This can potentially vastly improve access for patients, especially those in rural or underserved areas, and during pandemics.”

The study is published in EClinicalMedicine.

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