Study finds little or no difference in effectiveness of in-person versus remote cognitive behavioral therapy

There is little to no difference in the effectiveness of in-person versus therapist-guided remote cognitive behavioral therapy (CBT) across a range of mental health and somatic disorders, according to a review published in the March 18 issue of CMAJ, the journal of the Canadian Medical Association.

Sara Zandieh, from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a systematic literature review to compare the effectiveness of therapist-guided remote CBT and in-person CBT.

Based on 54 included randomized controlled studies (5,463 patients), the researchers found that 17 studies focused on treatment of anxiety and related disorders, 14 on depressive symptoms, seven on insomnia, six on chronic pain or fatigue syndromes, five on body image or eating disorders, three on tinnitus, one on alcohol use disorder, and one on mood and anxiety disorders.

There was moderate-certainty evidence showing little to no difference in the effectiveness of therapist-guided remote and in-person CBT on primary outcomes (standardized mean difference, –0.02; 95 percent confidence interval, –0.12 to 0.07).

"The World Health Organization has designated CBT as essential health care, but access remains an important barrier for many people in Canada," co-author Jason Busse, Ph.D., also of McMaster University, said in a statement. "Our findings suggest that therapist-guided, remotely delivered CBT can be used to facilitate greater access to evidence-based care."