Synchronous telehealth technologies in psychotherapy for depression: a meta-analysis

Depress Anxiety. 2013 Nov;30(11):1058-67. doi: 10.1002/da.22165. Epub 2013 Aug 6.


Background: Many patients suffering from depression lack immediate access to care. The use of synchronous telehealth modalities to deliver psychotherapy is one solution to this problem. This meta-analysis examined differences in treatment efficacy for psychotherapy administered via synchronous telehealth as compared to standard nontelehealth approaches.

Method: We located 14 articles that met inclusion criteria of the use of a synchronous telehealth modality for treatment compared to a standard nontelehealth modality comparison group.

Results: Overall, a statistically significant systematic difference between modes of delivery was not identified (g = 0.14, SE = 0.08, 95% CI = [-0.03, 0.30], P = .098, I(2) = 49.74%). Stratification methods and metaregression were used to analyze the contributions of type of comparison group, intervention modality, and targeted mental health outcome to moderation of effect size (ES) estimates and heterogeneity. Type of comparison group (face-to-face versus care-as-usual) had the strongest influence on observed heterogeneity and moderated the summary ES. The only detectable difference in efficacy was restricted to studies that used care-as-usual as the comparison group (g = 0.29, SE = 0.06, 95% CI = [0.16, 0.41], P < .001, I(2) = 5.14%).

Conclusions: Overall, we found no evidence to suggest that the delivery of psychotherapy via synchronous telehealth modalities is less effective than nontelehealth means in reducing depression symptoms.

Keywords: depression; meta-analysis; telehealth; telemental health.

Publication types

  • Meta-Analysis

MeSH terms

  • Depression / therapy*
  • Humans
  • Psychotherapy / instrumentation
  • Psychotherapy / methods
  • Psychotherapy / standards*
  • Telemedicine / methods
  • Telemedicine / standards*
  • Treatment Outcome*