Digital psychotherapy as an effective and timely treatment option for depression and anxiety disorders: Implications for rural and remote practice

J Int Med Res. 2020 Jun;48(6):300060520928686. doi: 10.1177/0300060520928686.


Patients in regional, rural and remote communities experience perennial difficulties accessing mental health treatments in a timely manner, which contributes to inequitable outcomes when compared with their metropolitan counterparts. This situation frequently stems from a shortage of specialised face-to-face psychotherapy services available in local areas. The recent development of digital psychotherapy as an alternative treatment delivery method provides an opportunity to address this healthcare gap and to avoid the challenges related to workforce maldistribution. This article provides a targeted narrative review of the relevant evidence base, and discusses the potential applications within the rural and remote context. Multiple randomised controlled trials and a large meta-analysis demonstrate that digital psychotherapy, particularly cognitive-behavioural therapy, is as effective as face-to-face psychotherapy. Its use has consequently been endorsed across international clinical practice guidelines as an efficacious and practical way to provide mental healthcare. Despite this, the adoption of digital psychotherapeutic options has been limited to date. Increased awareness of the available options may improve access to psychological treatments in rural and remote populations. Digital psychotherapy should be considered an option for patients with depressive or anxiety disorders of mild-to-moderate severity.

Keywords: Anxiety; Internet-based; cognitive-behavioural therapy; computer-assisted; depression; digital; electronic; psychotherapy; rural and remote.

Publication types

  • Review

MeSH terms

  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / therapy*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / therapy*
  • Evidence-Based Practice / methods
  • Evidence-Based Practice / organization & administration
  • Evidence-Based Practice / standards
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility / organization & administration
  • Health Services Accessibility / standards
  • Humans
  • Internet-Based Intervention
  • Mental Health Services / organization & administration*
  • Mental Health Services / standards
  • Meta-Analysis as Topic
  • Patient Education as Topic
  • Practice Guidelines as Topic
  • Psychotherapy / methods*
  • Psychotherapy / organization & administration
  • Psychotherapy / standards
  • Randomized Controlled Trials as Topic
  • Rural Population
  • Severity of Illness Index
  • Telemedicine / methods*
  • Telemedicine / organization & administration
  • Telemedicine / standards
  • Treatment Outcome