Efficacy of Remotely Delivered Evidence-Based Psychosocial Treatments for Schizophrenia-Spectrum Disorders: A Series of Systematic Reviews and Meta-Analyses

Michael W Best; Sylvia Romanowska; Ying Zhou; Linbo Wang; Talia Leibovitz; Karin A Onno; Shreya Jagtap; Christopher R Bowie

doi:10.1093/schbul/sbac209

Efficacy of Remotely Delivered Evidence-Based Psychosocial Treatments for Schizophrenia-Spectrum Disorders: A Series of Systematic Reviews and Meta-Analyses

Schizophr Bull. 2023 Jul 4;49(4):973-986. doi: 10.1093/schbul/sbac209.

Authors

Michael W Best^{1

2}, Sylvia Romanowska¹, Ying Zhou³, Linbo Wang³, Talia Leibovitz¹, Karin A Onno⁴, Shreya Jagtap¹, Christopher R Bowie⁵

Affiliations

¹ Department of Psychological Clinical Science, University of Toronto Scarborough, CA, USA.
² Ontario Shores Centre for Mental Health Sciences, CA, USA.
³ Department of Statistical Sciences, University of Toronto, CA, USA.
⁴ Department of Psychology, Lakehead University, CA, USA.
⁵ Department of Psychology, Queen's University, CA, USA.

Abstract

Background: Schizophrenia is among the most persistent and debilitating mental health conditions worldwide. The American Psychological Association (APA) has identified 10 psychosocial treatments with evidence for treating schizophrenia and these treatments are typically provided in person. However, in-person services can be challenging to access for people living in remote geographic locations. Remote treatment delivery is an important option to increase access to services; however, it is unclear whether evidence-based treatments for schizophrenia are similarly effective when delivered remotely.

Study design: The current study consists of a series of systematic reviews and meta-analyses examining the evidence-base for remote-delivery of each of the 10 APA evidence-based treatments for schizophrenia.

Results: Of the 10 treatments examined, only cognitive remediation (CR), cognitive-behavioral therapy (CBT), and family psychoeducation had more than 2 studies examining their efficacy for remote delivery. Remote delivery of CBT produced moderate effects on symptoms (g = 0.43) and small effects on functioning (g = 0.26). Remote delivery of CR produced small-moderate effects on neurocognition (g = 0.35) and small effects on functioning (g = 0.21). There were insufficient studies of family psychoeducation with equivalent outcome measures to assess quantitatively, however, studies of remotely delivered family psychoeducation suggested that it is feasible, acceptable, and potentially effective.

Conclusions: Overall, the evidence-base for remotely delivered treatment for schizophrenia is limited. Studies to date suggest that remote adaptations may be effective; however, more rigorous trials are needed to assess efficacy and methods of remote delivery that are most effective.

Keywords: cognitive remediation; cognitive therapy; psychosis; remote treatment; schizophrenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cognitive Behavioral Therapy* / methods
Humans
Outcome Assessment, Health Care
Schizophrenia* / therapy
Systematic Reviews as Topic

Grants and funding

#171738/CIHR/Canada