Effectiveness of videoconference-delivered cognitive behavioral therapy for adults with psychiatric disorders: Systematic and meta-analytic review

Matsumoto, Kazuki; Hamatani, Sayo; Shimizu, Eiji

doi:10.2196/31293

Cited by 67Digital Mental Health InterventionsTelemedicine and Telehealth ImplementationPsychotherapy Techniques and Applications

Effectiveness of videoconference-delivered cognitive behavioral therapy for adults with psychiatric disorders: Systematic and meta-analytic review

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Matsumoto, Kazuki, Hamatani, Sayo, Shimizu, Eiji·2021·Journal of Medical Internet Research

DOI 10.2196/31293PMC PMC8713091

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Abstract

BACKGROUND: Cognitive behavioral therapy (CBT) is the gold standard of psychotherapy for psychiatric disorders. However, the format of delivering CBT in person limits access to the intervention. The advancements in information and communication technology, especially the internet, present an opportunity for cognitive behavioral therapists to service patients or clients in remote areas through videoconferencing. Although many randomized controlled trials of videoconference-delivered cognitive behavioral therapy (VCBT) have already been conducted, the overall estimated effect size of VCBT for psychiatric disorders has not been examined by systematic reviews and meta-analyses. OBJECTIVE: This study attempts to evaluate the effectiveness of VCBT for psychiatric disorders through a systematic and meta-analytic review. METHODS: A systematic review and meta-analysis of studies in which VCBT was directly compared to control groups (such as treatment as usual, attention control, wait-list control, and other minimal supports) was carried out. To identify previous studies that meet our study objective, 2 independent reviewers undertook a systematic search through seven databases: MEDLINE (via PubMed), Web of Science, Science Direct, PsycINFO, CINAHL, LILACS, and SciELO. Other databases (ClinicalTrials.gov and Cochrane Central Resister of Controlled Trials) were also checked. All studies included in the review were assessed using the quality criteria of the Cochrane Collaboration. Statistical analysis was performed by using Cochrane Review Manager (RevMan, version 5.4.0). Standardized mean difference was used in major meta-analyses where a P value of .05 or less was the threshold for statistical significance. A heterogeneity test and the chi-square test were performed to assess the presence and extent of statistical heterogeneity with significance set at P<.10. Funnel plots were visually inspected to assess the risk of bias. Subgroup analyses were conducted for each disorder to estimate intervention effects. RESULTS: The systematic search resulted in 16 studies (total N=1745) that met the criteria for this study and were included in the review. There were 10 studies on depressive symptoms, 3 on chronic pain, 1 on generalized anxiety disorder, 1 on obsessive-compulsive disorder, and 1 on hypochondriasis. The quality and risk of bias was also assessed. Results showed a pooled effect size (Hedge g) post treatment of -0.49 (95% CI -0.68 to -0.29), indicating that VCBT is effective for clients with psychiatric disorders. Study quality did not affect outcomes. CONCLUSIONS: While the overall results indicate the effectiveness of VCBT, there are still only a limited number of studies on specific psychiatric and somatic conditions. Therefore, more randomized controlled trials are needed to establish the effectiveness of VCBT for different disorders. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42021224832; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=224832.

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The RCT's findings confirm what has been found in previous clinical trials for other anxiety disorders and other non-anxiety disorders.
“The analyses confirmed, with an RCT conducted according to CONSORT guidelines, what has been found in previous clinical trials for other anxiety disorders [30,32,34,77] and other non-anxiety disorders [26,28,33].”
From A Multisite Non-Inferiority Randomized Controlled Trial of the Efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder Delivered by Videoconference (2022) · cites this paper as [30]
The Results and Discussion report prior trials of videoconference-delivered CBT for depression and other conditions, including some anxiety disorders. But the Discussion’s “Comparison With Prior Work” says it would be premature to determine effectiveness for anxiety disorders from this review’s effect sizes. The source therefore supports the existence of relevant prior trials, but not an unqualified claim that the cited evidence confirms effectiveness across other anxiety disorders. (LLM, conf=0.83)
Experimental — accuracy not yet measured
Most studies using videoconferencing have been conducted on anxiety-related disorders and major depression.
“Indeed, most studies using videoconferencing have been conducted on anxiety-related disorders and major depression [26,29,30,32,33,88].”
From A Multisite Non-Inferiority Randomized Controlled Trial of the Efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder Delivered by Videoconference (2022) · cites this paper as [30]
The Abstract’s Results report that 10 of 16 included videoconference-delivered CBT studies examined depressive symptoms and three examined anxiety-related conditions, supporting the claim’s general pattern. But the review covers a defined set of CBT studies, not all videoconferencing studies, and it describes the largest group as studies of depressive symptoms rather than specifically major depression. (LLM, conf=0.86)
Experimental — accuracy not yet measured
An increasing number of studies have documented the efficacy and effectiveness of videoconferencing psychotherapy for mental health disorders.
“Indeed, an increasing number of studies have documented the efficacy and effectiveness of videoconferencing psychotherapy (VCP) for mental health disorders [26,29,30,32,33].”
From A Multisite Non-Inferiority Randomized Controlled Trial of the Efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder Delivered by Videoconference (2022) · cites this paper as [30]

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Authors: Matsumoto, K., Hamatani, S., & Shimizu, E.
Affiliations: Kanazawa University (JP)
Linköping University (SE)
Chiba University (JP)
Corresponding author: Matsumoto, Kazuki
ORCID: Matsumoto, Kazuki
Hamatani, Sayo
Shimizu, Eiji
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2021-12-13
Volume: 23
Issue: 12
Pages: e31293
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/31293
PMC: PMC8713091
OpenAlex: W3210224813
Cited by: 67
References: 69
Citations by year: 2026: 15 · 2025: 13 · 2024: 12 · 2023: 16 · 2022: 11
FWCI: 1.52
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal of Medical Internet Research (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DiVA (Linkoping University) (submittedVersion, other-oa)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders: Japan Society for the Promotion of Science (18K03130, 19J00227, 18K17313)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: external beam radiotherapy, mental illness, depression, chronic pain, generalized anxiety disorder, obsessive-compulsive disorder, health anxiety, online therapy, treatment effectiveness, access to mental health care, remote treatment delivery, risk of bias assessment, effect size heterogeneity, publication bias, study quality bias
MeSH terms: Systematic Reviews as Topic, Mental Disorders, Humans, Research Design, Cognitive Behavioral Therapy, Videoconferencing

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Effectiveness of videoconference-delivered cognitive behavioral therapy for adults with psychiatric disorders: Systematic and meta-analytic review

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