Psychotherapy mediated by remote communication technologies: a meta-analytic review

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Psychotherapy mediated by remote communication technologies: a meta-analytic review

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Title: Psychotherapy mediated by remote communication technologies: a meta-analytic review
Author: Bee, P.E.
Bower, Peter
Lovell, Karina
Gilbody, Simon
Richards, David
Gask, L
Roach, P
Citation: BMC Psychiatry 2008, 8:60
Publisher: BioMed Central Ltd
Journal: BMC Psychiatry
Date Issued: 2008-07
DOI: 10.1186/1471-244X-8-60
Abstract: Background Access to psychotherapy is limited by psychopathology (e.g. agoraphobia), physical disability, occupational or social constraints and/or residency in under-served areas. For these populations, interventions delivered via remote communication technologies (e.g. telephone, internet) may be more appropriate. However, there are concerns that such delivery may influence the therapeutic relationship and thus reduce therapy effectiveness. This review aimed to determine the clinical effectiveness of remotely communicated, therapist-delivered psychotherapy. Methods Systematic review (including electronic database searching and correspondence with authors) of randomised trials of individual remote psychotherapy. Electronic databases searched included MEDLINE (1966–2006), PsycInfo (1967–2006), EMBASE (1980–2006) and CINAHL databases (1982–2006). The Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDAN-CTR). All searches were conducted to include studies with a publication date to July 2006. Results Thirteen studies were identified, ten assessing psychotherapy by telephone, two by internet and one by videoconference. Pooled effect sizes for remote therapy versus control conditions were 0.44 for depression (95%CI 0.29 to 0.59, 7 comparisons, n = 726) and 1.15 for anxiety-related disorders (95%CI 0.81 to 1.49, 3 comparisons, n = 168). There were few comparisons of remote versus face-to-face psychotherapy. Conclusion Remote therapy has the potential to overcome some of the barriers to conventional psychological therapy services. Telephone-based interventions are a particularly popular research focus and as a means of therapeutic communication may confer specific advantages in terms of their widespread availability and ease of operation. However, the available evidence is limited in quantity and quality. More rigorous trials are required to confirm these preliminary estimates of effectiveness. Future research priorities should include overcoming the methodological shortcomings of published work by conducting large-scale trials that incorporate both clinical outcome and more process-orientated measures.
Type: Article
Description: Reproduced with permission of the publisher. © 2008 Bee et al; licensee BioMed Central Ltd. The electronic version of this article is the complete one and can be found online at: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Psychological disordersRemote psychotherapyCognitive behavioural therapyRemote communication technologiesPsychotherapeutic techniques

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