Characteristics of effective teletherapy for major depression: A systematic review

People would prefer to have psychotherapy as treatment over medication for major depression. There is evidence that psychotherapy does not require in-person delivery to be effective. Other modes of delivery, such as videoconferencing teletherapy, may make it a more accessible treatment.

The aim of this review was to identify the characteristics of effective psychotherapy delivered by videoconference for adults in primary care with a primary diagnosis of depression. A quantitative systematic review was conducted and reported according to PRISMA guidelines.

There were 8 studies included in the review. The therapies studied were tele problem-solving therapy, behavioural activation and cognitive behavioural therapy. All studies had a medium to high risk of bias. Six were randomized controlled trials, one was a pragmatic retrospective cohort study and one was an open-label design. Four studies found similar outcomes to the in-person comparators, one study found tele problem-solving therapy was more effective than behavioural activation, and one study found cognitive behavioural therapy to be similar to usual care.

The search identified only 8 studies. Due to the heterogeneity of outcome measures and comparators, a meta-analysis could not be conducted.

No definitive conclusions can be drawn about the effectiveness of teletherapy in primary care based on this review, however, there is emerging evidence to suggest it has similar outcomes to in-person therapy for people with a primary diagnosis of depression. There is no evidence regarding the superiority of one model of therapy over the others.