Is remote therapy as effective as face-to-face sessions? What the new research says – National |

Cognitive behavioral therapy (CBT) delivered remotely with a therapist is just as effective as face-to-face sessions, according to a new study published in the Canadian Medical Association Journal (CMAJ).

The study, published Monday in the CMAJ, found that “moderate-certainty evidence” showed little or no difference in the effectiveness of in-person therapist-guided remote CBT across a range of somatic and mental health disorders .

CBT is a form of psychotherapy that helps people recognize and modify harmful thought patterns and behaviors; It has been shown to be effective for a variety of mental health issues, including depression and anxiety, but also chronic pain.

“The World Health Organization has designated CBT as essential health care, but access remains a significant barrier for many people in Canada. Our results suggest that therapist-guided CBT can be used effectively remote to facilitate greater access to evidence-based care,” said Dr. Jason Busse, professor of anesthesia at McMaster University in Hamilton, Ont., in a news release Monday.

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In the wake of the COVID-19 pandemic, virtual healthcare, which ranges from face-to-face appointments to therapy sessions, has grown in popularity due to its convenience and accessibility, particularly benefiting people living in remote communities.

In 2022, more than five million Canadians met diagnostic criteria for a mood, anxiety or substance use disorder, and one in five adults live with chronic pain, according to the study.

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In Canada, CBT is mostly provided by psychotherapists, social workers and registered psychologists, making it expensive because it is not covered by many publicly funded health systems and is limited by many private benefit plans, the researchers said. .

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Although evidence supports the effectiveness of in-person CBT therapy, the study underscores the uncertainty surrounding a remote form of this therapy.

To find this data, researchers analyzed 54 randomized controlled trials with more than 5,400 patients. These trials looked at the effectiveness of CBT in treating a variety of conditions including anxiety, depression, insomnia, chronic pain, chronic fatigue syndrome, tinnitus and alcohol use disorder. They also specifically compared the results of face-to-face CBT with those of remote CBT.

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Types of remote CBT included interactive voice response technology, computerized CBT, telehealth-based and telephone, videoconferencing, and online CBT. The study also found that research has found that most patients are willing to receive psychotherapy in person or at a distance.

“Our systematic review found moderate-certainty evidence of little or no difference in the effectiveness of CBT delivered in-person or remotely with therapist support,” the authors said. “This finding was not affected by the type of clinical condition, length of follow-up, or whether CBT was provided individually or through group sessions.”

Barriers to face-to-face therapy

In August 2023, Mental Health Research Canada commissioned a survey of 3,189 Canadian adults, which revealed a notable increase in participants who cited financial constraints as a barrier to accessing mental health care, from 18% to 29% compared to the previous year.

The authors argue that barriers to accessing therapy go beyond financial constraints and also include geographic factors.

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“Access to psychotherapy is a significant barrier for many people in Canada, particularly those living in remote or rural areas, including military veterans and Indigenous populations, both of whom are at high risk for chronic pain and health disorders mental,” they said.

Remote CBT places fewer demands on patients’ time, as travel for face-to-face sessions is not necessary, the authors said. It can also be more cost-effective than in person, “especially when the intervention is supported by therapists, rather than being delivered remotely in real time.”

The study concludes that Canada’s provinces and territories should consider funding access to therapist-led remote CBT to facilitate greater access to evidence-based care. Currently, only two provinces, Saskatchewan and Ontario, offer funding for remote CBT.

“There are several options for providing remote psychotherapy, and the use of this delivery method for CBT is likely to evolve rapidly. Recent advances in artificial intelligence tools may open more avenues for providing CBT with reduced involvement of human therapists,” the authors stated.

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