Does Digital Therapy Work As Well As Face-to-Face?

When you think of mental health care, you may imagine a patient seated in a comfortable chair, talking through problems with a therapist. But today, the patient is equally likely to be seated in front of his computer screen working on online exercises.

Digital therapy has become a viable option for people with a range of mental health issues including depression, anxiety, and insomnia. Cognitive behavioral therapy is delivered digitally through self-guided mobile or computer applications. In some cases, patients complete online exercises on their own, and in other versions, patients work independently, but also receive support from a live therapist. Today, there are more than 20,000 digital mental health apps available on Android and Apple platforms, according to the European Connected Health Alliance.

The use of digital therapy skyrocketed during the COVID-19 pandemic for many reasons. The lockdowns required during the pandemic led to an increased need for mental health care services. In many regions, there were not enough therapists to meet this increased demand. And many people did not want to see therapists in person for fear of contracting COVID-19.

Certainly, it is more convenient to conduct your therapy sessions online. But is it as effective?

A new systematic review poses that exact question. German psychology researchers combined the data from 106 studies including nearly 12,000 patients to see if digital cognitive behavioral therapy (CBT) works as well as in-person therapy.

After initially combining the data, researchers found that face-to-face therapy was significantly more likely to reduce depressive symptoms and improve psychological functioning compared to digital therapy.

But the researchers didn’t stop there. They further analyzed the data to account for the characteristics of the patients in each type of therapy, including their ages, the severity of their depression, and their prescription medications. After these analyses, researchers found no significant differences between digital and in-person therapy; both types were equally likely to improve depression symptoms and psychological functioning.

The review did find one downside to digital therapy: Patients were more likely to miss sessions compared to the face-to-face version. Data also showed that digital therapy was more effective in the blended version, which includes in-person support over longer periods of time and when patients completed all of the prescribed sessions.

The take-home message: Digital cognitive behavioral therapy appears to work just as well as face-to-face sessions, according to the most recent research. The study authors pointed out that this conclusion should be tested in a clinical trial designed specifically to compare the two options.

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