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Learning Objective 1: Understand the existing evidence comparing face to face versus remote delivery of cognitive behavioral therapy
Learning Objective 2: Identify areas for further research into remotely delivered cognitive behavioral therapy
The purpose of this critical review is to evaluate studies that compare face to face versus remote cognitive behavioral therapy (CBT) in a parallel study design. The studies included in this review use either telephone or videoconference to deliver the remote therapy for conditions including insomnia, panic disorder, chronic fatigue syndrome, posttraumatic stress disorder, depression, obsessive compulsive disorder, and bulimia nervosa. Sample sizes range from 11-325 participants, with Caucasian females, males in the military, and urban participants disproportionately represented. The therapeutic dose (length of session) varied within studies, and remote therapy participants often receiving a smaller therapeutic dose. Therapeutic alliance (TA) and patient satisfaction with treatment were evaluated in 25% of the studies. TA was found to be higher in participants receiving the face to face therapy, while patient satisfaction with treatment was equal in both groups. Most studies showed no significant differences in outcomes between face to face and remote CBT delivered by telephone or videoconference. Two studies favored remote treatment while two indicated that face to face CBT was more effective.
In conclusion, this literature review supports the efficacy of remote delivery of CBT via the telephone or videoconference. Future studies need to examine challenges to the adoption of remote CBT in diverse groups including rural, minority, and elderly populations. In addition, alternative methods of delivering CBT remotely should be explored.