Internet-Delivered Versus Face-to-Face Cognitive Behavior Therapy for Anxiety Disorders: Systematic Review and Meta-Analysis

Summary & key facts

Researchers pooled evidence from trials that directly compared online cognitive behavior therapy with usual face-to-face cognitive behavior therapy for anxiety. They found no clear difference in overall benefit between the two formats across the included studies. The review used a small set of trials covering a few anxiety problems and says more research is needed to be sure when and for whom online therapy works as well as in-person therapy.

Key facts:

• This study combined results from trials that directly compared internet-delivered cognitive behavior therapy (online CBT) with face-to-face CBT for anxiety.
• The researchers screened 236 articles and found 8 studies that met their rules for including head-to-head comparisons.
• The 8 studies looked at five kinds of anxiety problems: social anxiety, anxiety in teenagers, panic disorder, spider phobia, and fear of public speaking.
• Those studies were done in Australia, Spain, and Sweden and included about 660 people in total (about 350 got online CBT and about 320 got face-to-face CBT).
• When the results were pooled, the overall difference between online and face-to-face CBT was essentially zero, meaning neither format showed a clear advantage overall.
• The results are limited because only a few studies were available, they covered a small set of anxiety types and countries, and the review says more research is needed to confirm that the two formats are generally equivalent and to learn what makes online therapy work.

Abstract

BACKGROUND: Over the last 20 years, internet-delivered cognitive behavior therapy (ICBT) has been tested in a large number of randomized controlled trials, often with positive results. However, it is not widely known about the efficacy of ICBT as compared to face-to-face cognitive behavior therapy (CBT). METHODS: In the present systematic review and meta-analysis, ICBT for treatment of anxiety disorders was directly compared to face- to-face CBT within the same trial. This study aimed to reinvestigate the effect of ICBT compared to face-to-face CBT for anxiety disorders. A total of 8 studies out of the 236 articles screened met all the inclusion criteria. The included studies targeting five different anxiety disorders, social anxiety disorder, adolescent anxiety, panic disorder, spider phobia, and fear of public speaking, had been carried out in Australia, Spain, and Sweden. The total number of participants was 348 in ICBT and 316 in face-to-face conditions. RESULTS: = 0.01 (95% CI: -0.16 to 0.18). CONCLUSIONS: ICBT and face-to-face CBT created equivalent overall effects. in treatment of anxiety disorders. Since there have been similar systematic reviews about anxiety disorders so far, and in majority of them, ICBT has not been compared against face-to-face treatment. More research is needed to establish the general equivalence of the two treatment formats. Also, understanding what makes ICBT work is a challenge for future research.

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Digital Mental Health Interventions Impact of Technology on Adolescents

Categories

Applied Psychology Psychology Social Sciences

Tags

Anxiety Clinical psychology Cognition Cognitive behavioral therapy Cognitive behaviour therapy Cognitive therapy Epistemology Face-to-face Generalized anxiety disorder Internal medicine Medicine Meta-analysis Panic Panic disorder Philosophy Psychiatry Psychology Psychotherapist Randomized controlled trial Social anxiety Specific phobia

Conditions & symptoms

Anxiety Panic disorder and phobias Anxiety or worry Panic