Background
Methods
Design
Inclusion criteria
Study design
Interventions
Populations
Search strategy
Methods of the review
Methods of analysis
Results
Study | Target population | Study groups | Description of intervention in each group |
---|---|---|---|
Hunkeler (2000) | Depressed primary care patients | Usual care plus telephone support & peer care | 'Good care' incorporating regular GP visits, continued antidepressant prescribing and any other referral thought usual by GP. Augmented by telephone-delivered medication adherence support, side-effect discussions and behavioural activation plans (mean of 10.1 × 5.6 min sessions over 16 wks) plus one or more telephone or face-to-face (6/62 participants) peer support contacts. |
Usual care plus telephone support | As above, minus peer support | ||
Usual care | As above minus telephone & peer support. | ||
Lange (2001) | Psychology students with trauma experience | Internet-mediated writing therapy | 30 web-pages of psychoeducation followed by 10 × 45-min writing sessions over 5 wks (2/wk), therapist feedback (appro× 450 words) provided on 7 occasions across 3 treatment phases (self-confrontation, cognitive re-appraisal, sharing & farewell ritual). |
Waiting list | 30 web pages of psychoeducation only | ||
Lange (2003) | Individuals with mild-relatively severe trauma symptoms | Internet-mediated writing therapy | 30 web-pages of psychoeducation followed by 10 × 45-min writing sessions over 5 wks (2/wk), therapist feedback (approx 450 words) provided on 7 occasions across 3 treatment phases (self-confrontation, cognitive re-appraisal, sharing & farewell ritual). |
Delayed treatment | As above, but only received once the intervention group had completed treatment. | ||
Lovell (2006) | Secondary care outpatients with OCD | Face-to-face CBT | 10 × 1-hr sessions using exposure & response prevention. Sessions incorporated the establishment of fear hierarchies, use of family co-therapist, weekly exposure targets (to be practised between sessions for at least 1-hr/dy), homework reviews and collaborative problem solving. |
Telephone CBT | 8 weekly telephone calls of up to 30-mins in length with treatment content identical to above. Homework sheets posted to participants. Initial 1-hr face-to-face session covering the same material as the face-to-face arm plus 1 × 1-hr final session face-to-face | ||
Lynch (1997) | Primary care patients with minor depression | Telephone counselling | 6 × 20-min sessions based on problem-solving for depression; homework comprising of 5 steps of treatment including a demonstration of the connection between depressed mood and problems, expressing problems in a form that facilitates solutions, evaluating and modifying these solutions. |
Comparison group | No further details provided | ||
Lynch (2004) | Primary care patients with minor depression | Telephone problem solving | Nezu's problem solving therapy adapted for telephone use and administered over a 6-wk period |
Telephone stress management | Treatment designed to serve as an attention control with topics including the identification of sources of stress, the importance of diet & exercise, ways of coping with stress | ||
Usual care | Usual treatment deemed appropriate by primary care physician. | ||
McName e (1989) | Housebound agoraphobics with panic disorder | Telephone self exposure | Exposure goals set via 10 × 12-min telephone contacts with therapists. Subjects posted a self-help manual that encouraged use of coping strategies and family co-therapists. |
Telephone relaxation therapy | Subjects posted standard taped instructions of Jacobsen's relaxation and instructed to listen for at least 1-hr/dy. Therapy augmented by 10 × 12-min telephone consultations. | ||
Miller (2002) | Women with history of recurrent/chronic depression | Telephone interpersonal psychotherapy (IPT-T) | 12 × 1-hr scheduled weekly sessions. |
Usual care | No treatment beyond usual care | ||
Mohr (2000) | Depressed MS patients | Telephone CBT | 8 × 50-min sessions plus a workbook with assignments. Treatment delivered alongside access to usual care. |
Usual care | Any treatment given in the course of usual clinician care. | ||
Mohr (2005) | Depressed primary care patients with MS | Telephone CBT (T-CBT) | Weekly 50-min sessions completed over 16 wks. |
Telephone supportive emotion focussed therapy (T-SEFT) | Weekly 50-min sessions completed over 16 wks | ||
Nelson (2003) | Depressed children aged 8–14 yrs | Videoconferenc e CBT | 8 sessions (1 × 90-min plus 7 × 60-min). |
Face-to-face CBT | 8 sessions (1 × 90-min plus 7 × 60-min). | ||
Simon (2004) | Depressed primary care patients | Telephone psychotherapy | 8 × 30–40 min CBT plus 1 mail contact and 3 × 10–15 min telephone sessions focussed on medication management, caseload tracking and structured assessment. |
Telephone care management | As above minus telephone CBT. Patients given CBT self-management booklet but no further support provided. | ||
Usual care | No further details given | ||
Swinson (1995) | Rural primary care patients suffering from panic disorder with agoraphobia | Telephone behaviour therapy | Mailed psychometric package and educational workbook serving as an introduction to behavior therapy concepts (e.g. hierarchy construction, exposure exercises, record keeping); 8 × 1-hr scheduled therapy sessions completed over approx. 10 wks. Therapy included exposure principles & exercises, long term goals, hierarchy construction, coping strategies, diary keeping, homework planning & reviewing. |
Waiting list | Initial psychometric package followed 10 wks later by an additional psychometric package and a workbook serving as an introduction to behavior therapy concepts (e.g. hierarchy construction, exposure exercises, record keeping). |
Study | Country | Target population | Recruitment | Sample size | Outcomes | Follow-up | Follow-up rate | CCDAN score |
---|---|---|---|---|---|---|---|---|
Hunkele r (2000) | US | Depressed primary care patients | GP referral | 302 | HAMD, BDI, SF-12 | Baseline, 6 w, 6 m | 90% at 6 w, 85% at 6 m | 25 |
Lange (2001) | Netherlands | Psychology students with trauma experience | From student pool in return for course credits | 30 | IES, SCL-90, POMS | Baseline, 5 w, 11 w | 83% at 5 w, 27% at 11 w | 18 |
Lange (2003) | Netherlands | Individuals with mild-relatively severe trauma symptoms | Website contact | 184 | IES, SCL-90 | Baseline, 5 w, 11 w | 79% at 5 w, 31% at 11 w | 21 |
Lovell (2006) | UK | Secondary care outpatients with OCD | Screening clinics | 72 | YBOCs, BDI | Pre-baseline, baseline, 1 m, 3 m, 6 m | 90% at 6 m | 36 |
Lynch (1997) | US | Primary care patients with minor depression | Screening | 29 | BDI, HAMD, DHP, PSI | Baseline, 7 w | 55% at 7 w | 20 |
Lynch (2004) | US | Primary care patients with minor depression | Screening | 54 | BDI, HAMD, DHP | Baseline, 6 w | 57% at 6 w | 17 |
McNam ee (1989) | UK | Housebound agoraphobics with panic disorder | Telephone screening | 23 | BDI, FQ, PT, GP, SA, GI | Baseline, 2 w, 4 w, 6 w, 8 w, 10 w, 12 w, 20 w, 32 w | 78% at 6 w, 61% at 32 w | 22 |
Miller (2002) | US | Women with history of recurrent/chronic depression | Ongoing longitudinal study | 30 | HRSD, GAS SAS-SR | Baseline, 12 w | 80% at 12 w | 22 |
Mohr (2000) | US | Depressed MS patients | Telephone screening | 32 | POMS | Baseline, 8 w | 72% at 8 w | 22 |
Mohr (2005) | US | Depressed primary care patients with MS | MS case registers & MS society newsletters | 127 | BDI, HDRS, PANAS | Baseline, 8 wk, 16 w, 3 m, 6 m, 9 m, 12 m | 91% at 16 w | 31 |
Nelson (2003) | US | Depressed children aged 8–14 yrs | Not clear | 38 | K-SADS-P, CDI | Baseline, 8 w | 74% at 8 w | 13 |
Simon (2004) | US | Depressed primary care patients | Computer records of patients starting new antidepressant treatment | 600 | SCL, PHQ | Baseline, 6 w, 3 m, 6 m | 89% at 6 m | 38 |
Swinson (1995) | Canada | Rural primary care patients suffering from panic disorder with agoraphobia | GP/family physician referral | 46 | FQ, STAI-T, BDI, ASI, SCL-90 | Baseline, 10 w, 3 m | 91% at 10 w, 76% at 3 m | 20 |
Scope of the included studies
Quality of the included studies
Quantitative results
Intervention | Comparison | Disorder | Follow -up period | No. Comparisons | Total Participants | Pooled Effect Size | 95% CI |
---|---|---|---|---|---|---|---|
Remote psychotherapy | Control | Depression | 0–6 m | 7 | 726 | 0.44 | 0.29 to 0.59 |
Remote psychotherapy | Control | Anxiety-related | 0–6 m | 3 | 168 | 1.15 | 0.81 to 1.49 |
Remote psychotherapy | Face-to-face psychotherapy | Depression | 0–6 m | 1 | 28 | 0.55 | -0.20 to 1.31 |
Remote psychotherapy | Face-to-face psychotherapy | Anxiety-related | 0–6 m | 1 | 63 | -0.11 | -0.60 to 0.38 |
Remote psychotherapy (problem solving therapy) | Remote psychotherapy (stress management) | Depression | 0–6 m | 1 | 18 | 0.38 | -0.56 to 1.32 |
Remote psychotherapy (cognitive behavioral therapy) | Remote psychotherapy (supportive emotion focused therapy) | Depression | 0–6 m | 1 | 122 | 0.39 | 0.04 to 0.74 |
Remote psychotherapy (cognitive behavioral therapy) | Remote psychotherapy (supportive emotion focused therapy) | Depression | 7 m+ | 1 | 117 | 0.25 | -0.12 to 0.62 |
Remote psychotherapy (exposure therapy) | Remote psychotherapy (relaxation therapy) | Anxiety-related | 0–6 m | 1 | 18 | 1.10 | 0.10 to 2.10 |
Remote psychotherapy (exposure therapy) | Remote psychotherapy (relaxation therapy) | Anxiety-related | 7 m+ | 1 | 14 | 1.22 | 0.06 to 2.38 |