In a recent publication in Frontiers Psychiatry, researchers conducted a nonrandomized, controlled study to compare the efficacy of a therapist-supported, online/electronically cognitive behavioral therapy (e-CBT) program to in-person therapy in individuals diagnosed with MDD.

The study involved an e-CBT treatment arm and an in-person CBT control arm that was comprised of 108 participants who were diagnosed with MDD. The participants were selected for either a 12-week in-person CBT or an asynchronous therapist–supported e-CBT program. Fifty-five participants who received e-CBT completed weekly interactive online modules delivered through a secure cloud-based online platform called Online Psychotherapy Tool. In addition to the modules, participants also completed homework in which participants received personalized feedback from a trained therapist. Among the 53 participants who received in-person CBT groups, they discussed sessions and homework with their therapists during 1-hour weekly meetings.

The researchers employed depressive symptomatology and quality of life questionnaires at preintervention, midintervention, and postintervention stages to assess program efficacy. The primary outcomes measured were changes in depressive symptoms based on the Patient Health Questionnaire-9 and the Quick Inventory of Depressive Symptomatology Questionnaire-Self Report. Secondary outcomes were the average number of sessions completed and dropout rates in the two treatment arms.

The results revealed that from baseline to posttreatment, both in-person and e-CBT produced meaningful improvements in depressive symptoms and quality of life. Moreover, among participants who chose in-person therapy, there were significantly greater baseline symptomatology scores when compared to those who opted for e-CBT. The authors also indicated that e-CBT appears to provide greater participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group.

Based on their findings, the authors wrote, “In line with the current body of studies, the findings support the efficacy of therapist-guided CBT, independent of delivery type, in improving depressive symptoms and quality of life.”

They also added that while both modes of CBT were efficacious, the study also emphasizes that patients with variable MDD severity may favor different levels of therapist support. The authors also indicated that additional studies should examine how treatment accessibility is correlated to program completion rates in the e-CBT versus the in-person CBT group.

The authors concluded, “The findings demonstrated that in-person and e-CBT groups significantly improved depressive symptom severity and quality of life. E-CBT may be critical in addressing accessibility barriers and providing significant time savings to care providers. However, MDD severity is a factor that should be considered when determining the most appropriate treatment delivery format for individuals seeking care.”

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