Originally published: . Volume 12, No. 6. Source pages: 9, 10.
Does Telepsychology Stack Up? A Review of a Comparative Meta-analysis on Efficacy Mental Health Services Delivered via of Video Conferencing Technology
COVID-19 pandemic has changed lives worldwide. In more technologically advanced cultures, there has been increased reliance on video conferencing platforms such as Zoom. Whether visiting with distant relatives or friends, for educational purposes, or for work-related functions, such platforms have become ubiquitous for many. Indeed, in March 2020 educators from the primary grades to graduate and professional schools were asked to suddenly “pivot” to the use of such technology for instructional purposes. The genie is unlikely to go willingly back into the bottle.
The delivery of health-care services has not been left untouched with many health-care professionals offering services via such distance technology. Important questions arise as to the efficacy of such treatment for a broad range of healthcare services including mental health-related services.
A recent meta-analysis by Batastini et al. (2021) pooled data from 57 qualified peer-reviewed journal articles, 43 examining clinical intervention outcomes and 14 examining evaluation reliability, to compare the use of video-conferencing technology (VCT) with more traditional in-person mental healthcare delivery. The studies included spanned over 20 years of research published in peer-reviewed literature between 2007 and 2019. The inclusionary criteria were that each study must have been published in or available in English, evaluate mental health outcomes following a mental health service, use a telecommunications system that allowed for synchronous audio and video connectivity, utilize a between-groups design, and provide enough information to calculate effect sizes and corresponding variances.
The 43 intervention studies that met inclusionary criteria were published between 2002 and 2019 representing a total of 281 individual treatment outcomes. In total, the studies analyzed subsumed 364 treatment outcomes among 4,668 participants. These studies included both male and female clients (no mention was made of clients who identified as non-binary or gender nonconforming) as well as child, adolescent, and adult clients. A variety of settings were represented including home-based, university clinics, veterans’ facilities, outpatient clinics, and correctional institutions. A wide variety of mental disorders were represented among the studies including, for example, depressive or mood disorders, as well as trauma and anxiety-related symptoms. Most of the studies reported the results of psychosocial interventions or psychotherapy while others focused upon psychotropic medication management with adjunctive counseling or psychotherapy.
There were 14 studies that were published between 1997 and 2019 that met inclusion criteria for assessing the reliability of psychological and psychiatric assessment procedures involving 332 examinees.
The results of two types of meta-analytic analyses revealed no overall statistically significant difference for treatment efficacy as a function of service delivery by VCT as compared to in-person interventions. Similarly, VCT-based assessments were found to yield similar assessment scores to those obtained with in-person formats.
The findings with regard to treatment efficacy are tempered somewhat by statistically significant moderation effects for client gender as well as a client intervention site. Specifically, there is evidence that in studies with a predominantly male sample treatment efficacy was higher for in-person interventions as compared to VCT-based interventions. The authors note, however, that other factors such as veteran status could be involved thus limiting the generalizability of this finding. In studies with a primarily female sample, the opposite was the case – females tended to benefit more from VCT-based interventions. The authors suggest that this finding may be related to evidence that women and girls are more frequent users of technology in the forms of text messaging, social media, and the like as compared to males.
Also, participants in medical facilities demonstrated higher efficacy for VCT- based interventions than was the case for in-person treatments. Regarding this latter finding, the authors speculate that it may be the case that medical facilities are equipped with superior online communication technologies than are those available in other settings and/or clients in such settings may differ from those in other settings in terms of types of presenting disorders, severity of disorder, etc.
Based on this careful and comprehensive meta-analysis, there is little reason at present to doubt the efficacy of VCT-based interventions and assessments as compared to such services offered in-person. This does not necessarily mean, of course, that there are in fact no differences nor obviate the possibility that with other outcome measures or samples drawn from other populations differences could be found. As we know, we cannot accept the null hypothesis, we can simply fail to reject.
Reference
Batastini, A., Paprzycki, P., Jones, A., & McLean, N. (2021) Are videoconferenced mental and behavioral health services just as good as in-person? A meta-analysis of a fast-growing practice. Clinical Psychology Review 83, 1 -22, https://doi.org/10.1016/j.cpr.2020.1019 44
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