AUTHOR=Alavi Nazanin , Moghimi Elnaz , Stephenson Callum , Gutierrez Gilmar , Jagayat Jasleen , Kumar Anchan , Shao Yijia , Miller Shadé , Yee Caitlin S. , Stefatos Anthi , Gholamzadehmir Maedeh , Abbaspour Zara , Shirazi Amirhossein , Gizzarelli Tessa , Khan Ferwa , Patel Charmy , Patel Archana , Yang Megan , Omrani Mohsen 

TITLE=Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial

JOURNAL=Frontiers in Psychiatry

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1113956

DOI=10.3389/fpsyt.2023.1113956

ISSN=1664-0640

ABSTRACT=<sec><title>Objective</title><p>The increased prevalence of major depressive disorder (MDD) amid the COVID-19 pandemic has resulted in substantial growth in online mental health care delivery. Compared to its in-person counterpart, online cognitive behavioral therapy (e-CBT) is a time-flexible and cost-effective method of improving MDD symptoms. However, how its efficacy compares to in-person CBT is yet to be explored. Therefore, the current study compared the efficacy of a therapist-supported, electronically delivered e-CBT program to in-person therapy in individuals diagnosed with MDD.</p></sec><sec><title>Methods</title><p>Participants (<italic>n</italic> = 108) diagnosed with MDD selected either a 12 week in-person CBT or an asynchronous therapist-supported e-CBT program. E-CBT participants (<italic>n</italic> = 55) completed weekly interactive online modules delivered through a secure cloud-based online platform (Online Psychotherapy Tool; OPTT). These modules were followed by homework in which participants received personalized feedback from a trained therapist. Participants in the in-person CBT group (<italic>n</italic> = 53) discussed sessions and homework with their therapists during one-hour weekly meetings. Program efficacy was evaluated using clinically validated symptomatology and quality of life questionnaires.</p></sec><sec><title>Results</title><p>Both treatments yielded significant improvements in depressive symptoms and quality of life from baseline to post-treatment. Participants who opted for in-person therapy presented significantly higher baseline symptomatology scores than the e-CBT group. However, both treatments demonstrated comparable significant improvements in depressive symptoms and quality of life from baseline to post-treatment. e-CBT seems to afford higher participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group.</p></sec><sec><title>Conclusion</title><p>The findings support e-CBT with therapist guidance as a suitable option to treat MDD. Future studies should investigate how treatment accessibility is related to program completion rates in the e-CBT vs. in-person group.</p></sec><sec><title>Clinical Trial Registration</title><p><ext-link xlink:href="https://ClinicalTrials.Gov" ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.Gov</ext-link> Protocol Registration and Results System (NCT04478058); <ext-link xlink:href="https://clinicaltrials.gov/ct2/show/NCT04478058" ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink">clinicaltrials.gov/ct2/show/NCT04478058</ext-link>.</p></sec>