Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct;13(3):288-95.
doi: 10.1002/wps.20151.

Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis

Gerhard Andersson  1 , Pim Cuijpers, Per Carlbring, Heleen Riper, Erik Hedman
Affiliations

Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis

Gerhard Andersson et al. World Psychiatry. 2014 Oct.

Abstract

Internet-delivered cognitive behavior therapy (ICBT) has been tested in many research trials, but to a lesser extent directly compared to face-to-face delivered cognitive behavior therapy (CBT). We conducted a systematic review and meta-analysis of trials in which guided ICBT was directly compared to face-to-face CBT. Studies on psychiatric and somatic conditions were included. Systematic searches resulted in 13 studies (total N=1053) that met all criteria and were included in the review. There were three studies on social anxiety disorder, three on panic disorder, two on depressive symptoms, two on body dissatisfaction, one on tinnitus, one on male sexual dysfunction, and one on spider phobia. Face-to-face CBT was either in the individual format (n=6) or in the group format (n=7). We also assessed quality and risk of bias. Results showed a pooled effect size (Hedges' g) at post-treatment of -0.01 (95% CI: -0.13 to 0.12), indicating that guided ICBT and face-to-face treatment produce equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there are still few studies for each psychiatric and somatic condition and many conditions for which guided ICBT has not been compared to face-to-face treatment. Thus, more research is needed to establish equivalence of the two treatment formats.

Keywords: Guided Internet-delivered cognitive behavior therapy; anxiety and mood disorders; face-to-face therapy; meta-analysis; somatic disorders.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study inclusion process
Figure 2
Figure 2
Estimated risk of bias across all included studies
Figure 3
Figure 3
Forest plot displaying effect sizes of studies comparing guided Internet-based treatment with face-to-face treatment
Figure 4
Figure 4
Funnel plot to assess for publication bias by relating effect sizes of the studies to standard errors. SE – standard error, SMD – standardized mean difference (Cohen's d)
See this image and copyright information in PMC

References

    1. Andersson G, Carlbring P, Ljótsson B, et al. Guided Internet-based CBT for common mental disorders. J Contemp Psychother. 2013;43:223–33.
    1. Hedman E, Ljótsson B, Lindefors N. Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert Rev Pharmacoecon Outcomes Res. 2012;12:745–64. - PubMed
    1. Titov N, Dear BF, Johnston L, et al. Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: randomised controlled trial. PLoS One. 2013;8:e62873. - PMC - PubMed
    1. Andersson G, Carlbring P, Berger T, et al. What makes Internet therapy work? Cogn Behav Ther. 2009;38(S1):55–60. - PubMed
    1. Lange A, Rietdijk D, Hudcovicova M, et al. Interapy: a controlled randomized trial of the standardized treatment of posttraumatic stress through the Internet. J Consult Clin Psychol. 2003;71:901–9. - PubMed