The Efficacy of Synchronous Teletherapy Versus In-Person Therapy: A Meta-Analysis of Randomized Clinical Trials

Public Health Significance Statements Teletherapy produces comparable outcome to in-person therapy. Trainee therapists are at greater risk of client dropout in teletherapy than licensed therapists. Despite the increasing use of teletherapy, it remains unclear if client outcomes differ between remote and in-person settings and, if they do differ, what factors might contribute to these differences. The current study synthesized findings on the comparison between teletherapy and in-person therapy using a meta-analytic approach. All known RCTs comparing teletherapy (telephone and videoconferencing therapy) to in-person therapy were identified via bibliographic database search (PsycINFO, Medline, and Cochrane database), manual searches of previously published meta-analyses, and expert contact. We identified 1,393 studies in the initial search, 20 of which satisfied study inclusion criteria. No significant difference was found between teletherapy and in-person therapy in treatment outcomes at posttreatment (g = -0.043) or follow-up (g = -0.045) or in attrition rates (RR = 1.006). Trainee therapists experienced greater client attrition rates in teletherapy than did licensed therapists. Videoconferencing therapy was at greater risk for client attrition than telephone therapy. Within-group findings showed that teletherapy produced a symptom reduction of a large magnitude at posttreatment (g = 1.026) and follow-up (g = 1.021). These findings provide empirical support for the practice of teletherapy and that client outcomes in teletherapy do not differ from in-person versions of treatments.