Comparing in-person to videoconference group cognitive behavioural therapy (CBT) for depressive disorders in an out-patient mood disorders clinic.

Background: Despite their considerable public health impact, most people with depressive disorders do not receive treatment due to barriers that limit access to high-quality care. Since the onset of the COVID-19 pandemic, depressive symptoms have sharply increased, and access-to-care barriers were magnified by physical distancing requirements. Videoconferencing is a virtual care modality that reduces access-to-care barriers and can be used to deliver cognitive behavioural therapy (CBT), an evidence-based treatment for depressive disorders. However, it is unclear whether videoconference CBT effectively decreases depressive symptoms, particularly in a group therapy format.

Aim: This non-randomized study compared outcomes of group CBT for depressive disorders delivered via videoconference versus in-person.

Method: Data on clinical outcomes (pre- and post-treatment depression, anxiety, and stress symptoms), treatment attendance, drop-out, and patient satisfaction were collected from adult outpatients of a mood disorders clinic who attended 14 weekly group CBT sessions either in-person (pre-pandemic; n=255) or via videoconference (during the pandemic; n=113).

Results: Pre- to post-treatment decreases in depression, anxiety and stress symptoms did not differ between treatment modalities (β=-.01-.06, p>.05). These effects were robust to patient-level factors (i.e. age, sex, co-morbidities, medication use). Moreover, videoconference group CBT was associated with higher attendance (d=0.33) and lower drop-out (53% vs 70% of participants) compared with in-person group CBT.

Conclusions: Videoconference group CBT for depressive disorders appears to be a promising and effective alternative to in-person CBT. However, these findings should be interpreted in light of the study's non-randomized design and the potential confounding effects of the COVID-19 pandemic.