Evidence of Phone vs Video-Conferencing for Mental Health Treatments: A Review of the Literature

Abstract

Purpose of ReviewThe goal of this paper is to provide a comparative review of using phone (audio-only) or video for mental health treatments. Our review includes evidence of phone and video's effectiveness in terms of reduced symptomology, retention, satisfaction, therapeutic alliance, and other outcomes of interest. This review also discusses how patients and providers' experiences and attitudes differ between these two modalities. Finally, we present information on different usage rates of phone and video across patient populations and mental health provider types, and different implementation strategies. Recent Findings Treatments through phone and video are both able to reduce symptoms related to mental health conditions and have both been found to be non-inferior to in-person care. Both phone and video are more convenient to patients. Video offers important visual information that can be important to diagnosing mental health conditions. Phone, however, is more broadly accessible and may come with fewer technological issues. Summary In the context of mental health care, where non-verbal cues are tied to symptomology and diagnosing, and a strong relationship between patient and provider can enhance treatment, we encourage the use of video, especially for psychotherapeutic services. However, as phone is more accessible, we ultimately recommend an accommodating approach, one that flexibly makes use of both phone and video. Future studies on telehealth should focus on direct, head-to-head comparisons between phone and video and conduct more rigorous testing on whether clinical differences exist.

Face‐to‐face versus telephone‐based cognitive‐behavioral therapy for family caregivers of people with dementia

“…In a project which evaluated TEL‐CBT for family caregivers of PwD, 72% of participants deemed the telephone setting very good and 27% good (Wilz & Soellner, 2016). Systematic reviews suggest that telephone‐based mental health treatments are more broadly accessible as they only require readily available equipment, have lower connection costs, and pose fewer technological challenges compared to video conferencing (Chen et al, 2022). Moreover, since many family caregivers of PwD are older and have limited experience with audiovisual communication technology, at least before the COVID‐19 pandemic (when the present study was conducted), we focus on TEL‐CBT.…”

Discipline-level differences in mental health provider perceptions of video and phone telehealth.

“…The added visual information provided during video calls may allow providers to better assess a patient’s affect and functioning, and patients may feel more connected to their provider by seeing them as opposed to only hearing them. There is a robust literature demonstrating that video is noninferior to in-person care across a range of conditions and patient populations; there are relatively fewer rigorous studies comparing phone to in-person care, but this work has also reported comparable effectiveness between these two modalities (Chen et al, 2022; McClellan et al, 2022). A smaller, albeit growing body of literature has directly compared video and phone care and found that video care is more effective than phone in the treatment of depression, trauma, and substance use disorders (Liebmann et al, 2019; McClellan et al, 2022; Meshberg-Cohen et al, 2023).…”

App-Based Interventions for Moderate to Severe Depression

“…[13][14][15] Among internet-based interventions, mobile health (mHealth) interventions, ie, medical and public health practices supported by mobile, wireless devices, 16 offer greater freedom with regard to time and distance with the use of portable devices and fewer technical complications compared with other internet-based therapies. 17,18 However, previous meta-analyses on app-based interventions for depression have reported variable effect sizes, ranging from small [19][20][21] to medium [22][23][24] to large. 25 Notably, a 2022 systematic review and meta-analysis 26 reported significant symptom reductions associated with app interventions for anxiety but not for depression.…”

“…Amidst the challenges posed by the COVID-19 pandemic impeding conventional therapies and the upsurge of technological advances in internet devices, internet-based interventions for mental disorders have gained prominence due to their enhanced efficacy, scalability, and accessibility . Among internet-based interventions, mobile health (mHealth) interventions, ie, medical and public health practices supported by mobile, wireless devices, offer greater freedom with regard to time and distance with the use of portable devices and fewer technical complications compared with other internet-based therapies . However, previous meta-analyses on app-based interventions for depression have reported variable effect sizes, ranging from small to medium to large .…”