Evidence-based telehealth interventions for post-traumatic stress disorder, depression, and anxiety

A systematic review and meta-analysis

Kelber, Marija S
Smolenski, Derek J
Boyd, Courtney
Shank, Lisa M
Bellanti, Dawn M
Milligan, Tiffany
Edwards-Stewart, Amanda
Libretto, Salvatore
Parisi, Kelly
Morgan, Maria A
Evatt, Daniel P

Psychological Health Center of Excellence, 508298Defense Health Agency, Falls Church, VA, USA

Marija S Kelber, Psychological Health Center of Excellence, 7700 Arlington Blvd, Suite 5101 Box #22, Falls Church, VA, 22041, USA. Email: [email protected]

Received October 3, 2023

Accepted December 16, 2023

Journal of Telemedicine and Telecare 31(6):p 757-767, July 2025. | DOI: 10.1177/1357633X231224491

Introduction

The goal of this systematic review was to examine the efficacy of behavioral health care treatments for post-traumatic stress disorder (PTSD), depression, and anxiety delivered via telehealth.

Methods

We searched a combination of keywords related to telehealth, relevant mental health disorders, and evidence-based psychotherapies in three databases (PubMed, PsycInfo, and Embase) from database inception to April 2022. We included randomized controlled trials published in English wherein at least one arm received an evidence-based psychotherapy via telehealth. To be included, studies also had to enroll an adult population with symptoms or diagnosis of PTSD, depressive disorder, or anxiety disorder.

Results

Moderate quality of evidence was consistent with only small differences, if any, in efficacy between video teleconferencing (VTC) and in-person delivery for patients with PTSD (d = 0.06, 95% CI −0.17, 0.28). However, for those with depression, in-person delivery was associated with better outcomes compared to VTC (d = 0.28, 95% CI 0.03, 0.54; low quality of evidence). We also found that evidence-based treatments delivered over telephone were more efficacious for depression compared to treatment as usual (d = -0.47, 95% CI −0.66, −0.28; very low quality of evidence). Very low quality of evidence supported the use of telehealth versus waitlist for anxiety (d = -0.48, 95% CI −0.89, −0.09).

Conclusions

A synthesis across 29 studies indicates that the efficacy of telehealth for delivery of evidence-based behavioral health interventions varies by target diagnosis and telehealth modality. More research is needed on the efficacy of telehealth treatments for depression and anxiety.