Batastini Ashley B, Paprzycki Peter, Jones Ashley C T, MacLean Nina
University of Southern Mississippi, USA; University of Mississippi Medical Center Department of Psychiatry, USA.
University of Southern Mississippi, USA; Mississippi Center for Clinical and Translational Research, USA; University of Toledo, USA.
Clin Psychol Rev. 2021 Feb;83:101944. doi: 10.1016/j.cpr.2020.101944. Epub 2020 Nov 17.
The use of videoconferencing technologies (VCT) is on the rise given its potential to close the gap between mental health care need and availability. Yet, little is known about the effectiveness of these services compared to those delivered in-person. A series of meta-analyses were conducted using 57 empirical studies (43 examining intervention outcomes; 14 examining assessment reliability) published over the past two decades that included a variety of populations and clinical settings. Using conventional and HLM3 meta-analytical approaches, VCT consistently produced treatment effects that were largely equivalent to in-person delivered interventions across 281 individual outcomes and 4336 clients, with female clients and those treated in medical facilities tending to respond more favorably to VCT than in-person. Results of an HLM3 model suggested assessments conducted using VCT did not appear to lead to differential decisions compared to those conducted in-person across 83 individual outcomes and 332 clients/examinees. Although aggregate findings support the use of VCT as a viable alternative to in-person service delivery of mental healthcare, several limitations in the current literature base were revealed. Most concerning was the relatively limited number of randomized controlled trials and the inconsistent (and often incomplete) reporting of methodological features and results. Recommendations for reporting the findings of telemental health research are provided.
鉴于视频会议技术(VCT)在缩小精神卫生保健需求与可及性之间差距方面的潜力,其使用正在增加。然而,与面对面提供的服务相比,这些服务的有效性却鲜为人知。我们使用过去二十年发表的57项实证研究(43项考察干预结果;14项考察评估可靠性)进行了一系列荟萃分析,这些研究涵盖了各种人群和临床环境。使用传统和HLM3荟萃分析方法,在281个个体结果和4336名客户中,VCT始终产生与面对面提供的干预措施基本等效的治疗效果,女性客户以及在医疗机构接受治疗的客户对VCT的反应往往比对面对面治疗的反应更积极。HLM3模型的结果表明,与在83个个体结果和332名客户/受测者中进行的面对面评估相比,使用VCT进行的评估似乎不会导致不同的决策。尽管总体研究结果支持将VCT用作精神卫生保健面对面服务的可行替代方案,但当前文献库中仍存在一些局限性。最令人担忧的是随机对照试验的数量相对有限,以及方法学特征和结果的报告不一致(且往往不完整)。本文还提供了关于报告远程心理健康研究结果的建议。