title: Comparing telehealth-based and clinic-based group cognitive behavioral therapy for adults with depression and anxiety: a pilot study.
abstract: BACKGROUND
  The primary objective of this pilot study was to demonstrate reliable adherence to a group cognitive behavioral (CBT) therapy protocol when delivered using on-line video conferencing as compared with face-to-face delivery of group CBT. A secondary aim was to show comparability of changes in subject depression inventory scores between on-line and face-to-face delivery of group CBT.
  
  
  METHODS
  We screened 31 individuals, 18 of whom met the criteria for a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) diagnosis of mood and/or anxiety disorder. All qualifying participants had the necessary equipment (computer, webcam, Internet) for participation in the study, but could exercise their preference for either the on-line or face-to-face format. Eighteen completed the 13 weekly session intervention program (ten face-to-face; eight video conferencing). We coded adherence to protocol in both intervention formats and generated pre-post changes in scores on the Beck Depression Inventory Second Edition (BDI-II) for each participant.
  
  
  RESULTS
  Application of the CBT protocol coding system showed reliable adherence to the group CBT intervention protocol in both delivery formats. Similarly, qualitative analysis of the themes in group discussion indicated that both groups addressed similar issues. Pre-post intervention scores for the BDI-II were comparable across the two delivery formats, with 60% of participants in each group showing a positive change in BDI-II severity classification (eg, from moderate to low symptoms).
  
  
  CONCLUSIONS
  This pilot study demonstrates that group CBT could be delivered in a technology-supported environment (on-line video conferencing) and can meet the same professional practice standards and outcomes as face-to-face delivery of the intervention program.
authors.affiliation: Rotman Research Institute, Toronto, ON, Canada.
authors.forename: Nasreen
authors.initials: N
authors.lastname: Khatri
authors.affiliation: Rotman Research Institute, Toronto, ON, Canada.
authors.forename: Elsa
authors.initials: E
authors.lastname: Marziali
authors.affiliation: Rotman Research Institute, Toronto, ON, Canada.
authors.forename: Illia
authors.initials: I
authors.lastname: Tchernikov
authors.affiliation: Rotman Research Institute, Toronto, ON, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: Shepherd
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D017216:Telemedicine / Q000379:methods*; D049269:Videoconferencing
keywords: cognitive behavioral therapy; computer-based; gerontology; mood disorders; psychotherapy