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.

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

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).

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.

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.

Implementation of video call-based cognitive behavioural therapy (CBT) has increased significantly since the COVID-19 pandemic, enabling more flexible delivery, but less is known about user experience and effectiveness. This systematic review and meta-analysis investigated feasibility, acceptability, and effectiveness of individual video call-based CBT for adults with mild to moderate mental health conditions (Prospero CRD42021291055). Medline, Embase, PsycINFO and Web of Science were searched until 4 September 2023. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) assessed methodological quality of studies. Meta-analysis was conducted in R. Thirty studies (n=3275), published 2000 to 2022, mainly in the USA (n=22/30, 73%), were included. There were 15 randomised control trials, one controlled clinical trial, and 14 uncontrolled studies. Findings indicated feasibility, acceptability and effectiveness (effect size range 0.02–8.30), especially in post-traumatic stress disorder (PTSD) for military populations. Other studies investigated depression, obsessive-compulsive disorder, panic with agoraphobia, insomnia, and anxiety. Studies indicated that initial challenges with video call-based CBT subsided as therapy progressed and technical difficulties were managed with limited impact on care. EPHPP ratings were strong (n=12/30, 40%), moderate (n=12/30, 40%), and weak (n=6/30, 20%). Meta-analysis on 12 studies indicated that the difference in effectiveness of video call-based CBT and in-person CBT in reducing symptoms was not significant (SMD=0.044; CI=–0.086; 0.174). Video calls could increase access to CBT without diminishing effectiveness. Limitations include high prevalence of PTSD studies, lack of standardised definitions, and limited studies, especially those since the COVID-19 pandemic escalated use of video calls.

1. This review assesses feasibility, acceptability, and effectiveness of individual video call-based CBT for adults with mild to moderate common mental health conditions, as defined by the ICD-11.

2. Secondary aims were to assess if the therapeutic relationship is affected and identify any potential training needs in delivering video call-based CBT.

3. The adjunct meta-analysis quantitatively explored whether video call-based CBT is as effective as in-person interventions in symptom reduction on primary outcome measures by pooling estimates for studies that compare these treatment conditions.

There is a significant psychiatry workforce shortage in Australia, particularly in rural and remote communities. Given the large distances involved, telehealth – providing consultation via videoconference – has been widely accepted. Psychiatrists were among the highest users of telehealth services in Australia before the COVID-19 pandemic. However, the outbreak of COVID-19 resulted in a major transformation to service delivery across Australia. Private psychiatrists and state public mental health services had to rapidly transition to largely telehealth delivery to ensure continuity of care for consumers.

In March 2020, additional telehealth item numbers were added to the Australian Medicare Benefits Schedule (MBS) to encourage physical distancing for those accessing medical services during the pandemic.

To provide an overview of the increase in telehealth activity since the COVID-19 pandemic.

The MBS is the list of services for which the Australian Government will pay a rebate. Key data on MBS telehealth activity since March 2020 was examined.

The use of telehealth has increased during the pandemic. A survey of Royal Australian and New College of Psychiatrists (RANZCP) psychiatrists found that 93% supported retention of telehealth MBS item number numbers following the COVID-19 pandemic, noting increased accessibility for consumers. Positive feedback has been received from consumers.

During 2020 and 2021, the RANZCP worked with the Australian Government to ensure there were appropriate MBS telehealth services available for consumers. The RANZCP continues to work with the Government as they plan for a longer-term transformation of telehealth services beyond 2021.

No significant relationships.

1. (1) To consider whether CBT can be effectively delivered in routine care via VCT.

2. (2) To explore whether CBT delivered in routine care via VCT is acceptable to children, young people and their families.

3. (3) To reflect on the benefits of VCT and the collection of a variety of ROMs via digital platforms.

There is limited research on the use of telerehabilitation platforms in service delivery for people with acquired brain injury (ABI), especially technologies that support delivery of services into the home. This qualitative study aimed to explore the perspectives of rehabilitation coordinators, individuals with ABI, and family caregivers on the usability and acceptability of videoconferencing (VC) in community-based rehabilitation. Participants’ experiences and perceptions of telerehabilitation and their impressions of a particular VC system were investigated.

Guided by a theory on technology acceptance, semi-structured interviews were conducted with 30 participants from a community-based ABI service, including 13 multidisciplinary rehabilitation coordinators, 9 individuals with ABI, and 8 family caregivers. During the interview, they were shown a paper prototype of a telehealth portal for VC that was available for use. Interview transcripts were coded by two researchers and analysed thematically.

The VC was used on average for 2% of client consultations. Four major themes depicted factors influencing the uptake of VC platforms; namely, the context or impetus for use, perceived benefits, potential problems and parameters around use, and balancing the service and user needs. Participants identified beneficial uses of VC in service delivery and strategies for promoting a positive user experience.

Perceptions of the usability of VC to provide services in the home were largely positive; however, consideration of use on a case-by-case basis and a trial implementation was recommended to enhance successful uptake into service delivery.

Rehabilitation of memory after stroke remains an unmet need. Telehealth delivery may overcome barriers to accessing rehabilitation services.

We conducted a non-randomized intervention trial to investigate feasibility and effectiveness of individual telehealth (internet videoconferencing) and face-to-face delivery methods for a six-week compensatory memory rehabilitation program. Supplementary analyses investigated non-inferiority to an existing group-based intervention, and the role of booster sessions in maintaining functional gains. The primary outcome measure was functional attainment of participants’ goals. Secondary measures included subjective reports of lapses in everyday memory and prospective memory, reported use of internal and external memory strategies, and objective measures of memory functioning.

Forty-six stroke survivors were allocated to telehealth and face-to-face intervention delivery conditions. Feasibility of delivery methods was supported, and participants in both conditions demonstrated treatment-related improvements in goal attainment, and key subjective outcomes of everyday memory, and prospective memory. Gains on these measures were maintained at six-week follow-up. Short-term gains in use of internal strategies were also seen. Non-inferiority to group-based delivery was established only on the primary measure for the telehealth delivery condition. Booster sessions were associated with greater maintenance of gains on subjective measures of everyday memory and prospective memory.

This exploratory study supports the feasibility and potential effectiveness of telehealth options for remote delivery of compensatory memory skills training after a stroke. These results are also encouraging of a role for booster sessions in prolonging functional gains over time.

While videoconferencing, telementoring, and peer support have been shown to enhance services in some instances, there has been no research investigating the use of these technologies in supporting professionals managing clients with dementia. The objective of this research was to evaluate expansion of an old age psychiatry consultation service and pilot test a model to improve medical supervision and clinical governance for staff within regional and remote areas using remote information technology.

The design was a mixed methods (qualitative and quantitative) evaluation using before, mid-point and post-implementation semi-structured interviews and questionnaires to examine orientation, acceptance, and impact underpinned by theoretical approaches to evaluation. Education evaluations used a Likert style response template. Participants were 18 dementia service staff, including staff from linked services and old age psychiatrists. Qualitative interviews addressed the pilot implementation including: expectations, experiences, strategies for improving the pilot, and perceived impact on work practice and professional development opportunities.

There was high satisfaction with the program. The case conference process contributed to perceived improved outcomes for clients, family, and staff. Clinicians perceived improvement in family carer and staff carer stress and their confidence in managing clients with behavioral and psychological symptoms of dementia (BPSD). Thematic analysis indicated that the pilot enhanced professional development, decreased travel time, and improved team cohesion.

Given the increasing aging population in regional, rural, and remote areas, initiatives using videoconferencing and telementoring will help to develop a confident and skilled workforce. This pilot program was found to be acceptable and feasible. Potential benefits for clients and family carers should be examined in future resesarch.