A Meta-analysis of the Effectiveness of Behavioral Intervention Technologies and Face-to-Face Cognitive Behavioral Thera
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A Meta-analysis of the Effectiveness of Behavioral Intervention Technologies and Face-to-Face Cognitive Behavioral Therapy for Youth with Depression Megan K. Higinbotham 1 & Ben Emmert-Aronson 2 & Eduardo L. Bunge 1,3 Received: 7 February 2020 / Revised: 22 March 2020 / Accepted: 13 April 2020 # Springer Nature Switzerland AG 2020
Abstract This study explored the effectiveness of behavioral intervention technologies (BITs) and face-to-face cognitive behavioral therapy (F2FCBT). Systematic review methods and meta-analysis techniques were used to analyze nineteen randomized controlled trials comparing face-to-face cognitive behavioral therapy (F2FCBT), or BITS, vs. a wait list control or a non-evidencebased control. A random-effects model was used, and effect sizes were calculated using Hedges’ g to determine the effectiveness of treatment from pre- to post-test and pre to follow-up. Subgroup comparisons were run for age and type of control group. Results of the analysis show that both interventions were effective for reducing childhood depression from pre-test to post-test, (F2FCBT g = − 0.36 and BITs g = − 0.34) and were not significantly different from one another (p = .90). At a 6-month followup, F2FCBT interventions were not significantly better than controls, and BITs were shown to be significantly better than controls. F2FCBT and BITs did not differ significantly from one another (p = 0.92). A subgroup analysis revealed that interventions targeted at adolescents were more effective (g = −0.51) than interventions targeting mixed ages. It was found that BITs were effective as a treatment of child and adolescent depression and were as effective in treating depression as F2FCBT, the gold standard treatment. Current evidence provides promising results that support the utilization of BITs as a treatment for depression in children and adolescents. Keywords Behavioral intervention technologies . Cognitive behavioral therapy . Meta-analysis . Depression . Children . Adolescents
Behavioral intervention technologies (BITs) are interventions that use technology (e.g., Internet, mobile applications, virtual reality) created with the intent to help the user improve overall mental health (Schueller et al. 2013). BITs have the potential to increase the reach to individuals, be applied on a large scale, and decrease the stigma of psychotherapy (Bunge et al. 2016; Kazdin and Rabbitt 2013). Although there is research showing the effectiveness of BITs for depression in adults (Andersson et al. 2014; Andrews et al. 2010), less is known about the effectiveness of BITs for children and adolescents with
* Eduardo L. Bunge [email protected] 1
Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
2
Open Source Wellness, Palo Alto, CA, USA
3
i4Helath (Institute for International Internet Interventions for Health), Palo Alto, CA, USA
depression. Child and adolescent depression is one of the most prevalent disorders in youth with rates of depression in childhood at 2.8% and increasing in adolescence t
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