Access to Psychotherapy in the Era of Web 2.0 – New Media, Old Inequalities? / Zugang zur Psychotherapie in der Ära des Web 2.0 – Neue Medien, Alte Ungleichheiten?

Abstract Background: Currently, the debate on regional and socio-structurally related treatment gaps in psychotherapeutic care increases the interest in e-mental health interventions such as the Internet-based psychotherapy, online self-help and new approaches for self-empowerment. Thus, health professionals could support informed decision-making by knowing the latest developments. However, if the ‘digital revolution’ fails to reach patients not familiar with Web 2.0, access to psychotherapies is unlikely to improve. Therefore, the objective of this review is to clarify whether online therapies should be recommended as an effective alternative to conventional psychotherapy in primary care. Methods: To investigate the research evidence of online therapies in adults within the last decade (2004-2014), a rapid review of literature was conducted by using electronic databases (i.e. Medline/PubMed, PubMed Central, Cochrane Library) to find systematic reviews, meta-analysis and clinical trials. Furthermore, a hand search in journals and grey literature was undertaken. Results: A search in PubMed for clinical trials on ‘online psychotherapy’ resulted in a total number of 245 publications. So, eight reviews and several clinical trials were chosen. Overall, mostly positive findings on the effectiveness and acceptance of online psychotherapy, primarily in the treatment of depression and anxiety disorders, were identified. Discussion: In sum, Internet-based psychotherapies have been effective in reducing symptoms of mood and anxiety disorders in clinical trials. However, due to the limited range of treatable disorders and non-representative samples (young female college graduates), external validity remains insufficient. Thus, further research is needed to determine if online therapies will be capable of improving access to psychotherapy.