How should Cognitive Behavioural Therapy (CBT) be delivered for adults with acute symptoms of depression?

A recently released study looked at different modes of CBT administration among adults with symptoms of depression. They compared the effectiveness of CBT delivered individually, by telephone, in a group, or by guided or unguided self-help. The researchers looked at randomized clinical trials published between January 1, 1966 and 2018.

The effect of CBT on patient outcomes was similar between individual, group, telephone and guided self-help. Individual and group therapy were more effective at retaining participants compared to guided self-help. Any therapy providing external support was deemed more effective than being on a wait-list.

Alternative formats of therapy, such as telephone and guided self-help, have practical applications for individuals living in remote and rural regions and who may not have direct access to psychotherapy services.

Based on your experience, in which other contexts would online or self-directed CBT be beneficial?

Can you anticipate any barriers to clients using these systems where you live?