Synchronous tele-interpersonal psychotherapy versus tele-cognitive behavioural therapy for adults: which works better? Results from a randomised clinical trial.

Background: Tele-cognitive behavioural therapy (t-CBT) is the most studied remote therapy, and evidence supports its efficacy in treating depression and anxiety symptoms. Aims: To compare the effectiveness of tele-interpersonal psychotherapy (t-IPT) to that of t-CBT. We hypothesise that t-IPT is as effective as t-CBT. Methods: We conducted a randomised clinical trial with two parallel arms and equal randomisation. The allocation was on a 1:1 ratio based on a computerised randomisation sequence of permuted blocks of 50. Interventions and assessments were done via a website designed specifically for the trial. Participants were community-based adults with symptoms of anxiety, depression or irritability who received four sessions of t-CBT or t-IPT. The main outcome measures were the Patient Health Questionnaire-9 for depressive symptoms, Generalised Anxiety Disorder-7 for anxiety symptoms and Affective Reactivity Index for irritability. Results: 149 individuals with a mean (standard deviation) age of 32.51 (10.73) years were randomised to receive t-CBT (n=73) or t-IPT (n=76). Seven participants withdrew from the interventions (t-CBT, n=4; t-IPT, n=3), and 20 participants completed the interventions but did not complete the follow-up questionnaires (t-CBT, n=9; t-IPT, n=11). Analysis was conducted by intention-to-treat. There was a significant overall reduction in symptoms of depression, anxiety and irritability (p<0.001) in both treatment arms; neither modality was superior to the other. Effectiveness analysis showed that the two interventions were equivalent. Conclusions: In community adults, t-IPT is as effective as t-CBT in treating symptoms of anxiety, depression or irritability.