The Effectiveness of Telepsychology With Veterans: A Meta-Analysis of Services Delivered by Videoconference and Phone

Veterans face a variety of stressors due to their military service and are more likely to develop psychological problems as a result. Research suggests that as many as half of veterans with mental health conditions go untreated due to barriers including lack of accessibility to services and stigma. The present study builds on previous research by using meta-analytic techniques to determine the effectiveness of telepsychology-delivered therapy with veterans. Empirical studies were included if they reported veteran-related outcome data on a psychological intervention used to treat a mental health condition remotely using either videoconferencing or telephone. Twenty-seven studies including 2,648 total participants (1,667 in treatment conditions and 981 in control conditions) met our inclusion criteria and were incorporated into our analysis. Twenty-five studies provided pre-post data to evaluate various therapy outcomes, and 18 studies used a randomized clinical trials (RCTs) design that allowed a comparison between telehealth and traditional in-person therapy. Publication bias was evaluated using correlations between sample and effect sizes for posttraumatic stress disorder (PTSD) and depression for pretest-posttest and RCT designs; risk was determined to be minimal. Weighted average pre-post effect sizes were moderate-to-strong for depression and trauma, and videoconferencing was more effective than telephone for depression (d = 0.86 and 0.46, respectively) and trauma (d = 1.00 and 0.51, respectively). Weighted average effect sizes computed from RCT studies suggest telepsychology is similarly effective as services provided face-to-face. More research is needed for telepsychology-delivered treatments for other mental health conditions faced by veterans. Impact Statement Only about half of veterans who meet criteria for a mental health condition obtain treatment due to barriers including service accessibility and embarrassment associated with waiting in line at provider offices. Telepsychology, specifically videoconferencing and telephone, can help reduce these barriers to treatment by eliminating some challenges associated with geographic distances to providers, and by allowing patients to skip office visits. Services delivered by technology are an effective way to alleviate mental health symptoms in this population and are comparable to services provided face-to-face.