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Text-Based Psychotherapy Matches Video Sessions in Large Trial

Findings published in JAMA Network Open bolster messaging as a flexible option for mild-to-moderate depression.

Overview

  • A randomized trial assigned 850 adults to 12 weeks of unlimited messaging or weekly video therapy on Talkspace, with non-responders re-randomized at week six.
  • Both groups achieved similar reductions in depression symptoms and gains in social functioning over the study period.
  • Messaging saw fewer early dropouts and greater scheduling flexibility, while video fostered a slightly stronger therapeutic alliance.
  • The study reported no adverse events and excluded people with psychosis or suicidal thoughts, limiting applicability to higher-risk cases.
  • Researchers and outside experts say the results support using messaging in stepped-care models and expanding insurance reimbursement.