One of the biggest questions in mental health care is whether online therapy is as effective as sitting face-to-face with a therapist. For depression, a large research review by López-López and colleagues (2019) — which pooled results from 91 randomised controlled trials — now gives us a clearer answer.
The study compared different ways of delivering Cognitive Behavioural Therapy (CBT): traditional face-to-face sessions, hybrid approaches (a mix of in-person and digital), and fully online or multimedia formats. All three produced meaningful reductions in depression compared to having no treatment at all. Face-to-face and hybrid CBT showed the strongest results, but online CBT also worked significantly better than waiting for help.
One finding really stood out: being placed on a waiting list actually made depression worse over time. That's a sobering reminder that doing something — even starting with an online program — is better than doing nothing while you wait for an appointment.
This matters because access is a real barrier for many people. If getting to a clinic is difficult — whether because of geography, cost, mobility, or a packed schedule — online or hybrid therapy is a legitimate and evidence-backed option, not a second-rate substitute. Depression responds to treatment. If you've been putting off reaching out, please know that the most important step is simply starting — in whatever format works for you.