eHealth to Redress Psychotherapy Access Barriers Both New and Old: A Review of Reviews and Meta-Analyses

COVID-19 public health proscriptions have created severe if temporary, barriers to accessing face-to-face psychotherapy across the world. As disruptive as these are, they come on top of more long-standing barriers to getting psychotherapy faced by millions in need. eHealth interventions offer an avenue for redressing both types of barriers, but evidence about their efficacy remains a concern. This review of reviews and meta-analyses outlines the strength of evidence and effect sizes for guided and unguided approaches to eHealth interventions targeting common problems in psychotherapy (i.e., depression, anxiety, substance abuse, and general well-being). After a comprehensive search, a total of 65 reviews and meta-analyses were identified and evaluated for treatment effects, moderators, acceptability, and attrition. Findings show eHealth is acceptable and effective at improving depression, anxiety, alcohol-related problems, and general mental health compared to waitlist, and can even offer benefit as an adjunct to traditional psychotherapy. Mixed evidence was found when comparing guided versus unguided interventions as well as the strength of benefit relative to active controls and the degree to which these approaches are associated with attrition. eHealth interventions have the potential to be an effective tool for redressing both new and old psychotherapy access barriers. eHealth para remediar las barreras de acceso a la psicoterapia, tanto nuevas como antiguas: una reseña de reseña y metaanálisis Las proscripciones de salud pública de COVID-19 han creado barreras severas, aunque temporales para acceso a psicoterapia cara a cara en todo el mundo. Tan disruptivos como estos son, se suman a las barreras más antiguas para obtener psicoterapia a los que a millones en necesidad se enfrentan. Las intervenciones de eSalud ofrecen una vía para corregir ambos tipos de barreras, pero la evidencia sobre su eficacia sigue siendo motivo de preocupación. Esta reseña de reseñas y los metaanálisis describen la fuerza de la evidencia y los tamaños del efecto para guiados y enfoques no guiados para las intervenciones de eSalud dirigidas a problemas comunes en psicoterapia (es decir, depresión, ansiedad, abuso de sustancias, y bienestar general). Después de una búsqueda exhaustiva, se identificaron un total de 65 reseñas y metaanálisis y se evaluaron los efectos del tratamiento, moderadores, aceptabilidad y desgaste. Hallazgos muestran que la eSalud es aceptable y efectiva p