A Systematic Review and Meta-Analysis of Third-Wave Online Interventions for Depression

Online psychological interventions for the treatment of depression are increasing as an alternative to traditional face-to-face psychotherapy. Adaptations of cognitive behavioral therapy for the treatment of depression have been tested, with meta-analyses showing weighted effect sizes ranging from d = 0.40 to 0.56. However, there is less evidence on the effect of adaptations of third-wave behavioral therapies for depression. Accordingly, this study reviews the evidence of online applications of third-wave behavioral therapies for depression. Nine randomized clinical trials were found with a total of 1910 participants. Most of these trials implemented online versions of behavioral activation (BA) and acceptance and commitment therapy (ACT). All studies reported positive effects of third-wave therapies. A meta-analysis was conducted with the 6 studies (N = 1744) that compared an online intervention versus wait-list or treatment as usual conditions. Medium to large effect sizes were found with a weighted effect size of d = 0.61. In conclusion, online adaptations of third-wave therapies seem to be legitimate options for the treatment of depression.