Objectives. The many important social changes produced by the Internet and the on-line phenomenon have caused many differences, compared to the past, in the ways in which we relate, communicate, and create bonds (Cabrè, 2016). This has been particularly evident in the current emergence of COVID 19, in which the increased distress related to fear, uncertainty of the situation, as well as forced self-exclusion, has been accompanied in many cases by the impediment of direct support, face-to-face communication proper to traditional treatment interventions (Zhang et al., 2020). Therefore, the purpose of this research is to present a systematic review to examine the evidence of efficacy and effectiveness in the treatment of clinically relevant psychological symptoms or mental disorders with on-line psychotherapeutic intervention type in order to arrive at an understanding of whether e-therapy can replace traditional therapy at particular times/situations or complement it as an additional form of support.
Method. The search, which used the electronic databases Scopus, PsycINFO, Pubmed/Medline, Google Scholar and Researchgate, took into consideration articles published in all languages in the last 8 years, selected on the basis of the following criteria: studies aimed at verifying the efficacy and effectiveness of at least one on-line treatment program for clinical psychological symptoms or mental disorders, conducted or at least guided by a clinical professional (trained psychologist or psychotherapist in training); with randomized controlled designs (RCTs or quasi-RCTs); with at least a follow-up of at least 3 months.
Results. The efficacy and effectiveness of these psychologist-led Internet-based intervention programs or self-help programs led by mental health professionals in reducing clinical symptomatology, mostly based on cognitive-behavioral theories, was equally effective compared with specific standard face-to-face cognitive-behavioral interventions in presence, and was significantly more effective than control groups undergoing usual care (TAU), waiting lists, interventions offered by health services, and on-line self-help conditions not led by psychologists. Importantly, however, in some cases these improvements were not maintained at follow-ups.
Conclusion. The studies included in the review confirmed the effectiveness of on-line intervention programs in treating clinical symptoms or specific mental disorders. Future studies should include treatments that address not only cognitive-behavioral theories or specific disorders, but also specific significant or transdiagnostic symptoms, if possible. It is hoped to continue in this direction as this could help in the development of increasingly effective internet-based programs, not exclusively cognitive-behavioral, aimed at preventing the development of any disorders
and relapse when disorders are already present, allowing for a reduction in time and cost as well.