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Text-based psychotherapy can be just as effective as live video sessions for patients receiving treatment for depression, a new study suggests.
research, published to JAMA Network Opencompared the outcomes of 850 adults who received message-based psychotherapy or weekly video-based psychotherapy through Talkspace, a commercial online mental health platform.
“We found that patients improved at a similar rate regardless of whether they communicated with their therapists via messaging or live video calls,” said Patricia A. Areán, senior author of the study and retired professor of psychiatry and behavioral sciences at the University of Washington School of Medicine. “This supports the use of text-based therapy as a viable, evidence-based method for treating the millions of Americans who suffer from depression each year.”
Participants were randomly assigned to one of two formats for 12 weeks. Those who did not respond after six weeks of treatment were rerandomized to receive a combination of the two regimens. At the end of the trial, participants in both groups showed similar improvements in their depression symptoms and social functioning.
The researchers noted that patients receiving video-based therapy were slightly more likely to drop out early in treatment, while message-based therapy gave patients greater flexibility to communicate with their therapists.
“Depression is one of the leading causes of disability and death worldwide,” said Michael Pullmann, a research professor of psychiatry at the UW School of Medicine and a health care practice and policy researcher and lead author of the paper. “Message-based psychotherapy can help doctors reach patients who otherwise wouldn’t be able to get treatment.” Pullmann is currently a senior program director for implementation science at the Patient-Centered Outcomes Research Institute in Washington, DC.
The authors emphasized that expanding insurance reimbursement for message-based treatments could make effective treatments more accessible.
Additional information:
Michael D. Pullmann et al., Message-based and video-based psychotherapy for depression; JAMA Network Open (2025). DOI: 10.1001/jamanetworkopen.2025.40065
recall: Text can be as effective as a live video on treating depression (October 30, 2025) Retrieved October 31, 2025.
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