Strengths and Limitations
STILL
This study has notable strengths. First, no study to date has evaluated the treatment outcome and acceptability of asynchronous message-based psychotherapy in a randomized controlled trial. Comparison to the more popular remote modality, video-based psychotherapy, is a critical step to creating and evaluating the evidence base for asynchronous message-based psychotherapy. Second, treatment outcome variables were collected longitudinally and allowed for both between-group and within-group comparisons. Within-group analyses were used to demonstrate significant changes in the outcome variables in both treatment conditions, and between-group analyses were used to demonstrate the noninferiority of asynchronous message-based psychotherapy to video-based psychotherapy. Third, participants were recruited from a neutral mental health advocacy organization, which increases the generalizability of the findings relative to recruiting individuals already interested in a particular platform or offering to begin.Some limitations of this study also need to be noted. First, in both treatment conditions, there were participants who dropped out relatively early in the protocol. Still, on average, participants completed a considerable proportion of their treatment, and varying levels of treatment engagement are reflective of the psychotherapeutic treatments provided in community settings [