Psychotherapy Research Trends During the COVID-19 Pandemic: The Increase of Digital Therapy Uptake (2019–2023)

Background The rapid transition to digital psychotherapy delivery formats necessitated by the pandemic has not been systematically quantified within psychotherapy research. This study presents an updated trend analysis of randomised controlled trials (RCTs) in psychotherapy from 2019 to 2023. Method Systematic searches of the PubMed, Web of Science and PsycINFO databases were conducted to identify trials evaluating one of fourteen predefined psychotherapeutic approaches. The trials were categorised by treatment approach, region, and age group. Results A total of 1,223 psychotherapy RCTs were identified. Despite a temporary decline in 2022 of 13%, the overall number of trials increased by 26.3% across the study period, with eHealth interventions constituting the largest proportion (43%), surpassing cognitive behavioural therapy (CBT; 37%). Of the eHealth trials, 71% evaluated internet-delivered CBT, and eHealth and telehealth were the only approaches to show statistically significant growth (both p < .001). Other approaches, such as psychodynamic treatments (2%) or systemic treatments (0.7%), continued to account for a small proportion. Trial activity remained concentrated in high-income countries (73.4%) and predominantly targeted adult populations, with trials involving children and adolescents accounting for 17.3% of the total. Conclusion The findings illustrate a dynamic field that remained active during the COVD-19 crisis, with eHealth emerging as the most frequently investigated therapeutic approach, accompanied by substantial growth in telehealth interventions. Despite the overall growth in trial activity, research efforts remained concentrated around CBT-derived interventions, adult populations and high-income country settings. Trial Registration This study was preregistered on AsPredicted (#149876).