Psychotherapy Research During the COVID-19 Pandemic: Trends in Treatment Modalities and Digital Therapy Uptake (2019-2023).

The COVID-19 pandemic necessitated rapid transitions to digital psychotherapy delivery formats, yet systematic quantification of these developments within psychotherapy research remains limited. This study presents an updated trend analysis of psychotherapy randomized controlled trials (RCTs) from 2019 to 2023. Systematic searches in PubMed, Web of Science and PsycINFO identified RCTs across predefined psychotherapeutic intervention categories. Trials were categorized by treatment approach, region and age group. A total of 1223 psychotherapy RCTs were identified. Despite a temporary decline in 2022 (-13%), the overall number of trials increased by 26.3% across the study period. eHealth interventions constituted the largest psychotherapeutic intervention category (43%), surpassing cognitive behavioural therapy (CBT; 37%). Among eHealth trials, 71% evaluated internet-delivered CBT. Only eHealth and telehealth showed statistically significant increases in proportional representation over time. Other therapeutic approaches each represented < 7% of treatment arms and showed no significant proportional change. Trial activity remained concentrated in high-income countries (73.4%) and predominantly targeted adult populations, with children and adolescents comprising 17.3% of trials. The findings illustrate a dynamic field that remained active during the COVID-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 heavily concentrated around CBT-derived interventions, adult populations and high-income country settings.