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Press "D" for Depression Therapy

Natalie Staats Reiss, Ph.D. Updated: Sep 25th 2008

man with cell phone scratching his headA new study published in this month's issue of the journal Clinical Psychology: Science and Practice suggests that phone therapy for depression may be an effective alternative to traditional face-to-face psychotherapy

The current study was a meta-analysis, which is basically a scientific procedure where the results of several different studies are collapsed into one statistical analysis.  Researchers use meta-analysis procedures to compare data across several different research projects in order to make broader conclusions.

Using strict inclusion criteria, authors of the current study compared the results of 12 different studies in their analysis. Eight of the studies involved cognitive behavioral phone therapy; while the others included interpersonal and emotion-focused psychotherapies.  Ten of the therapies were delivered in strictly individual telephone therapy formats, while two were group phone therapy sessions.  Each of studies reviewed involved phone therapy in isolation (i.e., not in combination with other forms of psychotherapy). Participants had depression and co-morbid (co-occurring) medical diagnoses (e.g., multiple sclerosis, cancer, etc.). 

Meta-analysis results suggested that study participants experienced significant reductions in depressive symptoms after receiving all forms of phone therapy. In addition, fewer people seemed to drop out over the course of phone therapy than with traditional psychotherapy sessions. Cognitive behavioral formats seemed to be most effective telephone therapy format, but this type of approach also had the most people drop out across time.  Treatment gains made by patients receiving phone therapy seemed to be comparable to gains made by individuals enrolled in traditional forms of psychotherapy. 

Telphone therapy is certainly an intriguing idea.  However, I see several different pros and cons with this type of psychotherapy.  

This type of therapy is easy and convenient.  Many people who need mental health services currently do not receive them. Therapists can help a wider array of people who might not get help otherwise (e.g., people who live in rural areas, people who do not have transportation or cannot leave their homes).  In addition, some people who are uncomfortable opening up and sharing private information face-to-face may be more likely to participate if this type of format is offered. This format (as suggested by the study) may also decrease drop out rates, which is good for both patients (they can get better faster) and therapists (fewer no shows and lost fees).

The therapist loses many interpersonal cues by talking on the phone rather than meeting in person (although this may be addressed by using video phone formats). Next, this type of therapy may not be the best choice for certain groups of people (e.g., the goal of treating agoraphobic individuals is to get them out of their homes rather than helping them find ways to stay there). Licensing issues may become difficult, because psychologists are only licensed to provide therapy in a particular state. It is currently unclear what rules, regulations, and protections apply if a therapist conducts phone therapy with a client who lives in another state. Finally, billing issues may arise. Insurance companies may not pay for telephone therapy sessions, or may not treat these sessions as equivalent to traditional psychotherapy (so, the patient may actually have to pay more in the long run). Clients may assume that phone fees should be cheaper than face-to-face fees, while most therapists would view this as a billable hour of therapy regardless of how it is delivered. 

Let us know what you think about the idea of telephone therapy. Is it a good idea? Would you seek out services if you had this option?  


Reader Comments
Discuss this issue below or in our forums. - Margaret - Aug 22nd 2009

I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


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