A recent research study in England revealed that for most people, cognitive therapy over the phone was just as effective as meeting with a psychotherapist face-to-face.The researchers analyzed data from 39,000 patients in the east of England who participated in a National Healthcare Service initiative that aimed to expand the availability of psychological therapies called: Improving Access to Psychological Therapies. The researchers compared cognitive behavioral therapy (CBT) delivered face-to-face versus (CBT) delivered over the phone, found that for all but an infrequent, identifiable clinical group with more severe illness, therapy over the phone was as effective as face to face.
Further benefits to telephone therapy were identified in a recent study in the Journal of Counseling and Development which showed that people are generally more satisfied with phone counseling than face-to-face counseling. A much higher percentage (93% for telephone compared to 63% for face-to-face) said they would seek counseling again. It also found that more than half (58%) of people who had experienced both phone and in-person counseling preferred phone.Other studies found that people who are experiencing depression were less likely to drop out of telephone therapy and consistently showed improved mood. One such study was published in the Archives of General Psychiatry in 2005 indicating that because telephone counseling offers convenience and anonymity,telephone therapy may provide clients with a greater sense of control.
Advantages to phone counseling
■ Privacy – You can have a phone counseling session from the privacy of your home, office or car.
■ Ease – It can require a lot of courage to begin counseling. It is less scary to do so over the phone for many people.
■ Anonymity – It can be easier to feel safe and open up to a counselor over the phone. This can lead to therapy being more effective.
■ Convenience and accessibility – You don’t have to drive to an office, saving time, gas and stress.
■ Research suggests it is just as effective – Several studies have come out looking at different forms of phone counseling and many therapists are publishing their experiences. From all of this research, it seems that therapy over the telephone can be just as effective as being in person.
Disadvantages to phone counseling
■ Some people feel safer letting themselves become emotional in the physical presence of another person.
■ Bad phone connections and other technical issues can interfere with phone sessions.
■ Being physically present with your counselor may help you feel more connected with him or her.
■ Phone counseling is not appropriate for people who are homicidal, suicidal, self injuring, or requiring more care than one session per week. Phone counselors are less likely to be acquainted with your local emergency service options.
Depression is extremely common, with the 1-year prevalence rate of major depressive disorder estimated at between 6.6 percent and 10.3 percent in the general population with roughly 25 percent of all primary care visits involving patients with clinically significant levels of depression. Psychotherapy is clinically effective in treating depression and most people prefer psychotherapy to taking antidepressant medication. When referred for psychotherapy, however, only a small percentage of patients follow through. The discrepancy between patients’ preference for psychotherapy and the low rates of initiation and adherence is likely due to barriers, such as time constraints, lack of available and accessible services, transportation problems, and cost.
David C. Mohr, Ph.D., of the Northwestern University Feinberg School of Medicine, Chicago, and colleagues compared face-to-face cognitive behavioral therapy vs. a telephone-administered cognitive behavioral therapy for the treatment of depression in primary care. The trial included 325 patients with major depressive disorder, recruited from November 2007 to December 2010. Participants were randomized to 18 sessions of Telephone CBT or face-to-face CBT. The researchers found that significantly fewer participants discontinued Telephone therapy and Telephone therapy patients attended significantly more sessions than those receiving face-to-face CBT.
These effects may be due to the capacity of telephone delivery to overcome barriers and patient ambivalence toward treatment. Access barriers likely exert their effects early in treatment, and thus the effect of the telephone on overcoming those barriers is most prominent in the first sessions,” the authors write.
In terms of changes in level of depression, the researchers found that T-CBT was not inferior to face to face CBT in reducing depressive symptoms at post treatment. However, face-to-face therapy was significantly superior to Telephone therapy during the 6-month follow-up period. By 6-month follow-up, 19 percent of T-CBT vs. 32 percent of face-to-face CBT participants were fully remitted.
The findings of this study suggest that telephone-delivered care has both advantages and disadvantages. The acceptability of delivering care over the telephone is growing, increasing the potential for individuals to initiate or continue with treatment,”