The Success Of Psychotherapy By Phone
Main Category: Psychology / PsychiatryAlso Included In: Depression; IT / Internet / E-mail
Article Date: 23 Sep 2008 - 7:00 PDT
The problem with psychotherapy has long been that nearly half the patients quit going after a few sessions. Therapy can't work if patients stop coming to the therapist's office.
But a new meta-analysis has found that when patients receive psychotherapy for depression over the phone, most of them continue with the therapy.
Researchers from Northwestern University's Feinberg School of Medicine have taken the first "snapshot" of telephone-administered therapy studies around the country. Telephone therapy is becoming more widely used by health care providers and employee-assistance programs.
The new study found that the average attrition rate in the telephone therapy was only 7.6 percent compared to nearly 50 percent in face-to-face therapy. The telephone therapy also was effective in reducing depressive symptoms with results that appear to be similar to face-to-face treatment.
"The problem with face-to-face treatment has always been very few people who can benefit from it actually receive it because of emotional and structural barriers," said David Mohr, professor of preventive medicine at the Feinberg School and lead author of the study, published in the September issue of Clinical Psychology: Science and Practice. "The telephone is a tool that allows the therapists to reach out to patients, rather than requiring that patients reach out to therapists."
Mohr said that of the patients who say they want psychotherapy, only 20 percent actually show up for a referral and half later drop out of treatment.
"One of the symptoms of depression is people lose motivation," Mohr said. "It's hard for them to do the things they are supposed to do. Showing up for appointments is one of those things."
Patients also may not have the transportation or time to travel back and forth to a therapist's office. It may be hard to squeeze an appointment into days already crammed with work, caring for kids or elderly parents or other family obligations.
Telephone therapy seems to transcend all these barriers. Mohr began using telephone-administered therapy because he was working with patients who had multiple sclerosis who could not get to a therapist's office.
Mohr said what's needed is a definitive study with a randomly selected population of patients that directly compares therapy delivered in the traditional face-to-face manner to therapy delivered over the phone. He has already launched such a study in subjects who receive their primary care from Northwestern's Medical Faculty Foundation. He expects to have results in two to three years.
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Source: Marla Paul
Northwestern University
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An Example Of How Consumers May Work Toward A Tomorrow Of 'Less, Least, And None-at-All'
posted by Vernon Lynn Stephens on 24 Sep 2008 at 4:48 pmI did a stint ~3/4 of a career in psychiatric social work before exiting as impaired-professional due to bipolar disorder. When I WORKED, I was quite aware that patients did seem + effect in an anecdotal way with telephone contact; I even tried (as a voluntary clinical trial, not an experiment) using telephone family therapy (the families were ~100 miles away & poor inevitably) and this too by participant-report turn out well. Now that I am CONSUMING mental health, I note now (in the USA under the Medicare/Medicaid etc. cuts) that it is getting harder and harder to maintain best therapeutic practice (psychopharmacotherapy + psychotherapy) given the fiscal parsimony/niggardliness of the utlization-review mechanism for the feds; thus there is a BURNING NEED TO DO MORE WITH LESS-- ALMOST NONE.
For some time now, almost all the (mounting) evidence that telephone therapy is effective (lacking mostly except for such trials as I made), and cost-effective. I would encourage the powers-that-be to strongly consider permitting the practice of tele-therapy (with somewhat better evidentiation/research to determine impact on psyches and purses.)
There is even thrust now for various clinical interventions (in MH and ancillary healthcare) for Internet-therapy; as about 1/2+ of the populace of the USA hath Web-hookup I see no reason why this should not be tried for effect on psyche and purse, too. [I think an even higher percentage have a phone, at least some kind of cell-phone in 2008. So ditto for phone-work here again too.]
Anyway: we consumers are going by necessity to reconcile to a 'Terrible '10s' and 'Terrible '20s' when there will-- s.p. the Budget Reduction Act of 2006-- deal with a situation of maximizing-the-least, and where nothing-is-best. I say, let us not WHINE about this 'hand' we have been dealt by the penny-wise-pound-foolish: let us instead do our best to manage WITHOUT -- meaning mostly manage-our-own-medicine!!!
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