Phone therapy sessions might help depressed people


(CBS News) Depressed individuals who have a hard time going to therapy session might still benefit from talking to a therapist on the phone.

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While psychotherapy might be an effective way to treat depression and a preferred method over taking medication for many, sometimes it can be hard to continually attend the in-person sessions because of logistic, personal and emotional problems.

Now, a study published in the Journal of the American Medical Association on June 6 shows that talking to a therapist on the phone might be as effective as showing up at their office - and could possibly be better since people were more likely to continue therapy if they just had to make a call.

Northwestern University researchers tracked a study of 325 Chicago-area patients with major depressive disorder. According to the study authors, between 6.6 percent and 10.3 percent of the general population have major depressive disorder each year. About 25 percent of all primary care visits involve patients who have clinically significant levels of depression.

In the study, each subject had to attend 18 weekly sessions of cognitive behavioral therapy (CBT) either in person at a therapist's office or over the phone. Thirty-three percent of the group who had to physically attend sessions ended up skipping out on them, while 21 percent of the phone subjects failed to keep up with their weekly meetings.

Though both groups of patients showed similar levels of improvement during their sessions regardless if therapy was in an office or on the phone, those who physically attended sessions were better off than the telephone group six months after therapy ended. Researchers pointed out that in-person sessions might have some added benefits such as behavioral activation, meaning the physical act of attending the session is therapeutic in itself, and additional human contact.

However, study author Dr. David Mohr, director of the center for behavioral intervention technologies at Northwestern University, believes it could also be because there were more severe cases of depression in the phone group than in the in office group. Since it was easier to keep tabs on phone patients - many of whom claimed they often slept through meetings or forgot their sessions when the therapists called - they tended to be more available for their therapy sessions.

"I think this study is definitive in saying that face-to-face contact is not really necessary," he told TIME. "I don't think this means that telephone psychotherapy replaces face-to-face therapy, but it means they are certainly interchangeable, and that phone therapy is not a second-rate treatment for patients with depression."

However, some doctors disagree that phone therapy can be as beneficial as seeing a person face-to-face. Clinical psychologist Mary Alvord based in Bethesda, Md. said to the Los Angeles Times that visual clues, such as lack of eye contact and a lapse in hygiene, might give a therapist some clues that their patient needs more help. She added that it's hard to express empathy and support over the phone, and could be difficult if the patient has anxiety.

"You need to have a strong relationship so that people can face their fears," Alvord said.

But, Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York, believes people are quibbling about the wrong thing. The point of this study - that people are more likely to continue with phone therapy - is the important part to highlight because it means people might be more likely to complete their sessions.

"The point of this study is that people do stick with telephone therapy," Kennedy told WebMD. "Depression, especially depression later in life, may be associated with conditions that make it impossible to come into psychotherapy on a regular basis. You don't want to skip a session of therapy any more than you want to skip a dose of medication."