Phone Therapy for Depression?
The Truth About What Works
by Kevin Hogan
The great thing about studies is you find out what works and what doesn't, and often the results surprise you. And sometimes they demand that professionals and the astute make changes in the way they do business and in their life.
Therapy by phone is something I found remarkably effective when I worked with people who suffered with severe tinnitus. This study isn't about tinnitus though, it's about depression.
Know what was discovered?
When people receive brief telephone-based psychotherapy soon after starting on antidepressant medication, strong positive effects may continue 18 months after their first session. So concludes a Group Health study in the April Journal of Consulting and Clinical Psychology.
This paper describes one more year of follow-up since a 2004 Journal of the American Medical Association (JAMA) report on the same random sample of Group Health patients.
"With close to 400 patients, this is the largest study yet of psychotherapy delivered over the telephone," said Evette J. Ludman, PhD, senior research associate, Group Health Center for Health Studies, the paper's lead author. "It's also the first to study the effectiveness of combining phone-based therapy with antidepressant drug treatment as provided in everyday medical practice."
Long-term positive effects of initially adding phone-based therapy included improvements in patients' symptoms of depression and satisfaction with their care, said Ludman. At 18 months, 77 percent of those who got phone-based therapy (but only 63 percent of those receiving regular care) reported their depression was "much" or "very much" improved. Those who received phone-based therapy were slightly better at taking their antidepressant medication as recommended, but that did not account for most of their improvement. And effects were stronger for patients with moderate to severe depression than for those with mild depression.
"We were surprised at how well the positive effects were maintained over time," said Ludman. "As with weight control, maintaining improvement is the hardest part of treating depression."
As is usual in clinical practice, the patients' primary care doctors diagnosed their depression and prescribed their antidepressants. Half of the patients also received eight sessions of telephone psychotherapy during the first six months, then two to four "booster" sessions in the second six months as well as medication follow-up and support from masters-level therapists.
Was it important to meet face to face?
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