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See Inside April 2005

Distance Therapy



Forget the therapist's couch. Some psychiatrists may soon be talking to their clients over the phone. And scientists testing the treatment method say patients like it.

Gregory E. Simon and his colleagues at the Group Health Cooperative in Seattle followed 600 patients who were just beginning treatment with antidepressants. Over six months, counselors provided a third of the participants with eight phone therapy sessions lasting 30 to 40 minutes each. Another third received three brief calls intended to monitor their medication use. The final third received no intervention. At six months, all three groups were assessed.

Simon, a psychiatrist, reported that patients who participated in telephone therapy had lower scores than the others on a checklist for depression, meaning that they were less depressed. What is more, 80 percent rated themselves as “much improved” versus 66 percent for those who got the three brief follow-up calls and 55 percent for those who just took their pills. Almost 60 percent who had long sessions said they were “very satisfied” with the approach.

In another study conducted by the Veterans Administration Medical Center in Maryland, people received talk therapy administered over a videophone link. Their level of satisfaction, indicated later, was as high as that expressed by patients who had face-to-face encounters with counselors.

These forms of teletherapy might be just what some doctors order, especially for individuals who are on the fence about starting counseling. Among psychotherapy beginners, Simon says, 25 percent attend just one session, only 50 percent make it beyond three sessions, and one quarter never even show up for the initial appointment. Phone sessions could also help people overcome worries about stigma, as well as transportation problems. Simon says more research will be needed before insurance companies would consider reimbursement for phone therapy.

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