June 5, 2012 -- People suffering major depression are more likely to get psychotherapy if it's offered by phone, Northwestern University researchers find.
Psychotherapy is an effective treatment for depression. Patient surveys show most would prefer psychotherapy to antidepressant drugs. Yet only a small fraction of patients referred to psychotherapy actually show up for sessions.
Would more depressed patients get psychotherapy if it were offered by phone? Would phone therapy be as effective as face-to-face therapy? Yes, say David C. Mohr, PhD, Joyce Ho, PhD, and colleagues.
The researchers randomly assigned 225 adults diagnosed with major depressive disorder to receive 18 weekly psychotherapy sessions either by phone or face to face. The treatment was cognitive behavioral therapy (CBT) for depression. Patients work with a therapist to learn to manage their moods and to focus on activities that increase feelings of pleasure and accomplishment.
"Telephone therapy was able to reduce dropout. Four out of five who got therapy over the phone could complete 18 weeks of treatment, while only two out of three assigned to face-to-face therapy could complete treatment," Ho tells WebMD.
Most of the dropouts in the face-to-face group were in the first few weeks of treatment. This suggests that phone sessions overcome some of the barriers to psychotherapy. These may include transportation, time constraints, and the sheer effort that it takes for a depressed person to get dressed, get out of the house, and go to a therapist's office.
But does phone therapy work as well as face-to-face therapy?
"After 18 weeks of treatment, the depression declines were equivalent in the two groups," Ho, a clinical psychologist, tells WebMD.
Six months after completing therapy, patients who received face-to-face treatment were less depressed than those who got phone therapy. That could be because something about face-to-face therapy makes it more effective. Or it could be that more of the patients who were not doing quite as well with the treatment dropped out of face-to-face therapy.
What do therapists think? Gary Kennedy, MD, is director of geriatric psychiatry at New York's Montefiore Medical Center. He was not involved in the phone therapy trial, but earlier led a study showing that phone follow-up worked to screen patients for symptoms of depression.