Depression May Be Lifted By Phone Therapy
Depression can be a Catch-22: The very symptoms that may be helped by psychotherapy–fatigue, hopelessness, difficulty concentrating–often inhibit a person from actively seeking professional help. So the idea of phone-based therapy is appealing; therapists could reach out to patients who would never make it out of the house for an appointment. The question is whether the calls would actually help.
The answer is yes, according to a new study. Writing in the April Journal of Consulting and Clinical Psychology, researchers from the Group Health Center for Health Studies in Seattle found that symptoms of depression were alleviated in people who added as many as 10 or 12 phone counseling sessions to their antidepressant medication regimen during the early months. After 18 months, many in the counseled group were still reaping the benefits.
Researchers first reported on the group of nearly 400 people six months after treatment started; this study was designed to follow up on their condition for an additional year. The participants were initially diagnosed by their primary care doctors and were prescribed antidepressants. On top of that, half the group got eight sessions of phone therapy (on average, about 32 minutes per session) during the first six months and two to four additional sessions averaging about 18 minutes each in the next six months. The other half of the group got usual care–in this case, the antidepressants and whatever other help they sought on their own.
After 18 months, the phone-therapy group had better scores on a test measuring depression symptoms, and 77 percent said that their depression was "much" or "very much" improved. That compares with 63 percent of the other group. There was also a difference in the percentage of patients whose depressive symptoms disappeared entirely–48 percent in the phone group versus 38 percent in the usual care group. While the former were also more likely to take their antidepressants as prescribed, they came out ahead even accounting for the better compliance, says the study's lead author, Evette Ludman, a senior research associate at Group Health Center. What isn't clear is whether it was the constant contact provided by the phone calls or something specific to the therapy that produced the positive effects. The counseling was a specific type already proved to help depression: a combination of cognitive behavioral therapy, which helps patients identify and counter negative thoughts, and behavioral activation, which encourages them to pursue activities they enjoy.
Telephone therapy isn't commonly used (or reimbursed by insurance) now. But it may be a way to intervene and help depressed people similar to the way people with chronic diseases are contacted to keep tabs on their symptoms or medications, says Ludman. It's notable, she says, that the study participants weren't actively trying to get this kind of help when recruited. "We brought psychotherapy to patients who weren't asking for it," Ludman says.