Phone Therapy

Here is some interesting information about phone therapy.

Looks like another solution to a problem is about to become available.

In particular, look at how clients completed a course of care.

Being able to call in, or have someone call you helps clients who are in need of services get services more effectively than coming to the office of a practitioner.

It would be nice to see how the clients evaluated phone therapy compared to in-office visits.

I am sure insurance companies will catch on to this rather quickly, and advocate that therapists get on the bandwagon.

600 people in the trail is a hefty number for a trial, and leaves me as a counseling advocate feeling a little safer.

"Phone-Based Therapy Improves Depression Care By Rick Nauert PhD Senior News Editor Reviewed by John M. Grohol, Psy.D. on October 6, 2009

Phone-Based Therapy Improves Depression Care

A new research study finds teletherapy in association with pharmaceutical management is a cost-effective method to treat depression.

Group Health researchers discovered brief, structured phone-based cognitive behavioral psychotherapy can provide benefits lasting for over two years.

“The most important reason to treat depression is to reduce suffering and improve daily functioning,” said Group Health psychiatrist Gregory E. Simon, MD, MPH, also a senior investigator at Group Health Research Institute.

“But our findings suggest that insurers or health care systems aiming to improve depression treatment in primary care should consider incorporating structured psychotherapy.”

The Journal of the American Medical Association (JAMA) reported earlier results from the same 600-person trial, the largest to date of psychotherapy by phone — and one of the largest studies of psychotherapy ever.

Over two years, phone psychotherapy plus care management led to a gain of 46 depression-free days, with only a $397 increase in outpatient health care costs. The incremental net benefit of phone psychotherapy plus care management was positive, even if a day free of depression was valued as low as $9.

By contrast, phone care management alone, with no phone psychotherapy, led to a gain of only 29 days free of depression, with a $676 rise in outpatient health care costs. The incremental net benefit of phone care management alone was negative, even if a day free of depression was valued up to $20.

The trial enrolled 600 Group Health patients whose primary care doctors diagnosed their depression and (as is usual in primary care) prescribed their antidepressants without psychotherapy.

The patients were randomly assigned to receive either:

* Usual primary care

* Phone care management: usual care plus a phone-based care management program including three outreach calls from a bachelors-level clinician (assessing patients’ symptoms, antidepressant drug use, and side effects and referring to mental health specialty care if needed), with care coordination and feedback to the primary care doctor

* Phone psychotherapy: usual care, plus phone care management, plus eight 30- to 40-minute sessions of structured cognitive-behavioral psychotherapy delivered by phone by a masters-level mental health clinician

The trial excluded people who were already seeing a therapist or intending to do so. The patients and mental health clinicians never met face to face, only over the phone. The mental health clinicians followed a structured protocol for psychotherapy.

They encouraged the patients to identify and counter their negative thoughts (cognitive behavioral therapy), pursue activities they had enjoyed in the past (behavioral activation), and develop a plan to care for themselves.

Few of the patients who received phone-based therapy—even fewer than those who did not receive it—sought in-person therapy.

Phone-based therapy is more convenient and acceptable to patients than in-person psychotherapy, said Dr. Simon.

Depression symptoms, including feeling discouraged and avoiding other people, can prevent people from seeking help, he added.

Nationally, only about half of insured patients receiving depression treatment make any psychotherapy visit, and less than a third make four or more visits. By contrast, in this trial, three in four patients completed at least six phone therapy sessions.

Conclusions For primary care patients beginning antidepressant treatment, a telephone program integrating care management and structured cognitive-behavioral psychotherapy can significantly improve satisfaction and clinical outcomes. These findings suggest a new public health model of psychotherapy for depression including active outreach and vigorous efforts to improve access to and motivation for treatment.

Phone Therapy Helps Depression

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