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BYU study says therapy for depression nearly as effective over phone

Many deeply depressed people who may never consider walking into a therapist's office can be counseled successfully over the phone, according to a new study just published by researchers at Brigham Young University.

The findings are particularly promising because approximately 50 percent of people with clinical depression "don't receive any treatment at all," according to Diane Spangler, a psychology professor at BYU, who co-authored the study.

Besides the fact that some people may be hesitant to meet with a therapist face-to-face, Spangler said the limited access to treatment for people who live in rural areas or are unable to schedule a visit during normal office hours was the impetus for the study.

"The idea was to take treatments that have already been established — in particular, cognitive behavioral therapy — and see if it would be feasible or acceptable for patients to do it over the phone as their only source of treatment." The study was directed at non-BYU students who called the campus outpatient mental health center for treatment of clinical depression.

Of those who were given the option of being treated by phone, two-thirds chose it over meeting face-to-face with a mental health practitioner, she said.

The study examined the efficacy of telephone treatment in 30 patients who had been diagnosed with moderate to severe depression. They agreed to eight counseling sessions by phone over a three-month period. None received medication to treat depression during the study period.

Calls varied in length from 21 to 52 minutes. After a six-month follow-up, 42 percent of phone-therapy patients had recovered from depression, while 50 percent of patients undergoing similar therapy face-to-face recovered.

She said the patients were not all members of The Church of Jesus Christ of Latter-day Saints, though they all sought treatment at the campus counseling center and ranged in age from 18 to 64. Though the study involved a relatively small number of patients, Spangler said one other study that has used this particular protocol over the phone was done in Seattle with several hundred patients.

In that study, medication was offered in addition to phone counseling. "We were the first to use the stand-alone treatment, yet we had similar if not somewhat better results than they did in Seattle." She said she doesn't believe there would be less interest in phone therapy in a more urban area because part of the challenge some people have in accessing treatment involves schedule conflicts.

While Spangler agreed there is some stigmatization of mental illness in the Mormon community, "I don't think that's the most compelling reason," that study participants opted to be treated by phone. "I think for most it's just distance (in travel) and time.

"The thing they liked most was the flexibility of the treatment. They could do it in their own home, according to their own schedule," which included evening calls.

Spangler said the researchers didn't look for a particular profile of the people who are most helped by phone therapy. And while the non-traditional method of dealing with depression may initially be threatening to some therapists, "we have to consider that people are now communicating more often with non face-to-face methods," including cell phones, texting, tweeting, Facebook and other social networking media.

"It makes sense for professionals to consider offering services in ways that don't require an office visit. In that sense, I'm not sure it's something that over the long haul professionals can ignore."

While she said such methods will never fully replace face-to-face therapy, "nor should they," new technologies can be successfully used to increase access to treatment for "some types of problems and some types of patients.

"It's not for everyone, but I think it's something to add to the mix, rather than replace what's currently being delivered."