Elsevier

Behavior Therapy

Volume 41, Issue 2, June 2010, Pages 229-236
Behavior Therapy

Evaluating the Effectiveness of Cognitive-Behavioral Teletherapy in Depressed Adults

https://doi.org/10.1016/j.beth.2009.03.002Get rights and content

Abstract

Telephone psychotherapy is an emerging form of delivery of care that has recently demonstrated utility and efficacy for adult depression when provided as an adjunct to antidepressant treatment in primary care trials. This study constitutes one of the initial evaluations of cognitive behavioral therapy–telephone treatment (CBT-TT) as a stand-alone treatment for adult depression in specialty care. Thirty adults initiating psychotherapy for depression at a mental health clinic participated in the trial. The majority of participants (69%) were very satisfied with the 8-session CBT-TT, reduction in depression severity was significant over 3 and 6 months, and 42% of participants were considered recovered at termination. These outcomes closely parallel the findings from an earlier primary care trial, despite specialty care participants beginning treatment with more severe depression and without adjunctive antidepressant medication. These findings suggest that CBT-TT for adult depression is feasible and has potential as a stand-alone treatment. Implementation of this telephone-based delivery approach in primary and specialty care settings is discussed.

Section snippets

Participants

Thirty nonpsychotic, nonbipolar depressed outpatient adults (ages 18 to 65) seeking treatment for depression at a mental health clinic were enrolled. Eligible adult clients were required to meet the following eligibility criteria during a baseline interview with the study therapist: no psychotherapy visit to a specialty mental health provider in the past 30 days (to exclude patients already receiving active psychotherapeutic treatment), no antidepressant prescription in the 180 days prior to

Sample characteristics

Sixty-eight adults initiating treatment for depression were referred to the study over the course of 14 months. Prior to the eligibility assessment, 23 adults (34%) declined to participate in the telephone counseling program. The majority of the patients refusing telephone treatment (n = 21 or 91%) indicated a preference for receiving in-person care, whereas the others (n = 2 or 7%) indicated they would not be able to commit to in-person or telephone therapy.

The remaining group (n = 45) participated

Discussion

Approximately two thirds (66%) of adults initiating treatment for depression were initially interested in receiving counseling by telephone, similar to a previous controlled trial that utilized CBT-TT in conjunction with pharmacotherapy (Simon et al., 2004). This level of demand for telephone counseling may reflect some of the unique features of this treatment, such as convenience (e.g., telephone sessions available evenings and weekends versus clinic business hours), direct access (e.g.,

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    This study benchmarks outcomes against a community based telephone counseling trial supported by the National Institute of Mental Health RO1 MH51338. Related reports have been published in the Journal of the American Medical Association, General Hospital Psychiatry, and Journal of Consulting and Clinical Psychology.

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