By Leslie Mann, Special to the Tribune
June 13, 2012
Phone therapy for primary-care patients with clinical depression is not only as effective as therapy at the doctor's office, it also can enable them to continue therapy, according to the results of a study by Northwestern Medicine in Chicago.
"Reductions of depression are identical, whether you use face-to-face therapy or phone therapy. And drop-out is reduced," said Dr. David Mohr, lead study author and professor of preventive medicine at Northwestern University Feinberg School of Medicine.
The study, published in the June 6 issue of the Journal of the American Medical Association, included 325 adults, male and female and of different races. "The results were the same, despite gender, race and ethnicity," Mohr said.
While depression patients want psychotherapy, most of them report barriers to doctor visits.
"They don't have a baby sitter or transportation. They can't get off work, or they're just not feeling up to leaving home," he said. "Especially in rural areas, getting to the therapist's office can be difficult."
For Nourene Alper, who has suffered from depression on and off since the birth of her first child 60 years ago, nothing can replace face-to-face therapy.
But after participating in the study about phone therapy, Alper said she now understands its value.
"When you're depressed, you grab at any piece of wood that comes along," said Alper, a retired nursing home administrator from Chicago. "Phone therapy can be that. After I closed my bedroom door and removed distractions, phone therapy was almost as good as being in the therapist's office. For the homebound, especially, I can see it being effective."
Phone therapy can be just as effective for some people with anxiety disorders, too, Mohr said.
"In fact, the physical distance may be what they prefer," he said. "But the study does not translate for people with psychotic disorders, when the therapist should see the patient's behavior."
Nor does phone therapy work for people who are unable to retreat to a quiet room, away from children, televisions and other distractions, Mohr said.
A 2008 study from the American Psychological Association said 85 percent of licensed psychologists have used phone therapy to some extent. However, not all insurance companies cover it, Mohr said.
"We hope this study will encourage more of them to consider it," he said. "Untreated, depression costs them more in the long run because it can lead to other health problems including eating disorders, alcohol abuse and greater cardiovascular risk."
More than 9 percent of adults currently suffer from depression and 4.1 percent have "major depression," according to the Centers for Disease Control and Prevention. For many, it is chronic.
"That's a lot of people," Mohr said. "So we need to continue to look at new ways to reach them."
What works for one patient does not work for the next. For Alper, for example, therapy and self-hypnosis work, but antidepressants do not.
Next up for Mohr, he said, is to study the most effective ways for therapists to use mobile telephones and the Internet to deliver treatment to their patients.
"For the youth, especially, this is a way to reach them," he said.