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Phone-based Therapy Eases Depression Long Term

s in the second six months as well as medication follow-up and support from masters-level therapists.

The patients and therapists never met face to face, only over the phone, said Ludman. Patients weren’t always easy to reach by phone, and the therapists worked hard to reach them all. Therapists 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.

“The patients participated more fully in psychotherapy and completed more sessions than do most depressed people in the community,” said Ludman. 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 study, three in four patients completed at least six phone therapy sessions. This is striking, she added, because the study did not include people who were already in counseling or planning to be.

“Giving psychotherapy to people with depression who were not seeking therapy may help them significantly,” said Ludman. Depression symptoms, including feeling discouraged and avoiding other people, can prevent people from seeking help. One in four depressed people who make appointments for in-person therapy are no-shows. “They slip through the cracks,” she added.

Few of the patients who received phone-based therapy—even fewer than those who did not receive it—sought in-person therapy. “This suggests the phone-based therapy met their needs, without whetting their appetite for more,” said Ludman. Phone-based therapy is more convenient and acceptable to patients than in-person psychotherapy, she said.

Next, Ludman said, the researchers plan to explore the combination treatment’s cost-effectiveness and impact on work and home life. They also
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