Analysis and Psychotherapy by Telephone: Twenty Years of Clinical Experience

Abstract

Psychoanalysis via telephone is becoming increasingly prevalent while remaining an area of comparatively little study. The author's early telephone treatment of a series of patients living some distance away or engaged in business travel, and his subsequent telephone treatment of nine analytic and five psychotherapy patients following his own geographic move, are discussed in detail. The mechanics of beginning and carrying out such treatment are examined. The theoretical implications of the shift to the telephone and the ambivalence with which it is often met by clinicians are also explored. The role of nonverbal communication in both in-person and telephone analysis is considered, as is the concept of the analytic office as a literal space and a psychological container. Suggestions for future research are advanced.

Telephone Genetic Counseling for High-Risk Women UndergoingBRCA1andBRCA2Testing: Rationale and Development of a Randomized Controlled Trial

“…In the nursing field in particular, the use of telephone-based services for many aspects of patient assessment and case management is highly entrenched and appears to be well accepted by patients (Greenberg, 2000;Greenberg and Schultz, 2002). Telephone counseling has also been used to provide psychological counseling and support (e.g., to cancer patients), although much of the literature is anecdotal, or contains small samples with limited follow-up and evaluation (Gotay and Bottomley, 1998;Donnelly et al, 2000;Sandgren et al, 2000;Leffert, 2003). Randomized trials have shown that brief telephone counseling can enhance adherence to antidepressant use (Peveler et al, 1999;Simon et al, 2000) and reduce depressive symptoms (Peveler et al, 1999;Hunkeler et al, 2000;Simon et al, 2000).…”

The Attractiveness of Telephone Counseling: An Empirical Investigation of Client Perceptions

“…Telephone therapy has been used by a number of therapists as the only modality of treatment to conduct family therapy and/or individual therapy, both long-and short-term (e.g., Hines, 1994;Leffert, 2003;Lynch et al, 1997;Shepard, 1987;Spiro & Devenis, 1991). Reese et al (2002) found in a study of effectiveness that clients receiving telephone counseling from a telephone counseling agency had reports of treatment effective-Attractiveness of Telephone Counseling ness comparable with effectiveness scores of face-to-face counseling.…”

Caractéristiques des appelants réguliers utilisateurs de deux centres d'écoute ou d'intervention téléphonique du Saguenay-Lac-Saint-Jean :

“…L'anonymat permettrait d'ailleurs aux appelants d'éviter la censure et de tomber plus rapidement dans le vif du sujet (Rosenfield, 1997). Par contre, le principal inconvénient en ce qui concerne l'intervention par l'entremise des CEIT serait le manque d'information nonverbale relatif à la communication (Leffert, 2001). Ce manque d'information non verbale peut contribuer à augmenter le transfert, le contretransfert, la projection et les jugements puisque l'appelant tout comme l'écoutant laissent à leur imagination le rôle de définir, en partie, l'individu avec lequel ils sont en interaction (Rosenfîeld, 1997).…”

“…Ceci rend la résolution de problème plus ardue car plus le motif de l'appel est précis plus les écoutants obtiennent du succès et peuvent facilement venir en aide aux appelants (Rosenfield, 1997). Ce sont ces appelants hésitants ou silencieux qui représentent le plus important défi pour les bénévoles débutants qui peuvent alors se demander si l'appelant souffre d'un problème de santé mentale (Haywood, 1981 (Leffert, 2001). Toutefois, l'usage du téléphone semble avantageux en tant qu'instrument complémentaire (Leffert, 2001 ;Reese, Conoley & Brossart, 2002).…”