Benefits and challenges of conducting psychotherapy by telephone.

Abstract

Telephone-delivered psychotherapy has increased utility as a method of service delivery in the current world, where a number of barriers, including economic hardships and limited access to care, may prevent people from receiving the treatment they need. This method of service provision is practical and has the potential to reach large numbers of underserved people in a cost-effective manner. The aim of this paper is to review the state-of-the-art of telephone-delivered psychotherapy and to identify improvements and possible solutions to challenges. Results of randomized controlled trials indicate high client acceptance and positive outcomes with this method of delivering psychotherapy. Nonetheless, psychotherapists wishing to deliver psychotherapy by telephone face a number of challenges, including a lack of control over the environment, potential compromises of privacy and confidentiality, developing therapeutic alliance without face-to-face contact, ethical and legal issues in providing psychotherapy by telephone, handling crisis situations at a distance, and psychotherapist adjustment to conducting psychotherapy in an alternative manner. There remains a need for further research, including direct comparisons of face-to-face psychotherapy with telephone-delivered psychotherapy and feasibility of telephone delivery of psychotherapies other than cognitive behavioral therapy.

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“…Other treatment methods involving phone counselling individually and in groups (Telehealth, Telecoaching) have been studied in the field of mental health research (Brenes et al 2011; Coman et al 2001; Evans et al 1984; IZAAK 2013; Reese et al 2002). Benson (2008) offers a 12 week Telecoaching group intervention for shopping addiction.…”

“…Anonymity is another advantage, often having special appeal to those clients experiencing shame and fear of identification. Phone counseling seems to help people express their views and feelings more easily, and equalize the power relationship (Brenes et al 2011; Coman et al 2001). In addition to observing that telephone counselling is cost effective, Brenes et al (2011) report both high levels of client satisfaction and lower rates of attrition in studies comparing telephone to face-to face counselling.…”

“…The challenges to conducting psychotherapy by telephone include issues of confidentiality and privacy, ethics and legality in some parts of the world (Brenes et al 2011). The management of crisis situations such as suicidal behaviours or worsening symptoms are considerations.…”

“…The management of crisis situations such as suicidal behaviours or worsening symptoms are considerations. Brenes et al (2011) writes, however, that the largest issue is psychotherapists’ openness to working in a non-traditional manner. The resistance stems from the perception that psychotherapy is more difficult because of the lack of nonauditory cues, distraction, the risk of the session becoming more social than therapeutic and concerns about therapeutic alliance (see also Tse et al 2013).…”

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“…For example, the results of a recent study suggest that therapists 31 rate face-to-face therapy as a more therapeutic experience than other types of treatment such as internet based therapy where such contact is absent (Bengtsson et al, 2015). Authors also suggest that psychological interventions delivered on the telephone present a variety of challenges, including a lack of control over environments, potential breaches of confidentiality and difficulty developing therapeutic alliance without face-toface support (Brenes et al, 2011). Researchers have also found that therapists achieved successful working alliances faster and more readily during face-to-face therapy (Bengtsson et al, 2015).…”