September 01, 2004

Therapy Via Telephone Shows Promise

Although treatments for many psychiatric disorders are much improved in the last fifty years, the majority of sufferers still struggle to find something that consistently works for them. For example, in the estimation of Dr. Allen Roses, an academic geneticist from Duke University, only 60% of schizophrenia patients treated with medication respond (Source: "Glaxo chief - our drugs do not work on most patients." The Independent, Dec 8 2003. No details were given as to the type of medication administered, the length of time meds were taken, or other therapies concurrent with medication). If medication alone is still largely hit-or-miss, than it's more important than ever to coordinate community health resources and make all kinds of therapies available. A recent study has brought one such therapy to light - the possibility of recieving counseling sessions by telephone.

In the journal article (published in the Journal of American Medicine), the recovery rates for clinically depressed patients taking anti-depressant drugs were significantly improved by telephone counseling sessions during the week.

600 subjects taking antidepressants were randomly assigned to recieve one of three treatment plans: a normal standard of care (a prescription, instructions, and encouragment to use it properly), telephone management (two phone calls with advice and support concerning the prescription, or phone therapy (up to eight telephone sessions with trained counselors providing targeted behavioral therapy). The results from the telephone therapy group were very encouraging - after 18 months, 80% of these subjects reported that their symptoms were "much improved." 66% of subjects recieving just telephone management reported similar improvement, while only 55% of those just receiving medication said the same.

Although it is not clear how many people might benefit from telephone therapy - the study subjects were all independently motivated to seek treatment, and were medication compliant - primary investigator Dr. Gregory E. Simon is excited by the potential in the results.

"This represents an important change in the way we approach treatment," Dr. Simon said, "not only using the phone, but being persistent, proactive, reaching out to people and finding them where they are. Depression is defined by discouragement; very often they're not going to come to you."
Telephone therapy could have many implications, among them improving medication compliance, supplementing existing medication regimens, and extending the reach of mental health services. Stigma is a huge barrier to therapy, particularly in small or rural communities where remaining anonymous is a challenge. Telephone therapy might offer a more secure, less stigmatizing alternative to people seekign support.

Regular follow-up with phone sessions might also help prevent tragedies such as suicide. According to Joanne Stern, who gave a workshop on suicide prevention (on behalf of SPAN-CA) at the NAMI California annual convention in August, good follow-up care is a key component of prevention. In her experience as a suicide-hotline staffer, suicidal feelings are generally lessened through talk. In her own words, "Talk is the breath of life to someone who's drowning."

For the full article, see "New Therapy on Depression FInds Phone Is Effective" (Aug 25 2004) in the New York Times (

For more information on the specific efficacy of psychotherapy in treating schizophrenia, see the following Psychiatric Times article: "Medication-Psychotherapy Combination Most Effective for Schizophrenia" (published in Psychiatric Times, May 1998, Vol XV, Issue 5).

For some supplemental treatments that may be helpful for schizophrenia when combined with medication therapy, see Other Treatments on the website (


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