Telephone-administered psychotherapy for depression

Arch Gen Psychiatry. 2005 Sep;62(9):1007-14. doi: 10.1001/archpsyc.62.9.1007.


Background: Several studies have shown that telephone-administered cognitive-behavioral therapy (T-CBT) is superior to forms of no treatment controls. No study has examined if the skills-training component to T-CBT provides any benefit beyond that provided by nonspecific factors.

Objective: To test the efficacy of a 16-week T-CBT against a strong control for attention and nonspecific therapy effects.

Design: Randomized controlled trial including 12-month follow-up.

Setting: Telephone administration of psychotherapy with patients in their homes.

Participants: Participants had depression and functional impairments due to multiple sclerosis.

Interventions: A 16-week T-CBT program was compared with 16 weeks of telephone-administered supportive emotion-focused therapy.

Main outcome measures: Hamilton Depression Rating Scale score, Structured Clinical Interview for DSM-IV diagnosis of major depressive disorder, Beck Depression Inventory score, and Positive Affect scale score of the Positive and Negative Affect Scale.

Results: Of the 127 participants randomized, 7 (5.5%) dropped out of treatment. There were significant improvement during treatment on all outcome measures (P<.01 for all) and an increase in Positive Affect Scale score. Improvements over 16 weeks of treatment were significantly greater for T-CBT, compared with telephone-administered supportive emotion-focused therapy, for major depressive disorder frequency (P = .02), Hamilton Depression Rating Scale score (P = .02), and Positive Affect Scale score (P = .008), but not for the Beck Depression Inventory score (P = .29). Treatment gains were maintained during 12-month follow-up; however, differences across treatments were no longer evident (P > .16 for all).

Conclusions: Patients showed significant improvements in depression and positive affect during the 16 weeks of telephone-administered treatment. The specific cognitive-behavioral components of T-CBT produced improvements above and beyond the nonspecific effects of telephone-administered supportive emotion-focused therapy on evaluator-rated measures of depression and self-reported positive affect. Attrition was low.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cognitive Behavioral Therapy / methods*
  • Comorbidity
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / therapy*
  • Disabled Persons / psychology
  • Female
  • Follow-Up Studies
  • Home Care Services
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / epidemiology
  • Multiple Sclerosis / psychology
  • Patient Dropouts
  • Personality Inventory
  • Psychiatric Status Rating Scales
  • Remote Consultation / methods*
  • Telephone / statistics & numerical data*
  • Treatment Outcome