Telephone-Administered Psychotherapy for Depression

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 .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.