For a number of years now I have worked with a fair portion of my patients by telephone. At first when it was suggested to me as a way to continue my practice when I moved, I was skeptical but now, seven years later, I find that therapy by telephone not only works, in some cases it works better than face to face meetings. So I was not surprised to see this appear in yesterday's NY Times:
A new analysis of phone therapy research by Northwestern University shows that when patients receive psychotherapy for depression over the phone, more than 90 percent continue with it. The research showed that the average attrition rate in the telephone therapy was only 7.6 percent, compared to nearly 50 percent in face-to-face therapy. The researchers also found that telephone therapy was just as effective at reducing depressive symptoms as face-to-face treatment.
The therapeutic space which develops when the work is done by telephone differs from that when therapist and patient sit face to face, but it is therapeutic space nonetheless. When my patients call. I am sitting in my customary place, just as if they were sitting in front of me in my office. And I suggest that my patient similarly be in the same place each time. We then create the space between us -- the sound of our voices and the time creating a temenos between us. Therapy works because it is contained. There is confidntiality, there is a fee, and a set time. Our work together is contained in this virtual space, just as it would be were we both in my office.
Phone psychotherapy eliminates travel and waiting time, and allows more flexible scheduling. It makes psychotherapy available to patients who are unable to travel, including many of the physically disabled and those whose symptoms, depression or agoraphobia, make them reluctant to leave home and for those whose work takes them away from home frequently. And in a time when gasoline costs are a significant part of household budgets, it saves the expense of driving. It also makes therapy readily available to people living in rural areas with few if any therapists available.
It's always nice when research confirms personal experience.