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Phone therapy is a convenient way to receive mental health services from home. Although phone therapy isn’t conducted in person, most patients have positive experiences, and it is considered a practical alternative to traditional therapy. However, is it effective?
Phone therapy is sufficient for most patients. Phone therapy is more convenient, affordable, and flexible than traditional treatment. It is effective for older patients and those with co-occurring conditions. It is also great for patients in rural areas and those with physical impairments.
This article will go over what phone therapy is, why it is practical, its advantages and disadvantages compared to traditional therapy, and some popular phone therapy service providers patients can look into.
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Differences Between Phone and Traditional Therapy
Phone therapy is when therapists talk to their clients over the phone instead of in-person. While some patients choose to meet their therapist in person before conducting phone therapy sessions, it is unnecessary. To conduct phone therapy, the patient and the therapist need to have cellphones with good cellular service or landlines.
Traditional therapy, also known as face-to-face therapy or in-person therapy, is when therapists speak with their patients in person. Typically patients will travel to their therapist’s office for their sessions. Therapists usually design their therapy rooms to have a calming atmosphere. This may include comfortable furniture, natural lighting, and soft music.
Similarities Between Phone and Traditional Therapy
Both phone therapists and traditional therapists are qualified professionals who are certified to talk to clients. Therefore, phone therapists are just as qualified as face-to-face therapists to treat anxiety, depression, and other common mental illnesses.
In both forms of therapy, therapists will conduct an initial assessment with their patients. During this time, therapists will assess their patients’ conditions and will determine their treatment plans. Patients can discuss scheduling, cost of treatment, whether their insurance is accepted, and other inquiries during this initial session.
Does Therapy Over the Phone Work?
According to a study by the University of Cambridge, phone therapy is just as effective as traditional therapy for most patients. Researchers looked at 39,000 patients with mental illness during the study, mainly individuals with mild anxiety and depression. They found that phone therapy and traditional therapy were equally helpful for these patients.
Additional studies have confirmed these same results. Researchers Anna Coughtrey and Nancy Pistrang reviewed 13 studies on phone therapy, which revealed that phone therapy is just as effective as in-person therapy, especially for patients with anxiety and depression.
Why Is Phone Therapy Effective?
Researchers at the University of Cambridge have developed a hypothesis regarding why phone therapy may be as effective as traditional therapy.
These researchers believe that therapy is valuable because it allows patients to have a meaningful dialogue with qualified professionals. They think this aspect of treatment is more important than being able to talk with someone face-to-face.
Phone therapy allows patients to have back and forth conversations with their therapists, just like they can during in-person therapy. This may be why both forms of therapy are equally effective for most patients.
Who Is Phone Therapy Effective For?
Some researchers have analyzed different populations to determine if phone-therapy works for them.
These studies have revealed that phone therapy is effective for people suffering from mild to moderate forms of several mental illnesses, especially anxiety and depression.
Phone therapy may also be effective for individuals who have co-occurring medical disorders and for older individuals. Further research needs to be conducted to determine if phone therapy is effective for other groups.
Phone therapy may not help individuals with very severe mental illnesses, including schizophrenia and clinical depression. These patients may benefit more from in-person sessions.
Advantages of Phone Therapy Over In-Person Therapy
Phone therapy has several advantages over traditional in-person therapy. Listed below are eight of its main benefits.
A study conducted by researchers at Northwestern University found that phone therapy may be more convenient than traditional therapy.
Researchers randomly assigned participants with depression to either a phone-therapy group or a face-to-face therapy group during the study. They found that participants in the face-to-face group were more likely to discontinue their treatment than individuals in the phone therapy group.
The researchers believe that the phone therapy group participants continued their treatment for longer than the traditional therapy group because it’s more convenient than conventional therapy. Patients were not required to drive or even leave their homes to receive their services. So, the convenience of phone therapy may make people more likely to attend.
While phone therapy may be more convenient for everyone, it is especially helpful for patients in rural locations.
Patients who live hours away from the closest therapist may choose to forgo therapy because it is too difficult for them to schedule appointments. Even if they were able to schedule an appointment, they likely wouldn’t go as frequently as their therapists recommend because of the distance. However, with phone therapy, patients in these areas can have frequent appointments with their therapists without the long drive.
Tends to Be More Affordable
On average, phone therapy is approximately 35% cheaper than traditional therapy. Phone therapy sessions typically cost between $40 to $80 per week, whereas traditional therapy sessions can cost upwards of $250 per hour.
And don’t forget about the time and money spent traveling to and from the therapist’s office. With phone therapy, patients get to avoid these travel-related fees. With traditional therapy, patients have to spend money on gas, parking fees, and other car-related expenses every time they go to a session. Even public transportation can be pricey, depending on how far away clients live from their therapists.
Making a phone call, on the other hand, is an affordable option for most people. With all of the phone plans available today, phone calls have never been cheaper.
Phone therapy is also cheaper for the therapist. When therapists conduct sessions over the phone, they don’t have to use their facilities. Because of this, they are usually able to charge less for phone therapy than traditional sessions.
So phone therapy is a fantastic option for individuals who can’t afford traditional treatment.
Some people may find it hard to open up to their therapist about specific problems in a face-to-face setting. Phone therapy helps with this since it provides the patient with more anonymity. This allows clients to say more to their therapists than they usually would, speeding up the treatment process.
Session Length/Time Is More Flexible
In-person therapists can only hold sessions with patients during their facility hours of operation. Sessions typically last 50-55 minutes without much wiggle room since therapists often have another client coming in, right after their current session finishes. Also, therapists cannot schedule shorter sessions since these typically aren’t worth the drive for their patients.
Phone therapy, on the other hand, is more flexible. Therapists can schedule sessions early in the morning or late in the evening when in-person facilities may not be open. They can also make sessions longer or shorter than traditional sessions since they can talk on their phone anytime, anywhere, and there is no need for the patient to travel.
Easier for Patients With Physical Impairments
Travel is difficult for patients with particular physical impairments. Patients with limited mobility or blindness cannot drive themselves, so they have to make travel arrangements to get to their therapy sessions. This can be time consuming and expensive.
Phone therapy removes these hassles since patients can receive therapy from home. This makes therapy more accessible to individuals who would typically have to jump through hoops to make it to their therapy sessions.
More Therapist Options
Typically patients have to choose a therapist based on their location. Patients are limited to providers in their area and often have to choose a therapist that doesn’t have the optimal skill set for the patient’s specific mental illnesses.
However, with phone therapy, patients can choose the right therapist since the distance is no longer a constraint. Patients can select therapists with the necessary skills and experience to provide them with the best therapy sessions possible.
Remember that therapists are licensed in specific states and generally are not allowed to work across state lines, even for phone therapy sessions. So patients have to select therapists that reside in the same state to avoid any legal issues. If patients find their therapist through a phone therapy service, the service will choose a licensed therapist in the state where the patient resides.
Important for Agoraphobics
Agoraphobia is a condition in which people view their environment as unsafe. Agoraphobics often experience intense anxiety when they are in public settings or open spaces. Many agoraphobics are afraid to leave their homes.
Because of this, most agoraphobics do not receive the therapy they need. Many are too afraid to leave their houses to go to their therapy sessions. Their intense fear prevents them from getting help, so they are unable to improve their condition.
Phone therapy is an excellent way for agoraphobics to talk to a mental health professional without exposing themselves to their greatest fear. Phone therapists can help agoraphobics slowly reveal themselves to the outside world. This can help them improve their condition safely and comfortably without inducing extreme levels of anxiety.
Safer During Pandemics
During pandemics such as COVID-19, vulnerable populations could not get in-person therapy services since this would have increased their chances of being exposed to the virus.
Similarly, less vulnerable individuals may have stopped their therapy services because they didn’t want to potentially expose susceptible family members to the virus.
Phone therapy provided patients with a way to continue their sessions during pandemics and other dangerous situations without putting themselves or their family members in jeopardy. If similar problems arise in the future, phone therapy will be a viable way to continue therapy sessions while keeping patients out of harm’s way.
Disadvantages of Phone Therapy
There are three main disadvantages of phone therapy. These are discussed in detail below.
Treatment Gains May Not Last As Long
One study by researchers from Northwestern University found that in-person therapy may lead to longer-lasting results than phone therapy.
During the study, therapists administered cognitive behavioral therapy (CBT) to clients with depression, either in-person or over the phone. Six months after the therapy sessions ended, they re-evaluated their patient’s symptoms. They found that patients in the in-person therapy group had fewer depressive symptoms than those in the phone-therapy group.
This study suggests that phone therapists may need to regularly evaluate their patients post-treatment to ensure their symptoms haven’t re-emerged.
May Experience Technical Difficulties
If a client or a therapist is in a location with lousy cell phone service, they may lose connection during their phone therapy session. This can be frustrating, as therapists and clients only have a certain amount of time allotted for each session.
Clients and therapists may also experience delayed speech, difficulty hearing the other person, and other technical issues during phone calls that could be avoided if the session took place in person.
It’s recommended that therapists use landlines since they are more reliable to help prevent these problems. Landlines are also more secure, helping protect the client’s personal information and confidentiality during phone therapy sessions.
More Challenging for the Therapists
According to researchers from Wake Forest University School of Medicine, phone therapy may be more challenging for therapists for several reasons. We’ll discuss each of these reasons in detail below.
Can’t Control Their Clients’ Environments
In a therapy room, therapists can dim the lights, remove distractions, and make their clients as comfortable as possible. They can create an environment conducive to therapy.
When clients do phone therapy sessions, they are often at home and maybe distracted by their spouses, kids, and other family members. These environments may be loud, stressful, and can distract the client from their therapy session. Also, if other family members are at home, the client may not be able to speak freely about family issues they are facing.
To help prevent some environment-related issues from arising, therapists should tell their clients their expectations about their therapy environment. This includes advising the clients that they need to have minimal distractions, and they should start each session on time.
Difficult to Guarantee Privacy
As mentioned above, clients may be around other people during home therapy sessions. Therefore, therapists can’t assure that everything their clients say will be completely private.
Also, whenever therapists use technology to communicate with their patients, they can’t guarantee 100% privacy. Unauthorized individuals can hear the client’s information if the client or therapist has an insecure phone connection.
Lastly, it is difficult to determine if therapists speak with their clients if they can’t see their faces. Therefore, it is possible for therapists to unwittingly disclose personal information to someone else if they think it is their client.
To help prevent this, clients and therapists can create a secret password that only they know. Clients should disclose this password at the beginning of each therapy session.
More Difficult to Build Rapport
Therapists try to build rapport with their clients, which means they try to get their clients to like them and trust them. The process of building rapport may be more difficult over the phone for several reasons.
One reason is that clients and therapists can’t see each other. This makes it so therapists have to rely solely on what their clients say to determine their thoughts, feelings, and experiences. People learn a lot from body language and non-auditory cues, so not having these signals can make it harder for therapists to interpret their clients’ mental states.
Secondly, clients may feel more disconnected from their therapists and may not view them as empathetic when they only speak to them over the phone. Empathy is partially conveyed through facial expressions and body language, so it may be harder for clients to determine if their therapist is empathetic solely through auditory cues.
So, for these reasons, building rapport with clients over the phone may be more complicated than during face-to-face therapy. More studies on this topic are needed to confirm this.
However, there is hope. Some studies have found that building rapport with a client is possible over the phone. Most patients in these studies had a positive view of their therapists and enjoyed their phone therapy sessions.
So, while it may be more challenging to build a relationship with clients over the phone, research suggests that it can be overcome.
Ethical and Legal Standards
There are several ethical and legal standards therapists have to uphold to practice phone therapy. Some of these include:
- Telephone therapy may not be legal in every state. Therapists need to make sure that it is acceptable in the state they reside in before pursuing phone therapy.
- Therapists need to provide their patients with informed consent forms and disclosure forms that state their level of experience with phone therapy, any limitations associated with phone therapy, and alternate ways to meet if phone therapy is not available.
- Therapists need to make sure that they can protect their clients’ information. They shouldn’t share personal information when they are using insecure methods of communication.
- The therapist must disclose how they will access and store records of their communications with the client, and who will have access to those records.
- Phone therapy may not be the best option for every client. Therapists need to use phone therapy responsibly.
These ethical and legal standards may hold some therapists back from trying out phone therapy.
Difficult to Assist Clients in Crisis
During phone therapy, therapists aren’t with their patients, so if a crisis occurs, they aren’t able to physically de-escalate the situation or remove harmful objects. If a client threatens suicide or homicide during a phone call, the therapist may not handle the situation as effectively as they could in person.
Also, clients can hang up the phone on their therapists during crises. This prevents therapists from being able to gauge how serious the problem is. So, therapists may over or underreact, which can be detrimental for their patients and their families.
How Do I Find a Phone Therapist?
To find a phone therapist, patients can either ask their current therapists to hold phone therapy sessions or find a therapist using a phone therapy service.
Ask Your Therapist
If patients already have a therapist that they like, they can ask them if they are open to providing therapy services over the phone. Patients should talk to their therapists to determine if phone therapy is right for them.
Because of the COVID-19 pandemic, many therapists have incorporated phone therapy or video therapy sessions into their practice. If patients are currently doing phone therapy with their therapists because of the pandemic, they can ask their therapists to continue these sessions even after the pandemic has subsided.
BetterHelp offers phone and video sessions with licensed therapists. While their therapists’ precise experience levels differ, all of them have at least three years and 1000 hours of experience working with clients.
BetterHelp helps individuals, couples, or teens work through various issues, such as anxiety, depression, stress, relationship problems, parenting dilemmas, drug or alcohol addictions, traumatic experiences, anger issues, family conflicts, and more.
Patients can chat with their therapist via messaging, live chat, phone, or video. Patients schedule phone or video sessions with their therapists using the Better Help platform. They can choose the date and time that is best for them.
Sessions cost $40 to $70 per week, making this a very affordable therapy option.
Talkspace is an online platform that provides clients with therapy services over the phone. To get started, clients simply take an assessment and answer some questions. A therapist will then be selected depending on the client’s needs and the state in which they reside.
Talkspace has licensed therapists in all 50 states and Canada. Clients can message their therapist whenever they want in their Talkspace chatroom. Therapists and clients can then schedule phone sessions, depending on the client’s needs and availability.
Plans cost between $65 to $100 per week. However, there is no commitment, so if clients aren’t happy with the services they are receiving, they can cancel their subscription at any time, or they can switch to a different therapist.
ReGain is a phone therapy provider that provides messaging, phone, and video counseling services for couples.
Licensed therapists help couples work out marital issues to rebuild intimacy, trust, and companionship within their relationships. ReGain therapists can also work with each partner one on one to talk about personal problems. Sessions can be conducted using a smartphone, computer, or tablet.
All of the therapists at Regain are licensed and experienced. They all have at least three years and 1,000 hours of experience.
ReGain costs $60 to $80 per week. If members no longer need ReGains services, they can cancel their subscriptions at any time.
PRIDE counseling was designed for people in the LGBTQ community. Therapists at PRIDE Counseling specialize in assisting LGBTQ individuals struggling with mental health problems, their identities, or any other issues.
LGBTQ individuals suffer from mental illnesses at a higher rate than the general population, making this service especially important.
PRIDE Counseling’s services are convenient, affordable, and private. Clients can message their therapist 24/7 and can schedule weekly phone calls or video calls.
All of the therapists at PRIDE Counseling are licensed professionals with masters or doctorate degrees. Each therapist has at least three years and 1,000 hours of experience and specialized experience working with members of the LGBTQ community.
The cost of counseling ranges from $60 to $80 per week.
TeenCounseling is a phone or video therapy platform for teenagers between the ages of 13-19. Teens can talk to their counsels using a computer, tablet, or smartphone.
Therapists can help teens experiencing various problems, including anxiety, overwhelming stress, poor coping skills, low self-esteem, family problems, depression, bulimia, anorexia, and more.
Counseling sessions cost $60 to $80 per week. This price includes counseling sessions for teens and their parents.
All counselors on Teen Counseling are experienced psychologists, therapists, social workers, or professional counselors with proper education, licenses, and training.
Teens are assigned to one therapist who they will work with throughout their therapy sessions. However, if the teen wants to switch therapists, they always have that option.
OnlineTherapy.com is focused on cognitive behavioral therapy (CBT). CBT is a very effective form of therapy used to treat several mental illnesses. CBT helps patients identify problematic thoughts and change them to more positive ones.
Patients who sign up for OnlineTherapy.com will be assigned a therapist based on their situation and the therapists’ expertise.
This platform offers four different price plan options depending on how much support your need. The most expensive option is $63.96 per week. This plan includes two live phone or video sessions with your therapist per week and yoga and meditation videos, online chapters about CBT with accompanying worksheets, and daily feedback from the assigned therapist.
Phone therapy is as effective as traditional therapy for most clients. It is more convenient, flexible, and affordable than in-person therapy. It is also easier for clients with physical impairments and is an important treatment option for agoraphobics.
Phone therapy does have a few disadvantages. Its effects may not last as long as traditional therapy. Also, patients and therapists can experience technical difficulties during sessions. Lastly, phone therapy may be more challenging for therapists to perform.
Overall, phone therapy is a wonderful option for most patients. It provides patients with a cost-effective way to receive effectual therapy services without having to leave their homes. Phone therapy is genuinely unique because it makes therapy services accessible to more people than ever before.
- NCBI: Benefits and Challenges of Conducting Psychotherapy by Telephone
- PubMed: The effectiveness of telephone-delivered psychological therapies for depression and anxiety: A systematic review
- American Psychological Association: Telephone psychotherapy: Ensuring patients have access to effective care
- Moment of Science: Is Therapy Over-The-Phone As Effective As In-Person Therapy?
- Psychology Today: Phone Therapy for Depression
- EurekAlert!: Therapy over the phone as effective as face-to-face
- UK Therapy Guide; Phone Counselling / Therapy
- Counseling Hub: HOW LONG DOES EACH COUNSELING SESSION LAST?
- The Good Trade: 6 Online Therapy Options That Are Affordable & Accessible
- Talkspace: Online therapy with a licensed therapist
- Top10.com: Best Online Therapy Services 2020
- Zencare: Can I Provide Teletherapy Across State Lines During the Pandemic?
- Psychology Today: How to Transition to Seeing Your Therapist Online