title: Telephone-administered psychotherapy for depression.
abstract: 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.
  
  
  METHODS
  Randomized controlled trial including 12-month follow-up.
  
  
  METHODS
  Telephone administration of psychotherapy with patients in their homes.
  
  
  METHODS
  Participants had depression and functional impairments due to multiple sclerosis.
  
  
  METHODS
  A 16-week T-CBT program was compared with 16 weeks of telephone-administered supportive emotion-focused therapy.
  
  
  METHODS
  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.
authors.affiliation: Veterans Administration Medical Center, University of California, San Francisco 94121, USA. dmohr@itsa.ucsf.edu
authors.forename: David C
authors.initials: DC
authors.lastname: Mohr
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Hart
authors.forename: Laura
authors.initials: L
authors.lastname: Julian
authors.forename: Claudine
authors.initials: C
authors.lastname: Catledge
authors.forename: Lara
authors.initials: L
authors.lastname: Honos-Webb
authors.forename: Lea
authors.initials: L
authors.lastname: Vella
authors.forename: Edwin T
authors.initials: ET
authors.lastname: Tasch
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000523:psychology; D010352:Patient Dropouts; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D019114:Remote Consultation / Q000379:methods*; D013689:Telephone / Q000706:statistics & numerical data*; D016896:Treatment Outcome