Are there interactional differences between telephone and face-to-face psychological therapy?: A systematic review of comparative studies

Annie Louise Irvine; Paul Drew; Peter Bower; Helen Brooks; Judith Gellatly; Christopher J Armitage; Michael Barkham; Dean McMillan; Penny Bee

doi:10.1016/j.jad.2020.01.057

Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies

Annie Louise Irvine, Paul Drew, Peter Bower, Helen Brooks, Judith Gellatly, Christopher J Armitage, Michael Barkham, Dean McMillan, Penny Bee

Research output: Contribution to journal › Article › peer-review

Abstract

Background
Despite comparable clinical outcomes, therapists and patients express reservations about the delivery of psychological therapy by telephone. These concerns centre around the quality of the therapeutic relationship and the ability to exercise professional skill and judgement in the absence of visual cues. However, the empirical evidence base for such perceptions has not been clearly established.

Methods
We conducted a systematic review to establish what is known empirically about interactional differences between psychotherapeutic encounters conducted face-to-face vs. by telephone.

Results
The review identified 15 studies that used situated, comparative approaches to exploring interactional aspects of telephone and face-to-face psychological therapy. These studies revealed evidence of little difference between modes in terms of therapeutic alliance, disclosure, empathy, attentiveness or participation. However, telephone therapy sessions were significantly shorter than those conducted face-to-face.

Limitations
We identified only a small number of heterogeneous studies, many of which used non-randomised, opportunity samples and did not use validated measures to assess the constructs under investigation. Disparate therapeutic modalities were used across studies and samples included both clinically diagnosed and non-clinical populations.

Conclusions
Available evidence suggests a lack of support for the viewpoint that the telephone has a detrimental effect on interactional aspects of psychological therapy. The challenge for clinical practice is to translate this evidence into a change in practitioner and patient attitudes and behaviours. In order to do so, it is important to understand and address the breadth of factors that underpin ongoing ambivalence towards the telephone mode, which pose a barrier to wider implementation.

Original language	English
Journal	Journal of affective disorders
Volume	265
Early online date	15 Jan 2020
DOIs	https://doi.org/10.1016/j.jad.2020.01.057
Publication status	Published - 15 Mar 2020

Bibliographical note

Keywords

Psychological therapy
Telephone therapy
therapeutic alliance
Interaction
CONVERSATION ANALYSIS
Telehealth

Access to Document

10.1016/j.jad.2020.01.057

1-s2.0-S0165032719319743-main
©2020 Published by Elsevier B.V. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.
Accepted author manuscript, 921 KBLicence: CC BY-NC-ND

NIHR Programme Grant: Enhancing the quality of psychological interventions delivered by telephone (EQUITy)
McMillan, D., Drew, P. & Gilbody, S.
2/04/18 → 1/05/24
Project: Research project (funded) › Research

Cite this

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title = "Are there interactional differences between telephone and face-to-face psychological therapy?: A systematic review of comparative studies",

abstract = "BackgroundDespite comparable clinical outcomes, therapists and patients express reservations about the delivery of psychological therapy by telephone. These concerns centre around the quality of the therapeutic relationship and the ability to exercise professional skill and judgement in the absence of visual cues. However, the empirical evidence base for such perceptions has not been clearly established.MethodsWe conducted a systematic review to establish what is known empirically about interactional differences between psychotherapeutic encounters conducted face-to-face vs. by telephone.ResultsThe review identified 15 studies that used situated, comparative approaches to exploring interactional aspects of telephone and face-to-face psychological therapy. These studies revealed evidence of little difference between modes in terms of therapeutic alliance, disclosure, empathy, attentiveness or participation. However, telephone therapy sessions were significantly shorter than those conducted face-to-face.LimitationsWe identified only a small number of heterogeneous studies, many of which used non-randomised, opportunity samples and did not use validated measures to assess the constructs under investigation. Disparate therapeutic modalities were used across studies and samples included both clinically diagnosed and non-clinical populations.ConclusionsAvailable evidence suggests a lack of support for the viewpoint that the telephone has a detrimental effect on interactional aspects of psychological therapy. The challenge for clinical practice is to translate this evidence into a change in practitioner and patient attitudes and behaviours. In order to do so, it is important to understand and address the breadth of factors that underpin ongoing ambivalence towards the telephone mode, which pose a barrier to wider implementation.",

keywords = "Psychological therapy, Telephone therapy, therapeutic alliance, Interaction, CONVERSATION ANALYSIS, Telehealth",

author = "Irvine, {Annie Louise} and Paul Drew and Peter Bower and Helen Brooks and Judith Gellatly and Armitage, {Christopher J} and Michael Barkham and Dean McMillan and Penny Bee",

note = "{\textcopyright}2020 Published by Elsevier B.V. This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. ",

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T2 - A systematic review of comparative studies

AU - Irvine, Annie Louise

AU - Drew, Paul

AU - Bower, Peter

AU - Brooks, Helen

AU - Gellatly, Judith

AU - Armitage, Christopher J

AU - Barkham, Michael

AU - McMillan, Dean

AU - Bee, Penny

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N2 - BackgroundDespite comparable clinical outcomes, therapists and patients express reservations about the delivery of psychological therapy by telephone. These concerns centre around the quality of the therapeutic relationship and the ability to exercise professional skill and judgement in the absence of visual cues. However, the empirical evidence base for such perceptions has not been clearly established.MethodsWe conducted a systematic review to establish what is known empirically about interactional differences between psychotherapeutic encounters conducted face-to-face vs. by telephone.ResultsThe review identified 15 studies that used situated, comparative approaches to exploring interactional aspects of telephone and face-to-face psychological therapy. These studies revealed evidence of little difference between modes in terms of therapeutic alliance, disclosure, empathy, attentiveness or participation. However, telephone therapy sessions were significantly shorter than those conducted face-to-face.LimitationsWe identified only a small number of heterogeneous studies, many of which used non-randomised, opportunity samples and did not use validated measures to assess the constructs under investigation. Disparate therapeutic modalities were used across studies and samples included both clinically diagnosed and non-clinical populations.ConclusionsAvailable evidence suggests a lack of support for the viewpoint that the telephone has a detrimental effect on interactional aspects of psychological therapy. The challenge for clinical practice is to translate this evidence into a change in practitioner and patient attitudes and behaviours. In order to do so, it is important to understand and address the breadth of factors that underpin ongoing ambivalence towards the telephone mode, which pose a barrier to wider implementation.

AB - BackgroundDespite comparable clinical outcomes, therapists and patients express reservations about the delivery of psychological therapy by telephone. These concerns centre around the quality of the therapeutic relationship and the ability to exercise professional skill and judgement in the absence of visual cues. However, the empirical evidence base for such perceptions has not been clearly established.MethodsWe conducted a systematic review to establish what is known empirically about interactional differences between psychotherapeutic encounters conducted face-to-face vs. by telephone.ResultsThe review identified 15 studies that used situated, comparative approaches to exploring interactional aspects of telephone and face-to-face psychological therapy. These studies revealed evidence of little difference between modes in terms of therapeutic alliance, disclosure, empathy, attentiveness or participation. However, telephone therapy sessions were significantly shorter than those conducted face-to-face.LimitationsWe identified only a small number of heterogeneous studies, many of which used non-randomised, opportunity samples and did not use validated measures to assess the constructs under investigation. Disparate therapeutic modalities were used across studies and samples included both clinically diagnosed and non-clinical populations.ConclusionsAvailable evidence suggests a lack of support for the viewpoint that the telephone has a detrimental effect on interactional aspects of psychological therapy. The challenge for clinical practice is to translate this evidence into a change in practitioner and patient attitudes and behaviours. In order to do so, it is important to understand and address the breadth of factors that underpin ongoing ambivalence towards the telephone mode, which pose a barrier to wider implementation.

KW - Psychological therapy

KW - Telephone therapy

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