Email or phone? The relative impact on treatment engagement, therapeutic alliance and outcome

Internet-administered Cognitive Behavioral Therapy (iCBT) is an effective treatment of depression, yet much remains to be learned about the specific mechanisms influencing symptom reduction. Although previous research has consistently shown that therapist-guided iCBT is more effective than unguided iCBT, it is unknown whether the medium used for therapist-client communication has an impact on results.

In a new study that was published today 38 subjects with major depression were randomised to a guided iCBT program with therapist guidance either by telephone calls or e-mail correspondence. Outcome measures were self-rated measures of depression, anxiety and quality of life.

At post-treatment, both groups showed significant and large symptom reductions yet did not differ from each other. Neither was there any between-group difference in client-rated therapeutic alliance or treatment engagement. Symptom reductions were maintained at a three-month follow-up.

The conclusion was that therapist guidance by telephone does not appear to differ from therapist guidance by e-mail in iCBT for depression, although further research featuring larger samples is necessary to draw more definite conclusions.

Read the full paper: Lindner, P., Olsson, E. L., Johnsson, A., Dahlin, M., Andersson, G., & Carlbring, P. (in press). The impact of telephone versus e-mail therapist guidance on treatment outcomes, therapeutic alliance and treatment engagement in Internet-delivered CBT for depression: A randomised pilot trial. Internet Interventions. doi: 10.1016/j.invent.2014.09.001

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