Telephone Psychotherapy Essay: Benefits, Challenges, and Ethical Issues

Telehealth entails using telecommunications and information technology to offer access to health services and information across a geographical distance. According to Castro et al. (2020), the use of telehealth, particularly for mental health care, has observed significant popularity based on the desire to offer health care to marginalized populations, meet consumer desires, and reduce healthcare costs. Several challenges to traditional face-to-face psychotherapy may limit individuals from accessing the services they need, such as perceived stigma, transportation issues, difficulty leaving work, and the need for childcare (Castro et al., 2020). Telephone-delivered psychotherapy tends to minimize this care. The paper will examine the benefits of telephone-delivered therapy and why it should be used as a primary method for delivering treatment or an adjunct to traditional face-to-face psychotherapy, even though it currently faces several ethical issues.

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         Telephone psychotherapy is beneficial to clients. According to Castro et al. (2020), clients using telephone psychotherapy services enjoy more convenience with respect to time flexibility and location of appointments. Clients can complete sessions in privacy and at their homes, which helps in reducing the issues of stigma associated with mental health treatment, in addition to being less threatening compared to face-to-face sessions. Clients that benefit from the services include individuals lacking local service providers, older adults, individuals with chronic medical illness or homebound, incarcerated clients, and active military personnel preferring to care from military providers (Markowitz et al., 2021). Essentially, telephone-delivered psychotherapy tends to make treatment available to individuals who are less likely to receive mental healthcare.

Telephone-delivered psychotherapy is more popular than most telehealth services. According to Markowitz et al. (2021), even with advancements in computer and video technology, the telephone is still preferred compared to these advanced forms of communication strategies. About 96% of the American population own a landline or cell phone. On the other hand, 62% of the population has access to the internet. Furthermore, residents in rural areas, who are the primary targets of telehealth services, have limited internet access compared to urban residents. Using the telephone to offer services to clients does not require special or potentially costly equipment.

Client acceptance of telephone-delivered treatment is high. Even before receiving treatment, research shows that client report willingness and interest to participate in telephone sessions. For instance, a study on depression clients showed that 66% of adults were open to telephone sessions (Markowitz et al., 2021). Furthermore, only 29% of clients were satisfied by primary face-to-face care, with 59% being satisfied with telephone psychotherapy. Researchers claim that the satisfaction rate has been increasing progressively over the past years and is becoming more prevalent in mental health treatment. According to Rowen et al. (2022), there is evidence of a low rate of attrition in relation to telephone psychotherapy compared to face-to-face psychotherapy, with the attrition rate being 8% and 47%, respectively. Therefore, while low attrition and high client satisfaction should not be the reason to adopt telephone psychotherapy, both factors combined, in addition to reports showing consistent and robust outcome data, require more consideration of the benefits and utility of conducting mental health therapy using this approach.

While the approach is gaining popularity, major ethical issues limit its adoption. According to Rowen et al. (2022), concerns over client confidentiality and privacy loom larger, especially with modern digital and mobile technologies compared to traditional face-to-face psychotherapy. The use of insecure phones can threaten the confidentiality of a patient, not only leading to ethical issues but also legal issues. Also, medical providers tend to have limited control over their clients, who can record and post sessions online. If the client is a high level personnel, there is a possibility that the phone calls can be traced and recorded hence posing a security threat (Markowitz et al., 2021). Telephone-delivered psychotherapy also limits the development of therapeutic alliance, a bond that forms between client and psychotherapist as they tackle mutually agreed tasks and goals. The psychotherapist may also be unable to understand the client’s experience due to a lack of access to nonverbal cues. Lastly, the psychotherapist may not convey empathy, or clients may be nonattentive as they may feel it is less critical and, therefore, less invested.

There are currently no ethical guidelines for the practice. The American Psychological Association notes that psychologists practicing this approach to mental health intervention should not be within their code of ethics, as issues can be addressed on a case-by-case basis (Rowen et al., 2022). Due to increased popularity, some associations, such as the Ohio Psychology Association associations have provided guidelines improving the standard of care delivered to clients.

In conclusion, telephone-delivered psychological services are becoming more popular in current society. The approach is particularly convenient and cost-efficient and hence preferred by most clients. Additionally, the practice has been established to have a high satisfaction rate and low attrition levels compared to face-to-face sessions. However, even with success, major ethical concerns, including privacy and confidentiality, impact adoption. Essentially, even with ethical concerns, I believe its benefits outweigh its concerns; hence it is an effective mode of mental health treatment. Also, with time we will be able to develop effective interventions to address these ethical concerns.

References

Castro, A., Gili, M., Ricci-Cabello, I., Roca, M., Gilbody, S., Perez-Ara, M. Á., … & McMillan, D. (2020). Effectiveness and adherence of telephone-administered psychotherapy for depression: a systematic review and meta-analysis. Journal of affective disorders, 260, 514-526.

Markowitz, J. C., Milrod, B., Heckman, T. G., Bergman, M., Amsalem, D., Zalman, H., … & Neria, Y. (2021). Psychotherapy at a distance. American Journal of Psychiatry, 178(3), 240-246.

Rowen, J., Giedgowd, G., & Baran, D. (2022). Effective and accessible telephone-based psychotherapy and supervision. Journal of Psychotherapy Integration, 32(1), 3.