Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: The conclusions of the study
by Dr Simon and colleagues1 state that “these
findings suggest a new public health model of psychotherapy for depression. . . . ”
However, as noted in their Comment section, the specific elements of the telephone
psychotherapy program that accounted for its effectiveness cannot be determined.
We do not know if it is the psychotherapy per se or simply the increased number
of telephone contact or management sessions that accounted for the improved
outcome. Furthermore, as different professionals were used in the 2 groups
(care managers who were mental health clinicians with experience in depression
assessment vs psychotherapists with experience in outpatient psychotherapy),
it is hard to conclude that the positive outcomes in the study were due to
telephone psychotherapy itself. Because a telephone management care program
has already been shown to be effective,2 a
future controlled study comparing telephone management and telephone psychotherapy,
but using professionals with the same background and same number of telephone
sessions and schedules in both groups, would strengthen the conclusion.
Wong SYS. Telephone Psychotherapy and Care Management for Depression. JAMA. 2004;292(22):2720-2721. doi:10.1001/jama.292.22.2720-b