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December 8, 2004

Telephone Psychotherapy and Care Management for Depression

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(22):2720-2721. doi:10.1001/jama.292.22.2720-b

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.