Department of Language and Linguistic Science, University of York, Heslington, York, UK.
Department of Language and Linguistic Science, University of York, Heslington, York, UK.
J Affect Disord. 2020 Mar 15;265:120-131. doi: 10.1016/j.jad.2020.01.057. Epub 2020 Jan 15.
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.
We conducted a systematic review to establish what is known empirically about interactional differences between psychotherapeutic encounters conducted face-to-face vs. by telephone.
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.
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.
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.
尽管临床结果相当，但治疗师和患者对通过电话提供心理治疗表示保留意见。这些担忧集中在治疗关系的质量以及在缺乏视觉线索的情况下行使专业技能和判断力的能力上。然而，对于这些看法的实证证据基础尚未明确确立。
我们进行了一项系统综述，以确定关于面对面与通过电话进行心理治疗之间互动差异的实证知识。
该综述确定了 15 项使用情境比较方法探索电话和面对面心理治疗互动方面的研究。这些研究表明，在治疗联盟、披露、同理心、关注或参与方面，两种模式之间几乎没有差异。然而，电话治疗疗程明显短于面对面治疗。
我们仅确定了少数异质研究，其中许多研究使用非随机机会样本，并且未使用经过验证的措施来评估所研究的结构。不同的治疗模式在研究和样本中都有使用，包括临床诊断和非临床人群。
现有证据表明，电话对心理治疗的互动方面没有不利影响的观点缺乏支持。临床实践的挑战是将这一证据转化为治疗师和患者态度和行为的改变。为了做到这一点，重要的是要了解和解决支持对电话模式持续持矛盾态度的广泛因素，这些因素构成了更广泛实施的障碍。
