Cited by 196Telemedicine and Telehealth ImplementationPsychotherapy Techniques and ApplicationsDigital Mental Health Interventions

Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies

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Irvine, Annie, Drew, Paul, Bower, Peter, Brooks, Helen, Gellatly, Judith, Armitage, Christopher J., Barkham, Michael, McMillan, Dean +1 more·2020·Journal of Affective Disorders

Abstract

BACKGROUND: 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. METHODS: We conducted a systematic review to establish what is known empirically about interactional differences between psychotherapeutic encounters conducted face-to-face vs. by telephone. RESULTS: 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. LIMITATIONS: 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. CONCLUSIONS: 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.

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  1. Antonioni, D.T., 1973. A field study comparison of counselor empathy, concreteness and client self-exploration in face-to-face and telephone counseling during first and second interviews(Doctoral Thesis). University of Wisconsin, USA.
  2. Brown, L. J., 1985. Antecedents of compliance in employee assistance programs: telephone vs. face-to-face communications(Doctoral Thesis). University of Windsor, Ontario, Canada.
  3. Daniel, L.S., 1973. A study of the influence of introversion-extraversion and neuroticism on telephone counseling vs. face to face counselling(Doctoral Thesis). University of Texas, Austin, USA.
  4. Heritage J. Maynard D. Communication in Medical Care 2006 Cambridge University Press Cambridge
  5. National Institute for Health and Care Excellence (NICE), 2011. Generalised anxiety disorder and panic disorder in adults: management. NICE, London. 31961629
  6. Spizman, P., 2001. Is Counseling by Telephone Effective?(Doctoral Thesis). University of Pennsylvania, Indiana. USA.
  7. Webb, C., 2014. A qualitative study of the therapeutic alliance during telephone cognitive behavioural therapy: Clinicians’ perspectives(Doctoral Thesis). University of East Anglia, UK.

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Authors
Irvine, A., Drew, P., Bower, P., Brooks, H., Gellatly, J., Armitage, C. J., Barkham, M., McMillan, D., & Bee, P.
Affiliations
  • University of York (GB)
  • Manchester Academic Health Science Centre (GB)
  • University of Liverpool (GB)
  • University of Manchester (GB)
  • University of Sheffield (GB)
Corresponding author
Irvine, Annie
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2020-03
Volume
265
Pages
120-131
ISSN
0165-0327 (ISSN-L)
OpenAlex
W2998977303
Cited by
196
References
80
Citations by year
2026: 13 · 2025: 13 · 2024: 17 · 2023: 41 · 2022: 35 · 2021: 52 · 2020: 25
FWCI
6.41
Type
journal article
Language
en
Open access
Locations
  • Journal of Affective Disorders (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, cc-by-nc-nd)
Funders
  • National Institute for Health Research (RP-PG-1016-20010)
  • Department of Health and Social Care
  • Manchester Biomedical Research Centre
  • NIHR Greater Manchester Patient Safety Translational Research Centre
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
face-to-face psychotherapy, therapeutic relationship, empathy, patient participation, disclosure, session duration, therapist attitudes, patient attitudes
MeSH terms
Empathy, Humans, Telephone, Exercise

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