The DOI matches its Crossref record; 73 of the 80 references it cites were found in a registry or an index.
Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies
Open accessAbstract
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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“Despite sporicidal skepticism, the good therapeutic relationship reported in our and earlier studies (Bee et al., 2010; Haller et al., 2019) is in line with studies reporting no difference in therapeutic relationship in telephone- or face-to-face therapy (Irvine et al., 2020; Stiles-Shields et al., 2014).”
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Cites
PRISMA-P Group, Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015) · Systematic Reviews · doi:10.1186/2046-4053-4-1 · Cited by 26,223 · cited 2×
“The paper followed the PRISMA guidelines for reporting of systematic reviews and metaanalyses (Moher et al., 2015).”
MethodThe American Psychological Association
Langfeld, H. S. (1919) · Science · doi:10.1126/science.49.1254.51 · Cited by 7,453
Development and validation of the working alliance inventory
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“, 2014) considered patient and/or therapist ratings of therapeutic alliance across telephone and face-to-face therapy sessions, using versions of the Working Alliance Inventory (WAI; Horvath and Greenberg, 1989).”
MethodThe Effectiveness of Telemental Health: A 2013 Review
Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013) · Telemedicine and e-Health · doi:10.1089/tmj.2013.0075 · Cited by 1,048 · cited 1×
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Heritage, J., Robinson, J. D., Elliott, M. N., Beckett, M. K., & Wilkes, M. S. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0279-0 · Cited by 436
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“The method of Conversation Analysis (CA) offers a proven method for adding understanding to the interactional processes of clinical encounters (Drew et al., 2001; Heritage and Maynard, 2006; Heritage and Robinson, 2006; Perakyla et al., 2008; Robinson, 2003; Robinson and Heritage, 2006).”
MethodThe Social Impact of the Telephone
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“The method of Conversation Analysis (CA) offers a proven method for adding understanding to the interactional processes of clinical encounters (Drew et al., 2001; Heritage and Maynard, 2006; Heritage and Robinson, 2006; Perakyla et al., 2008; Robinson, 2003; Robinson and Heritage, 2006).”
MethodDrew, P., Chatwin, J., & Collins, S. L. (2001) · Health Expectations · doi:10.1046/j.1369-6513.2001.00125.x · Cited by 367 · cited 1×
“The method of Conversation Analysis (CA) offers a proven method for adding understanding to the interactional processes of clinical encounters (Drew et al., 2001; Heritage and Maynard, 2006; Heritage and Robinson, 2006; Perakyla et al., 2008; Robinson, 2003; Robinson and Heritage, 2006).”
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Flagged first, then by citations
7 of the 80 references couldn’t be matched to a known paper.
Research works printed but not linked: 7
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Bennemann, A. C. K., Paiva, C. E., Julião, M., Chochinov, H. M., Marques, C., Costa, R. F. A., de Oliveira, L. C., Miwa, M. U., Trevizan, F. B., Valentino, T. C. D. O., et al. (2024) · Palliative & Supportive Care · doi:10.1017/s1478951524001408 · Cited by 3
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BackgroundTherapist-Reported Differences between Teletherapy via Phone and via Videoconferencing
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Price, C., & Masud, S. (2022) · Clinical Psychology Forum · doi:10.53841/bpscpf.2022.1.360.36 · Cited by 1
Sinai, D., Lassri, D., Spira, C., & Lipsitz, J. D. (2023) · Psychotherapy Research · doi:10.1080/10503307.2023.2200982 · Cited by 2
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Relationship Development with Psychotic Clients
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Managing Negative Feelings About Clients
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0010
Clients Toward Whom a Social Worker Feels Attraction
Walsh, J. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780197517956.003.0009
The Worker/Client Relationship in Technology-Assisted Interventions
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Definitions and Theoretical Perspectives
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Aljaafar, M. M., Kouyoumjian, S. P., Mahmoud, G., & AlMulla, A. (2025) · BMC Family Practice · doi:10.1186/s12875-025-02858-2
“There are concerns about the delivery of counseling therapy over the phone, however according to a systematic review there is no support for the idea that telephone has a detrimental effect on interactional aspects of psychological therapy [44].”
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The therapeutic relationship in in‐person, video call, and telephone psychotherapy sessions
Stefana, A., Fazia, T., & Nova, A. (2026) · British Journal of Clinical Psychology · doi:10.1111/bjc.70050
“Current evidence shows comparable levels of working alliance in patients receiving VT (Seuling et al., 2024) or TT (Irvine et al., 2020) compared to those receiving IT (see also Davis et al., 2024).”
Donkin, L., Jones, A., & van Kessel, K. (2026) · Counselling and Psychotherapy Research · doi:10.1002/capr.70124
Sun, Z., & He, T. (2026) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2026.101160
Howes, E., Gillies, K., Smith, S. G., Ahmed, S., & Farrin, A. (2026) · Research Square · doi:10.21203/rs.3.rs-9301843/v1
Crossing the chemsex divide: Using avatars for inclusive research on sensitive topics
Crichton, L. M., & Andrade, J. (2026) · Addictive Behaviors · doi:10.1016/j.addbeh.2026.108814
Karlsson, I., Kwak, L., Bültmann, U., Bergström, G., Axén, I., & Brämberg, E. B. (2026) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-026-10441-4
Lee, H., Hwang, J.-H., Cho, C., & Heo, J. (2026) · Journal of Medical Internet Research · doi:10.2196/85281
“Despite initial concerns about relationship building, evidence indicates that VCT achieves effects comparable to those of F2FT, with similar alliance formation and perceived empathy [4,6,10-14] for patients and therapists [15].”
Woodford, J., Reuther, C., Dun, L. A., Farrand, P. A., Johansen, K., Parent Advisory Board, Richards, D. A., Sampaio, F., Thiblin, E., & von Essén, L. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-124267
“49 Rationale for the CHANGE-pilot RCT Procedural uncertainties ENGAGE was a single-arm feasibility trial.”
Nguyen, J. Q. P., Melvin, G. A., & Hallford, D. J. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122636
Metadata
- 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
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 265
- Pages
- 120-131
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC7049904
- 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
- hybrid
- doi.org
- Licence
- 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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