Telephone Counseling: Are Offices Becoming Obsolete?

Reese, Conoley, and Brossart (2002) conducted research on the effectiveness of telephone counseling and the quality of the counseling relationship. Reese et al. stated that the purpose of the study was to investigate whether telephone counseling as used in the field is effective for providing general mental health counseling" (p. 234). They examined clients' self-reported satisfaction with telephone counseling's treatment of their problems, their self-reported improvement in specific areas of their life, and global improvement in emotional state. Furthermore, Reese and colleagues were interested in whether clients perceived that a therapeutic bond had been developed between themselves and the counselor. Research of this nature is critical for many reasons. First, more and more companies who have employee assistance programs are using some form of telephone counseling to help them. Second, although telephone counseling is used widely, little is known about its effectiveness compared with traditional face-to-face therapy. Reese and colleagues (2002) make an important contribution to the literature dealing with the effectiveness of such counseling by comparing the results of their study with those from a large scale study of face-to-face therapy conducted by Consumer Reports (CR; "Mental Health,"1995). In this study, participants were 186 adult clients with various emotional difficulties. These clients were receiving services from a private telephone counseling agency that serves as an employee assistance program for several large Fortune 500 companies. More than 2 million employees had access to the service. The participants were mostly women (73%), a majority were White (76%), and they were 18 to 60 years old. The clients presented with problems in a range of areas including depression, anxiety, substance abuse, eating disorders, work-related difficulties, and grief. The average number of sessions was 12, with a range of 1 to 99 sessions. These clients accessed the counseling using a toll-free telephone number. There was a brief intake over the phone, and then the client was given a time to call back to speak to a counselor. Sessions lasted an average of 30 minutes and were considered to be solution-focused therapy (SFT; De Jong, & Berg, 1998). All counselors were licensed and had a master's degree in counseling, psychology, marriage and family therapy, or social work. All counselors were trained in SFT and received live supervision. Three measures were used to determine therapeutic effectiveness. The Consumer Reports Annual Questionnaire (CRAQ; "Annual Questionnaire," 1994) was used so that comparisons could be made with the results of the CR study. Three subscales from the CRAQ--Specific Improvement, Satisfaction, and Global Improvement--were used. The Working Alliance Inventory-Bond Scale (WAI-B; Horvath & Greenberg, 1986) was used to "assess the interpersonal aspect of the therapeutic alliance" (Reese et al., 2002, p. 236). The final measure, Counselor Rating Form-Short Version (CRF-S; Corrigan & Schmidt, 1983), was used to measure the client's view of the counselor's influence. Reese et al. (2002) provided compelling evidence for the effectiveness of telephone counseling. The first question as to the client's perceptions of the effectiveness of telephone counseling yielded very positive results. "Over 80% of the participants felt that the specific problem that led them to counseling had improved" (Reese et al., 2002, p. 236). These mean scores were slightly, but significantly, lower than those for the CR face-to-face group. In terms of global improvement, most of the clients (53%) reported doing "so-so" (Reese et al., 2002, p. 237). These scores did not differ significantly from the CR face-to-face results. Regarding satisfaction, "over two-thirds of the telephone counseling sample (68%) reported being either 'very satisfied' or 'completely satisfied' with telephone counseling" (Reese et al. …