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Use
of the Telephone in Psychotherapy
Edited by Joyce
K. Aronson. Northvale, N.J.: Jason Aronson International,
2000
Reviewed by
Roy Phillips, Ph.D.
The
focus of this book is to provide therapists with suggestions
about how to effectively use the telephone in their practice.
Each section of the book includes a discussion, practical
suggestions, and case illustrations about: the use of the
telephone as it pertains to general issues in individual
therapy; specific issues regarding individual therapy with
parents, children and adolescents; and various therapeutic
modalities and diagnostic disorders.
The
first section describes how the telephone has effectively
been used for crisis intervention, for the initial interview
or call of inquiry, for couple and/or group therapy, family
work, impasse resolution between adolescents and parents,
and for persons with medical illness. For example, the
telephone can be used as a tool for therapy when formal
office visits are not available or are anxiety provoking.
The disadvantage of using the telephone is that it can
cause transference and counter transference with the therapist
and patient. Also, the telephone does not allow for visual
cues, and it is suggested that fees not be discussed on
the telephone; it is preferable to discuss this face-to-face.
The
second section discusses the benefit of using the telephone
in transitional times, for example, when the patient or
therapist relocates, or when a patient needs to work out
of town and therapy is at a crisis point and needs to be
continued. Also, the telephone is an effective way to open
up more intense areas of therapy that the patient has not
been able to discuss in person, perhaps because the patient
may feel safer with distance from the therapist.
The
book’s third section describes how the telephone can be
a vital link for allowing the parent and therapist to keep
in close touch. One suggestion was for the therapist to
call the parent to learn of the child’s reaction to his
or her initial session, thus also confirming the interdependence
between the parent and the therapist. My personal experience
is that therapy is more effective if the therapist knows
what is going on at school and at home prior to the session.
Later
sections in the book discuss how the telephone is used
to meet developmental needs in various stages of adolescence.
It also discusses how telephone therapy has been used for
years for suicide prevention and interaction, to follow
up psychiatric hospitalization, as well as for alcohol
rehabilitation, group therapy, reducing reactions caused
by a transition to a new therapist, and to treat separation
anxiety. The telephone has also been shown to be helpful
for communicating with a helper, identifying and solving
problems, working on language difficulties, for increasing
self-observation, for freedom of expression, and to overcome
family resistance to therapy with hospital patients.
Telephone
therapy is suggested as an effective treatment for learned
helplessness, for traumatized or suicidal or alienated
patients and for crisis intervention. Also, separation
anxiety appears to be positively affected by telephone
therapy. It is also an effective tool for a consultant
to use to help resolve an impasse between a therapist and
patient. The weakness of the telephone is that it omits
information that can be obtained by observing body language
and visual cues, and can be challenging to use with people
who have difficulties focusing their attention and maintaining
concentration.
A discussion
of the state laws that govern the use of Internet, telephone
conferencing and telephone therapy was also included in
the book. Other suggestions included having the therapist
do a mental status examination in the office before scheduling
telephone therapy, which is suggested as an adjunct to,
rather than a replacement for, office therapy. Written
and informed consent should be obtained from the patient
and therapists need to consult with their clients about
the use of telephone therapy, with the therapist maintaining
records of telephone sessions. The authors also suggest
reviewing the American Psychological Association
(APA) rules for telephone use and warn that state laws regarding
telephone use may be revised yearly. Finally, the author
suggests consulting with an attorney to answer possible
legal, confidential and ethical issues.
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