Psychotherapy by telephone: Risks and benefits for psychologists and consumers

The telephone has long been a vehicle for delivering psychological services such as referral information and crisis intervention. Recently, the use of the telephone as the primary vehicle for delivering psychotherapeutic services has been promoted. This article considers the advantages of telephone psychotherapy, especially those claimed as positive features of pay-per-call telephone lines, and finds that they may be less helpful than claimed. Telephone therapy is claimed to offer ease of access, increased sense of safety and privacy, and lower cost relative to face-to-face treatment. On the other hand, telephone therapy increases the difficulty of providing for patient safety in crisis situations, increases risks to privacy, and may ultimately be more expensive than conventional psychotherapy. In addition, serious questions have been raised about the degree to which effective treatment can be carried out without direct experience of the other person in the encounter and without a specifically designated and designed location in which to carry out treatment and how the best interests of the client can be served.