The Attractiveness of Telephone Counseling: An Empirical Investigation of Client Perceptions

By Reese, Robert J.; Conoley, Collie W. et al. | Journal of Counseling and Development : JCD, Winter 2006 | Go to article overview

The Attractiveness of Telephone Counseling: An Empirical Investigation of Client Perceptions


Reese, Robert J., Conoley, Collie W., Brossart, Daniel F., Journal of Counseling and Development : JCD


The purpose of this study was to discover what features of telephone counseling clients found attractive and how the issues could be conceptualized from their perspective. Understanding clients' perspectives of telephone counseling is an important initial process study into how telephone counseling appears to consumers. This study should be considered a sister study, or the second part, to a study we published previously that examined the effectiveness of telephone counseling (Reese, Conoley, & Brossart, 2002). Specifically, we used the same outcome measure as the Consumer Reports (CR; 1995) effectiveness study and found that telephone counseling respondents reported similar levels of improvement and satisfaction with the counseling process as did the CR face-to-face sample. However, telephone counseling clients who indicated having more severe problems reported less improvement than did the sample in the CR study. Participants who reported severe problems evaluated telephone counseling as less helpful than face-to-face counseling.

Because consumers of telephone counseling had found it effective, the next question was to study the processes of telephone counseling. In the present study, telephone counseling clients rated the attractiveness of attributes they experienced when they used mental health counseling (not crisis intervention) over the telephone. The telephone counseling clients were also asked about their openness to future use of face-to-face counseling and telephone counseling.

Telephone counseling has been evolving for many years. The early use of the telephone for counseling was limited to crisis intervention or hotline services (Lester, 2002). Miller (1973) was an early advocate of using telephone therapy as an adjunct to traditional counseling, but more than a decade ago, the telephone was suggested as a primary treatment medium (e.g., Shepard, 1987). Telephone counseling has become a viable alternative for people who otherwise could not receive counseling. Some examples of the obstacles that telephone counseling can circumvent are a client's physical disability, social anxiety, geographical isolation, and time constraints (Haas, Benedict, & Kobos, 1996).

Most telephone counseling services discussed in the literature have been problem- or population-focused treatments. Telephone counseling has been used for many purposes, such as group counseling for older individuals, individuals who are housebound because of agoraphobia, minor depression, and smoking cessation. Evans, Smith, Werkhoven, Fox, and Pritzl (1986) conducted cognitive group therapy over the telephone with older individuals, who were severely disabled, to lessen loneliness, to encourage them to become more active, and to solve problems. Older people received group therapy using telephone conference technology. Most reported that telephone counseling was effective as measured by goal attainment and loneliness scores. Telephone therapy for individuals who were housebound because of agoraphobia and also had panic disorder was also found to be moderately successful, albeit only for some cases (McNamee, O'Sullivan, Lelliott, & Marks, 1989). Lynch, Tamburrino, and Nagel (1997) found brief telephone therapy helpful for individuals with minor depression compared with a control group that received no treatment.

Telephone therapy for smoking cessation is an example of a well-researched treatment. Results from these studies (e.g., Katz, Muehlenbruch, Brown, Fiore, & Baker, 2002; Mermelstein, Hedeker, & Wong, 2003; Orleans et al., 1991; Zhu et al., 1996a; Zhu, Tedeschi, Anderson, & Pierce, 1996b; Zhu et al., 2002) have been favorable, with smoking reduction and cessation rates higher for those using telephone counseling than for other cessation methods.

Telephone therapy has been used by a number of therapists as the only modality of treatment to conduct family therapy and/or individual therapy, both long- and short-term (e. …

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