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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Evaluation of an Australian primary care telephone cognitive behavioural therapy pilot

Bridget Bassilios A D , Jane Pirkis A , Kylie King A , Justine Fletcher A , Grant Blashki C and Philip Burgess B
+ Author Affiliations
- Author Affiliations

A Centre for Health Policy, Programs and Economics, Melbourne School of Population Health, University of Melbourne, Vic. 3010, Australia.

B School of Population Health, Queensland Centre for Mental Health Research, University of Queensland, Level 3 Dawson House, The Park, Wacol, Qld 4076, Australia.

C Nossal Institute for Global Health, University of Melbourne, Vic. 3010, Australia.

D Corresponding author. Email: b.bassilios@unimelb.edu.au

Australian Journal of Primary Health 20(1) 62-73 https://doi.org/10.1071/PY12111
Submitted: 4 September 2012  Accepted: 24 October 2012   Published: 6 December 2012

Abstract

A telephone-based cognitive behavioural therapy pilot project was trialled from July 2008 to June 2010, via an Australian Government-funded primary mental health care program. A web-based minimum dataset was used to examine level of uptake, sociodemographic and clinical profile of consumers, precise nature of services delivered, and consumer outcomes. Key informant interviews with 22 project officers and 10 mental health professionals elicited lessons learnt from the implementation of the pilot. Overall, 548 general practitioners referred 908 consumers, who received 6607 sessions (33% via telephone). The sessions were delivered by 180 mental health professionals. Consumers were mainly females with an average age of 37 years and had a diagnosis of depressive and/or anxiety disorders. A combination of telephone and face-to-face sessions of 1 h in duration were conducted, delivering behavioural and cognitive interventions, usually with no cost to consumers. Several implementation issues were identified by project officers and mental health professionals. Although face-to-face treatment is preferred by providers and consumers, the option of the telephone modality is valued, particularly for consumers who would not otherwise access psychological services. Evidence in the form of positive consumer outcomes supports the practice of multimodal service delivery.

Additional keywords: access to allied psychological services, better outcomes, primary mental health care, psychological intervention, telephone therapy.


References

Anderson P, Jacobs C, Rothbaum BO (2004) Computer-supported cognitive behavioral therapy treatment of anxiety disorders. Journal of Clinical Psychology 60, 253–267.
Computer-supported cognitive behavioral therapy treatment of anxiety disorders.Crossref | GoogleScholarGoogle Scholar |

Bassilios B, King K, Fletchet J, Reifels L, Blashki G, Burgess P, Pirkis J (2011) Evaluation of the Access to Allied Psychological Services (ATAPS) component of the Better Outcomes in Mental Health Care (BOiMHC) program: Eighteenth interim evaluation report: an overview of the achievements of Tier 1 and Tier 2 ATAPS. Centre for Health Policy Programs and Economics, The University of Melbourne, Melbourne.

Beck AT, Kovacs M, Weissman A (1979) Assessment of suicidal intention. Journal of Consulting and Clinical Psychology 47, 343–352.
Assessment of suicidal intention.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE1M3jvFyrsg%3D%3D&md5=de20335b2c350ae0dd9914357e5afb41CAS |

Bee PE, Bower P, Lovell K, Gilbody S, Richards D, Gask L, Roach P (2008) Psychotherapy mediated by remote communication technologies: a meta-analytic review. BMC Psychiatry 8,
Psychotherapy mediated by remote communication technologies: a meta-analytic review.Crossref | GoogleScholarGoogle Scholar |

Burgess N, Christensen H, Leach LS, Farrer L, Griffiths KM (2008) Mental health profile of callers to a telephone counselling service. Journal of Telemedicine and Telecare 14, 42–47.
Mental health profile of callers to a telephone counselling service.Crossref | GoogleScholarGoogle Scholar |

Callahan A, Inckle K (2012) Cybertherapy or psychobabble? A mixed methods study of online emotional support. British Journal of Guidance & Counselling 40, 261–278.
Cybertherapy or psychobabble? A mixed methods study of online emotional support.Crossref | GoogleScholarGoogle Scholar |

Centore AJ, Milacci F (2008) A study of mental health counselors’ use of and perspectives on distance counseling. Journal of Mental Health Counseling 30, 267–282.

Eisen SV, Grob MC, Klein AA (1986) BASIS: the development of a self-report measure for psychiatric inpatient evaluation. The Psychiatric Hospital 17, 165–171.

Goss S, Anthony K (2009) Developments in the use of technology in counselling and psychotherapy. British Journal of Guidance & Counselling 37, 223–230.
Developments in the use of technology in counselling and psychotherapy.Crossref | GoogleScholarGoogle Scholar |

Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, Walters EE, Zaslavsky AM (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine 32, 959–976.
Short screening scales to monitor population prevalences and trends in non-specific psychological distress.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38vls1Wltg%3D%3D&md5=b7511aaa2fa1ba1d8a55ae9799108b84CAS |

King N (2004) Using template analysis in the thematic analysis of text. In ‘Essential guide to qualitative methods in organizational research’. (Eds G Symon, C Cassell) pp. 256–270. (Sage: London)

Leach LS, Christensen H (2006) A systematic review of telephone-based interventions for mental disorders. Journal of Telemedicine and Telecare 12, 122–129.
A systematic review of telephone-based interventions for mental disorders.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD283jtF2qsQ%3D%3D&md5=f224ca44609e11c5ed62be8658551364CAS |

Lovell K, Cox D, Haddock G, Jones C, Raines D, Garvey R, Roberts C, Hadley S (2006) Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial. British Medical Journal 333, 883–886.
Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial.Crossref | GoogleScholarGoogle Scholar |

Lovibond SH, Lovibond PF (1995) ‘Manual for the Depression Anxiety Stress Scales.’ 2nd edn. (Psychology Foundation: Sydney)

Miller IW, Norman WH, Dow MG, Bishop SB (1986) The Modified Scale for Suicidal Ideation: reliability and validity. Journal of Consulting and Clinical Psychology 54, 724–725.
The Modified Scale for Suicidal Ideation: reliability and validity.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL2s%2FjsVGhtQ%3D%3D&md5=91e5dae5f0f51cf7b3a9a1f58f806c43CAS |

Payne L, Casemore R, Neat P, Chambers M (2006) ‘Guidelines for telephone counselling and psychotherapy.’ (BACP Publishing: Rugby)

Pirkis J, Bassilios B, Fletcher J, Sanderson K, Spittal MJ, King K, Kohn F, Burgess P, Blashki G (2011) Clinical improvement after treatment provided through the Better Outcomes in Mental Health Care program: Do some patients fare better than others? The Australian and New Zealand Journal of Psychiatry 45, 289–298.
Clinical improvement after treatment provided through the Better Outcomes in Mental Health Care program: Do some patients fare better than others?Crossref | GoogleScholarGoogle Scholar |

Richards DA, Lovell K, Gilbody S, Gask L, Torgerson D, Barkham M, Bland M, Bower P, Lankshear AJ, Simpson A, Fletcher J, Escott D, Hennessy S, Richardson R (2008) Collaborative care for depression in UK primary care: a randomized controlled trial. Psychological Medicine 38, 279–287.
Collaborative care for depression in UK primary care: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c%2FlsFCrsw%3D%3D&md5=50ba865fadb07ab839dbbbdeacf228cbCAS |

Rosenfield M (1997) ‘Counselling by telephone.’ (Sage: London)

Rosenfield M (2003) Telephone counselling and psychotherapy in practice. In ‘Technology in counselling and psychotherapy: a practitioner’s guide’. (Eds S Goss, K Anthony) pp. 91–108. (Palgrave: London)

Scharff JS (2012) Clinical issues in analyses over the telephone and internet. The International Journal of Psycho-Analysis 93, 81–95.
Clinical issues in analyses over the telephone and internet.Crossref | GoogleScholarGoogle Scholar |

Williams R, Bambling M, King R, Abbott Q (2009) In-session processes in online counselling with young people: an exploratory approach. Counselling & Psychotherapy Research 9, 93–100.
In-session processes in online counselling with young people: an exploratory approach.Crossref | GoogleScholarGoogle Scholar |

Wing JK, Beevor AS, Curtis RH, Park SB, Hadden S, Burns A (1998) Health of the Nation Outcome Scales (HoNOS): research and development. The British Journal of Psychiatry 172, 11–18.
Health of the Nation Outcome Scales (HoNOS): research and development.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c7ps1ehtg%3D%3D&md5=90e36b6de798a5986f6fb1a61198d039CAS |