Texting, webcams and instant chat might seem like innovations best suited to passing along teenage gossip, but medical researchers are discovering their usefulness in helping people with psychological disorders.
The new communication technologies have helped in the treatment of people with anxiety and depression, according to recent research. Patients have been able to better connect with specialists who can help them. And doctors have found the technologies make it easier to track patients' progress.
"You gain a lot more convenience," said Dr Gregory Simon, a psychiatrist and senior investigator with Group Health Research Institute in Seattle. "They don't have to come down to your office, and you don't have to play telephone tag with patients."
Simon led a team of researchers who found that people with depression responded well to follow-up treatment conducted via a chat messaging system on a health-care website. The study built upon prior research that proved the effectiveness of follow-up treatment by telephone.
Treating depression by phone
The team randomly selected 106 people with depression to receive follow-up care via the Group Health chat system. They chatted online with a care manager at regular intervals after their initial treatment for depression, and then completed a four-month assessment of their progress.
"It seemed to be just as effective as the telephone," Simon said. "People were more satisfied with their care, their depression was more likely to improve and they were more likely to take their medications as directed."
That study parallels another project in which doctors at Drexel University in Philadelphia used home videoconferencing via Skype to treat people with obsessive-compulsive disorders, or OCD.
The Drexel project involved cognitive-behavioural therapy, which has been shown to be very effective in treating OCD but can be hard for people to begin and maintain, according to Evan Forman, a clinical psychologist, associate professor and director of clinical training in Drexel's psychology department.
"People find it either inconvenient or difficult or embarrassing to make contact with those kinds of therapists," Forman said. "In most of the country, you'd have a hard time finding someone with the appropriate training."
Web-conferencing and depression
Forman and James Herbert, a clinical psychologist and associate dean of the Drexel College of Arts and Sciences, are attempting to overcome this through the use of videoconferencing through the Internet, using Skype communication software.
Therapists role-play with patients via webcam, presenting them with different scenarios aimed at helping them overcome their anxiety and OCD, Forman said.
"So far, we have very encouraging results," he said. "It's been very successful, both in terms of our ability to deliver the treatment and in patients' response to therapy."
Using such technology does have its drawbacks, Simon and Forman admitted. Therapists can't see their patients very well, or at all, and therefore cannot pick up on small nonverbal cues that can be very telling.
Also, technical glitches can cause a session to be interrupted, which can be distressing for the patient, Forman said.
On the other hand, using such technology for treatment opens up the possibility for a patient to shop around and find the therapist who could help them best - even if that person is in some far-flung locale.
"Someone doesn't have to choose between the nine therapists in their town," Forman said. "They can choose someone based on expertise, even if they're hundreds of miles away."
Such treatments also are low-cost for both patient and doctor. The technologies - whether online messaging or videoconferencing - are generally free. Anyone with Internet access and a webcam can participate.
And it's convenient, as well. "You can answer the message any hour of the day and night," Simon said. "You save a lot of time in the back-and-forth and the telephone tag."
SOURCES: Gregory Simon, M.D., M.P.H., psychiatrist and senior investigator, Group Health Research Institute, Seattle; Evan Forman, Ph.D., clinical psychologist, associate professor and director, clinical training, department of psychology, Drexel University, Philadelphia; March 7, 2011, Journal of General Internal Medicine, online
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