Telephone counseling for patients with minor depression: preliminary findings in a family practice setting

Depression is a frequently occurring condition in family practice patients, but time limitations may hamper the physician's ability to it treat effectively. Referrals to mental health professionals are frequently resisted by patients. The need for more effective treatment strategies led to the development and evaluation of a telephone-based, problem-solving intervention.

Patients in a family practice residency practice were evaluated through the Medical Outcomes Study Depression Screening Scale and the Diagnostic Interview Schedule to identify those with subthreshold or minor depression. Twenty-nine subjects were randomly assigned to either a treatment or comparison group. Initial scores on the Hamilton Depression Rating Scale were equivalent for the groups and were in the mildly depressed range. Six problem-solving therapy sessions were conducted over the telephone by graduate student therapists supervised by a psychiatrist.

Treatment group subjects had significantly lower post-intervention scores on the Hamilton Depression Rating Scale compared with their pre-intervention scores (P < .05). Scores did not differ significantly over time in the comparison group. Post-intervention, treatment group subjects also had lower Beck Depression Inventory scores than did the comparison group (P < .02), as well as more positive scores for social health (P < .002), mental health (P < .05), and self-esteem (P < .05) on the Duke Health Profile.

The findings indicate that brief, telephone-based treatment for minor depression in family practice settings may be an efficient and effective method to decrease symptoms of depression and improve functioning. Nurses in these settings with appropriate training and supervision may also be able to provide this treatment.