J. Med. Internet Res. - A comparison between phone-based psychotherapy with and without text messaging support in between sessions for crisis patients.

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Resumo

CKGROUND: Few studies have tested whether individually tailored text messaging interventions have an effect on clinical outcomes when used to supplement traditional psychotherapy. This is despite the potential to improve outcomes through symptom monitoring, prompts for between-session activities, and psychoeducation.OBJECTIVE: The intent of the study was to explore the use of individually tailored between-session text messaging, or short message service (SMS), as an adjunct to telephone-based psychotherapy for consumers who present to the Emergency Department (ED) in situational and/or emotional crises.METHODS: Over a 4-month period, two therapists offered 68 prospective consumers of a telephone-based psychotherapy service individually tailored between-session text messaging alongside their telephone-based psychotherapy. Attendance and clinical outcomes (depression, anxiety, functional impairment) of those receiving messages were compared against a historical control group (n=157) who received telephone psychotherapy only.RESULTS: A total of 66% (45/68) of the consumers offered SMS accepted the intervention. A total of 432 messages were sent over the course of the trial, the majority involving some kind of psychoeducation or reminders to engage in therapy goals. There were no significant differences in clinical outcomes between consumers who received the SMS and those in the control group. There was a trend for participants in the intervention group to attend fewer sessions than those in the control group (mean 3.7, SD 1.9 vs mean 4.4, SD 2.3).CONCLUSIONS: Both groups showed significant improvement over time. Individually tailored SMS were not found to improve clinical outcomes in consumers receiving telephone-based psychotherapy, but the study was underpowered, given the effect sizes noted and the significance level chosen. Given the ease of implementation and positive feedback from therapists and clients, individually tailored text messages should be explored further in future trials with a focus on enhancing the clinical impact of the tailored text messages, and utilizing designs with additional power to test for between-group effects.

Resumo Limpo

ckground studi test whether individu tailor text messag intervent effect clinic outcom use supplement tradit psychotherapi despit potenti improv outcom symptom monitor prompt betweensess activ psychoeducationobject intent studi explor use individu tailor betweensess text messag short messag servic sms adjunct telephonebas psychotherapi consum present emerg depart ed situat andor emot crisesmethod month period two therapist offer prospect consum telephonebas psychotherapi servic individu tailor betweensess text messag alongsid telephonebas psychotherapi attend clinic outcom depress anxieti function impair receiv messag compar histor control group n receiv telephon psychotherapi onlyresult total consum offer sms accept intervent total messag sent cours trial major involv kind psychoeduc remind engag therapi goal signific differ clinic outcom consum receiv sms control group trend particip intervent group attend fewer session control group mean sd vs mean sd conclus group show signific improv time individu tailor sms found improv clinic outcom consum receiv telephonebas psychotherapi studi underpow given effect size note signific level chosen given eas implement posit feedback therapist client individu tailor text messag explor futur trial focus enhanc clinic impact tailor text messag util design addit power test betweengroup effect

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