Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Aug;62(8):936-42.
doi: 10.1176/ps.62.8.pss6208_0936.

Telephone-based cognitive-behavioral therapy for Latino patients living in rural areas: a randomized pilot study

Megan Dwight-Johnson  1 , Eugene Aisenberg, Daniela Golinelli, Seunghye Hong, Mary O'Brien, Evette Ludman
Affiliations
Randomized Controlled Trial

Telephone-based cognitive-behavioral therapy for Latino patients living in rural areas: a randomized pilot study

Megan Dwight-Johnson et al. Psychiatr Serv. 2011 Aug.

Abstract

Objective: This pilot study tested the effectiveness of culturally tailored, telephone-based cognitive-behavioral therapy (CBT) for improving depression outcomes among Latino primary care patients living in rural settings.

Methods: A total of 101 Latino patients at a rural family medical center who met criteria for probable major depression were randomly assigned to enhanced usual care or eight sessions of CBT delivered by phone by trained bilingual therapists from the community. Blinded study assistants assessed depression symptom severity, using the Hopkins Symptom Checklist (SCL) depression items and the Patient Health Questionnaire-9, and patient satisfaction after six weeks, three months, and six months. Mixed-effects models were used to estimate intervention effects over time. For cross-sectional analyses, attrition weights were used to account for missing data.

Results: In intent-to-treat analyses, patients who received CBT by phone were more likely to experience improvement in depression scores over the six-month follow-up period compared with patients who received enhanced usual care (β=-.41, t=-2.36, df=219, p=.018, for the SCL; and β=-3.51, t=-2.49, df=221, p=.013, for the PHQ-9). A greater proportion of patients in the CBT group than in the group that received enhanced usual care achieved treatment response at three months (p=.017), as indicated by a 50% improvement in SCL depression score or a score <.75, and reported high satisfaction with treatment (p=.013).

Conclusions: Although limited by small sample size, pilot results suggest culturally tailored, telephone-based CBT has the potential to enhance access to psychotherapy in an underserved Latino population with little access to mental health services.

PubMed Disclaimer

Conflict of interest statement

Disclosures

The authors report no competing interests.

Figures

Figure 1
Figure 1
Scores on the Hopkins Symptom Checklist depression items over time among 101 patients who received telephone-based cognitive-behavioral therapy (CBT) or enhanced usual carea aPossible scores range from 0 to 4, with higher scores indicating more severe depression.
Figure 2
Figure 2
Scores on the Patient Health Questionnaire–9 over time among 101 patients receiving telephone-based cognitive-behavioral therapy (CBT) or enhanced usual carea aPossible scores range from 0 to 27, with higher scores indicating more severe depression.
See this image and copyright information in PMC

References

    1. Gonzalez HM, Vega WA, Williams DR, et al. Depression care in the United States: too little for too few. Archives of General Psychiatry. 2010;67:37–46. - PMC - PubMed
    1. Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Rockville, Md: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2001. - PubMed
    1. Sentell T, Shumway M, Snowden L. Access to mental health treatment by English language proficiency and race/ethnicity. Journal of General Internal Medicine. 2007;22:289–293. - PMC - PubMed
    1. Vega WA, Kolody B, Aguilar-Gaxiola S, et al. Gaps in service utilization by Mexican Americans with mental health problems. American Journal of Psychiatry. 1999;156:928–934. - PubMed
    1. Annual Resident Population Estimates of the United States by Age, Race, and Hispanic or Latino Origin: April 1, 2000, to July 1, 2003. Hyattsville, Md: US Census Bureau; 2003.

Publication types