UMaine Psychologist Finds Minimal Therapist Contact Effective
Contact: Joe Carr at (207) 581-3571
ORONO — If a handful of face-to-face contacts with a psychologist are as beneficial to some clients with panic disorder as weekly psychotherapy sessions, perhaps even fewer face-to-face consultations would be better still.
That’s the theory and basis of a new study on “self-directed” therapy being conducted by University of Maine psychologist Jeffrey Hecker. It is the third study conducted by Hecker, who also chairs the UMaine Psychology Department, and several graduate students in the department, to explore new ways that people with panic disorder can be treated more efficiently, effectively and less expensively.
“This type of research continues to indicate that there may not have to be a lot of contact to be effective,” Hecker says. “If we can teach a person to understand the problem so it’s no so mysterious, and give them some small measure of success” they’ll be more likely to succeed with their therapy.
Hecker also seeks in his current research ways to identify the personality types of people with panic disorder or agoraphobia — fear of crowds or places from which escape would be difficult — who are most likely to succeed with self-directed therapy.
With 56 volunteers in the study now, he’s actively looking for another couple dozen volunteers diagnosed with panic disorder to participate.
Benefits for participants include free therapy, according to Hecker, a licensed clinical psychologist with a small private practice in Orono.
Already knowing from previous studies that some people can do well with a self-directed therapy program, Hecker is certain his research can benefit many people living in rural areas in Maine, particularly those for whom getting to a therapist’s office may not be convenient.
“The reality of people living in a rural state is they have limited access to health care,” he says. If people can be treated for panic disorder with a workbook and occasional telephone contact with a therapist, that could reduce the cost and inconvenience of psychological therapy.
In the first study, conducted in the early 1990s, half of a group of volunteers suffering from anxiety and panic disorder were given an initial consultation with a research therapist, a workbook and four face-to-face visits with the therapist. The meetings occurred about once ever three weeks. The second half of the group had weekly scheduled therapy sessions with an individual therapist.
At the end of the 12-week experiment, Hecker found that both treatment methods were effective.
“Then we launched into this second study to look at whether we could make the treatment as effective with even less contact, so we assigned people into groups of four, five or six to meet in group sessions four times with a therapist,” he says.
Members of the other half of the study group had just one individual face-to-face meeting with a psychotherapist and three follow-up telephone consultations. The latter group also had workbooks to read and homework exercises to complete.
Hecker says the telephone calls from the therapists in effect, coached the volunteers, and helped them keep up with their assignments.
In comparing the results for the clients getting more traditional face-to-face therapy in an office environment with clients working at home with a self-directed therapy program, “they seemed to be equally effective,” Hecker reports. “Both conditions led to significant improvement and they seemed to be equally effective. In post-treatment, more people we’d reached by telephone had reached what we call the high end-state functioning status, which is close to normal.”
Six months later, it appeared that both sets of volunteers were at the same levels of functioning, a sign of significant success, according to Hecker and his colleagues.
“It’s not clear if the telephone was better, but it’s at least as good as having the contact with the therapist,” he says.
Results of the second study recently were published in the February 2004 edition of “Journal of Anxiety Disorders,” an academic journal read by leading authorities in psychology.
The next study Hecker wants to do is to isolate different personality types, to see if there are ways to determine who is best suited, and who might not be, for self-directed therapy.
For instance, he says, people with panic disorder who also experience significant depression may be less successful at sticking to their self-directed program, a hypotheses he wants to clarify through more research.
For the current study, however, measuring the success of self-directed therapy as opposed to more frequent, traditional office visits, Hecker asks that prospective volunteers call the UMaine Psychological Services Center at 330 Corbett Hall on the Orono campus at (207) 581-2034.
Volunteers will be interviewed over the telephone briefly to determine their eligibility. The second step would be to meet with a university researcher for a diagnostic interview.