Steve Tutty's Telehealth Depression Research with Greg Simon, MD

Therapy by Telephone, Starting in 2000

Beginning in 2000, Steve Tutty worked with principal investigator Greg Simon, MD on one of the early telehealth programs in behavioral health: structured psychotherapy delivered by telephone to adults being treated for depression in primary care.

Long before video visits were routine, the program tested a simple idea. Many adults with depression are treated only by their primary care doctor, often with an antidepressant, and never see a therapist. If therapy came to them by phone, more of them might get it.

The four papers, in order

2004 · JAMA

The main randomized controlled trial, testing telephone care management and telephone psychotherapy for primary care patients who were starting antidepressant treatment.

2005 · General Hospital Psychiatry

A look at the program itself: whether telephone psychotherapy was feasible to deliver in primary care and acceptable to the patients who received it.

2007 · Journal of Consulting and Clinical Psychology

A continuation study asking whether the effects of telephone psychotherapy and medication lasted after the sessions ended.

2010 · Behavior Therapy

An evaluation of the effectiveness of cognitive-behavioral teletherapy for depressed adults.

Full citations

Telephone psychotherapy and telephone care management for primary care patients starting antidepressant treatment: a randomized controlled trialSimon GE, Ludman EJ, Tutty S, Operskalski B, Von Korff M. JAMA. 2004;292(8):935–942.
A randomized controlled trial with adults who were starting antidepressant medication through their primary care doctor. It tested two kinds of support delivered by phone: care management calls that follow up on treatment, and structured psychotherapy sessions held over the telephone.
Feasibility and acceptability of a telephone psychotherapy program for depressed adults treated in primary careTutty S, Ludman EJ, Simon G. General Hospital Psychiatry. 2005;27(6):400–410.
Before asking whether a treatment works, researchers have to know whether it can be delivered at all. This paper looked at the feasibility and acceptability of a telephone psychotherapy program for depressed adults seen in primary care: could it run in that setting, and would patients take part.
A randomized trial of telephone psychotherapy and pharmacotherapy for depression: continuation and durability of effectsLudman EJ, Simon GE, Tutty S, Von Korff M. Journal of Consulting and Clinical Psychology. 2007;75(2):257–266.
A follow-up to the telephone psychotherapy trial. It asked whether the effects of telephone psychotherapy combined with medication carried on after the sessions ended: the 'continuation and durability' in the title.
Evaluating the effectiveness of cognitive-behavioral teletherapy in depressed adultsTutty S, Spangler DL, Poppleton LE, Ludman EJ, Simon GE. Behavior Therapy. 2010;41(2):229–236.
A study of cognitive-behavioral therapy delivered remotely ('teletherapy') to adults with depression, evaluating how effective that format was.

Some terms, explained

What is telephone psychotherapy?

Talk therapy held over the phone instead of in an office. In structured forms, such as cognitive-behavioral therapy, the sessions follow a set plan and the patient practices skills between calls.

What is care management?

Regular follow-up contact, often by phone, to check how a patient is doing on treatment, whether they are taking their medication, and whether the plan needs to change.

What does 'feasibility and acceptability' mean?

Feasibility asks whether a program can actually be delivered in a real setting. Acceptability asks whether patients are willing to take part and stay with it.

What does 'durability of effects' mean?

Whether a treatment's benefits last after the treatment stops, rather than fading once sessions end.

Then and now

Remote mental health care is now ordinary. Steve Tutty's own practice offers consultations and feedback sessions by video, though testing itself is done in person.

Telehealth & Depression Research