Telephone Psychotherapy Fills a Mental Health Gap : New For-Profit Services Go Beyond Crisis Hot Lines and Point the Way Toward Ongoing Sources of Help

Highway conditions, stock quotations and Santa Claus are all as close as Ma Bell. It is possible to bank by telephone, call for sports scores or dial a prayer.

Now the latest twist in the telecommunications trend is the call-in therapist, whereby, with the help of a major credit card, it is possible to charge a consultation with your local shrink; a consultation that will take place over the telephone. Private Line, the Counseling Connection and Shrink Link are all groups of mental health professionals who operate for-profit, call-in counseling services.

“Telephone consultation is not meant to replace conventional therapy,” said Martin Bravin, a clinical psychologist and creator of the Encino-based Private Line. “It is an attempt to fill the gap between crisis hot lines and face to face, on-going therapy.”

This group of licensed therapists is on call daily from 9 a.m. until midnight, and for a $24 fee anyone can have a 15-minute session. No appointment is needed and there are no forms to fill out.

A typical caller might be a young mother with a new baby whose parents live in another state. Her husband is out of town on business when their 8-year-old son breaks a neighbor’s window. She falls apart. This kind of crisis, while not monumental, calls for attention. The therapist can offer immediate reassurance and coping skills.

Another caller is new to the city, divorced and hasn’t made new friends yet. The holidays are approaching and he’s very lonely and depressed. Not a life-threatening situation. He just needs a sympathetic ear and a little guidance. The immediacy of the telephone can prevent a more serious problem.

How do these groups differ from the radio call-in therapists such as Toni Grant and David Viscott?

“We offer immediacy and anonymity,” said Bravin. He added that the radio callers are screened since not all problems are suitable for airing and others would require too much time. Then the caller must queue up and wait his turn. While real names are not used, voices are identifiable.

Like all new ideas, this one has not met with complete approval from the professional community.

David Mills, administrative officer of ethical affairs for the American Psychological Assn. questioned whether therapy can take place without visual contact. “We are now in the process of formulating policy and should have a formal statement by the end of the year,” he said.

On the other hand, Bravin contends that the lack of visual contact can be an advantage. “Callers seem willing to reveal very personal problems very quickly over the telephone,” he noted.

Shrink Link, established in October, 1984 by Howard Glazer, a clinical psychologist, and Sidney Lecker, a psychiatrist, was the nation’s first for-profit, call-in consultation service for individuals. This New York-based group started as an employee assistance program, providing psychological support to employees of large corporations with the employer footing the bill.

Alcohol abuse, depression and relationship problems have a high price in terms of lost productivity as well as higher insurance. On the other hand, instant help as a preventive can often save money.

Successful Venture

The success of this venture prompted the partners to offer the service to the public. They now have six on their staff and serve the nation with an 800 toll-free number. Glazer says his staff makes referrals when necessary to more than 80 trained therapists across the country.

EAR (Employee Advisory Resource) is a service offered by Control Data Corp. to other corporations. The Mineapolis-based firm offers a wide range of advice to employees of participating corporations, including financial and industrial relations (work grievances), in addition to psychological counseling.

EAR Director David Robinson differentiates between hot lines and for-profit services. “Most hot lines use volunteers but EAR employs only experienced counselors.”

Hot lines are usually operated by churches and community groups. These volunteers are almost always given some training in active listening. They do not usually offer advice. But, they are free and they do provide the lonely with someone to talk to. The for-profit groups stress that they staff only mental health professionals; psychiatrists, psychologists, marriage counselors, psychiatric social workers, etc., whose profession it is to offer guidance.

Another local group, the Counseling Connection of Long Beach, was established in May 1985 by Mary Remlinger, a clinical psychologist who specializes in family issues and problems related to women, such as premenstrual syndrome. She emphasizes that long-term therapy is not her purpose. “When crisis intervention or in-office psychotherapy is indicated, we make referrals to an appropriate agency or therapist.”

A Frightening Prospect

This group is on call from 10 a.m. until 10 p.m. Monday through Friday and charges $15 per 10 minutes. Remlinger pointed out that for those not familiar with it, therapy can seem frightening. A call-in service offers the opportunity to experience the process in a safe, non-threatening way.

None of the therapists interviewed encouraged repeated calls. “We do set a limit, although I can’t be specific about a number,” said Bravin, who added that he might talk to an individual two or three times before making a referral but often one call is all that is needed. A consultation could last anywhere from 10 minutes to an hour but the average call is about 20 minutes.

Jacqueline Bouhoutsos, Ph.D., is president of the Assn. For Media Psychology for the California State Psychological Assn. She said, “There is some precedent for telephone therapy. It has been used, for instance, in the treatment of agoraphobia (the fear of open spaces). Used as a preventive measure and as long as both caller and therapist understand the limitations, I think it has value.”