Phone Counseling .org

“Phoning it in” works when it comes to losing weight and getting fit, according to a new systematic review.

“There’s an important use for the telephone in delivering support for making changes to physical activity and diet,” said Elizabeth Eakin, Ph.D., lead study author, at the University of Queensland in Australia.

The review appears in the May issue of the American Journal of Preventive Medicine.

Eakin and her colleagues in the School of Population Health reviewed 26 studies published between 1965 and early 2006. Twenty took place in the United States; the rest were conducted in Australia and New Zealand. All of the studies were randomized controlled trials.

The studies used either live telephone counselors, such as nurses, health educators or trained researchers, or automated phone systems. Researchers separated studies into three categories: those that assessed changes in physical activity levels, those that assessed changes in dietary behaviors and those that examined both physical activity and diet.

The telephone proved to be an effective delivery mechanism for health behavior change, the reviewers said. Overall, 77 percent of the studies found that people receiving phone counseling made positive dietary and physical activity behaviors.

“It shows that support for physical activity and dietary change can come from a variety of mechanisms. This is great news for people who don’t want to join a more structured group program or who don’t have access,” Eakin said

Sixty-nine percent of the studies that evaluated physical activity, 83 percent of the studies that evaluated dietary behaviors and 75 percent of the studies that addressed both diet and exercise reported positive improvements after the phone counseling intervention.

Although telephone counseling was the primary method of delivering information about exercise and nutrition for all of the studies, most interventions also offered participants nutrition and exercise information via an initial face-to-face meeting and printed materials.

One reviewed study aimed to increase walking. It began by offering participants detailed feedback on whether their initial level of walking was consistent with recommended levels. Counselors also provided information on ways participants could walk more each day. Throughout the study, telephone counselors helped participants set achievable goals and come up with solutions when they had difficulty meeting their goals. At the end of the intervention, researchers evaluated whether participants increased the total time spent walking from the start of the study.

Longer interventions appeared to be especially effective in helping people change their ways. Of the 13 studies that lasted between six to 12 months and included 12 or more calls, 77 percent reported positive changes in dietary behaviors and physical activity levels. In comparison, only 50 percent of the interventions lasting less than six months reported positive outcomes.

“Physical activity and diet are complex behaviors to change, so providing support over a longer period of time is more effective than short-term interventions,” Eakin said.

Despite the review’s overall positive findings, few studies evaluated whether the positive outcomes of phone counseling lasted after the counseling sessions ended.

“Our big challenge as a field is to learn how to help people maintain those positive changes,” Eakin said.

Only two studies evaluated costs; both concluded that phone interventions did offer cost benefits.

Melissa Napolitano, Ph.D., an associate professor at the Center for Obesity Research and Education at Temple University in Philadelphia, said telephone counseling is not only convenient and cost-effective but it may also “be useful as it provides the accountability and social support that are important components for behavior change.”

The telephone also allows for a real-time interaction, so a telephone counselor can help people problem-solve their trouble spots, reevaluate their goals and set new goals if they’re successful, said Napolitano, who was not involved in the review.

The study authors and Napolitano agreed that the phone may prove especially helpful for people with limited access to medical care or those who live in remote areas.

Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
http://www.hbns.org

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Recent breakthroughs in phone counseling services have jump-started a new market that is safe, private, and professional. Counselors and therapists are now available by phone or chat to take calls 24/7 from anywhere in the US, and consumers can view and leave ratings for the practitioners as well.

In years past, popular pay-per-usage telephone services were phone psychics, and phone chat lines. The rates were high, and the services were poor. Needless to say, their popularity soon faded along with the rubix cube and magic 8-ball.

Lately, a new professional service has emerged over the telephone with a similar pay-per-usage model, only this one seems like it may stick. Online phone counseling has become available over the internet and is becoming widely accepted. On some websites, like Phone-Counseling.org, the visitor can choose from a list of therapists who are available for chat or phone counseling. The list can have 20 or more therapists, along with pictures and a short statement from the counselor. Next to the therapist listing, there will be an “Online” statement that indicates whether or not that therapist is currently available.

The systems that make this type of live, on-demand service possible are provided by a company called Kasamba. Kasamba does more than just phone counseling though; consulting in many different forms is available through their network of “experts.” Kasamba’s experts have a program installed that can indicate their online status and be used for chat. Their servers house the system that takes care of billing and all of the back-end operations. It is a very unique and robust application. When a consumer decides to contact a live therapist, all they have to do is click the “contact live” button and fill in some basic information to create an account. From there, they will be assigned a phone number to call that will connect them with the therapist of their choice.

Phone counselors can be from many different educational backgrounds, but all should be licensed by the state in which they practice. Some typical credentials one may see behind a therapist’s name are: LCSW, Ph.D., MA, LPC, LMFT and LMHC. In that order, the credentials stand for “Licensed Clinical Social Worker,” “Doctor of Philosophy” (Psychologist), “Master of Arts (in counseling),” “Licensed Practicing Counselor,” “Licensed Marriage and Family Therapist,” and “Licensed Mental Health counselor.” All of these educational backgrounds can vary in their degree of training on different expertise. Specialties even exist amongst each individual from the same educational background. That’s why it can be very helpful to inquire about a therapist’s training in the area you need help with. Ideally, if a therapist doesn’t have the necessary experience to work effectively with the issues you are facing, they will refer you to someone who does.

Phone counseling presents a new and more accessible way for therapists to connect with patients. Kasamba’s network has been successful in their implementation of this service, so who knows where it may one day lead? There may come a day when we can do physician referrals over the internet and telephone rather than waiting in a crowded doctor’s office. Phone counseling has many uses, for people who don’t have access to transportation or therapists within their area – to people suffering from severe anxiety or depression who need someone to speak to right away. Visit http://phone-counseling.org, for more information.

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