Telemedicine as a means of delivering cognitive-behavioural therapy to rural and remote mental health clients

We explored the feasibility and acceptability of delivering cognitive-behavioural therapy (CBT) via videoconference to clients with depression and/or anxiety living in rural north Queensland. The study involved 15 mental health clients and their five case managers. First, each case manager was instructed in the use of telemedicine for clinical consultation, and given training in CBT. This was done via videoconference. Then the clients were introduced to telemedicine. Following six to eight intensive weekly sessions of CBT, there was improvement in certain clinical outcome measures (i.e. the Mental Health Inventory and the Health of the Nation Outcome Scale). There was a significant improvement (P<0.05 using a t-test) in the client Mental Health Inventory scores before (mean=109) and after treatment (mean=148). However, in the absence of a control condition, it was not possible to conclude that the treatment had a specific effect on the disorders studied. Both clients and case managers found telemedicine consultations acceptable. Clients' ratings ranged from 3 to 4.5, while case mangers' ratings ranged from 3 to 5 ('average' to 'much better than average').