5 Audio-only and phone-based counselling

Phone-based counselling has a long history (Reese et al., 2006). Originally reserved for crisis hotlines, it has for decades already been used both as an adjunct for face-to-face therapy and as a sole intervention, in particular for clients who might struggle to attend face-to-face counselling – perhaps because of a physical health condition or disability (Proctor et al., 2018). According to Irvine et al. (2020, p. 121) ‘one-fifth of publicly-funded adult primary care mental health provision is delivered via this mode’ currently in the UK.

Pause for reflection

Do you like to have long conversations on the phone? If yes, why? Or if not, why not? Have you ever used the phone to do more than, say, organise appointments with any of your clients? If you have, what was that like?


It is worth thinking about your own history of using a phone to talk rather than sending text messages because – as you considered in Section 1 of this course – this is likely to affect how you engage with audio-only/phone-based counselling.

Phone-based therapy has been shown to be effective (Leach and Christensen, 2006), and client satisfaction and acceptance of telephone psychotherapy has also found to be high (Reese et al., 2006; Bee et al., 2008). Of course, this does not necessarily mean that conducting counselling through the phone is the same as a face-to-face session.

What does the research say about the differences of phone-based counselling?