Text Messages are Helpful Treatment for People with Depression

Nearly everyone has a cell phone with text messaging capability. For people with depression, this method of communication may help them maintain their treatment regimen. “Poor adherence to the elements of depression treatment presents a major barrier to effectiveness in real-world settings,” said Adrian Aguilera, Ph.D. and assistant professor of the School of Social Welfare at the University of California, Berkeley. “Mobile phone-based text messaging (short messaging service; SMS) is a widely available and cost-effective tool, used by people of all socioeconomic backgrounds, that holds promise in improving adherence to mental health treatments.” Clients are often assigned homework between therapy sessions, and non-adherence to the work delays treatment. Practicing and monitoring mood regulation in real-life situations are necessary to move forward from a depressive state.

People from low-income communities may find this strategy especially helpful. “Low socioeconomic status and ethnic minority status are associated with higher rates of attrition,” said Aguilera, stating that previous research has shown less than half of low-income women complete their therapy. He added, “Thus, we need to develop practical ways of making empirically supported psychotherapy more accessible in a community context.” Aguilera and his colleagues theorized that SMS would increase treatment adherence and tested their theory on 10 clients over a 4 month period. After only two months of receiving two to three SMS daily, the results were positive. “Nine of 10 patients indicated that the text messaging made them feel closer to the group and their therapists by responding that they agreed or strongly agreed with that statement,” said Aguilera. “Patients commented that receiving text messages improved self-awareness.” He added, “Spanish-speaking patients often mentioned that receiving messages made them feel as if someone cared for them.” Aguilera hopes the findings from this study offer optional treatment avenues to people of lower socioeconomic conditions. He said, “The SMS adjunct may help provide continuity of care for those who miss sessions, may encourage consistent attendance through reminders, and can extend the intervention well after the group sessions have ended to prevent relapse and recurrence.”

Aguilera, A., & Muñoz, R. F. (2011, October 31). Text Messaging as an Adjunct to CBT in Low-Income Populations: A Usability and Feasibility Pilot Study. Professional Psychology: Research and Practice. Advance online publication. doi: 10.1037/a0025499

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • joel w

    joel w

    November 9th, 2011 at 5:17 AM

    I have to say that when texting first became popular I never thought that it would take off the way that I did. Boy was I wrong! And now to see that texting is even being used as a form of treatment for some is a real eye opener to just what direction our society is taking.

    I guess that this is the only alternative for some people who really do not have access to any other type of care in their community. But I do have to say that it makes me sad in a way to realize that email and texting have taken the place of just a good old fashioned conversation.

  • MRM


    November 9th, 2011 at 1:16 PM

    great idea.Its not practical to have someone call everyone every now and then, and it would be intrusive. Leaving recorded messages would not have the human touch. A subtle message whenever required popping up on a phone screen sounds like a great way to remind the patients,make them feel that they are under care and is non-intrusive. Bull’s eye!

  • Ryan


    November 9th, 2011 at 2:36 PM

    What texting does is offers these depressed individuals the chance to talk about their problems without really having to go out and face the real world. I kind of think that this could be an overall detriment to therir treatment plan, don’t you? There has to be some encouragement to go out and face the real world and this kind of treatment does not force them to live up to this at all.

  • CampingOut


    November 9th, 2011 at 3:36 PM

    Texting with my therapist was a blessing several years ago when I was going through a suicidal crisis. I had to think before texting my thoughts and she could use CBT to help me through the crisis. Then I had a record of the conversation to read over after a good sleep.

  • V. Barr

    V. Barr

    November 9th, 2011 at 6:33 PM

    When you’re depressed, texting is the way to go. There are times when you don’t want to say things, and text messages give you time to look clearly at what you’re about to say and decide if you want to say it or not. It also means that nobody will mishear you because you stumbled over a word or anything.

  • Corrine D.

    Corrine D.

    November 9th, 2011 at 8:18 PM

    @V.Barr: You can also let a conversation span over multiple days and everyone involved can pitch in their two cents whenever they want to after being given time to think about it. It happens at everyone’s own pace and not at a single person’s. People who are depressed don’t need to feel they’re being pulled around.

  • NaomiDunlop


    November 10th, 2011 at 3:49 PM

    For me it’s easier to vent by typing things to my friends on MSN than running off at the mouth face-to-face. There’s a major difference in walking into work and saying for example you feel like buying a crowbar and smashing up your boss’s car, and typing it out.

    When you start to say something stupid, you’ve already done the damage. At least when you realize halfway through typing it there’s always the delete key!

  • rachel d.

    rachel d.

    November 10th, 2011 at 5:15 PM

    Isn’t there a little therapy technique that suggests people writing an email or letter and not sending it? I’m sure there has to have been a few mishaps with that approach where they went ahead and mailed it, but done correctly it lets you see how you really feel and get it out of your system. Sometimes that’s all a depressed person needs.

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