Telehealth Addiction Treatment: Unexpected Benefits?

As we progress through the challenges imposed by the pandemic, healthcare, and behavioral health providers are discovering the many options and possibilities available through telehealth. It is likely that virtual care is here to stay and will be used in conjunction with in-person services.

Healthcare professionals specializing in addiction and substance abuse recovery are currently learning how to incorporate telehealth into their practices to improve access to quality care. The pandemic has allowed behavioral health providers to witness the many benefits of telehealth addiction treatment, which were largely unexpected but revealed previously unanticipated telehealth benefits. At the University of Alabama in Birmingham (UAB), providers in the UAB Medicine Addiction Recovery Program turned to video conferencing to continue individual and group treatment and support programs.

According to a press release published by UAB, ARP Director Bronwyn McInturff, MSW, summarized the focus of the study: “Addiction is already a very isolating disease… Because of that, a large part of recovery involves reestablishing and maintaining connections with others. What we faced with COVID was an almost immediate move to isolation for everyone. This created a huge obstacle for people who wanted to begin or continue recovery. Most people can relate on some level to the problems of isolation due to COVID. But for people with substance use disorders, that kind of ongoing isolation has far higher stakes. It can be deadly.”

The UAB press release goes on to explain that there were reports of an increase in substance overdoses and of people turning to substances to cope at UAB, thus risking the onset of severe addiction.

Telehealth Addiction Treatment Interventions

Working with addiction can be complex, particularly in a group. UAB uses videoconferencing to spot these critical red flags. For example, if a client’s emotional state is declining or if they are not fully attentive and engaged in sessions, small cues such as poor eye contact or poor camera alignment can allow the provider to comment, thereby opening the conversation to a deeper exploration of potential issues. Other clues include: clothing choices are indicators of possible concern, such as a client wearing a hooded sweater during a video conference to hide facial expressions, people walking into the room, hearing unexplained noises from their environment, or leaving their camera off. When operating in a group therapy context, group rules need to be established, agreed to in advance, in writing, and repeated at the beginning of every session.  For more information, see Telehealth Group Therapy: Reimbursement Clinical Issues.

These strategies were also implemented by UAB clinicians:

• Clients at UAB received technical coaching to increase their comfort with virtual sessions
• Providers created smaller virtual groups 
• Visual aids were used to make up for the absence of body language
• Break-out rooms were created from the larger meetings to allow members to interact in smaller groups
• Family members were invited in some situations to participate in therapy sessions and treatment coordination by using telehealth tools
• Hybrid telehealth was also being offered to clients and patients needing or wanting a combination of in-person and telehealth addiction treatment.

See Telehealth.org’s previous articles Hybrid Healthcare System: Establishing a Post-Pandemic Telehealth and Hybrid Counseling: Telehealth and In-Person Healthcare for more information. Clinicians seeking policymakers in governmental agencies are encouraged to entreat them to broaden coverage and accessibility for telehealth addiction treatment, so that help, resources, and support are made available to more and more people in need.

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