As mental health declines and substance abuse climbs, online recovery programs are no longer just a potential resource. They're critical. COVID-19 has made online treatment more common, and signs suggest it's here to stay. But do online programs work?
This video from Kati Morton, LMFT, talks about some really important aspects of online therapy. First of all, it is DIFFERENT! And different can actually be really good. Kati makes some great points about how to have a more effective experience in online therapy, such as taking time to prepare yourself and your environment before your online session begins. Create a space where you can feel safe, grab your water bottle, and embrace an engaged mentality as you go into your session.
Some people suffering from severe anxiety or co-occurring physical limitations with their mental health or substance use disorders find online therapy a godsend. They don't have to worry about the difficulty of leaving the house or getting out of bed in order to attend therapy. Those who live in remote locations or whose treatment centers are not currently seeing patients in person due to COVID-19 restrictions are also finding the advantages of telehealth/online therapy.
Let's better understand some of thee factors involved with online therapy and treatment.
Let's look first at one big contributor to increased online treatment programs: COVID-19. Not only is it affecting the prevalence of online therapy, but it's also affecting the issues that often motivate people to seek help.
It's been in the news, people are talking about it, and you or someone you know has probably felt it: substance use is reaching unprecedented levels since the onset of COVID-19. A recent article published by Ashley Abramson for the American Psychological Association references several studies which are substantiating the trend. The Centers for Disease Control and Prevention reported in June 2020 that 13% of Americans were turning to substance use to cope with stress related to COVID-19. There was an 18% increase in overdoses during early months of the pandemic compared with those same months in 2019. And by the end of 2020, the same theme continued: The American Medical Association reported more than 40 U.S. states are seeing increased opioid-related mortality along with continued concern surrounding substance use disorders.
All that said, COVID-19 isn't the only factor contributing to increased substance use and abuse. Increased availability of certain substances and decreased stigma surrounding types of substances (eg psychedelics) were cited as also affecting the rise in use and abuse. The need for treatment and recovery programs seems to also be increasing. Almost as a catch-22, some centers and programs have significantly decreased or even discontinued in-person services they offer due to COVID-19 issues. Enter telehealth.
Therapy once a week online is a very different thing than full-blown intensive recovery programming, whether that's face-to-face or online. Some balk at the idea of a full treatment program online; does it work as well as face-to-face? A November 2020 article from Rehab Clinics Group put a spotlight directly on that question. A study they highlighted speaks volumes; here's an overview:
A recent Yale University study looked at 137 users of alcohol, cocaine, opioids or marijuana, all of whom had been diagnosed with abuse or dependence problems. They were split into three groups, with one receiving weekly group counselling, one receiving face to face cognitive behaviour therapy (CBT) and the third used a specially designed online addiction treatment programme called CBT4CBT. This programme featured a number of elements including cognitive behaviour therapy delivered by video, interactive exercises and quizzes.
The results were impressive. At the end of the treatment period, nearly half of the subjects had dropped out of both the face to face programmes. Only around a quarter had failed to complete the sentiments of CBT4CBT programme. Furthermore, over two thirds (67%) of those taking the web-based programme were found to no longer meet the official diagnostic criteria for substance abuse. The same was true for just over half (52%) of those who underwent face to face CBT and 43% of those given the standard counselling.
They also referenced this study:
An earlier study published in the American Journal of Psychiatry in 2014 showed similarly promising results. 255 adults used another web-based programme called the Therapeutic Education System (TES) while the same number engaged in a standard face to face outpatient treatment for addiction. Writing in Psychology Today Adi Jaffe, Ph.D said that the online programme was found to reduce drug and alcohol use. Participants were also more likely to remain in face to face programmes when supplementary online treatment was also used.
Online treatment doesn't only work for substance abuse. A study published in Journal of Affective Disorders from back in 2014 concluded that face-to-face and online treatment for depression were equally effective. A 2018 study published in the Journal of Psychological Disorders also concluded that online Cognitive Behavioral Therapy (CBT) was as effective online as as face-to-face when used to treat major depression, social anxiety disorder, panic disorder, and generalized anxiety disorder. The National Center for Health Research posted an article reviewing several meta-analyses which found various online therapy approaches as effective as face-to-face in treating anxiety, depression, and PTSD/trauma. Additionally, "those who had online therapy were just as satisfied with their experience as the in-person therapy patients."
One of the greatest benefits of online therapy might be increasing access to services. As the National Center for Health Research article suggests: "online therapy might make mental health services more accessible for patients who might otherwise delay or drop out of treatment."
More and more resources are becoming available online, but not all services are created equal. Very Well Mind recently released an article listing top online resources for mental health and recovery. Maybe you're attending therapy online yourself or maybe you've seen mental health or sobriety support apps. Maybe you're attending AA or a 12-step program or a trauma support program online. The growth of online resources is exciting, especially in light of the studies quoted above.
Finding online treatment or therapeutic resources may take time. Focus on what you need and then seek out a service which responds to that specific need. Some online programs include a variety of services, while others exclusively offer video/audio therapy. Some programs use texting more heavily for immediate therapeutic needs. Regardless of what is available within a program or service, the key is finding something that fits your needs.
Hope Recovery and Healing offers fully online programming and is encouraged by the success several other online recovery initiatives around the world are having. A variety of resources, treatment of the whole person, and highly trained staff are important elements in any online program. We're proud to be partners with several other organizations and resource providers, offering clients a robust and individualized program for their healing or recovery journey online. Contact us today to find out if our program could be a good fit for you.
