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Group Telehealth: Opening the Door for Clinical Advantages and Operational Efficiency

SMART Management understands the effectiveness of group model delivery of clinical services. As a management company, formerly managing the Discovery House programs, SMART took an innovative and aggressive approach developing a robust Group Model for the delivery of clinical services, shifting away from a more predominant model consisting of nearly all individual sessions.A well-structured group program, with some clinics offering up to dozens of sessions per week and over 20 specialized group topics, proved to be well received by patients and associates and had an overall positive impact.

SAMHSA’s TIP 41 Substance Abuse Treatment-Group Therapy is a trusted resource outlining the advantages of Group Therapy. With Telehealth service delivery gaining increased momentum nationally, the latest SMART Telehealth Group Feature is the perfect opportunity to expand/develop an enhanced Group Therapy Model at your facility. In addition to the clinical benefits outlined below, making a connection with patient in a group setting is more critical than ever in these times of isolation.

The increase in stress and relationship between Mental Health issues and Substance usage is well-documented. A Fully integrated, HIPAA compliant SMART Group Telehealth Feature will set your clinic apart, creating that irreplaceable face to face group dynamic.

In addition to the clinical benefits, there are tremendous efficiencies with remote associates providing Group Sessions from the safety of their homes. The ability to schedule up to 16 attendees through the SMART Scheduler with automatic notifications and reminder messaging via e-mail and text, your clinical associates should be able to increase direct service hours and access to critical services more readily.

Treating adult clients in groups has many advantages, as well as some risks. Any treatment modality—group therapy, individual therapy, family therapy, and medication—can yield poor results if applied indiscriminately or administered by an unskilled or improperly trained therapist. The potential drawbacks of group therapy, however, are no greater than for any other form of treatment.

Some of the numerous advantages to using groups in substance use treatment are described below (Brown and Yalom 1977; Flores 1997; Garvin unpublished manuscript; Vannicelli 1992).

Groups provide positive peer support and pressure to abstain from substances of abuse. Unlike Alcoholics Anonymous (AA), and, to some degree, substance use disorder treatment program participation, group therapy from the very beginning elicits a commitment by all the group members to attend and to recognize that failure to attend, not being on time, and not treating group time as special all disappoint the group and reduce its effectiveness. Therefore, both peer support and pressure for abstinence are strong.

Groups reduce the sense of isolation that most people who have substance use disorders experience. At the same time, groups can enable participants to identify with others who are struggling with the same issues. Although AA and treatment groups of all types provide these opportunities for sharing, for some people the more formal and deliberate nature of participation in process group therapy increases their feelings of security and enhances their ability to share openly.

Groups enable people who abuse substances to witness the recovery of others. From this inspiration, people who are addicted to substances gain hope that they, too, can maintain abstinence. Furthermore, an interpersonal process group, which is of long duration, allows a magnified witnessing of both the changes related to recovery as well as group members’ intra‐ and interpersonal changes.

Groups help members learn to cope with their substance abuse and other problems by allowing them to see how others deal with similar problems. Groups can accentuate this process and extend it to include changes in how group members relate to bosses, parents, spouses, siblings, children, and people in general.

Groups can provide useful information to clients who are new to recovery. For example, clients can learn how to avoid certain triggers for use, the importance of abstinence as a priority, and how to self‐identify as a person recovering from substance use disorder. Group experiences can help deepen these insights. For example, self‐identifying as a person recovering from substance use disorder can be a complex process that changes significantly during different stages of treatment and recovery, and often reveals the set of traits that makes the system of a person’s self as altogether unique.

Groups provide feedback concerning the values and abilities of other group members. This information helps members improve their conceptions of self or modify faulty, distorted conceptions. In terms of process groups in-particular, as specific themes emerge in a client’s group experience, repetitive feedback from multiple group members and the therapist can chip away at those faulty or distorted conceptions in slightly different ways until they not only are correctable. The very process of correction and change is revealed through the examination of the group processes.

Groups offer family‐like experiences. Groups can provide the support and nurturance that may have been lacking in group members’ families of origin. The group also gives members the opportunity to practice healthy ways of interacting with their families.

Groups encourage, coach, support, and reinforce as members undertake difficult or anxiety‐provoking tasks.

Groups offer members the opportunity to learn or relearn the social skills they need to cope with everyday life instead of resorting to substance abuse. Group members can learn by observing others, being coached by others, and practicing skills in a safe and supportive environment.

Groups can effectively confront individual members about substance abuse and other harmful behaviors. Such encounters are possible because groups speak with the combined authority of people who have shared common experiences and common problems. Confrontation often plays a part of substance abuse treatment groups because group members tend to deny their problems. Participating in the confrontation of one group member can help others recognize and defeat their own denial.

Groups allow a single treatment professional to help a number of clients at the same time. In addition, as a group develops, each group member eventually becomes acculturated to group norms and can act as a quasi‐therapist himself, thereby ratifying and extending the treatment influence of the group leader.

Groups can add needed structure and discipline to the lives of people with substance use disorders, who often enter treatment with their lives in chaos. Therapy groups can establish limitations and consequences, which can help members learn to clarify what is their responsibility and what is not.

Groups instill hope, a sense that “If he can make it, so can I.” Process groups can expand this hope to dealing with the full range of what people encounter in life, overcome, or cope with.
Groups often support and provide encouragement to one another outside the group setting. For interpersonal process groups, though, outside contacts may or may not be disallowed, depending on the particular group contract or agreements.

The SMART Telehealth Group Feature helps you to carry on providing the tremendous benefits of Group Therapy, even if meeting in-person is difficult, especially during a public health emergency (PHE). The United States Department of Health and Human Services has already extended the COVID-19 PHE into April 2021 and, with that action, expressed its intent to continue such renewals to year-end or into early 2022. For more information on our substance abuse EHR software, contact us today.