Telehealth and Rehab: The New Paradigm
by Alastair Mordey
There is some evidence to suggest that video telehealth may have some advantages over standard in person psychotherapy. Research has found that telehealth practices could represent “an important component of the future of psychotherapy and clinical practice”.
Since March 2020 when Coronavirus hit, businesses globally have had to adjust their practices and the medical field including addiction treatment, has been no exception. In fact these fields, particularly addiction treatment, are perfectly suited to what was already a growing sector, namely, ‘telehealth’.
Telehealth means any type of medical service which can take place online, or across telephone, video or messaging services. Addiction treatment programs and other forms of psychotherapy and counselling have found it particularly easy to make this shift. Many were already doing it as a part of their substance abuse programs and most have now moved to doing online counselling.
It is looking increasingly likely that businesses in multiple fields will have to get use to this ‘new normal’ of doing business remotely. Counselling and psychotherapy, including addiction counselling, will undoubtedly continue to develop in this area over the next 12-24 months as borders remain closed and people limit their travel severely.
Until recently the private sector rehabs (and indeed much of the public sector rehabs in the UK and the US) conducted their business face to face. Of course this often involved significant travel on the part of clients accessing those addiction treatment services. In the time of COVID this is no longer possible of course, and so a new paradigm has sprung into being – online addiction treatment – or ‘online rehab’.
Most online rehab services are able to offer the same, or similar services to an ‘in-person’ treatment centre. As group counselling and individual counselling makes up the bulk of addiction treatment programs anyway, moving it to online platforms such as zoom, google-meets, or tailor made in-house platforms, does not entail any significant reduction in the capability of the services. These are ‘talk-therapies’ after all, and the boom in quality of video conferencing has enabled this therapeutic model to carry on regardless.
Even the more holistic services (or body-based therapies) such as yoga, mindfulness meditation and trauma-release-exercises (TRE) are able to be performed in video conference groups. Many people these days follow yoga instruction and work-outs from Youtube demonstrations. Well the holistic elements of rehab can also be replicated in this way, apart from you have a ‘live’ teacher working with you. Guided meditations with live teachers can also be a distinct ‘move-up’ in quality from just following a podcast or pre-recorded video. Whilst many would say that it’s not the same as being in the room with your teacher and peers, there are other advantages. If you’re not that great at yoga, or are a beginner in meditating, then at least you can turn off your own screen!
All in all, the research and evidence base for the efficacy of video counselling and adjunct holistic therapies is pretty good. According to researchers at the University of Marburg in Germany, clients accessing video counselling found the experience “as intense” as face to face therapy, and “sufficiently stable to create an emotional bond with the therapist”.
Researchers as Portland State University also found that “teletherapy clients experience similar results compared with control groups” and that the working alliance was “unaffected by the medium of communication”.
In fact, there is even some evidence to suggest that video telehealth may have some advantages over standard in person psychotherapy. Research conducted by the Medical University of South Carolina and the National Centre for PTSD (Veterans Affairs) found that telehealth practices could represent “an important component of the future of psychotherapy and clinical practice” especially with regard to the lowered costs for service users and by increasing accessibility for people in need of counselling and psychotherapy including addiction counselling.
And so it seems that telehealth and video counselling in particular are a paradigm shift in medicine and psychological services which are here to stay. In some countries the provision of drug and alcohol rehab services are now close to 100% online. But the good news is – it works.