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Substance-Use Disorder Group Therapy Via Telehealth

In this video interview, Dr. Malcolm Horn talks about using telehealth as a treatment format for substance-use clients. In terms of evidence-based care, Dr. Horn shares how group therapy is often a more effective format than individual therapy for treating substance-use disorders. On top of that, the COVID-19 pandemic made the online treatment model an even greater necessity for practitioners. During the video, Dr. Horn outlines what steps and strategies you can take to make the most of your online therapy group.

In online group therapy for substance-use disorders, engagement can be one of the most significant challenges for facilitators. According to Dr. Horn, “one of the first things…is making sure you have good technology.” For Dr. Horn, investing in high-quality cameras and microphones has been essential.  Also, by “frontloading [patients] with the expectation [that they will be] engaged,” and emphasizing group participation, sets the tone for group interaction.

To reinforce active participation, Dr. Horn advises that facilitators go around the screen one-by-one and ensure that client “webcams [are] on at all times.” This helps ensure privacy and participation, and helps clients build connections. In the video, you’ll hear how many clinical tasks transfer easily to an online setting. For instance, bringing attention to group dynamics, using breaks mindfully, or saving client concerns for individual sessions may be treated the same way whether members are online or not.

In Dr. Horn’s experience, using phones for audio calls in group sessions is “not necessarily the best fit” for clients because they can’t connect as well with other group members or the therapist. If the client has no other option, then a phone may be a helpful solution for a stand-alone session before moving back to video conferencing. According to Dr. Horn, knowing a client’s personal and environmental barriers—such as “not having an internet connection” or a private location—should be factored into the process.

At Rimrock, Dr. Horn uses other technologies outside of the group session, such as Gomo—a platform that allows staff to chat live with clients from a distance—and online peer support, to stress the importance of individualizing client treatment. These diverse virtual approaches can buffer substance-use clients against isolation and external stressors. Overall, Dr. Horn reports that clients are generally thrilled that they can participate in group therapy from their homes. If a client does have an occasional stumbling block, therapists can invite clients to a physical on-site office to get them up to speed.

Dr. Horn is a Licensed Clinical Social Worker who is licensed by the state of Montana as an Addiction Counselor. She is also accredited by NAADAC as a Masters Level Addiction Counselor (MAC) and a Substance Abuse Professional (SAP). She currently works as the Director of Mental Health Services for Rimrock Foundation, a CARF-Accredited co-occurring treatment facility.

By: Michael Tugendhat

To learn about Dr. Malcolm Horn, you can go to the Rimrock Foundation website

For assistance with your telehealth services visit us (Telehealth Certification Institute LLC)

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