Transitioning Virtual-Only Group Therapy for Substance Use Disorder Patients to a Hybrid Model

Abstract

Purpose

Telehealth is associated with a myriad of benefits; however, little is known regarding substance use disorder (SUD) treatment outcomes when participants join group therapy sessions in a combination in-person and virtual setting (hybrid model). We sought to determine if treatment completion rates differed.

Patients and Methods

Policy changes caused by the COVID-19 pandemic created a naturalistic, observational cohort study at seven intensive outpatient (IOP) programs in rural Minnesota. Virtual-only delivery occurred 6/1/2020-6/30/2021, while hybrid groups occurred 7/1/2021-7/31/2022. Data was evaluated retrospectively for participants who initiated and discharged treatment during the study period. Participants were IOP group members 18 years and older who had a SUD diagnosis that both entered and discharged treatment during the 26-month period. A consecutive sample of 1502 participants (181–255 per site) was available, with 644 removed: 576 discharged after the study conclusion, 49 were missing either enrollment or discharge data, 14 transferred sites during treatment, and 5 initiated treatment before the study initiation. Helmert contrasts evaluated the impact of hybrid group exposure.

Results

A total of 858 individuals were included. Data was not from the medical chart and was deidentified preventing specific demographics; however, the overall IOP sample for 2020–2022, from which the sample was derived, was 29.8% female, and 64.1% were 18–40 years of age. For completed treatment, hybrid group exposure relative to virtual-only had a univariate odds ratio of 1.88 (95% CI: 1.50–2.41, p < 0.001). No significant difference was seen across IOP sites.

Conclusion

These results describe a novel hybrid group approach to virtual care for SUDs with outcome data not previously documented in the literature. While virtual treatment delivery can increase access, these results suggest a benefit is derived from including an in-person option. Further research is needed to identify how an in-person component may change dynamics and if it can be replicated in virtual-only models.

Keywords:

• substance-related disorders
• telemedicine
• group psychotherapy
• comparative study
• outcome assessment
• health care

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Dr. Oesterle was supported by National Institutes of Health [R18 HS029774-01], the Terrance and Bette Noble Foundation, and the Mayo Clinic Kern Center for the Science of Health Care Delivery.