A need or problem encourages creative efforts to meet the need or solve the problem. Plato
The cornerstone of addiction treatment has always been in-person connection and group therapy. But with the advent of COVID-19 and the stay-at-home directives, Sanford therapists have had to get inventive with Virtual Addiction Treatment. Because now more than ever, people need that connection. Uncertainty, financial stress, and isolation can make it more likely for a person in recovery to relapse. Social distancing precautions in response to the pandemic have also been responsible for a surge in people looking for first-time addiction help.
Everyone (clients and therapists alike) says that virtual treatment is an adjustment. And coupled with social distancing, real life connection and human contact is sorely missed. But everyone is grateful to be able to participate and connect virtually. Therapists are able to use the discomfort and newness of online treatment as a learning tool – adjustment is necessary in recovery and in life.
Virtual Addiction Treatment? Here are the experts’ pros and cons …
There is a new intimacy to virtual addiction treatment during the pandemic. And although everyone is grateful for the technology, it is taking some getting used to and a reminder that “patience is a virtue”. Therapists report being transparent with their clients. That the current situation is not easy for them either and that, “We will all get through this together”.
The way our therapists and clients are interacting, shows a common humanity in this unprecedented time. Addiction treatment seems more personal. It is not normal to see your therapist in their home environment, for example. But virtual treatment during social distancing, presents an opportunity for a therapist to share their experiences when appropriate and it serves to strengthen the group. Lynnel Brewster, RN, LPC, LLMFT, CCTP, Sanford Clinical Director
Virtual addiction treatment also offers a good opportunity to talk through “environmental triggers.” This is an issue we normally address in residential and outpatient treatment that is tangible now. While clients are cloistered at home with potentially triggering situations, they can experience those triggers real time, and share with the group for feedback.
Just How Different is Virtual Addiction Treatment?
The initial few minutes of each session can be awkward while folks are logging on. Therapists report that they ask about paintings, backdrops and room decorations while waiting, which leads to interesting conversation. Things that go unspoken during in-person groups must be voiced prior to telehealth gatherings. Wear appropriate clothing (at least from the waist up); don’t turn off your camera; minimize distractions like eating and drinking; no smoking, no cooking, etc.
For the clients, I think virtual groups are going better than I expected. I heard a lot of good feedback from them about being excited to be back in groups and how it was helpful, especially during this time, to have some additional structure in their day. Drew Martini, LMSW
Therapists say they miss the comradery of group exercise/activities (see Creativity in Programming below). But they try to present the information in a way that is still interactive and engaging. And clients report they are struggling with creating routines during the evening/off hours – something that those in early recovery have trouble with, in the best of times.
One of the remarkable pros of Virtual Addiction Treatment is the inclusion of pets. Our therapists say that almost everyone has a pet nearby while in group. And dogs and cats seem to relieve stress and bring out vulnerability and openness when clients are sharing difficult issues. Our therapists report a decided relaxing when a client has Fluffy or Sparky on their lap.
We’ve been seeing a lot of fur babies during groups. One night in IOP, we had a pet show-and-tell at the end of the session (mine included). This was super cute and fun for all! Karli Henning, Therapist
Adapting, Vulnerability & Openness
Therapists say our clients have been upbeat, excited and very happy to see one another – bringing their energy into the telehealth platform. Group members seem to feel a strong obligation to attend groups, make each other accountable, and support one another. This is understandable as the groups are small with high cohesiveness.
Treatment from home presents a number of challenges, but I believe our clients are able to share more openly in a space they are comfortable with. The women of Cherry Street appear to be more vulnerable and open with their thoughts/feelings, relaxed, and willing to contribute. Jess Kimmel, MSAT, LLPC
The Walls have Ears
Virtual Addiction Treatment is still addiction treatment and bound by the HIPAA regulations protecting the privacy and security of health information. One of the challenges of online group activity, is making sure everyone has a secure space in which to work. We recommend white noise machines when available and appreciate the cooperation from housebound family members!
Video Sharing and Journaling
The video sharing feature of telehealth has been a great resource for Sanford clinicians. They have been incorporating short clips and graphics into their groups and clients are very receptive to this medium. Topics include short meditations, emotional intelligence activities, Ted Talks on addiction, etc.
Journaling prompts are also client favorites. It breaks up the screen time. And journaling tends to lead to productive discussions, and constructive problem-solving regarding feelings of isolation.
Creativity in Programming
Therapist Ellen Sork, LLMSW, was missing the white board she uses in the Sanford Outpatient Center. So, what did she do? Ellen conducted part of her Intensive Outpatient Program (IOP) in her bathtub. With (hopefully) erasable markers on the white tile.
And when Drew Martini LMSW, noticed the guys in her day program looking sleepy – she invented an impromptu scavenger hunt. Asking them to locate something within their house that corresponded to programming (and providing a well needed break from sitting in place).
Virtual Addiction Treatment during a pandemic requires a sense of humor. Period.
For giggles, one time I said, “Someone smells good. Is that perfume or cologne?” Judith Snow, MA, LLP, CAADC, Clinical Manager Sanford Outpatient Center
Clients are happy to see each other. and they say virtual group interaction helps with the isolation. And in the same way clients strike up friendships during in-person groups, they are making virtual friendships too. Our clients have organized support opportunities outside of programming, including group meditations and movie watching. They also have group-chats to hold one another accountable for attendance and troubleshooting.
Therapists report that our clients are making new people feel welcomed and part of the group. And our clients are more talkative and engaged as the weeks of virtual treatment go on and they became familiar with the telehealth format.
The Takeaways from Virtual Addiction Treatment
Way back in 375 BC, Plato knew that problems are solved with creative effort. And that you have to have a problem to solve a problem. No one at Sanford could imagine, just four months ago, that we would all have the problem of addiction treatment in a pandemic to solve. But, when the going gets tough … Sanford therapist, Ali Kitchin says it best.
For the clinicians, I think virtual treatment during this uncertain time is an example of the real reason we all got into the helping profession – to provide services to anyone who needs them in a hopeful and professional way. Regardless of the circumstances! Ali Kitchin, MSW