Does online rehab really work?

Does online rehab really work?

 

The ongoing stress and uncertainty of COVID-19 has led to an increased demand for mental health services in Canada. While we often think of mental health issues like anxiety and depression as the predominant conditions people are challenged by at this time, we are also facing a public health crisis with increasing opioid, alcohol and stimulant addictions. More than ever, people need varied and accessible treatment options to recover from addictions.

One form of service filling this need is virtual or online treatment. Online programs make recovery more affordable and accessible – but are they effective in treating addiction?

What makes rehab effective?

Within the different types of treatment options that exist, there are common factors that make a rehab program effective. An effective rehabilitation program will focus not only on the individual’s substance use, but also on coping strategies, interpersonal relationships, and other important areas of functioning.1 While the definition of success may vary from one program to another, effective treatment should always include a few common results.

A person receiving effective addiction treatment should demonstrate some of the following:

  • Reduced amount and frequency of substance use, including longer gaps between relapses
  • Improved employment or education status and attendance
  • Improved physical health, indicated by fewer medical visits
  • Improved mental health, indicated by improved mood, personality traits and behaviors
  • Improved relationships with friends, family, and others2

A good program should ultimately help you reach and maintain sobriety, using the coping skills you develop while in treatment. As a result, other areas of your life should also improve.

Differences and similarities between virtual and in person

Some elements of in person and virtual rehab are very similar while others can be slightly different. Both are highlighted below.

Differences

Accessibility

One of the main differences between the two are accessibility. With an online program, you can seek help no matter where you or the program are based. With convenience and location removed from the equation, you can focus on the program and specialities best suited to your individual needs. You also don’t have to worry about factors like weather or access to transportation.

Travel and Time Commitment

Because there is no travel time for online addiction treatment, another thing that differs is your time commitment. You no longer need to factor in the time it takes to commute to and from your program. It is also worth noting that online programs may be very structured, but they also give you the freedom to recover from home while you continue to work or tend to family commitments.

Perceived Vulnerability

As with any recovery program, there is always a perceived vulnerability involved in trying something new and for some, anonymity can be an important aspect of a program. Because you can participate on a virtual platform further away from your home, there is less chance of running into someone in your program you know, which can provide a sense of greater freedom to be vulnerable. You also don’t run the risk of seeing someone you know in a parking lot or near the location of your program, which can remove a lot of anxiety involved in seeking and getting help.

Affordability

It is also worth noting that there can be a difference in cost. Because you are not living in a facility, online programs are not as costly as in-person rehab. In addition, you don’t have to worry about expenses like childcare or gas, as you are recovering from home.

Similarities

Personal Connections

Like in person rehab, virtual programs allow you to make personal connections with those in your program. Not only can you connect with the professional leading the program, but there is also the opportunity to connect with peers as you would in person. Group sessions and shared experiences, whether online or in person, have therapeutic benefits and encourage the creation of emotional connections with others.

Crisis Response

Both types of programs also offer interventions in case of an emergency. Those trained to run in person and online sessions know how to spot someone in crisis by reading their facial expressions and physical cues. Many programs also offer apps, where a person can self-report if they need immediate assistance.

Efficacy

For people experiencing mild-to-moderate addiction symptoms, online treatment can be equally, if not more, effective than in-person rehab. With the right program, you can meet all the “efficacy qualifications” listed above, with the added benefit of being able to practice and encourage the skills and coping mechanisms you are learning in real time. One area of your life where you can practice this is in your relationships. When you are doing the work from home, you have the opportunity to discuss and repair relations with your family and friends.

Proven benefits of online rehab

Online rehab offers many benefits, especially for someone with mild to moderate addiction issues. As mentioned above, virtual programs are often more accessible, especially for those who live in remote areas and would not have help close by otherwise.

While it would be great if everyone could occasionally take a break from their everyday lives to work on their wellness, for many, that is simply not possible. Online programs allow you to continue to live at home and go to work if you need to.

When your life has not been uprooted, you can recover without worrying about how much time you are away from home for, what it is you might be missing, or how soon you have to re-enter your day-to-day routine. It also helps you to recover without removing some of the stressors in your daily life, which gives you the opportunity to apply new coping skills in real-time, something you might not necessarily get to practice in a residential treatment program.

There is evidence that shows that those with social anxiety often do better in online settings as they are less concerned about encountering others face-to-face.3 This can make it easier to open up and express the challenges you are facing.

It is worth noting that even though they are online, these programs are structured. They have set times and specific activities or exercises that are designed to keep you on track and give you better support overall.

How EHN Online’s program sets you up for sobriety

EHN Online’s addiction recovery program has several benefits to help set participants up for success. The Substance Use Disorder Intensive Outpatient Program (IOP) is structured to provide an eight-week intensive rehabilitation course that provides a wide variety of education and skills to help participants regain control over their cravings, habits, and lives. Each week will include nine hours of treatment time composed of individual and group therapy, as well as psychoeducation about substance addiction and skill building.

Following the eight weeks of intensive care, participants have access to 10 months of aftercare, keeping up with progress tracking on the Wagon app, and meeting with a group once per week. This will encourage maintenance of positive habits and beneficial skills, while continuing the opportunity to build a strong support network of individuals with similar experiences and hardships.

If your loved ones are looking for better ways to support you, EHN’s IOP also offers a Family program as part of the package, so that loved ones can also receive advice and access better tools to aid in long-term recovery.

EHN Online’s substance use disorder program provides all the benefits of virtual rehab, such as accessibility and structure, while also making treatment affordable and providing the chance to work on challenges, skills and relationships in real time.

Most importantly, EHN Online’s virtual program is one that works. While there is no one “right” way to receive treatment, as the effectiveness of each setting and treatment approach is dependent on you and your unique situation, online rehab can be a sustainable and helpful option to consider.

How to access an online rehab program

If you have mild to moderate addition symptoms and believe online rehab may suit your needs, then don’t hesitate to call us. Our consultations are free and there are no wait times for enrolment. Book an assessment and see if this program is right for you.

It is always a good time to get started, so give us a call today!

 

Be prepared for conversations surrounding mental health. Contact us today to learn how EHN can help.

 

 

References

  1. Administration (US), S. A. and M. H. S., & General (US), O. of the S. (2016). Early Intervention, Treatment, and Management of Substance Use Disorders. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. US Department of Health and Human Services. https://www.ncbi.nlm.nih.gov/books/NBK424859/
  2. May 28, E. S. L. U. & 2021. (n.d.). How to Find Effective Drug Rehab Programs? How to Evaluate American Addiction Centers. Retrieved September 6, 2021, from https://americanaddictioncenters.org/rehab-guide/effective
  3. McCall, H. C., Helgadottir, F. D., Menzies, R. G., Hadjistavropoulos, H. D., & Chen, F. S. (2019). Evaluating a Web-Based Social Anxiety Intervention Among Community Users: Analysis of Real-World Data. Journal of Medical Internet Research, 21(1), e11566. https://doi.org/10.2196/11566

Does online counselling work for depression?

Does online counselling work for depression?

Man-thinking

It is estimated that 1 in 3 Canadians will be affected by a mental illness during their lifetime.1 With mental health conditions like depression on the rise in Canada,2 access to treatment and care are more important than ever. Therapy has long been studied and proven as a positive treatment for many mental illnesses, but online or virtual treatment is a relatively newer endeavour. While teletherapy has existed for over twenty years,13 interest in virtual treatment for mental health concerns grew significantly in 2020 when most in person services had to quickly switch to virtual due to the COVID-19 pandemic. This switch increased both the study of and interest surrounding online counselling for conditions like depression and anxiety. Research shows that both modes of delivery are effective and there may even be some lifestyle benefits to online treatment.

What makes therapy effective?

To decide whether online treatment may be the right choice for you, it helps to understand what therapy is and what makes therapy effective. In psychotherapy, professionals apply scientifically validated procedures to help people develop healthier, more effective habits. There are several approaches to therapy—including cognitive behavioural (CBT), interpersonal, and other kinds of talk therapy—that help individuals work through their problems.3 Psychotherapy offers people the opportunity to identify the factors that contribute to their mental conditions and to deal effectively with the causes. Skilled therapists work with individuals so they can identify negative thought patterns, pinpoint and solve certain life problems, and regain a sense of control and pleasure in life.4

Effective therapy can be determined by several factors. Broadly speaking, a person may notice a reduction in their symptoms, an increase in overall happiness, more energy, and better self-worth. 5,6

Differences and similarities between virtual and in person therapy

All of the above outcomes can be achieved whether someone chooses to seek therapy in person or online. When thinking about which option is right for you, consider how the two modes are similar and how they differ.

Keep in mind is that both are effective for treating a mental disorder. A 2014 study found that online treatment was just as effective as face-to-face treatment for depression,7 while a 2018 study found that online CBT was equally as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.8

Reading body language

Both in person and online treatment also offer the opportunity to make a personal connection with your counsellor and have one-on-one time with them for a personal assessment and to identify any potential concerns. Therapists that operate virtually are often trained to pick up on social and body language cues even in a virtual session and can take similar, if not the same, steps to intervene in a crisis. Before selecting a virtual therapist, you can inquire about their online training and how crises are addressed to ensure that you are satisfied with their approach.

Location and time

The largest difference between the delivery of in person and online therapy is the logistics surrounding sessions, such as time and place. While virtual treatment can be done from your own home and requires no commute time, in person therapy involves travelling to and from a therapist’s office.

Because virtual treatment takes place remotely, your location does not matter. With face-to-face treatment, the therapist must be in a vicinity close to you and your choices are limited to those that practice in your area. When geographical location is eliminated from the mix, more specialized treatment can often be found online with a larger pool of services to choose from.

Cost of treatment

Cost is another thing that might differ between in person and virtual. While some therapists may charge the same for online and in person sessions, certain virtual programs may be more cost-effective, where the price breakdown per hour comes out to less than a typical session.

Anonymity and privacy

You may also want to consider the varying levels of anonymity that come with programs. With in-person, there is always the chance of running into someone you recognize in a waiting room or in front of the therapist’s office, particularly if you live in a small town. In virtual programs, there may be a group session where other participants are involved. As with many programs that deal with private subject matter, measures are taken to ensure a level of privacy. These measures are another thing to consider when inquiring about programs that may include a group component.

Privacy and confidentiality are among common concerns for those who consider online treatment programs. Despite popular belief, online therapy can be equally as confidential as in person therapy. If you are feeling unsure about your privacy, inquire about whether your service is compliant with the Health Insurance Portability and Accountability Act (HIPAA). In short, this act works to protect the confidentiality of people receiving medical treatment, including mental health services.

Suitability

Lastly, consider what option is truly right for your condition and symptoms. Some individuals may not be suitable for online therapy. Individuals with severe mental health disorders such as schizophrenia, intellectual disabilities, or high suicidality may not be a good fit for some online therapy services.9 On the other hand, those with severe social anxiety might benefit from testing the waters of socialization through virtual group meetings where the perceived risks are much lower.

Proven benefits of online counselling

Flexibility

There are several benefits to online therapy. For many people, being able to partake in therapy from their own home saves them the time it takes to commute to and from treatment. It also allows for greater flexibility if the person cannot leave the house to attend a session. Those with younger children, for example, can attend a virtual session from their own home without having to arrange childcare.

Accessibility

A virtual program is also ideal for those with less accessibility to individual counsellors, such as those who live in smaller towns or remote areas. In these cases, online therapy works well as distance is no longer an issue. This also allows people to access a particular kind of service or therapeutic program that might not be offered anywhere physically near to them.

Less intimidation, more connections

Online group programs create a safe space for participants to open up to one another, which increases the number of opportunities to access peer support and make connections. Online therapy also encourages the disinhibition effect. Knowing you can close your laptop, are in a safe space, and that your support system may be close by allows people to feel more relaxed and comfortable to share their experiences. This is especially true for those who deal with social anxiety. Not having to leave the house and being able to attend treatment from a safe space makes getting help less intimidating.

 

While online therapy does not have the century of research behind it that in person therapy does, several studies and research in the last decade have found that online treatment has equal efficacy to in person treatment. One study directly compared the effectiveness of the online CBT to in-person CBT and found that they were equally effective at reducing depression.10 In that study, those who stayed in therapy the longest saw the greatest benefit. It is not only CBT and the treatment of depression that works well online. Solution-Focused Brief Therapy, which focuses on setting goals and finding solutions to problems, has also been tested online. In one study, researchers assigned students with mild to moderate levels of anxiety to receive either online or in-person therapy. Both methods were equally effective.11 Online therapy has also been studied regarding teletherapy’s success for PTSD and proved to be an effective method of treatment.12

To summarize, online therapy can bypass factors such as transportation, accessibility, and affordability. Remember that while a lot happens in sessions, most of the growth work is done out in the world while you are experimenting with and practicing the things you learned in treatment. Whether doing counselling in person or online, deciding to focus on your mental health and well being is always a worthwhile commitment.

 

How to access online counselling

If you think online treatment would suit your needs and lifestyle, consider EHN Online’s Mood (Depression) and Anxiety Intensive Outpatient Program. This online therapeutic program is for individuals struggling with mood or anxiety disorders such as (but not limited to) depression, anxiety or panic disorders and are looking to manage or alleviate their symptoms.

This online intensive outpatient program provides a supportive and structured treatment experience that allows patients to make meaningful changes to sustain long-term recoveries. You can expect to receive evidence-based therapy and support in a safe and non-judgemental space.

 

 

Still not sure which type of treatment is right for you?

Chat with an admissions counsellor or take our self-assessment quiz to learn more!

 

 

References

1 Canadian Community Health Survey – Mental Health (CCHS – MH), 2012. Percentage of the household population aged 12+ living in the 10 provinces that met criteria for at least one of six mental disorders (including mood disorders, generalized anxiety disorder, and substance use disorders).

2 Mental Health in Canada: Covid-19 and Beyond. (2020). CAMH Policy Advice. https://www.camh.ca/-/media/files/pdfs—public-policy-submissions/covid-and-mh-policy-paper-pdf.pdf

3 Understanding psychotherapy and how it works. (2020, July 31). Https://www.Apa.Org. https://www.apa.org/topics/psychotherapy/understanding

4 Depression and how psychotherapy and other treatments can help people recover. (n.d.). Https://Www.Apa.Org. Retrieved July 20, 2021, from https://www.apa.org/topics/depression/recover

5 What is Psychotherapy? (2019, January). American Psychiatric Association. https://www.psychiatry.org/patients-families/psychotherapy

6 Gillihan, S. (2018, February 7). How Do You Know When Your Depression Is Improving? Psychology Today Canada. https://www.psychologytoday.com/ca/blog/think-act-be/201802/how-do-you-know-when-your-depression-is-improving

7 Wagner, B., Horn, A. B., & Maercker, A. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders, 152–154, 113–121. https://doi.org/10.1016/j.jad.2013.06.032

8 Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018). Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. Journal of Anxiety Disorders, 55, 70–78. https://doi.org/10.1016/j.janxdis.2018.01.001

9 Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical Issues in Online Psychotherapy: A Narrative Review. Frontiers in Psychiatry, 0. https://doi.org/10.3389/fpsyt.2019.00993

10 Carlbring P, Andersson G, Cuijpers P, Riper H, Hedman-Lagerlöf E. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cognitive Behaviour Therapy. 2018; 47(1):1-8.

11 Novella JK, Ng KM, Samuolis J. A comparison of online and in-person counseling outcomes using solution-focused brief therapy for college students with anxiety. Journal of American College Health. 2020:1-8.

12 Turgoose D, Ashwick R, Murphy D. Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder. Journal of Telemedicine and Telecare. 2018;24(9):575-85.

13 Novotney, A. (2017, February). A growing wave of online therapy. Https://www.Apa.Org. https://www.apa.org/monitor/2017/02/online-therapy