Transitioning In-Person Group Therapy to Teletherapy in the Age of Physical Distancing

COVID-19 upended life as we know it. Although some states have eased initial lockdown restrictions, indoor gatherings of unrelated people remain risky, according to the Centers for Disease Control and Prevention (CDC). Some communities continue to prohibit them, and nearly all continue to recommend working from home when possible.

While everyone is feeling the effects of social distancing, the ongoing isolation can be devastating for those who are used to attending regular group therapy sessions. And the loss of these sessions can be a major blow to treatment facilities operating on thin margins.

Fortunately, pairing teletherapy with a strong behavioral health EHR (electronic health record) system offers a flexible solution that allows you to continue to provide value-based care. Here’s a look at how you can keep therapy groups going in these uncertain times, and what you need to do to conduct them safely, ethically, and in compliance with HIPAA.

Why You Need to Offer Teletherapy for Group Sessions

According to a recent article in Forbes, 59% of people who started working from home during the COVID-19 outbreak want to continue doing so. Meanwhile, as cases surge following the loosening of restrictions, older adults and those with a range of underlying conditions–from asthma to diabetes to obesity–are being urged to stay home due to an elevated risk of severe infection. It’s highly likely someone participating in group therapy could fall into this higher-risk category.

Even when COVID-19 is no longer a threat, clients have many factors that may affect their ability to attend in-person group sessions. Transportation issues, childcare concerns, disabilities, and even social anxiety could lead to skipping meetings or dropping out of group sessions altogether. Offering teletherapy groups, either instead of, or in addition to in-person options, can help improve retention rates while giving behavioral health programs an additional potential revenue stream.

Group therapy is a vital component of many forms of behavioral healthcare, but especially when treating substance use disorder. Many clients need that ongoing support from others who are facing similar challenges. Humans are social by nature, and participating in group therapy can help clients feel less alone while improving treatment outcomes. Transitioning to group teletherapy allows clinicians to continue providing this valuable interaction and uninterrupted care while keeping clients safe and healthy.

APA Guidelines for Group Teletherapy

Providing group teletherapy isn’t as simple as firing up your computer and jumping on a standard meeting platform. The same ethical and legal issues involved in any behavioral healthcare delivery also apply to teletherapy. Fortunately, the American Psychological Association (APA) has put together guidelines for practitioners interested in providing group teletherapy.

Highlights include, but are not limited to:

  • Establishing confidentiality by allowing clients to choose whether to show their faces, or wear a mask or other disguise, as well as allowing them to log in using initials or a pseudonym
  • Asking clients to sign informed consent documents prior to joining the group
  • Using a HIPAA-compliant meeting platform (penalties for non-compliance have been temporarily waived but are likely to return)
  • Pre-screening potential new group members
  • Working with the group to set basic protocols, such as all group members wearing appropriate clothing, and isolating themselves from household members for the duration of each session

A Behavioral Health EHR Can Help

By design, a behavioral health EHR promotes flexible workflows that can be easily accessed from remote locations. Not only does it gather critical data that allows clinicians to provide evidence-based care, backed up by definable clinical measures, it also streamlines the documentation and billing tasks that often bog down behavioral healthcare providers.

You can easily code group telehealth sessions under the emergency Medicare codes set out during the pandemic, and amend the codes later if guidelines change. EHRs also allow care providers to gather electronic informed consent documents from all group members, enter notes from each session into each client’s chart, and even have each group member’s bill automatically routed to the correct insurance company or other payer.

In addition, a well-designed behavioral health EHR should be able to provide a safe and secure, HIPAA-compliant teletherapy platform baked right into the system. Clinicians should be able to provide high quality group therapy that is seamlessly integrated with all the tools they’ve come to rely on in their “normal” every day workflow. There should never be a concern about whether or not adequate privacy is being offered, nor should a provider need to switch back and forth between multiple platforms to provide care. If you choose the right behavioral health EHR, all staff members should be able to continue to work without interruption, while offering quality outcomes-based care for clients, even if you are new to teletherapy. Even during a pandemic.

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