An interesting study comparing traditional drug counselling treatment with an online equivalent:

New way to treat drug addicts -- online

By Lauren C. Williams
Capital News Service
Posted 5/13/09
The idea that addicts need to physically go to treatment may be becoming obsolete,

"Virtual" drug treatment -- online therapy sessions conducted by home computer -- works, according to a study released last month.
A 50-patient pilot study published by the Journal of Substance Abuse Treatment showed that participants in online drug addiction counseling were more satisfied with their treatment overall, compared to traditional group sessions.
Patients for the study were drawn from the Addiction Treatment Services program in Baltimore and had ongoing illicit drug use problems.
Some were randomly selected to receive online treatment with eGetGoing, an online counseling center, or traditional counseling at a local treatment site.
"An individual's pathway to recovery can be varied," said Kathleen Rebbert-Franklin, acting director of the Alcohol and Drug Abuse Administration. "There are some who will flourish with online counseling and others will need to face-to-face."
The eGetGoing patients cited more convenience and privacy compared to traditional care.
"The ideal form of therapy would be face-to-face," said H. Westley Clark, director for the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration, who is also a psychiatrist.
"But I can't help an empty chair. Sometimes, it's Internet or nothing," Clark said.
EGetGoing helps patients with severe and chronic abuse problems. For $400 a month, patients receive a headset and software that brings treatment home in a format similar to instant messaging.
Patients, without fear of being stigmatized by their problems, log on to the site and attend virtual group sessions.
Each group member is assigned a screen name and cannot be identified by the others.
Group members see real-time video of their counselor, but not each other, and talk to one another and the counselor as if they were face-to-face. It's like an online forum with microphones.
"No approach is without limitations," Clark said. "If you don't have a computer or access to the Internet, this form of treatment is not available to you."
Adherence to the schedule of treatment sessions is a big obstacle in addiction treatment, said Dr. Van King, of Johns Hopkins University, co-author of the study.
Online patients attended 92 percent of their scheduled sessions, while those in traditional treatment attended 76 percent.
In Maryland, many addicts can't get help because there are too few counselors and treatment centers, Rebbert-Franklin said.
"We need to explore new technologies to overcome the barriers," she said.
Even with the potential success of online treatment, there are technical difficulties.
Nine of the selected participants were removed from the study after failing to adhere to mandatory computer software registration appointments.
Four others were withdrawn either because they did not have a working computer at home or had problems connecting to the eGetGoing Web site.
Those access problems could be significant, said Maryland Health Department Deputy Secretary Renata Henry.
"Great intervention methods mean nothing unless we can get them into the field," she said.
Henry's comments came during a conference at the Institutes for Behavior Resources in Baltimore that also featured U.S. Rep. Elijah Cummings, a Democrat whose 7th Congressional District includes part of north Baltimor, and former White House drug czar retired Gen. Barry McCaffrey.
Glen Conrad, a counselor at Institute for Behavior Resources who did not attend the conference, said the benefits of face-to-face counseling cannot be replaced with Internet sessions, unless the counselor could view the patients.
"Body language is so important when you're a counselor," Conrad said. "A patient can say 'I'm fine' and when you see them, you know they're not."
Virtual therapy may not be ideal, some experts acknowledged.
But it can be a tool in the treatment arsenal.
"(Addiction) is an illness that is progressive in nature, and every opportunity that we have to reach these individuals is valued," Rebbert-Franklin said.


Rowdy Yates
Senior Research Fellow
Scottish Addiction Studies
Dept. of Applied Social Science
University of Stirling
Scotland

T: +44 (0) 1786-467737
F: +44 (0) 1786-466299
W: http://www.dass.stir.ac.uk/sections/showsection.php?id=4  (home)
W: http://www.drugslibrary.stir.ac.uk/ (online library)

-- 
Academic Excellence at the Heart of Scotland.
The University of Stirling is a charity registered in Scotland, 
 number SC 011159.