Remote rehab - what is a web-based recovery program?

Today, more than ever, we are living our lives online. From banking to shopping to working from home, we are all having to access traditional face-to-face services in new, remote ways. The traditional face-to-face aspect of health services and education systems have had to adapt rapidly to providing services online. Addiction treatment and rehabilitation is no different.

The word ‘rehab’ has traditionally come to mean, to many, a physical place – such as a residential or out-patient setting – for help with addiction, but in the face of the recent global coronavirus epidemic, web-based recovery programs are inevitably growing, and the E-health approach has subsequently come under the spotlight. So how do these remote-access services differ from traditional rehab?

What is a web-based recovery program?

Web-based recovery programs offer a route around some of the obstacle is thrown up by the pandemic. Flexible Internet programs are not restricted to business hours, meaning that support can be accessed whenever works best for the user. Some web-based programs provide a level of anonymity, as individuals can receive care without leaving their homes. Some suggest that this anonymity is a crucial factor in the rise of online addiction support, pointing to stigma and shame surrounding substance addiction as one the key factors in preventing people from seeking support in the first place.

One such example is Tempest Sobriety School. Designed for individuals of all levels of substance use, the service consists of psycho-social education and peer support, and it is founded on evidence-based treatments, including cognitive behavioural therapy, dialectical behavioural therapy, mindfulness, positive psychology, and peer interventions, all provided by trained peer coaches.

The program consists of an eight-week intensive program, delivered online, designed to assist individuals in their recovery from alcohol use and related problems. The program takes a holistic approach and addresses not just alcohol use but also other aspects of health and well-being, with the goal of addressing the causes and cycles of addiction.

The program is advertised as being tailored to the unique needs of women, though its services are also available to men. The School carried out a systematic outcome evaluation of their program, examining short and long-term outcomes. You can read the full report here (requires a CareKnowledge subscription).

In the study, participants reported improvements in their alcohol and other substance use, overall physical and mental health, and quality of life.

Several studies carried out in the USA suggest that participants in web-based programs were less likely to drop out while showing higher success rates (with 67 percent no longer meeting diagnostic criteria for substance abuse, compared to 43-52 percent for individual and group counselling).

Adapting to a new normal

As with all health care and education services, there is an argument that the face-to-face form of the service remains the best option for effective outcomes. Immersing yourself entirely in the intensive process of treatment and recovery for the duration of your program remains, many voices concur, the best form of treatment on offer. One of the key benefits offered by residential rehab is remove the individual from environmental and social influences that may be causing or contributing to their addiction, and often these factors can be a leading cause of a relapse. Yet web-based recovery programs offer some people a welcome alternative. We are in the early days of the ‘new normal’ and the relevance – and influence – of web-based recovery programs will only increase in the years to come, as the world adapts to and adopts new and accessible ways of supporting those in need; and there is a growing body of evidence to suggest those in need are rising in numbers.

One in six (16%) current or former drinkers said they have felt concerned about their drinking in lockdown, revealed a recent study by Alcohol Exchange, and more than one in three (37%) said they have taken active steps to manage their drinking. Yet just 1% had confided to a friend or family member or sought advice and support from family and friends. There are also risks beyond the individual. One in 14 (7%) felt that alcohol had increased tension in their household since lockdown. If we apply this to the UK adult population, that is more than 3.5 million adults living in households where alcohol has exacerbated tensions.

A recent national data study from the USA indicates that more than 25% of adults engaged in binge drinking in the past month. Over 14 million of these individuals had an alcohol use disorder, with rated higher among men than among women (7.6% compared to 4.1%).

One of the key lessons to emerge was that many people in need of services do not receive them. Less than eight percent of adults who had AUD in the past year reported receiving treatment. This gap is especially evident among women. If online programs can help improve the rate of people who seek support – by offering anonymity and flexible schedules – then this can only be a welcome, positive step.

How the landscape of alcohol recovery services changes over the coming months and years will be watched closely as the arena of online e-health services continue to grow, along with the demand for support.