Utilizing web-based videoconferencing to improve the continuum of care in long-term outpatient substance abuse treatment

Web-based videoconferencing technologies hold far-reaching potential to increase and improve delivery of evidence-based substance abuse treatment interventions. A review of the literature reveals very few reports on the efficacy of web-based videoconferencing intervention strategies for treating substance use disorder, and many of those have been descriptive reports that do not meet the requirements of establishing effective and replicable evidence-based care. Comparatively more studies have reported on the use of computer-administered pre-programmed treatment and education modules. These approaches can be very helpful, but do not expand the availability of flexible and professional counseling services for patients in long-term therapy relationships that can be realized with web-based videoconferencing. One of the next important advances in the substance abuse treatment continuum is to evaluate how web-based videoconferencing can help engage patients with serious and chronic problems in the long-term outpatient treatment process. Patients requiring long-term treatment often require responsive and flexible levels of counseling to manage symptoms that fluctuate greatly in scope and intensity over time. Unfortunately, the overall effectiveness of long-term therapy is often seriously hindered by treatment demands to on-site scheduled counseling and psychosocial services that often continue for many years. These demands reduce utilization of therapy services with resulting negative impacts on treatment outcome. Web-based videoconferencing service delivery provides a remarkable opportunity to reduce some of the inconvenience of counseling and so facilitate the long-term treatment process while at the same time allowing pursuit of other responsibilities (e.g., child care) or treatment goals (e.g., employment) essential to rehabilitation. A recent study by our research group demonstrated both increased satisfaction and improved attendance in patients receiving long-term substance abuse treatment who were assigned to web-based counseling versus on-site counseling, with no differences in treatment outcomes. However, much more work is needed to establish how best to use this technology since the great majority of published studies have focused on individuals with mild to moderate problems and/or on brief interventions. Using web-based videoconferencing to expand the continuum of care holds great promise to improve treatment satisfaction, adherence and retention for the many patients with chronic substance use problems requiring longterm outpatient substance abuse treatment.