Difficulty Trusting Yourself and Others in Recovery
A life of addiction can make it difficult to trust yourself or to believe others, but the success of recovery depends on opening yourself to feedback.
Help for substance abuse may come in many forms, but traditionally, those enrolled in treatment programs have been required to show up in person to access needed support. Since there may be a variety of barriers with that model of care, telemedicine (aka telehealth) offers new options for those who need mental health services and substance abuse treatment. Here’s a look at how and why to use telehealth for substance use treatment, and how it works.
Broadly speaking, telehealth uses HIPAA-compliant technologies, including telephone-based services, smartphone applications, videoconferencing, and web-based tools, to provide care over distance without requiring patients to travel to a clinic or provider’s office. One of the most common technologies used is videoconferencing with a secure online platform.
A recent post by the online Doctor of Social Work (DSW) program from USC’s Suzanne Dworak-Peck School of Social Work describes how the university is doing just that. Dr. Nadia Islam is an associate professor of clinical practice in the DSW program and clinical director of USC Telehealth, a virtual outpatient behavioral health clinic. She says telehealth support is a “real game-changer” that is underutilized for substance abuse treatment.
I see it having the most impact in terms of helping to reach people before their problem becomes really acute,” she said. “From the flip side, many people will seek assistance when they experience a crisis and then there’s difficulty with maintaining follow-up. There is room in prevention and early intervention for tele mental health care, but I also think there’s a place for aftercare and follow-up.”
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There are many reasons to pursue treatment through telehealth, and often they’re related to overcoming barriers to care. These might include the stigma associated with seeking help, lack of access to providers in remote areas, the inability to take time away from a job or other responsibilities, and the costs of traveling to a provider’s location.
Islam says she has frequently witnessed the impact of such barriers: “Many of the clients we work with tell us that they have never sought therapy in the past or if they have sought therapy they haven’t stuck with it. Not always because they didn’t want to, but sometimes because barriers around transportation, mobility, taking time off work, childcare … it was just too much. When it came to juggling all these things, their own self-care was the first thing to go.”
She says the opinions of others can also be a barrier: “They’ll tell us that the stigma around not just having a mental health problem, but seeking help for that mental health problem, was so great that they were reluctant to even try. So, I’ve always said that telehealth really provides an opportunity and an option for individuals who otherwise wouldn’t seek help for a variety of personal and structural reasons.”
Although she sees telehealth as an excellent option, Islam emphasizes in-person care may still be best “in the most acute situations that involve a level of high risk of harm to either the client themselves or to others.”
In addition to improved access, Islam highlights another benefit of telehealth: more holistic care. “There’s a greater appreciation for trauma and how trauma influences substance use and abuse. For instance, one of the services that telehealth provides involves Seeking Safety, which is a cognitive behavioral intervention developed to address both trauma and substance use disorders concurrently. Telehealth offers a specific advantage in its capacity to respond not only to addiction and related behaviors, but to also address trauma and perhaps other mental health conditions underlying that problematic behavior.”
Another benefit is the network of partnerships that may form as a result. When the resources of a large telehealth program like USC’s combine with providers in the community, everyone benefits. Small clinics and individual providers can gain access to expertise and secure technologies — and both can serve as referral sources and partners to meet the needs of the local community, no matter where that may be.
If you see someone in need of help, just offering the suggestion might make all the difference. “I think one major piece that we’ve observed that’s so important is having someone who the person trusts recommend telehealth as an option for them. Just knowing that something exists may not be enough to inspire the level of trust needed to motivate someone to try it,” Islam says. “For instance, if a student is talking to a professor or a guidance counselor — or even a friend —having them say, ‘It sounds like you’re really struggling with this. Have you thought about contacting a therapist at telehealth?’ Often, that’s the crucial link.”
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