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Virtual Group Therapy Programs—The Wave of the Future

      To the Editors:
      The mercurial rise in popularity of nicotine vaping has effectively reversed 5 decades of nicotine denormalization among youth, and created brand new public health challenges as new generations struggle with nicotine addiction. Responses to the 2019 National Youth Tobacco Survey suggest that there is widespread youth interest in quitting vaping, though rates remain high, and little is known about interventions to help adolescents quit.
      Group therapy is a developmental preference for adolescents, and while evidence for treating youth vaping remains limited, the most recent Cochrane review suggests that group-based behavioral interventions are the most promising. Transportation is a significant barrier for youth, and challenges of in-person gatherings were magnified by the COVID-19 pandemic. Virtual care can surmount logistical challenges and has been demonstrated as acceptable to youth, including for substance use disorder treatment [
      • Levy S.
      • Deister D.
      • Fantegrossi J.
      • et al.
      Virtual care in an outpatient subspecialty substance use disorder treatment program.
      ]. A virtual group therapy approach is efficient, as a single professional can treat patients from disparate geographic locations. Group cohesion, camaraderie, accountability to peers, relatability, and decreased barriers to access may be key drivers of impact for youth. However, scientific studies are needed to determine the efficacy of virtual group therapy.
      From March 2020 to February 2021, the authors piloted a virtual group therapy program with 23 adolescents referred from a substance use disorder treatment program or high school guidance counselor. The average group attendance was 89%. Feedback indicated that participants were comfortable with the virtual format (participant quote: “The virtual format helped me come out of my shell and talk more”), appreciated connecting with peers (“The most helpful portion of group is relating to peers”), felt supported through shared experiences (“It felt good sharing…it created a positive environment and felt like people were taking advantage of what group was about/intended for”), and learned helpful coping skills and quit strategies (“We would ask each other ‘What are your ways of coping with cravings? How did you go so long without breaking sobriety?’”).
      There is still much to learn about how best to support youth who vape nicotine. A scientific agenda is needed. The COVID-19 pandemic has increased the urgency of finding new and practical modalities for youth behavioral healthcare. Advancing virtual group therapy has the potential to harness a developmentally attuned intervention model to address adolescent health problems, including nicotine use and could be expanded to other behavioral and mental health disorders. The approach merits rigorous investigation.

      Funding Source

      This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

      Reference

        • Levy S.
        • Deister D.
        • Fantegrossi J.
        • et al.
        Virtual care in an outpatient subspecialty substance use disorder treatment program.
        J Addict Med. 2021; https://doi.org/10.1097/ADM.0000000000000871