Question 1

Should groups be based on demographics, location, culture, or perhaps topic-focused?

Accepted Answer

The more group members have in common, the easier it is for them to develop bonds.

However, in today's world, there are so many ways you can categorize people. People of the same race may have vastly different attitudes and values, for instance.

But more than anything else, people bond over shared experiences. Also, people with different mental conditions may have great difficulty relating to each other, even if they share the same culture or race. Thus, it is important that a group be focused on a specific mental health condition.

Question 2

What group size is ideal for group therapy?

Accepted Answer

There is no hard and fast rule. It depends on the topic, instructor, and participants.

Nevertheless, the larger the group, the more impersonal it may feel. Having a group size of 4-6 people makes it easier for the group to develop a stronger bond.

However, even a group of 15-20 people can develop a bond remotely, it just may take more time and effort to do so. One advantage of a larger group is that an absence of one member may not have as much of an impact on the discussion.

Question 3

Does remote group therapy allow the participants to develop a bond?  How important is that?

Accepted Answer

One of the main purposes of group therapy is to allow patients to learn from, and be supported by, other members of the group. This happens more easily if there is a sense of solidarity or connection amongst the group members.

Can you achieve that same level of connection with remote groups? Yes: Ensure that all members of the group can see and hear each other clearly at all times. Also, encourage and give space for all members to actively participate in the discussion so that no one is left behind.

Question 4

Are there certain conditions that benefit more from remote care for group therapy?

Accepted Answer

There is insufficient research to determine if group therapy done remotely is more suited for a specific type of patient.

However, remote care is often less intimidating than being in person. For example, a patient with an anxiety disorder such as social phobia or agoraphobia may be reluctant to put themselves in front of a group of strangers for the first time. They may be more likely to participate in remote groups instead.

Question 5

What are some of the advantages of remote group therapy?

Accepted Answer

Remote group therapy is very convenient to all who are involved. Being able to log in for a remote group is easier than fighting traffic to and from where the onsite sessions are located. For this reason, people may be more willing to schedule remote group sessions in their busy lives.

Also, this mode of healthcare delivery allows greater access to care to remote populations those who have been underserved by onsite care.

Question 6

Do you see group therapy sessions on the horizon for telepsychiatry?

Accepted Answer

Most forms of mental health treatment can be equally effective as in person care, including group therapy. Remote group therapy has been slower to take hold than one-on-one care given by psychiatrists and mental health clinicians. However, as the world continues to embrace telehealth, group therapy is anticipated to become more prevalent.

Question 7

How can I combat Zoom fatigue symptoms?

Accepted Answer

Videoconferencing and remote professional services are now a regular practice in many industries. However, these remote calls can lead to feelings of fatigue.

If you find yourself exhausted by all of the video calls in your life, here are a few tips:

Schedule “no meeting” blocks of time. Make sure there are parts of your day when you are away from a screen.
Avoid multitasking. When you are on a call, focus on the business of the call. Avoid pulling up a second window to read emails or conduct other work. Multitasking during calls leads to a loss of productivity and difficulty remembering what occurred in the meeting.
Limit the number of calls. Do what you can to cut down on your overall number of calls. Group calls with separate people or teams together where feasible and appropriate. If a video call is not actually necessary, resolve the issues via phone, email, or a collaborative document. Do not default to a video call for every type of meeting. If you are meeting a stranger for the first time, such as a networking connection, for example, video calls can feel personal and invasive; start with a phone call.
Take breaks. If your call lasts more than an hour, it is important to take breaks. Get up and walk around, use the restroom, get a glass of water. Everyone will have more energy and remain more productive as a result.
Turn off your self-view. Video call programs like Zoom default to displaying your own video as well as others on the call. Staring at your own face can be distracting and increase stress and anxiety. Hide yourself from your own view so you can focus on the other people on the call.
Limit on-screen stimuli. In addition to hiding your face and keeping other windows closed, do what you can to limit what you see on-screen. Encourage people to take calls in front of plain backgrounds instead of a room full of objects. Seeing five different rooms full of furniture can cause disorientation and increase mental fatigue.

Learn more in our complete article, "Videoconferencing Fatigue and What to Do About It."

Question 8

What is Zoom Fatigue, and why does it occur?

Accepted Answer

As the COVID-19 coronavirus pandemic continues into its second year, people have become accustomed to handling most or all of their personal and professional interactions remotely. Videoconferencing has become a normal part of daily life. Videoconferencing fatigue, now commonly called “Zoom fatigue” in reference to one of the most popular videoconferencing platforms, refers to the exhaustion caused by constant video calls.

While Zoom fatigue is not yet an official diagnosis, many psychologists state that the condition is both real and prevalent in the new pandemic era.

Constant video calls on any platform, including Google, Skype, Microsoft Teams, FaceTime, and other professional platforms can lead to fatigue. People can start to feel extra irritable, less energized, constantly “on the clock” for work, confused or awkward during meetings, and isolated even while communicating with others.

There are scientific reasons for these feelings. Video calls can make people feel like they are always “on.” People are hyper-aware of their appearance, their mannerisms, the sound of their voice, and they can begin to feel like they are “performing” in a way that is not true of in-person interactions. The silence on the other end of the line when people mute their microphones, delays in response time, as well as the added effort necessary to identify nonverbal cues via video chat, contribute to stress and fatigue as well.

Video calls from home also allow us to become easily distracted. When technology fails us--the WiFi goes out, someone’s camera or microphone fails to work, etc.--we can feel even more overwhelmed.

Learn more in our complete article, "Videoconferencing Fatigue and What to Do About It."

Question 9

How can a provider start a telepsychiatry practice?

Accepted Answer

To start a telepsychiatry practice, you must be licensed by the state to practice, and meet the requirements of your practice. Ideally, you would have board certification in psychiatry.

You'll additionally need broadband, a desktop computer such as a Mac or Windows PC, along with a webcam. Ideally, you can use a dedicated microphone and speaker headset, to maximize your audio.

You need to ensure you have the right software. You need to ensure you have an electronic health record, a prescription system, and ways to receive and send messages. Your videoconferencing setup -- whether it's Zoom, Google Meet, or Microsoft Teams -- needs to be HIPAA-compliant, and you would need a signed business associates agreement (BAA). While you could create a telemedicine service from scratch, there can be costs for telehealth implementation. Costs include human resources (HR) time, but also marketing, malpractice and legal, along with additional training time.

Finally, you can join an existing group, like Orbit Health. Orbit Health offers full-time and part-time positions in adult psychiatry (outpatient, inpatient, partial hospitalization, and more), child & adolescent psychiatry, community psychiatry, emergency & crisis psychiatry, and forensic psychiatry/health. Partnering with Orbit Health is a faster way to implement telepsychiatry services than building your own services from scratch. Orbit Health provides telepsychiatry for facilities across the United States, with board-certified physicians and nurse practitioners licensed in all 50 states.

Whether you enjoy working from home or on-site, Orbit Health has multiple positions for psychiatrists, nurse practitioners, and more! Here’s why people like working for Orbit Health — where you can tell us about your job interests and apply to work with us.

Question 10

How can I improve the telehealth experience for those with hearing difficulties or who are deaf?

Accepted Answer

You and your team may treat persons who have hearing difficulties, whether they are hard of hearing or death. Consider the following in your workflow, such as involving staff to troubleshoot audio quality, involving a sign language interpreter, and sharing your screen:

Check to make sure if the patient is understanding you. Have them repeat back what you said from time to time.
If you have a telepresenter (a staff member on the patient side), they can tell you if its poor audio quality or if its good quality but the patient just can’t hear you because of their impairment. You can have the telepresenter repeat your words to the patient during your appointment.
If the patient knows American Sign Language, you can easily include an ASL interpreter into the videoconferencing session as part of a group chat.
Type out what you want the patient to know and screen share it with them. Make sure to use a big text so they can easily see the words. You can put your words in a Word document or the like, then click screen share. Problem solved!
If all else fails, arrange for the patient to be seen in person. Usually this is not necessary as there are so many ways to ensure good quality of audio. These days, audio via technology should not differ much from the audio in person.

Check out our full post on "Telepsychiatry for the Hearing Impaired – Top 10 Tips."