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Telehealth for behavioral health care

Group teletherapy

Group therapy involves a small number of people who meet together with one or more behavioral health therapists. There is a growth in the use of telehealth to provide group therapy as evidence shows that it is an effective and affordable alternative to individual therapy.

Medicare currently covers group therapy and health behavior assessment and intervention treatment using telehealth. This includes audio-only services. These sessions must involve members participating in the therapy session at the same time. Most private insurers and Medicaid plans also cover telebehavioral and telemental health care delivered using telehealth.

Benefits of group telebehavioral health therapy

  • Building a sense of community.
  • Validating feelings.
  • Reducing feelings of isolation.
  • Encouraging the sharing of different perspectives.
  • Improving coping strategies.
  • Receiving advice and tips from other patients.
  • Creating a trusted support system for outside of group sessions.

Ways to conduct group therapy using telehealth

  • Live talk therapy: Group telehealth talk therapy involves virtual interactions among several individuals, often through video or phone calls where all members of the group are interacting at the same time. Most group therapy sessions using telehealth are live or in real time.
  • Asynchronous communication: While less common than talk therapy, some groups may elect to interact by group chat or email. This allows individuals to share their thoughts and respond to other group members at a time that is convenient for them.
  • Online applications: Some applications support the creation of groups that interact through social media or chat rooms either in real time or asynchronously. These sessions typically do not involve a clinical provider and are not covered by insurance but may be helpful to individuals who prefer anonymity and more informal interactions.

Did you know?

Group therapy using telehealth has been used to treat a number of behavioral and mental health conditions, including substance use disorder, eating disorders, anxiety, and depression.

Considerations when providing group therapy

  • Pre-screen group members: Group members may have various needs, experiences, or personalities. It is helpful to screen each potential patient to make sure every member can benefit from group therapy and that their needs match the goals of the group.
  • Choose a group size that fits the therapy goals: Consider the following factors when deciding on how many individuals to include in the group: therapy goals, treatment approach, individual personalities, number of members who regularly attend.
  • Group members should complement each other: Make sure the members of the group can relate to one another and support each other. For example, create a group that shares common experiences, interests, and health care needs.
  • Create detailed consent forms: Group telebehavioral or telemental health sessions involve multiple people and are conducted outside of a controlled setting like an office. Patient consent forms should be available online and should outline any associated risks, benefits, and limits to confidentiality.
  • Develop group guidelines: Make clear ground rules covering what is acceptable and what is not. Some common ground rules include requiring all participants to have their camera on, attend from a room where they can be alone during the session, and use the digital “raise hand” feature (or raise their hand) when they want to speak. Address housekeeping and logistical topics too, like how many missed sessions are allowed and how to contact the group leader(s).
  • Select your settings and technology: Choose the telehealth video platform that best suits your needs for encryption and privacy, user controls, and more. Review the settings ahead of time to make sure participants know how to use the technology and select the options that provide the most privacy. Think about any tools that will help you and the group communicate effectively such as screen sharing options or a virtual whiteboard.
  • Be engaging: When you are on screen instead of in person, it is even more important to be conscious of the group dynamic and take steps to keep group members interested, energized, and engaged. Start with introductions and greetings using first names only for privacy. Make eye contact with group members by looking into the camera and use body language and hand gestures to help express your ideas. Build in moments for patients to interact and contribute to the conversation, such as break out rooms or paired discussions.
  • Group participation: Some group members might be more willing to talk than others. Make sure to pause so that everyone has a chance to contribute to the discussion. Let participants know that they can always decide to pass if they do not want to talk when they are called upon.


University of California, Davis Center for Health and Technology

University of California, Davis Center for Health and Technology researchers, in partnership with five rural Indian Health Services clinics, are studying the impact of telebehavioral health consultations on both adults and children within tribal communities. The study, called Tele-Behavioral Health for American Indians Affected by Mental Illness, also examines the financial side of tele-behavioral health care and potential funding sources to bring more telebehavioral services to these communities. Read more about the UC Davis Center for Health and Technology.