Hybrid Virtual Group Model for Substance Use Disorder Therapy: A Scoping Review

Background: Substance use disorder (SUD) group therapy has traditionally been conducted in-person; however, there is growing interest in virtual formats. While virtual group therapy can address certain barriers for in-person attendance, it may compromise key elements like therapeutic alliance and group cohesiveness. A model that integrates both in-person and virtual participants may help balance the benefits of these two approaches. Objective: To identify and define approaches to SUD group therapy that integrate in-person and virtual participants, summarize study outcomes associated with these models, propose standardized terminology, and provide preliminary recommendations for their application in SUD treatment. Design: A comprehensive search was conducted on 11/13/2024 and updated on 12/16/2024 by a medical librarian. Included articles were published 2000 onwards and conducted with SUD group therapy where participants or group facilitators were both in-person and virtual. We extracted data from 4 articles that met the search criteria. Results: A total of 1353 articles were screened, 20 were evaluated at the full-text level, and 4 met study inclusion criteria. Two "hybrid" model designs for SUD were identified. One model utilized a virtual group facilitator, while participants remained together in-person. The second model kept the facilitator in-person and allowed group participants to be present either virtually or in-person within the same group. Outcomes evaluated included treatment completion across groups and patient perceived changes in therapeutic alliance, group cohesion, and understanding of addiction. Conclusion: We propose a consensus definition of hybrid virtual group models where at least one group member, either the facilitator or one of the participants, attends groups in-person while at least one member attends virtually. While research is limited, early findings suggest that hybrid SUD groups have similar outcomes to in-person groups and better outcomes than virtual-only groups. Unique considerations should be made to ensure that hybrid SUD models are implemented appropriately and effectively.