7 Evidence-Based Reasons Virtual IOP Works

While telebehavioral health became ubiquitous during the pandemic, it is not widely known that virtual intensive outpatient treatment has been available through ERC Pathlight since 2016. To date, more than 7,000 patients have received virtual treatment at Eating Recovery and Pathlight At Home.

Clinicians and patients considering a virtual intensive outpatient program (IOP) should know that a program based on best clinical practices and evidence-based treatments, in conjunction with longstanding clinical experience, can be highly successful—and ERC Pathlight has data to confirm program efficacy based on patient outcomes, which is collected at the initiation and completion of treatment. The overall patient experience is evaluated alongside symptom endorsement, patient engagement and program completion rates. “We use this important clinical data to inform our standards of excellence in the quality of patient care,” says Deborah Michel, PhD, CEDS-S, FAED (she/her/hers), National Clinical Director at Eating Recovery and Pathlight At Home.

Based on our research, clinicians can feel confident about recommending Eating Recovery and Pathlight At Home, our virtual IOP, which delivers exceptional patient experience and outcomes. Here’s what we’ve learned.

1. Virtual IOP participation results in symptom reduction.

Results showed statistically significant and clinically meaningful improvements in body dissatisfaction, binge eating, cognitive restraint, purging, restricting and excessive exercise for those in the eating disorders program. In addition, there were statistically significant improvements in depression and anxiety when pre-admission was compared with postadmission. These findings are based on data obtained from 882 Eating Recovery and Pathlight At Home patients completing the Eating Pathology Symptoms Inventory (EPSI) before and after treatment between January 2021 and December 2021.

2. Patients are highly engaged with virtual IOP.

Several statistics indicate higher engagement rates in virtual than in on-site IOP. We have seen a more than 25% increase in program completion for virtual IOP versus on-site IOP.1 We also see close to 90% attendance rates in the virtual program, which is slightly higher than attendance rates in on-site IOP.

3. Patients build strong connections to one another in a virtual setting.

“As a clinician, you’re trained in what to look for when you’re sitting in an office with a patient,” says Casey Tallent, PhD (she/her/hers), Director at Eating Recovery and Pathlight At Home. “What we’ve found in virtual therapy is that being so close to a patient’s face, you see visual cues—a lip quivering, eyes blinking—that you might miss from across the room.” In our virtual IOP pilot study, all patients surveyed said they felt connected to facilitators and group members, and we’ve continued to see patients report these strong connections.

4. Virtual IOP is covered by many insurance plans.

Eating Recovery and Pathlight At Home is in-network with nearly all major commercial insurance providers. “During the COVID-19 pandemic, insurers had to cover virtual IOP and fortunately they witnessed how well it works and vowed to continue coverage,” says Dr. Tallent. The Patient Access Team works closely with insurance companies and patients to help them understand coverage and to advocate for patients with insurers.

5. Virtual IOP is effective for children and adolescents.

“This generation of children and adolescents has been living in the virtual world for quite some time, and they are comfortable in it,” says Dr. Michel. A preliminary evaluation of admission and discharge assessments for children and adolescents participating in our virtual eating disorders program reported statistically significant and clinically meaningful Improvements on all clinical measures, including cognitive restraint, eating concerns, shape concerns and weight concerns [Eating Disorder Examination Questionnaire (EDE-Q), n=218], as well as in depression [Patient Health Questionnaire-9 (PHQ-9), n=217] and anxiety [General Anxiety Disorder-7 (GAD-7), n=84].1

6. Virtual treatment enables more intensive family-based treatment (FBT) than many in-person programs.

“The key to our success with children and adolescents is the family support system, and virtual IOP makes it easy to incorporate that,” says Dr. Michel. Virtual treatment allows more families to participate in IOP programming, thereby supporting the FBT-informed component of IOP. A parent or caregiver is required to be at each virtual IOP meal and receives feedback on how to assist the child in completing the meal. There is a strong focus on family therapy using emotion-focused family therapy with multiple family education and skills groups available each week. Parent/caregiver nutritional counseling sessions with registered dietitians occur weekly to assist parents/caregivers with meal planning and portioning for the child or adolescent.

7. Care is well coordinated with the outpatient team.

In many cases, patients may continue to meet with their outpatient providers while in virtual IOP, particularly toward program completion. Most insurance plans will cover both when clinical services occur on different days.

The Eating Recovery and Pathlight At Home treatment team includes a primary therapist for all programs and a registered dietitian for the eating disorder programs. Other licensed therapists may facilitate psychoeducation skills groups as well. Outpatient providers are regularly updated on patient progress and are included in their patient’s treatment planning including discharge planning. Patients surveyed about outpatient team coordination of services agree that virtual IOP staff effectively coordinate with other service providers. Outpatient providers also report being very pleased with the communication received from the Eating Recovery and Pathlight At Home team.

“In addition to all its other benefits, including high patient satisfaction and outcomes, virtual mental health care expands access to so many people who need treatment,” says Dr. Tallent. “If a clinician has any hesitance about referring a patient for virtual care, we encourage them to connect with our virtual treatment team to take a tour of the treatment environment and learn about our evidence-based treatments and the positive outcomes our patients have achieved.”

Learn more about Eating Recovery At Home and Pathlight At Home, our virtual intensive outpatient programs for eating disorders and mood and anxiety disorders. Available and accessible across the nation, these programs are covered in-network by most commercial insurance plans.

Citations:

1. Michel, D.M., O’Melia, A.M., Mathes, W.F., & Tallent, C.N. (2022). Telebehavioral health intensive outpatient program attendance and length of treatment compared to in-person service. [Manuscript submitted for publication]