Privacy factors contribute to success of online treatment program

The co-founders of the online treatment program Lionrock Recovery knew about addiction (from family experience) and knew about technology (they routinely used videoconferencing in their previous lines of work) as they embarked on their new venture. What they didn’t quite anticipate was the mechanism by which the marriage of treatment and technology could have such a great impact on individuals for whom conventional care might prove ineffective.

What Peter K. Loeb and Iain D. Crabb originally envisioned as an addiction treatment alternative emphasizing convenience has developed more as an option guaranteeing privacy. Loeb, Lionrock’s president and CEO, says the confidential nature of Lionrock’s services has been the attraction for numerous individuals, such as the woman in her 60s who said, “If my daughter found out I was in treatment, I would never get to see my grandchild again.”

“We focus on being a safe haven,” says Loeb, who with Crabb launched Lionrock about a year ago.

Loeb lost a younger sister to addiction at age 49, and his daughter began having problems with substances before her teen years (she is now in recovery and serves as the first point of contact for Lionrock’s prospective clients). He and Crabb, who had seen a close relative of his struggle with addiction as well, were working in other fields when they began to research the treatment industry and the possible role of telehealth.

They became aware of CRC Health Group’s ambitious eGetgoing initiative, an effort that ultimately failed to reach its potential because of timing, Loeb believes. “Its real problem was simply being too early,” he says. “People at home didn’t have the bandwidth they have now.”

Throughout the process of designing Lionrock Recovery’s program, Loeb and Crabb (who serves as chief financial officer and administrator) have emphasized taking deliberate steps to ensure that they can deliver high-quality online counseling. In this regard, they have been particularly proud that their program earned Joint Commission accreditation this year.

Designing a program

Lionrock does not seek to be all things to all people; rather, it is targeted to individuals who can excel at an intensive outpatient (IOP) level of service, without the extent of direct supervision inherent in residential treatment.

“This level is not the right one for everyone,” says Loeb. “Some people need more structure and accountability, and we do refer to higher levels of care.”

The partners studied Treatment Improvement Protocol (TIP) literature from the Substance Abuse and Mental Health Services Administration (SAMHSA) to become familiar with IOP programming, and enlisted clinical expert Roland Williams to help design their program. Williams, who co-founded the Bayside Marin and Alta Mira Recovery Programs operations in California, serves as Lionrock’s acting clinical director.

Loeb says Lionrock’s clinical focus is heavy on cognitive-behavioral and Motivational Interviewing approaches. He adds, “While we don’t actively work the Steps in our program, support group participation is a key part of our curriculum. Our clients work with Lionrock for a few months at most, and so building a strong support network is essential for a life of recovery.”  

Online groups are conducted with no more than five clients per counselor. The technological requirements to participate are basic: an Internet connection and a computer with a webcam, or an iPad2 or newer. There is great attention to detail in terms of where the camera is placed, the backdrop that is used, and how the images project on screen to the participants. “How it looks and sounds is very important,” says Loeb.

The program has attracted a somewhat unexpected cohort of clients in its early months. Projections had the online option mainly attracting the youngest adults, but Loeb says he has been pleased to see that an underserved population of women ranging in age from 30s to 60s has been well-represented.

Marketing the effort

Most individuals who pursue Lionrock’s online services find the organization through Internet searches, Loeb says. At the same time, Lionrock has sought to form working partnerships with primary treatment organizations that might be looking for viable aftercare options for clients exiting residential treatment.

“We’re interested in any treatment center that wants to work with us for clients going home, for a step-down service,” Loeb says. He adds that the task of attracting clients has proven to be more complex than he anticipated going in, and Lionrock will continue to look for creative marketing options.

The program continues to emphasize offering a high-quality service at a low cost (its website advertises a $288 per month payment plan, with options that include one month of IOP services followed by six months of access to a monthly drop-in group).

Loeb says Lionrock will proceed carefully in any effort to expand beyond its current base. “I’m very pleased that we have been able to build a program that’s highly credible,” he says.