Structuring Telepsychiatry Group Therapy Sessions

In the second part of this Q&A, Edward Kaftarian, MD, Psych Congress Steering Committee member and CEO of Orbit Health Telepsychiatry, Encino, CA, discusses group demographics and offers suggestions on the best ways to structure remote group therapy sessions, expanding on his recent Psych Congress Elevate virtual session, entitled “Telespychiatry 2.0: Where do we go from here.” 

The bond created between group therapy members will depend more on their shared experiences than a shared physical space, notes Dr Kaftarian.

In Part 1, Dr Kaftarian gave an overview of how group therapy would work for telepsychiatry.

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 among the group members. Can you achieve that same level of connection with remote groups? I think so. Just take care to ensure that all members of the group can always see and hear each other clearly. Also, encourage and give space for all members to actively participate in the discussion so that no one is left behind.  

Q: What group size do you believe would be ideal?  

A: 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 to 6 people makes it easier for the group to develop a stronger bond. However, even a group of 15 to 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 1 member may not have as much of an impact on the discussion.  

Q: Would you keep the characteristics of the group based on demographics, location, culture, or perhaps topic-focused?  

A: 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. I think more than anything else, people bond over shared experiences. Also, people with different mental health conditions may have greater difficulty relating to each other, even if they share the same culture or race. Therefore, I think that a group should be more focused on a specific mental health condition.

 Edward Kaftarian, MD is a nationally recognized psychiatrist and leader in the field of telepsychiatry. Trained at the world-renowned Johns Hopkins Hospital, he is board-certified in Psychiatry, Forensic Psychiatry and Addiction Medicine. 

Dr. Kaftarian has served in a variety of executive roles within the California prison system, including Chief Psychiatrist, Senior Psychiatrist, Medical Director, and Director of Pharmacy. He is the founder of California’s Statewide Prison Telepsychiatry Program, which is the largest correctional telepsychiatry program in the world. As a representative for California Correctional Healthcare Services, Dr. Kaftarian has served alongside Federal Court monitors on extensive quality improvement audits for prisons throughout the State of California.   

Dr. Kaftarian is currently the Chairman and CEO of Orbit Health Telepsychiatry, a company that provides telepsychiatry services to jails and prisons.