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Measuring The Efficacy of In-Person IOP Mental Health Treatment vs Virtual IOP Care for Young Adults

Est. reading time: 3 mins
Posted Under: Treatment Insights

Clinically Reviewed by: Amanda Fialk, PhD, LCSW, LICSW


Virtual mental health care spiked dramatically in 2020 as a response to the COVID-19 pandemic. It was a vital, non-contact lifeline for many individuals and today remains a viable option for those facing geographic, financial and physical barriers to treatment. 

However, in cases of severe acuity and high clinical need, there are several therapeutic disadvantages that can impact care including:

  • Missing nonverbal communication cues and signals
  • Potential disruption in transferability of clinical modalities and interventions
  • Difficulty with handling crises due to distance
  • Perpetuation of avoidant tendencies and isolating behavior
  • Confidentiality issues in doing therapy in one’s own home or public places
  • Weakened ability to build meaningful connections that occur organically in a face-to-face environment

As leaders in young adult intensive outpatient treatment, our goal at The Dorm is to deliver client-centered care that fully meets the needs of those we serve. This includes taking into account the mediums by which we offer care, especially for clients with more acute symptoms, or those who may be transitioning from inpatient or residential care. 

The Dorm Asks: Is Virtual or In-Person Treatment Better at Supporting Intensive Mental Health Treatment Clients?

While virtual treatment was necessary during the peak of the pandemic, including within our Dorm community, it is imperative that we assess if it continues to always be the best option for a population that is high-acuity undergoing intensive treatment. 

In order for us to effectively answer this question, we needed a measurement tool to quantitatively capture this information.

Given the lack of surveys that exist to compare the efficacy of virtual and in-person mental health treatment, our research team at The Dorm set out to fill this gap, creating a survey tool that could effectively compare mediums of mental healthcare across factors shown to contribute to successful therapy including therapeutic alliance, engagement, and rapport. 

The survey was developed, and tested with over 80 young adult clients at The Dorm over the course of 16 months with the oversight of an Institutional Review Board (IRB) to ensure a standard of rigorous research design. The results were striking:

In Person Treatment Outperforms Virtual Care Across All Criteria:

in-person young adult iop treatment

Clients experienced the following as part of in-person care:

  • 75% better ability to connect with their therapist in-person. 

Why this matters: Research shows that therapeutic rapport is a key factor related to client improvements and satisfaction in treatment. 

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  • 68% ability to maintain relations with other clients in-person.

Why this matters: Social connectedness is shown in research to be a key protective factor in mental health outcomes and the development of a healthy sense of self.

  • 56% in therapist’s approachability in-person. 

Why this matters: This is an important factor to evaluate, given the switch to virtual care may pose a challenge to the organic connection between patient and provider.

  • 60% more comfortable sharing feelings in-person. 

Why this matters: Comfort is an essential factor for engagement in the therapeutic process. 

  • 26% ability to make clinical change when in-person for sessions

Why this matters: Assessing client perception of treatment, rather than solely relying on clinical assessment, is a key tenet of quality assessment.

We spoke with The Dorm’s Partner and Chief Clinical Officer, Amanda Fialk, Phd, LCSW, to gain a better understanding of why these results are important in clinical practice.

While virtual care undeniably holds a lasting role in mental health treatment—it is of paramount importance to discern the circumstances under which virtual care aligns with the best interests of the young people we serve and when it does not. In particular, we must recognize that some mental health conditions are aggravated by isolation and avoidance, which is more pronounced in clinically-complex cases. In these instances, therapeutic encounters that inadvertently reinforce these treatment-interfering behaviors stand in the way of client-centered care.

Why Validate a Survey?

A crucial step in survey development is validation, to ensure trust in the results that it yields. We sought to develop, and further validate, the factors in our own measurement device at The Dorm to ensure accuracy in interpreting our results. 

How It Came To Be: 

An exploratory factor analysis was conducted to ensure validity of The Dorm’s measure of virtual and face-to-face therapy. Results indicated that our survey is measuring 3 groups of factors:

  1. Therapeutic Impact of Face-to-Face Care
  2. General Factors in Virtual Care (i.e., technology)
  3. Therapeutic Impact of Virtual Care

A research poster of the validated survey was presented at the American Psychological Association (APA) Convention in Washington, D.C. in August of 2023, available for download here:

Access to the Poster

Looking Ahead 

As we strive to advance mental health care for young adults nationwide, it is our responsibility as providers to unwaveringly uphold the principles of accountability. 

This commitment guarantees the delivery of the highest quality care, adapting to meet the ever-changing needs of those we serve. Our aspiration is that our research will not only benefit our industry but also empower others to leverage these insights for the betterment of mental health care.

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