What are some of the most effective digital tools currently available for supporting peer recovery, and how do they compare to traditional methods?

First, thank you for the opportunity to weigh in on this topic! As you’re aware, September is National Recovery Month, and this is a wonderful opportunity to consider how we can enhance the unique and powerful connections forged through shared lived and living experiences of mental health and substance use disorders. 

Digital support tools can be a powerful complement to traditional peer recovery methods and can provide enhanced accessibility, personalization, and continuous support, while traditional methods of peer recovery support focus primarily on human connection and face-to-face interactions that remain invaluable for many. In other words, they should augment, not replace, in-person services and pro-social activities.

The most effective approach often involves a combination of both digital and traditional methods tailored to the individual's needs. Over the past 4-5 years, digital tools for supporting peer recovery have become increasingly effective, offering several advantages and augmenting traditional peer recovery connections. These tools include mobile apps, telehealth, video capabilities, online support groups, wearable technology, text-based support, “gamification” and virtual reality. These digital support approaches include real-time and asynchronous support, community forums, mood tracking, and crisis management. Some provide GPS-based sober social networks and instant access to peer support. 

What are the main challenges or barriers to implementing digital support solutions in peer recovery programs, and how can they be overcome?

One of the primary challenges for digital support solutions is directly tied to access. Unlike traditional peer support groups, digital support tools, particularly mobile apps, provide 24/7 access and allow individuals to connect with others outside their immediate geographic area. They can also complement in-person meetings by providing ongoing support between sessions. However, for these services to be beneficial, it requires that the person you are trying to support have access to the necessary digital tools and be able to easily use them. 

Tracking recovery progress has also historically been challenging. Traditional methods for tracking recovery progress often rely on self-reporting, which can be less accurate than obtaining objective “passive” data. Wearable technologies, for instance, provide objective data that can help individuals monitor their physical and mental health more effectively. Engagement in recovery services, whether these services are provided in a professional treatment context or peer recovery support context has also been challenging. Traditional approaches can sometimes feel repetitive or lack meaningful engagement. Gamification and virtual reality experiences can make recovery more interactive and carry potential appeal to younger demographics. To overcome access challenges, we also need payment models that support the distribution of digital tools, internet connectivity, and community education.

How can companies offering digital support solutions ensure they are accessible and equitable for all individuals in recovery, including those with limited technology access or digital literacy?

Ensuring that digital support solutions are accessible and equitable for all individuals in recovery, including those with limited technology access or digital literacy, requires a multifaceted approach. For instance, providing digital literacy training, including in-app tutorials, can be helpful. This can include the inclusion of step-by-step tutorials within the app that guide users through the key features, helping them become more comfortable with the technology. Offering text message-based support services that do not require smartphones or internet access can also be helpful. SMS texting can be used for reminders, crisis support, and motivational messages. Providing support via voice-activated phone calls for those who may not be comfortable with or have access to text-based or online services. This can include both automated check-ins and human-operated helplines. Simplified app and website designs that are intuitive and easy to navigate and ensuring platforms support screen readers, voice commands, and other accessibility tools to accommodate users with disabilities can help. Providing content and support in multiple languages to cater to diverse populations can include offering translations for the app interface, support materials, and customer service. Along with this, developing culturally sensitive content that resonates with different communities, recognizing that recovery experiences and challenges may vary across cultures. With respect to technological access, companies can collaborate with nonprofits and other tech companies to provide smartphones, tablets, or computers to individuals in recovery who lack access to these devices. Under certain circumstances, offering a mix of digital and in-person services to ensure those who are less comfortable with technology can still receive the support they need. This can include in-person meetings, telephone support, and paper-based resources. Addressing barriers tied to affordability and mistrust with respect to data privacy and security is also important.

Looking ahead, what emerging trends or innovations in digital support do you anticipate will have the greatest impact on peer recovery strategies?

Looking into the future, digital support innovations in the peer recovery space will need to be conscientious of many of the key points previously mentioned, including how these digital support tools improve access to quality and evidence-based interventions that improve overall engagement in recovery. A digital support tool's ability to measure and track progress, along with improved interoperability with provider practice management systems, will also be paramount. Also, AI will continue to evolve along with digital support tools in this space, with the potential for enhancing these solutions in ways that weren’t possible even 3-4 years ago. AI can certainly enhance a digital support tool’s ability to interact with end users in ways that provide a predictive and tailored experience tied to individualized goals. That said, it will be very important to continue monitoring and researching how AI promotes information to the end user in ways that not only provide tailored content but assurance that this content is both accurate and appropriate to the end user's recovery journey. With all of this in mind, patient adoption and utilization of digital tools tend to be most successful when recommended directly by a provider or peer support specialist. Going forward, to complement the evolution of digital support tool innovation, consideration for how these tools will be incorporated into the cost of care will be very important. From that perspective, it will be very important for digital support tools to demonstrate their value, such as improving access and engagement. 

As it relates to expanding access to peer support, is there anything on the policy front you're taking note of?

Third Horizon Strategies (THS) has been working diligently to keep on top of policies surrounding how digital support tools maintain data security integrity and how they fit into the behavioral health service array, which includes peer recovery support interventions. For instance, in this reel, our CEO, David Smith, shared a few insights related specifically to new reimbursement codes for the FDA-cleared digital mental health tools in the CY2025 Physician Fee Schedule (PFS). Whether or not policies like this improve the adoption and utilization of digital support tools remains to be seen. Though not directly related to a specific policy, in the context of peer recovery support, there are circumstances in which these tools can be a powerful tool to enhance the peer recovery support service experience. That said, digital support tools will never replace the valuable human connections that are made through meaningful and deep relationships forged from shared experience.