Digital behavioral health platform Two Chairs is looking to address access challenges and scalability with new group therapy and care navigation offerings.

Many providers and payers are turning to group therapy as a way to help more patients access care amid a behavioral health clinician shortage. Still, the main focus of many providers is on the individual therapy space.

In fact, group therapy makes up at most 5% of treatment at private practices, according to the American Psychological Association. But it is as effective for several symptoms and conditions.

“We know from the research that group therapy is effective. It’s as effective as individual therapy for a wide range of conditions, but it’s really underused by the behavioral health industry,” Alex Katz, CEO and founder of Two Chairs, told Behavioral Health Business. “And so we see a real opportunity to take this service that scales beautifully and can serve many, many clients in a real-time that need and bring the Two Chairs lens to groups, in other words, an emphasis on matching and measurement-based care and exceptional client experiences.”

Founded in 2017, Two Chairs has raised $28 million throughout three funding rounds. The startup is first launching this service in Washington state. Its team of 450 licensed clinicians provides virtual behavioral health services.

Katz said most patients will access the care through one of Two Chairs payer or employer partners, including Kaiser Permanente of Northern California, Kaiser of Washington and Aetna.

Patients opting for group therapy will have a 45-minute matching consultation and data collection session. Two Chairs then runs an algorithm considering several variables and matches it against clinical judgment and expertise.

Some of the conditions that Two Chairs can care for in a group setting are depression, anxiety and adjustment disorder. Practitioners use evidence-based approaches, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT).

“I definitely think it hits the access question very straight on. There are specific things that individuals learn from being in a community, for example, normalizing behaviors and learning from other people’s experience,” Colleen Marshall, VP of clinical care at Two Chairs, told BHB. “They’re not alone and learning some of the basic skills together in a larger group is more cost-effective, but it’s also more effective at times for different clinical presentations and different clinical things we’re dealing with.”

Two Chairs prioritizes including measurement-based care into its practice, including in group, Marshall said. The three main measures that the provider focuses on are the client-patient relationship, clinical measures, such as the PHQ-9 and the GAD-7, and group cohesion.

“In individual therapy, we’ve spent the last five years building a care platform and training protocols to make sure measurement-based care is being practiced in the right way in the room with the client,” Katz said. “And we’ve taken that core competence, competency and brought it to group therapy, which happens even more rarely in groups.”

Two Chairs isn’t the only digital behavioral health company eyeing the group therapy space. Last year, Teladoc (NYSE: TDOC) announced that it is looking at group therapy sessions as a way to yield improvements in margin for its direct-to-consumer virtual behavioral health business BetterHelp.

Care navigation 

In addition to group therapy, Two Chairs is also launching a care navigation service, which includes a curated referral network of health care providers and systems. The provider’s care navigation services are designed to help patients find in-network health care providers.

“Historically, the outpatient mental health industry has often been kind of a black hole and pretty disconnected from the rest of healthcare,” Katz said. And we’ve now built an offering with amazing care navigators that can partner with our clients to help connect them with the care they need, be it primary care, specialty, behavioral health, or other medical specialties.”

Two Chairs providers ask about their medical history and access to physical health care services. If a patient doesn’t have a primary care provider, the new care navigation team can help them find a provider in their area that can care for their medical needs.