In response to the coronavirus disease 2019 (COVID-19) pandemic, federal, state, and local governments in the United States implemented restrictions on in-person gatherings and provided recommendations for minimum distance between individuals to minimize the spread of severe acute respiratory syndrome coronavirus 2. These restrictions necessitated an unprecedented scaling up of telehealth services across the health care system, including in mental health and substance use disorder care. The learning curve for clinicians-many of whom had no prior experience with telehealth -has been steep. The rapid shift to remote services required adjusting to technical and clinical challenges as services were being provided. The lessons learned during this time have potential to continue to inform telehealth services, even after the acute need for social distancing has abated. In this article, we aim to share some of our lessons learned during this period from providing group-based cognitive-behavioral therapy. We discuss both technical and clinical challenges in conducting remote cognitive-behavioral groups via videoconferencing software, as well as successes and failures in adjusting to these challenges. Clinical Impact StatementThis article provides tangible technical and clinical recommendations for providing group-based cognitive behavioral therapy (CBT) using videoconferencing during the coronavirus disease 2019 (COVID-19) pandemic. Many experiential and didactic exercises can translate well, with modifications, to an online CBT group.

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