Effective cognitive-behavioral treatments for childhood depression have developed over the last decade, but many families face barriers to such care. Telemedicine increases access to psychological interventions by linking the child and the clinician using videoconferencing (VC). The current study evaluated an 8-week, cognitive-behavioral therapy (CBT) intervention for childhood depression either face-to-face (F2F) or over VC. The telemedicine setup included two PC-based PictureTel systems at 128 kilibits per second (kbps). Success was defined by (1) decreasing depressive symptoms at similar rates in both the VC group and the F2F group and (2) demonstrating the feasibility of a randomized controlled trial in telemental health. Children were assessed for childhood depression using the mood section of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present Episode (K-SADS-P). Twenty-eight children were randomized to either F2F or VC treatment. The participants completed the K-SADS-P and the Children's Depression Inventory (CDI) at pre- and post-treatment. The CBT treatment across the two conditions was effective. The overall response rate based on post-evaluation with the K-SADS-P was 82%. For the CDI total score, both the Time and the Group by Time effects were significant (p < 0.05). The interaction effect reflected a faster rate of decline in the CDI total score for the VC group. The study serves as a model for building on past research to implement a randomized controlled trial. This information provides persuasive research data concerning treatment effectiveness for clinicians, families, and funders.

As telecommunication technologies have become more widely available and affordable, opportunities for psychologists to engage in telebehavioral health (TBH) have expanded greatly. A national sample of 164 professional psychologists completed a 28-item survey focusing on (a) current and anticipated use of telecommunication technologies in delivering TBH services, (b) types of telecommunication modalities currently used in clinical practice, (c) ethical and legal/regulatory concerns related to delivery of TBH services, and (d) educational and training needs for TBH practice. Associations between demographic factors (i.e., age, gender, practice setting, practice region, and years since completion of highest academic degree) and responses on survey items were examined. In descending order, the technologies most commonly used by psychologists were: landline telephone, mobile telephone, e-mail, and videoconferencing. A lower proportion of psychologists working in public settings used landline telephones, mobile telephones, or e-mail to deliver TBH than that of psychologists engaged in independent practice. In regard to respondents' age, the proportion of psychologists delivering TBH collapsed across technologies was substantially higher among respondents 37 years of age or older compared with that of 36-year-olds or younger. Respondents also noted several ethical/legal barriers in providing TBH services, particularly managing emergencies, licensure requirements, and uncertainties about security, as well as confidentiality, Health Insurance Portability and Account Act (HIPAA) compliance, and malpractice insurance coverage. Overall, a substantial discrepancy was noted between psychologists' positive appraisals of ROBERT L. GLUECKAUF received his MS and PhD in clinical psychology from Florida State University. He is Professor in the Department of Behavioral Sciences & Social Medicine at the Florida State University College of Medicine and research director of the Tallahassee Memorial HealthCare Memory Disorder Clinic. His research interests lie in the development and evaluation of telehealth-based interventions for individuals with chronic health conditions and their family care partners, outcomes measurement, and spirituality and health. MARLENE M. MAHEU received her MA and PhD in clinical psychology from the California School of Professional Psychology-San Diego. She is founder and executive director of the Telebehavioral Health Institute, Inc. Her areas of professional interest include telebehavioral health professional training and consultation on legal and ethical best practices for telehealth and various technologies. KENNETH P. DRUDE received his PhD in counseling psychology from the University of Illinois. He currently serves on the Ohio Board of Psychology and has an outpatient practice in the Dayton, Ohio area. His areas of professional interest include telebehavioral training, practice, policy, and standards.

Purpose/Objectives To report functional (physical & cognitive) late effects, experiences and information needs of adult survivors of childhood cancer. The increasing population of survivors makes understanding the effects of treatment and identifying needs vital to promoting health. Design Descriptive, mixed methods survey. Setting Two pediatric oncology programs in the Midwest. Sample Convenience sample of 271 young adult survivors. Methods Voluntary survey completion by young adult survivors regarding late effects, experiences and educational needs to develop appropriate comprehensive care programs for care provision before, during and after transition to adult care. Survey domains were identified from existing survivorship literature and focused on all aspects of survivorship; however, this paper focuses on results specific to the functional domain. Main Research Variables Functional late effects, experiences, information needs, age, gender and treatment intensity of young adult survivors of childhood cancer. Findings Response rate was 47.5%. Functional late effects, perceptions, and information needs all correlated with intensity of treatment (those survivors most heavily treated experiencing the most symptoms). Survivors wanted more information about late effects and how to deal with them. Females wanted more information about fertility-related topics and participants who received more intense treatment generally wanted more information. Brain tumor survivors perceived greater cognitive difficulties, cognitive late effects, fatigue, and financial difficulties. Conclusions Survivors experience myriad physical late effects and require ongoing access to information as needs change over time. Implications for Nursing Identifying new and innovative ways to reach survivors and better meet needs is important for care, research and program development.

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