Guidelines for establishing a telemental health program to provide evidence-based therapy for trauma-exposed children and families.

Abstract

While similar rates of traumatic experiences exist in both rural and urban settings, mental health resources available to those living in rural areas are often scarce. Limited resources pose a problem for children and families living in rural areas, and several barriers to service access and utilization exist including reduced anonymity, few “after-hours” services, decreased availability of evidence-based treatments, few specialty clinics, and expenses associated with travel, taking time off work, and provision of childcare. As a solution, the authors discuss the utility, use, and set-up of a telemental health program through an existing community outreach program. Suggestions for establishing a telemental health clinic are presented along guidelines for the delivery of trauma-focused, cognitive-behavioral therapy (TF-CBT) via telemental health videoconferencing technology. Specific guidelines discussed include (1) establishing and utilizing community partnerships, (2) Memoranda of Understanding (MOU), (3) equipment setup and technological resources, (4) videoconferencing software, (5) physical setup, (6) clinic administration, (7) service reimbursement and start-up costs, (8) therapy delivery modifications, and (9) delivering culturally competent services to rural and remote areas.

Identifying and addressing barriers to treatment for child sexual abuse survivors and their non-offending caregivers

“…For example, Community Outreach Program-Esperanza (COPE) was created to "address cultural barriers by offering culturally-modified, evidence-based trauma treatments, led by bilingual/bicultural clinicians, for Hispanic children and families" (Jones et al, 2014, p. 399). COPE services are typically provided in the family's home, church, library, or the child's school to increase access to care (Jones et al, 2014). Telehealth programs can further reduce practical barriers to treatment (Jones et al, 2014;Stewart, Orengo-Aguayo, Cohen, Mannarino, & de Arellano, 2017).…”

“…COPE services are typically provided in the family's home, church, library, or the child's school to increase access to care (Jones et al, 2014). Telehealth programs can further reduce practical barriers to treatment (Jones et al, 2014;Stewart, Orengo-Aguayo, Cohen, Mannarino, & de Arellano, 2017).…”

“…Finally, while telehealth programs are promising and can reduce some of the practical barriers to treatment (Jones et al, 2014), further research on the utilization of telehealth for families impacted by CSA and finding solutions to the challenges of telehealth are needed (Stewart et al, 2017).…”

Collaborative Care at a Distance: Student Therapists' Experiences of Learning and Delivering Relationally Focused Telemental Health

“…For example, therapy provided face‐to‐face in the therapist's office may need to be modified when provided in a client's home, a medical exam room, or other locations. It would follow that modifications may be needed to accommodate the unique virtual environment of videoconferencing (Dunstan & Tooth, 2012; Jones et al, 2015; Levy & Strachan, 2013).…”

The Right to Mental Health in the Digital Era

“…The cultural background of patients, such as their psychosocial environment, and cultural explanations for the problem should be considered by mental health providers. 161 These elements might affect the acceptability of the service by patients. E-mental health has the potential to enhance coordination and participation in care between psychiatrists and GPs and between family members and patients.…”