Telepsychiatry in the Emergency Department

Telepsychiatry is used in some emergency departments to make the process of evaluating and treating patients with mental health issues more efficient. This paper examines seven ED telepsychiatry programs in terms of structure, financing, and challenges. It also looks at the potential value that telepsychiatry could bring to the efficient operation of the ED and improved patient care. The issues discussed include: Technology and infrastructure, Financial support, Federal and California regulatory issues, Licensing requirements, Accreditation standards, Reimbursement related to Medicare, Medicaid, and private payers. 

Telepsychiatry Via videoconferencing

Article provides a baseline of information, definitions, and terminology relevant to telepsychiatry.  It posits that physicians are satisfied with using teleconferencing because it brings brevity and more focus to the consultation process. Patients appear to feel more on an equal footing with the psychiatrist (it mitigates the dynamics of power distance).    

Telepsychiatry for Child and Adolescent Outpatient Services

Article outlines the process of telepsychiatry.  This article details the usefulness of telepsychiatry in providing access to children in underserved areas in the country. Through the application of telepsychiatric services in Menninger Clinic (rural South Central Kansas), this article supports that children, parents, and school personnel found their telepsych sessions satisfying. Telepsych has reduced problems and enabled academic success for children with challenging emotional, behavioral, and learning problems throughout the  five counties that the clinic serves.  

Telemedicine and Geriatric Psychiatry

Article provides telemedicine terminology and the foundation for the application of telepsychiatry in the treatment of geriatric patients. Validates the contention that telepsychiatry is a cost effective means of serving the geriatric population. 

Telemedicine Services to a County Jail

Study of the creation of a telepsychiatry clinic to service inmates of the Lyon County jail in Kansas. Establishing the clinic provided cost savings by reducing inmate transportation costs, and eliminating the costs associated with keeping inmates on suicide (staffing costs and transportation cost of visiting psychiatrist) watch while they await psychiatric care and evaluation. Study validated that telepsychiatry is a positive solution to providing psychiatric care to the rural inmate population. 

Diagnostic Reliability of Telepsychiatry in American Indian Veterans

Study compared the administration and reliability of SCID as a means of psychiatric assessment via videoconferencing and face to face interviews to 53 American Indian veterans.  The veterans most commonly displayed panic disorder, major depressive disorder, or ptsd. Participants underwent both methods of assessment, with the order of administration of the testing being the variable (i.e. f-t-f then videoconferencing or videoconferencing then f-t-f). There was no significant difference in SCID administration and prevalence between the two methods (exception was past-year substance dependence and abuse/dependence combined).  The therapists reported that using videoconferencing enhanced symptom reporting with the PTSD patients. 

Face-to-Face Versus Remote Administration of the Montgomery-Asberg Depression Rating Scale Using Videoconferencing and Telephone

35 patients were administered the MADRS in 2 waves of interviews, one f-t-f, the other f-t-f, or videoconferencing. The mean MADRS scores results for the test administered by videoconferencing showed no significant statistical difference form the scores garnered by f-t-f technique.  Patients were also satisfied with the results of the videoconferencing at a rate of 68%, or better.  This study validates that there is comparability and reliability amongst the results of testing that is administered either f-t-f or through videoconferencing. 

Telecourt: The Use of Videoconferencing for Involuntary Commitment Hearings in Academic Health Centers

Univ. Michigan Health System and Washtenaw Probate court partnered to implement telecourt/(telepsychiatry) to handle the involuntary commitment process for volatile patients. Article emphasizes the cost savings associated with telepsych. Also, highlights the increased safety issues for the patients, staff, and court patrons.  Further, discusses that hospital liability decreased because telepsych was implemented. 

Satisfaction of Forensic Psychiatric Patients with Remote Telepsychiatric Evaluation

43 inmates were evaluated over a 10 week period either by f-t-f, or teleconference by 1 psychiatrist to rate their satisfaction with their evaluations. There was no significant difference between the 2 groups of inmates in their satisfaction with their evaluations.  Substantiates telepsych as an effective diagnostic tool especially for the underserved inmate population.

Use of Video Conferencing for Psychiatric and Forensic Evaluations

Brief Psychiatric Rating Scale & MacArthur Competence Assessment Tool (Criminal Adjudication) was administered to 72 forensic inpatients by 3 conditions to test the reliability of the results garnered from telepsych assessment. Conditions were in-person interview with remote (videoconference) observation, remote interview with in-person observation, and in-person interview and observation. The reliability was rated good to excellent and that the results are similar to those obtained by in-person interviews.  

Telemedicine in Emergency Psychiatry

Article provides background information on telemedicine and telepsychiatry. This article also describes the applications of emergency telepsychiatry and suggests means of limiting the liabilities associated with the practice.  

Reliability and Acceptability of Psychiatric Diagnosis Via Telecommunication and Audiovisual Technology

30 patients were tested for major depression, bipolar disorder, panic disorder, and alcohol dependence using the DSM-III-R. 15 patients had 2 f-t-f interviews, 15 had 1 f-t-f and 1 remote interview. The same diagnosis was obtained utilizing both methods. Also, patients were satisfied with telepsych services.   

Feasibility, Acceptability, and Sustainability of Telepsychiatry for Children and Adolescents

387 telepsychiatric assessment and consultation sessions conducted over a 1 yr. period for approximately 172 patients in 20 satellite locations (serving rural communities) affiliated with the Children's hospital in Seattle, Washington. Pediatricians were highly satisfied with the telepsychiatry care received by their patients. The high rate of patients that were referred and kept 1st and follow-up appointments demonstrated the feasibility of telepsych. Additionally, a high rate of pediatricians and PCPs gave high satisfactions ratings for telepsych and exemplified acceptance of this psychiatric method for the purposes of this study.

Recent Advances in Telepsychiatry: An Updated Review

This article gives a summation on a collective of articles that explore certain variables associated with telepsychiatry. Reports that patients & clinicians are highly satisfied with remote treatment and care. Highest satisfaction was observed in jail population, rural settings, geriatric patients, child/adolescent patients, non-psychotic patients, and limited access patients. Costs for telepsychiatric services are either less expensive than f-t-f, or at the break-even point. Only 3 states have statutes that directly address telehealth via telepsychiatry/ counseling, but overall, more research is needed concerning legality and telepsychiatry.

An Economic Evaluation of Telehealth Data Collection With Rural Populations

Telepsych interviews were conducted on 53, non VA, American Indian veterans comparing f-t-f and videoconferencing methods in 2003 and 2005. When clinics needed to be established, telepsych costs $6000 more than f-t-f interviews in 2003, but improved transmissions (tech) led to an $8000 cost saving in 2005. In established clinics, in 2003 telepsych cost $1700 more than f-t-f, but by 2005 when tech improved there was a $12000 savings in comparison to the f-t-f model. Therefore, as transmissions (tech) has improved, there has proven to be a substantial cost savings and benefit to using telepsychiatry for remote, underserved populations.   

Is Telepsychiatry Equivalent to Face-to-Face Psychiatry? Results from a Randomized Controlled Equivalence Trial

495 patients in Ontario were referred to psychiatric consultation  and short-term follow-up visits that would either be conducted using f-t-f or telepsychiatry. Results from telepsych were equivalent to those obtain via f-t-f. Patients in both groups expressed similar levels of treatment satisfaction. Additionally, telepsych was found to be 10% less expensive than f-t-f care.  

VA Telemental Health: Suicide Assessment

This article provides background on the role of telemedicine in suicide assessment process in the VA health System. It also posits 4 best practices to manage the legal issues surrounding tele suicide assessment, which are: licensing, procedures for involuntary detainment, and liability. The best practices suggested are: practicing and understanding the local legal procedures, exercise sound clinical judgment in patient/ population selection, use accepted suicide assessment parameters, and contingency planning.  

Teleconferencing Model for Forensic Consultation, Court Testimony, and Continuing Education

Uses for teleconferencing are discussed: education, testimony, consultation, diagnosis, and treatment. This article speaks primarily to the use of teleconferencing in education and supervision. It also discusses the means of creating valuable forensic testimony through teleconference. Also posits that teleconferencing is a cost-effective and consumer satisfying means of administering telepsychiatric services. 

A Review of the Costs of Telepsychiatry

This article reviews other literature that discusses whether telepsych services are a worthy financial investment. There was an examination of 12 studies that evaluated the cost-effectiveness and performed a cost-benefit analysis in comparison to f-t-f therapy. The result was that 7 studies concluded that telepsychiatry was cost-effective. This article also posits that a well executed business plan aids in the cost-effectiveness of telepsych services.

Cultural Aspects of Telepsychiatry

This article explores how the patients cultural background and the cultural distinctions of the service provider are relevant to the administration of telepsychiatry. This article suggest ways to circumvent these barriers.  It suggest that special attention be given to understanding the nuances of the culture that you are serving. It also suggests that therapists exert more effort into establishing trust and rapport building. Use of a clinical facilitator and gaining a sense of the local community will also eliminate these barriers.

Telepsychiatry in Psychogeriatic Service: A Pilot Study

During this study performed in China,149 assessments were provided to 45 rest home patients over an 11 month time span to compare the feasibility and cost-effectiveness of telepsychiatry in geriatric services. Videoconferencing was declared an acceptable and cost-effective means of delivering psychiatric consultation and assessment for the patients.  It provided faster response times to patient needs. An additional discovery was made in that, special consideration is for needed patients with dementia (or limited cognitive functioning) when using videoconferencing.  

Telemedicine as a means of delivering cognitive-behavioral therapy to rural and remote mental health clinics

15 mental health patients displaying depressive and anxiety disorders in rural Queensland, Australia were administered CBT (cognitive behavioral therapy) via teleconferencing to test the acceptability and feasibility of this delivery method. Patients and therapists found this to be an acceptable method of delivering care. Additionally, there was significant improvement among the patients after 6-8 weekly sessions on the MHI (Mental Health Inventory) scale. This validated that videoconferencing is a feasible means of delivering the CBT method of care.

Telepsychiatry improves pediatric behavioral health in rural communities

This article supports the contention that telepsychiatry affords rural residents with the access to treatments available to the urban centers. This article also discusses that health care providers must be sensitive to the reimbursement policies of the healthcare system in making telepsychiatric services an available and affordable option in rural communities. 

International telepsychiatry: a study of patient acceptability

30 patients in Denmark were asked to rate their experience with telepsychiatry sessions over an 18 month period administered by therapists that spoke their native language. The patients preferred telepsychiatry with a therapist speaking their native language to interpreter assisted f-t-f therapy. The greatest advantage of telepsychiatry for the patients was its ability to offer greater clarity and freer expression during the therapeutic process.  

Practice Parameters for Telepsychiatry with Children and Adolescents

Discusses the use of telepsychiatry to provide services to children and adolescents. The parameter defines terms and reviews the status of telepsychiatry as a mode of health service delivery. The principles presented are based on existing scientific evidence and clinical consensus. Telepsychiatry is still evolving, and this parameter represents a first approach to determining "best practices.”

Procedural Issues & Telepsychiatry Research and Program Development 

Psychiatric interviews conducted by telepsychiatry appear to be generally reliable, and patients and clinicians generally report high levels of satisfaction with telepsychiatry. A significant limitation of the literature is the lack of empirical research on telepsychiatry, especially cost analyses and clinical outcome studies. The authors outline a research agenda addressing the procedural and methodological issues that should shape future research: study design, outcome measurement, consideration of patient characteristics, and program design.

Using Telemedicine to Improve Health Care in Distant Areas

The authors outline some pioneering telemedicine programs of the 1960s and 1970s and describe two recently activated systems in Texas.

Benefits of a Telepsychiatry Consultation Service for Rural Nursing Home Residents

Analyzed data for 278 telepsychiatry encounters for 106 nursing home residents to estimate potential cost and time savings associated with this modality compared to in-person care. The telepsychiatry approach was enthusiastically accepted by virtually all residents, family members, and nursing home personnel, and led to successful patient management. Providing psychiatric care to rural nursing home residents by videoconference is cost effective and appears to be a medically acceptable alternative to face-to-face care.

Pilot Studies of Telemedicine for Patients With Obsessive-Compulsive Disorder

The authors assessed the reliability of rating scales administered in person and over video to patients with obsessive-compulsive disorder. Reliability was excellent in both conditions, and there was no degradation in reliability when the assessment t was conducted over video. Conclusions- Telemedicine resulted in near-perfect interrater agreement on rating scale scores. Its use for other disorders and for more in-depth assessments should be explored.

Applicability of Telemedicine for Assessing Patients With Schizophrenia: Acceptance and Reliability

This study was conducted to assess the reliability and acceptance of videoconferencing equipment in the assessment of patients with schizophrenia.

Rural Jail Telepsychiatry: A Pilot Feasibility Study

This feasibility study describes a project that provided telepsychiatric consultation to increase access to psychiatric treatment in an underserved rural jail in upstate New York. The project provided interactive two-way audio– video communication between the psychiatrist located in an urban university medical center and subjects who were incarcerated 182 miles away. During the project period, 15 inmates were assessed and treated in 37 consultations.Telepsychiatric examination and treatment appears to be a feasible method to increase access to mental health care in rural jails.

Clinical Use of Telemed in child psychiatry

The authors provide a definition of telepsychiatry, a review of the limited published child research in the area, and a child telepsychiatry clinic model. The value of child telepsychiatry is emphasized, as well as the need for standardized practice and research.

Cost Effectiveness, Safety, and Satisfaction with Video Telepsychiatry versus Face-to-Face Care in Ambulatory Settings

Videoconference telepsychiatry provides an alternative for the psychiatric treatment of mental health patients who reside in remote communities. The objective of this study was to compare institutional ambulatory and hospitalization costs, treatment adherence, patient and physician satisfaction, and treatment safety between mental healthcare via videoconferencing and care provided in person. During the year of telepsychiatry treatment, patients and physicians were satisfied and treatment was safe. However, 1 hour of telepsychiatry treatment was more expensive than face-to-face care, and a tendency of increased hospitalizations was noted.

Emergency Telepsychiatry

Telepsychiatry can be used in two kinds of psychiatric emergencies: one-time clinical events and public health situations associated with mass disaster. Emergency telepsychiatry delivered by videoconferencing has the potential to improve patient care in many settings. Although experience is limited, it has been found to be safe and effective, as well as satisfactory to both emergency department staff and the psychiatric patients treated. The development of comprehensive and standardized guidelines is necessary. There has been little use of acute telemedicine in disaster situations to date. However, telemedicine is becoming part of routine emergency medical response planning in many jurisdictions. Emergency telepsychiatry has the potential to reduce emergency department overcrowding, provide much needed care in rural areas and improve access to psychiatric care in the event of a natural or manmade disaster.

Empirical Evidence on the Use and Effectiveness of Telepsychiatry via Videoconferencing: Implications for Forensic and Correctional Psychiatry

This article reviews empirical evidence on the use and effectiveness of videoconferencing in providing diagnostic and treatment services in mental health settings that serve child, adolescent, and adult populations. Descriptive reports, case studies, research articles, and randomized controlled trials related to clinical outcomes were identified and reviewed independently by two authors. Articles related to cost-effectiveness, technological issues, or legal or ethical aspects of telepsychiatry were excluded. The review of the evidence broadly covers mental health service provision in all settings, including forensic settings. Given the sparse literature on telepsychiatry in forensic settings, we discuss implications for mental health care across settings and populations and comment on future directions and potential uses in forensic or correctional psychiatry.

Experience With a Rural Telepsychiatry Clinic for Children and Adolescents Access to child and adolescent psychiatric services in many rural areas is limited by lack of physicians and long travel times. A child and adolescent telepsychiatry clinic that is part of the University of Kansas Medical Center’s telemedicine program addresses this problem by linking the medical center with a county mental health center in rural Pittsburg, Kansas. The clinic receives ten to 18 visits a week and has been able to serve severely disturbed children and children in crisis. The quality of clinical interactions in the telepsychiatry clinic appears comparable to that in face-to-face meetings.

Randomized Clinical Trial of Telepsychiatry through Videoconference versus Face-to-Face Conventional Psychiatric Treatment

This paper evaluates the efficacy of telepsychiatry through videoconference in the treatment of mental disorders by comparing to face-to-face conventional (F2FC) treatment. No statistically significant differences were observed when the efficacy of VCTP treatment was compared to F2FC psychiatric treatment efficacy. This study demonstrated that telepsychiatry treatment through videoconference has equivalent efficacy to F2FC psychiatric treatment. Telepsychiatry showed to be an effective mean of delivering mental health services to psychiatric outpatients living in remote areas with limited resources. 

Satisfaction of Forensic Psychiatric Patients With Remote Telepsychiatric Evaluation

 The level of satisfaction with telepsychiatry evaluations was determined in a sample of 43 forensic psychiatric patient inmates in a large urban jail. A forensic psychiatrist interviewed 20 patients in person, the other 23 remotely via interactive video. Demographic characteristics, physical health status, and psychiatric symptom severity on the Global Severity Index of the Brief Symptom Inventory were comparable in the two groups. Patient satisfaction with the evaluations was moderately high for patients in both groups, with no significant differences between them.

Telemedicine can Reduce Correctional Health Care Cost

76 page report on how the use of telemedicine can reduce correctional health care costs

 Telemedicine to Iowa’s Correctional Facilities: Initial Clinical Experience and Assessment of Program Costs

Evaluated the costs and benefits of a prison telemedicine program for the institutions involved and to assess early provider satisfaction. Conclusions. No one should anticipate instantaneous cost-effectiveness with telemedicine. However, with careful planning, implementing a telemedicine program can be "cost-acceptable" initially. Telemedicine ultimately becomes cost-effective as the volume of teleconsults increases. 

Telepsychiatry: Critical Dimensions for Forensic Services

The use of telepsychiatry technology and services has gained attention among legal and clinical practitioners. In the current article, telepsychiatry is defined, and an innovative model of telepsychiatry care delivery that is in use in a child and adolescent forensic evaluation clinic is examined. Critical factors specific to forensics services are examined, as are those specific to telepsychiatry, including transmission mode, privacy and confidentiality, expense, quality of care, face-to-face versus video transmission, user satisfaction, and liability concerns in the use of telepsychiatry.

Telepsychiatry Improves Pediatric Behavioral Health care in Rural Communities

In the US, children with special health care needs are underserved by both the medical and educational systems. This problem is especially serious in rural states. Telemedicine is a technique that can reduce these gaps in service and help connect the two systems. The technology required has become cheaper and more accessible. Progress on reimbursement for such services has also been made. For some years, we have provided telepsychiatry for children in Washington State using videoconferencing. Interviews with families and service providers were conducted in Washington and Missouri. Some parents reported that their child actually preferred telepsychiatry to conventional consultation. The telepsychiatry service model was built on the existing system of outreach clinics, thus involving specialists who were familiar with the community and who were known and trusted by the community. Before starting, we ensured that all relevant service delivery agencies and providers were comfortable about using videoconferencing as a method of service delivery. In the 18-month period ending in March 2003, three providers in Seattle saw 159 patients by telepsychiatry and 210 patients face-to-face at the hospital clinic. The main barrier to further growth of the telepsychiatry service is the absence of reimbursement for telepsychiatry. 

The Effectiveness of Telepsychiatry: A Review

Effectiveness must be determined for each new technology because it may have advantages and disadvantages over what is currently offered. We reviewed the literature to synthesize information on whether telepsychiatry is effective. Based on the literature, we suggest that the effectiveness of telepsychiatry be evaluated on access to care, quality of care (that is, outcomes, reliability, satisfaction and comparison with in-person care), costs and empowerment. Further, we discuss other factors that influence effectiveness (for example, technology, administrative coordination and financial support). Telepsychiatry appears effective, and recommendations are offered for further evaluation of its effectiveness.

The success of emergency telemedicine at the State University of New York at Buffalo.

Treating Childhood Depression over Videoconferencing

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 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.

Therapist Adherence and Competence With Manualized Cognitive-Behavioral Therapy for PTSD Delivered via Videoconferencing Technology

Using secondary analyses from a randomized trial comparing the effectiveness of manualized cognitive-behavioral therapy for posttraumatic stress disorder, we compared ratings of therapist competency and adherence between two service delivery modes: telepsychiatry (TP) and same room (SR). Patients were 38 male treatment-seeking veterans recruited from a veterans affairs medical center. Domains of therapist competence and adherence included structuring sessions, implementing session activities, providing feedback, dealing with difficulties, developing rapport, and conveying empathy. Only one difference emerged between the two treatment conditions, with more favorable ratings on this item in the TP condition. Findings suggest that therapist competence and adherence to cognitive-behavioral therapy is similar whether the treatment is delivered via TP or by traditional means, and TP does not compromise therapists’ ability to effectively structure sessions or build rapport with patients. These data further support the use of TP to address shortages in access to mental health care.

Treatment Outcomes in Depression: Comparison of Remote Treatment Through Telepsychiatry to In-Person Treatment

Remote treatment of depression by means of telepsychiatry and in-person treatment of depression have comparable outcomes and equivalent levels of patient adherence, patient satisfaction, and health care cost.

To investigate whether forensic evaluations can be performed reliably using telemedicine, we compared the results on a standard competency assessment instrument using telemedicine (TM) and live interviews (LI). Two boardcertified forensic psychiatrists used the Georgia Court Competency Test (GCCT) to evaluate 21 forensic psychiatric inpatients. Half of the patients were randomly assigned to a telemedicine interview and half were assigned to a live interview. Total scores on the GCCT were similar for both raters, indicating high levels of agreement between telemedicine and live interviews. Patient and provider satisfaction were measured and indicated that, although patients did not express a preference for a particular interview modality, providers reported greater satisfaction with live interviews. Findings suggest that one aspect of competency to stand trial can be reliably evaluated using telemedicine and that patients perceive telemedicine as an acceptable alternative to a standard live interview. The limited sample size precludes definite conclusions and further studies involving a larger forensic study population are warranted.

The Child and Adolescent Telepsychiatry 

The literature on the efficacy of telepsychiatry for assessing and treating children and adolescents with mental health problems is still developing, but there is evidence that telepsychiatry is diagnostically valid, and that there is high patient and provider satisfaction. Outcome studies are awaited, with the assumption that telepsychiatry has to demonstrate at least as good outcomes and reliability as face-to-face psychiatric care. In this article we suggest, by reviewing the process of telepsychiatry with children, and illustrating relevant issues with five case studies of patients we have seen, that there is a valid case for arguing that in certain children and adolescents, telepsychiatry, as a consultation process, might actually be a superior method of psychiatric assessment to face-to-face consultation. Four factors stand out supporting this view. These are the novelty of the consultation, the capacity to provide direction, the extra distance involved (both psychological and physical), and the authenticity of the interaction. More research in child and adolescent telepsychiatry is indicated.

 Telepsychiatry is successfully used for various clinical services and educational initiatives. Telepsychiatry is feasible, increases access to care, enables specialty consultation, yields positive outcomes, allows reliable evaluation, has few negative aspects in terms of communication, generally satisfies patients and providers, facilitates education, and empowers parties using it. Data are limited with regard to clinical outcomes and cost effectiveness. 

 States expand videoconferencing in prisons

Faced with the high costs of transporting and escorting sick inmates to the doctor, states are expanding their use of videoconferencing to provide health consultations to prisoners without resorting to costly — and sometimes dangerous — off-site trips.

Telepsychiatry in Emergency Consultations  A Follow-Up Study of Sixty Patients

The objective was to investigate how telepsychiatry works in the assessment of psychiatric emergency patients. Sixty consecutive patients referred to the acute open ward having their first psychiatric contact through the video link with the psychiatrist on duty. Only minor technical problems occurred. The results suggest both acceptance and satisfaction on the part of patients and staff with new technology, instead of waiting for a consultation or traveling to see a psychiatrist in face-to-face meeting. Telepsychiatry seems to be suitable for the assessment of psychiatric emergency patients, and satisfactory for patients and staff alike.

post-traumatic stress disorder

We compared the efficacy of telepsychiatry and same-room treatment of combat-related post-traumatic stress disorder (PTSD) using cognitive behavioural therapy in 14 weekly, 90-min treatment sessions. Of 97 patients referred for study participation, 38 were randomized (17 into telepsychiatry, 21 into same-room), and approximately 25 (the number differed by instrument) had at least one post-baseline assessment. Measures of clinical and process outcomes were examined. No group differences were found on clinical outcomes at threemonth follow-up. Satisfaction with treatment ratings was similar in both groups, with ‘strong satisfaction’ indicated by veterans in both modalities. Attendance and drop-out were similar in the two groups. The same room group reported more comfort in talking with their therapist at post-treatment and had better treatment adherence. The results provide preliminary support for the use of telepsychiatry in the treatment of PTSD to improve access to care.

Quantitative Documentation of the Therapeutic Efficacy of Adolescent Telepsychiatry