WRCAC Telemental Health Resource Center

What is the Telemental Health Resource Center?

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WRCAC’s Telemental Health Resource Center (TMHRC) was launched in 2019 to provide Children’s Advocacy Centers (CACs) with research and resources to support the implementation of telemental health (TMH) services. Since then, we have seen many CACs initiate TMH services, especially during the COVID-19 pandemic when information related to the implementation of TMH expanded exponentially. WRCAC has responded to these changes by relaunching the TMHRC with an updated structure as well as more curated resources and research relevant to CACs.

Our goal is to provide a site where State Chapters, CAC directors, clinicians, and victim advocates can find resources, helpful websites, and a highlight of relevant research to support the implementation and maintenance of TMH services at CACs.

Why Should CACs Utilize Telemental Health Services?

There are many advantages to building capacity to deliver trauma-focused telemental health services to CAC clients.

	First, telemental health extends the reach of the CAC program. Families may be challenged to access in-office therapy due to the distances they need to travel. In rural and frontier communities, families may live an hour or more from the center, and in more populated areas, limited transportation options make it hard for families to come to a CAC office regularly. In addition, work and school schedules, childcare issues and weather can all prevent consistent, in-person participation. Telemental health overcomes these barriers and allows CACs to reach these families. For CACs that have the capacity for onsite services, a hybrid option of in-person and TMH sessions allows for access to services when weather, transportation, or other issues get in the way. The ability to pivot to a TMH session if there is a barrier to getting to the center on the day of an appointment means maintaining continuity of care. Hybrid options give flexibility to both CAC staff and clients.
	Second, telemental health is a viable and effective means for delivering evidenced-based and trauma-informed therapies to children, adolescents, and adults. TMH has moved beyond a response to when clinicians cannot provide in-person services. Research supports that TMH is not “less than” when it comes to delivering clinical services. This is not only great news for rural and frontier CACs where TMH may be the only option they can offer clients, but for all CACs who want to offer more options for their clients.
	Third, telemental health allows CACs to increase the number of clients they serve. As the use and acceptance of telemental health grows, it opens the possibility for CACs to launch a mental health program where they previously could not because of a dearth of local clinicians. Some rural CACs who have, at the most, one part-time or full-time therapist on-site can utilize trauma therapists who work remotely to provide TMH services. In this way, TMH expands the ability for CACs to serve clients who may have otherwise spent months on a waiting list.

What the Research Says

Fortunately, there are many research studies that support the implementation and efficacy of TMH for children experiencing trauma.

The Child Abuse Library Online (CALiO™), a service of the National Children’s Advocacy Center, has a comprehensive and recently updated bibliography on telemental health: Telehealth and Telemental Health Services: A bibliography

If you are looking for some essential information to get started, we suggest reviewing the following articles. These articles are highlighted in Issue 20 of the WRCAC Roundup.

- The Fast and the Furious: The Rapid Implementation of Tele-mental Health Practices Within a Children’s Advocacy Center (Conradi, Hazen, & Covert, 2022)
- Provider perspectives on telemental health implementation: Lessons learned during the COVID-19 pandemic and paths forward (Lipschitz et al., 2022)
- Effectiveness of telemental health during the COVID-19 pandemic: A propensity score noninferiority analysis of outcomes. (Gurm et al., 2023)
- Patient perceptions of trauma-focused telemental health services using the Telehealth Satisfaction Questionnaire (TSQ) (Villalobos et al, 2021)
- Feasibility and effectiveness of a telehealth service delivery model for treating childhood posttraumatic stress: A community-based, open pilot trial of trauma-focused cognitive–behavioral therapy (Stewart et al., 2020)
- Virtual Family Play Therapy: A Clinician’s Guide to using Directed Family Play Therapy in Telemental Health (Smith, Norton, & Marroquin, 2023)
- Using EMDR therapy to treat clients remotely. (Fisher, 2021)

Featured Resources

Telemental Health Network Readiness and Planning Guide for Chapters

January 2024

There are many things to consider in deciding whether to proceed with planning a TMH network for CACs in your state. This guide starts with sharing the benefits of Chapters establishing statewide TMH networks and briefly reviews why Chapters may not want to proceed. The guide then includes a series of checklists and questions centered around areas that are important to consider at the beginning stages of establishing a statewide TMH network.

View the Guide

Telemental Health Network Implementation Resource Toolkit

January 2024

This toolkit provides an overview of helpful CAC-focused resources to assist Chapters and CACs in implementing TMH programs. The toolkit includes resources and sample documents related to program development, recruitment, assessment, safety planning, and virtual delivery of evidence based treatments. This document is informed by work done on WRCAC’s Telemental Health Resource Center as well as support from Chapters and states doing TMH work.

View the Toolkit

Recruiting, Hiring, Supervising, and Retaining Remote Therapists for Rural Children's Advocacy Centers

September 2022

This issue brief explores strategies to recruit and retain qualified mental health professionals who will work remotely to serve CAC clients via telemental health. Areas addressed include interviewing and selecting a candidate the CAC may never have met in person, remote onboarding, issues in supervision, and helping remote clinicians manage secondary traumatic stress.

View the Issue Brief

Task Sharing in a Children’s Advocacy Center: The Role of Victim Advocates in Meeting the Mental Health Needs of Children & Families

December 2021

This issue brief examines task sharing in the CAC context and promotes the active collaboration between the CAC victim advocate and the child’s therapist as a task sharing team, especially in rural areas where the therapist may provide services remotely through telemental health.

View the Issue Brief

Navigating the Site

Wondering where to start?

Depending on your role in the CAC field, different areas of the TMHRC may be more helpful to you. Click on your role below for guidance on where to find the most relevant information and resources.

Chapters

Where you start in the TMHRC depends on what stage your Chapter is in with supporting TMH services and/or developing TMH networks in your state. For Chapters new to the process, the CAC Staffing section is a good place to start as it addresses readiness considerations and statewide strategies to support CACs with developing TMH services. The Legal/Regulatory section is a good place to find information related to licensing as well as reimbursement through Medicaid and other funding sources. For a comprehensive overview of the things to consider before establishing a statewide TMH Network, please refer to WRCAC’s Telemental Health Network Readiness and Planning Guide for Chapters. If you are ready to move forward and are seeking resources related to implementation, refer to WRCAC’s Telemental Health Network Implementation Resource Toolkit.

Clinicians

The Clinical Services section is a great place to start for best practices on delivering TMH services to CAC clients, including TMH adaptations of EBTs, safety planning, ethical issues, and cultural considerations.

CAC Directors

The entire TMHRC is designed to support the development and implementation of TMH services at CACs. The CAC Staffing section is a great place to start to assess readiness and recruitment strategies. The Legal/Regulatory section is a good place to find information related to licensing as well as reimbursement through Medicaid and other funding sources. To support your clinicians in providing evidenced-based treatments (EBTs) via TMH, review the Clinical Services section. For sample TMH program documents, such as informed consent forms and TMH policies & procedures, see the Additional Resources section.

Advocates

Advocates are an important part of engaging clients and their caregivers in TMH services. To familiarize yourself with the efficacy of TMH services, review “Why Should CACs Utilize Telemental Health?” and “What the Research Says” at the top of the Home Page. Additionally, see the page on Task Sharing within the CAC Staffing Section, which provides guidance on active collaboration between the CAC victim advocate and the child’s therapist.

You can also search keywords using the search bar below. The search results will display the pages where that keyword is found.

Contributors

Amelia Siders, Ph.D., Western Regional Children’s Advocacy Center
Patty Terzian, Western Regional Children’s Advocacy Center
Charles Wilson, MSSW, Western Regional Children’s Advocacy Center
Lisa Conradi, Psy.D., Western Regional Children’s Advocacy Center
Vicky Gwiasda, Western Regional Children’s Advocacy Center
Madison Stark, MSW, Western Regional Children’s Advocacy Center
Lana Lo, Western Regional Children’s Advocacy Center

WRCAC would like to acknowledge the hard work and generosity of our telemental health pilot project partners including the Washington and Montana State Chapters and the project consultants for sharing their expertise and resources that helped to inform this site:

Brenda George, Children’s Alliance of Montana
Paula Reed, Children’s Advocacy Centers of Washington
Regan Stewart, Ph.D., Medical University of South Carolina
Paula Condol, MS, LPCC, Dakota Children’s Advocacy Center
Nicola Herting, Ph.D., Sanford Traumatic Stress Treatment Center