Healing: Promising Mental Health + Medical Trends
Trauma Treatment via Tele-health: Reaching Underserved Children in South Carolina
RESEARCH INTO PRACTICE
The use of tele-health services—providing therapy over a computer—is changing the landscape of mental health and providing more opportunities to disseminate evidence-based treatments to underserved communities. CAC professionals in South Carolina or any state with a large number of rural counties know the many barriers faced by children and families trying to access mental health services. What’s more, families in urban areas also encounter many of the same barriers to treatment, like lack of transportation, work schedules, and the need for childcare. These barriers can make the idea of weekly therapy sessions seem impossible, even for families who live a 15-minute drive away from a clinic. Tele-health can help children receive quality, evidence-based trauma treatment, even if they experience barriers that would prevent them from coming in for traditional office-based care.
The Telehealth Outreach Program at the Medical University of South Carolina (MUSC) has been serving both rural and urban families with barriers to accessing care for the last two years. By collaborating with schools, we have been able to meet children where they already are and provide families an option to receive services in a location they trust as a part of their community. Now you might ask, can you really make meaningful change with trauma therapy provided over a computer? My answer is an overwhelming yes! Even better, the research we have done to evaluate our program has demonstrated that we can deliver trauma-focused treatment to children with fidelity and with the same level of improvement as that seen in traditional office-based services.
So, what does trauma therapy look like with tele-health? Our program in schools utilizes HIPAA-compliant videoconferencing software to connect clinicians with patients using laptop computers. We coordinate weekly child and family therapy sessions with the help of guidance counselors, nurses, and other school staff. The trauma treatment we use, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), is considered the gold standard for children and lasts approximately 12 to 24 sessions. We see children and adolescents who have been victims of crimes, like child abuse, robberies, and shootings, as well as those who have experienced traumatic loss and serious accidents.
One common misconception about using tele-health is that you can’t achieve the same level of connection with patients as you would in person. When doing trauma treatment via tele-health, programs must consider how to adjust therapy sessions so that they are still engaging even though providers are located miles away from patients. For us at MUSC, this means adapting what we would normally do in person with the help of screen sharing, online videos, and interactive handouts and games. Satisfaction surveys with children and caregivers participating in our trauma treatment demonstrate high levels of satisfaction with services and comfort using the tele-health equipment, the same level of connection with therapists as in-person appointments, and a preference for tele-health versus in-person treatment at MUSC.
There’s still more work to be done to expand the use of tele-health services, even more so for children in need of trauma treatment. For more information:
Stewart, R. W., Orengo-Aguayo, R. E., Cohen, J. A., Mannarino, A. P., & de Arellano, M. A. (2017). A Pilot Study of Trauma-Focused Cognitive–Behavioral Therapy Delivered via Telehealth Technology. Child Maltreatment, 22(4), 324-333.
Stewart, R. W., Orengo-Aguayo, R. E., Gilmore, A. K., & de Arellano, M. A. (2017). Addressing Barriers to Care Among Hispanic Youth: Telehealth Delivery of Trauma-Focused Cognitive Behavioral Therapy. The Behavior Therapist, 40(3), 112.
Bianca Villalobos, Ph.D., is a postdoctoral fellow in the Mental Health Disparities and Diversity Program at the Medical University of South Carolina. She has spent the last two years providing trauma-focused therapy to children and families through the Telehealth Outreach Program in Schools. Bianca’s research focuses on addressing mental health disparities for racial/ethnic minorities by increasing access to services.
For Children’s Advocacy Centers (CACs), family engagement refers to the process of family members accepting a referral for mental health treatment, then attending and participating in that treatment to successful completion. CAC staff know the importance of mental health treatment to help children and families who have experienced trauma heal from that trauma. We also …
The original mission of Children’s Advocacy Centers (CACs) was to improve a community’s response to the investigation of child abuse. The advances in our knowledge of trauma and the availability of mental health treatments effective in reducing the negative impact of trauma expanded the focus of CACs to include helping children and families heal. In …