Developing Rapport and Therapeutic Alliance During Telemental Health Sessions with Children and Adolescents.

Objective: The purpose of this study was to describe the special considerations for building rapport and establishing a therapeutic alliance when conducting mental health evaluations for children and adolescents via videoconferencing.

Methods: The authors review the literature and describe their experience in conducting mental health evaluations, developing rapport, and establishing a therapeutic alliance during telemental health practice.

Results: Clinical need and shortages of clinicians with expertise in evaluating mental conditions for children and adolescents in underserved communities have stimulated the rapid expansion of telemental health programs while the research base continues to develop.

Bridging cultures: child psychiatry via videoconferencing.

Although telepsychiatry can increase access to care for underserved populations, its use presents challenges to practicing culturally competent care, especially when high degrees of cultural disparity exist between the psychiatrist and the patient and/or family. Psychiatrists delivering care from a distance may be challenged to understand the health beliefs and practices of the local community as well as the social and community settings of clients from different cultural backgrounds. Similarly, because providing services via telepsychiatry typically requires the involvement of different health care organizations, bridging distinct institutional cultures can challenge the effective delivery of services.

Telepsychiatry in private practice.

Telepsychiatry is being increasingly adopted in private practice and is predicted to play an important role in increasing access to care in rural communities and other underserved areas. With the current level of need, it is unlikely that all of the required services can be fully met through existing telepsychiatry practitioners. Thus, in light of this new research and the significant needs of rural communities, some of the historical barriers to using telepsychiatry in private practice can be overcome through the use of new technology and sound financial modeling.