By Vicky Gwiasda, Program Manager, Western Regional Children’s Advocacy Center
Through training and technical assistance, the Western Regional Children’s Advocacy Center (WRCAC) helps children’s advocacy centers (CACs) within the region develop comprehensive, multidisciplinary responses to meet the needs of child abuse victims and their nonoffending family members.
Because we support a disproportionately rural and frontier population, we began an effort in 2018 to develop the CACs’ capacities to provide trauma-focused telemental health services. Telemental health—therapy delivered via videoconferencing, text messaging, e-mail, phone calls, and other telecommunications technologies—brings therapy within reach of people who may otherwise not have access to these services.
Initially intended to address the challenge of providing therapy to families in rural and remote areas, our efforts to promote telemental health were accelerated during the COVID-19 pandemic as CACs nationwide sought alternatives to in-person therapy. In collaboration with the National Children’s Alliance, we began hosting a monthly peer forum to address the challenges therapists are experiencing with the transition, provide informal peer support to counteract the isolation of remote work, and answer practice-related questions.
We also hosted a five-part webinar series on delivering trauma-informed, evidence-based mental health services via telemental health and published an issue brief that answers CACs’ commonly asked questions on the topic.
Our online Telemental Health Resource Center provides a host of resources, including guides for establishing a telemental health program, an overview of useful technology and video conference platforms that are compliant with the Health Insurance Portability and Accountability Act, legal and regulatory information, and funding options for setting up or updating a program. We also have a dedicated resource page for CACs and clinicians transitioning to telemental health during the pandemic.
In fall 2020, we launched pilot programs in Washington and Montana to build sustainable networks of clinicians who provide telemental health and to improve related IT infrastructure. In May, we will begin offering training on the use of trauma-focused cognitive behavioral therapy in telemental health settings. In addition, we are assisting with reimbursement and cross-state licensing issues, and facilitating networking among the participants. We also provide families “telemental health boxes” filled with supplies to engage children during therapy. Our goal is to build the states’ capacity to sustain a robust telemental health network long after the pilot programs end.
When we began the telemental health initiative in 2018, many people in the field were not familiar with the approach or were skeptical about its efficacy. However, the Department of Veterans Affairs has relied on telemental health to deliver treatment to veterans in rural areas and tribal lands since the 1990s, and the approach has proven to be as effective as in-office therapy. More recently, researchers at the Medical University of South Carolina have shown that telemental health works with older children and teens, although more research demonstrating positive outcomes for young children is needed.
Since this effort got under way, we have made tremendous strides in expanding access to trauma-focused, telemental health services to families living in remote places. Still, more work remains.
OJJDP provides funding to support four regional CACs—one located in each of the U.S. Census regions. The regional centers offer technical assistance and indepth training to develop new or strengthen existing multidisciplinary teams, local CACs, and state chapters. Learn more about the centers by reading the Children’s Advocacy Centers In Focus fact sheet.