Evidence-Base Supporting Child and Adolescent Telepsychiatry
Kathleen Myers, MD, MS, MPH, DFAACAP, DFAPA, FATA

• The evidence-base supporting the delivery of telepsychiatry services to children and adolescents has been developing incrementally.
• Telepsychiatry services have been successfully utilized with diverse populations across diagnoses and settings.
• Multiple studies have demonstrated the feasibility of delivering varied treatments to youth and families through telepsychiatry.
• Referring providers, psychiatrists and families report high satisfaction with telepsychiatry services.
• The ability to establish a therapeutic rapport with youth and families through telepsychiatry is well established.
• Multiple commercial vendors now provide telepsychiatry platforms and services. They attest the commercial feasibility of telepsychiatry with youth and families, as well as new revenue streams for child and adolescent psychiatrists.
• Multiple pre- to post- intervention studies, multiple small randomized trials, and a few large trials indicate the effectiveness of treatment delivered through videoconferencing.
• The implementation of evidence-base interventions are rapidly outpacing the research. Programs are being implemented in clinic settings, emergency rooms, school-based clinics, correctional facilities, and the home. Inpatient settings have been reported.
• More research is needed to understand the best uses of telepsychiatry with youth and mechanisms of success.

References

1. American Academy of Child and Adolescent Psychiatry Committee on Telepsychiatry and the Committee on Quality Issues. Clinical Update for Telepsychiatry with Children and Adolescents.  Journal of the American Academy of Child and Adolescent Psychiatry. 2017;56(10):875–893.
2. Comer JS, Furr JM, Miguel E, Cooper-Vince CE, Carpenter AL, …Myers KM & Chase R. Remotely delivering real-time parent training to the home: An initial randomized trial of Internet-delivered Parent-Child Interaction Therapy (I-PCIT). Journal of Consulting and Clinical Psychology. 2017; 85 (9): 909–917.
3. Gloff N, Lenoue S, Novins D, Myers K. Telemental health for children and adolescents. International Review of Psychiatry. 2015;27(6):512-524.
4. Kriechman A, Bonham C. Telemental health in primary care. In: Myers K, Turvey C, eds. Telemental Health: Clinical, Technical, and Administrative Foundation for Evidence-Based Practice. London: Elsvier Insights; 2013; 155-170.
5. Lee JF, Schieltz KM, Suess AN, Wacker DP, Romani PW, Lindgren SD, Kopelman TG, Padilla Dalmau YC. Guidelines for developing telehealth services and troubleshooting problems with telehealth technology when coaching parents to conduct functional analyses and functional communication training in their homes. Behavior Analysis Practice DOI 10.1007/s40617-014-0031-2; Published online 27 November 2014.
6. Myers K and Roth DE. Telepsychiatry with children and adolescents. In: Martin A, Volkmar FR, and Bloch MH (Eds), Lewis’s Child and Adolescent Psychiatry: A Comprehensive Textbook, 5th Edition.  Wolters Kluwer, Philadelphia, 2018; Chapter 6.3.5. 
7. Myers K, Vander Stoep A, Zhou C, et al. Effectiveness of a telehealth service delivery model for treating attention-deficit hyperactivity disorder: results of a community-based randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry. 2015;54(4):263-274.
8. Reese RM, Jamison R, Wendland M, Fleming K, Braun MJ, Schuttler JO et al. Evaluating interactive videoconferencing for assessing symptoms of autism. Telemedicine and J E Health. 2013;19(9):671-677.
9. Storch EA, Caporino NE, Morgan JR, Lewin AB, Rojas A, Brauer L et al. Preliminary investigation of web-camera delivered cognitive-behavioral therapy for youth with obsessive-compulsive disorder. Psychiatry Research. 2011;189(3):407-412.
10. Vander Stoep A, McCarty C, Zhou C, Rockhill CM, Schoenfelder E, Myers K. The Children’s Attention-Deficit Hyperactivity Disorder Telemental Health Treatment Study: caregivers’ outcomes. Journal of Abnormal Child Psychology. 2016; 45(1):27-43.
11. Xie Y, Dixon JF, Yee OM, Zhang J, Chen YA, Deangelo S et al. A study on the effectiveness of videoconferencing on teaching parent training skills to parents of children with ADHD. Telemed Journal and E Health. 2013;19(3):192-199.