Delivering an Evidence-Based Mental Health Treatment to Underserved Populations Using Telemedicine: The Case of a Trauma-Affected Adolescent in a Rural Setting

Abstract

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychological treatment that can effectively ameliorate symptoms of depression and anxiety that are common responses to trauma exposure. However, access to high-quality mental health services can be problematic, especially for traditionally underserved populations such as rural/remote residents, racial/ethnic minorities, and those from low socioeconomic strata. Individuals living in remote areas encounter additional obstacles to care, including long travel distances to reach services, increased time out of work or school, lack of access to transportation, and childcare difficulties. Many rural/remote communities struggle with scarcity of resources in general, and specialized mental health resources specifically, which may inadvertently exclude patients from obtaining the most appropriate health care. Telemedicine, or the use of Internet-based video conferencing, allows a patient live and direct virtual access to specialized mental health care providers. This article examines the application of TF-CBT via telemedicine to treat trauma exposure in a teenager living in a rural setting. Though this case example originates in the rural southeastern United States, the barriers and concepts addressed are generalizable to other remote areas in the United States and worldwide. Specific attention is given to evidence-based treatments for trauma, the merits of the telemedicine modality, and confidentiality considerations when using Internet-based teleconferencing for the application of psychological services.