Telehealth Outreach ProgramFor Traumatized Youth

NORTH DAKOTA

Nicola Herting, PhD

Project Collaborators and Funders

Medical University of South Carolina

National Children’s Alliance

This project was supported by Grant Number 2018-V2-GX-0008, awarded by the North Dakota Department of Corrections and Rehabilitation through the VOCA Regionalization Project. The opinions, findings, conclusions, and

recommendations expressed in this presentation are those of the authors and do not necessarily reflect the views of the North Dakota Department of Corrections and Rehabilitation.

CACs in North Dakota

CACND

DCAC -Bismarck

RRCAC -Fargo

NPCAC -Minot

State Telehealth Network

Implementing Telehealth in CACs

1. Choose platform and equipment– Vsee, Laptops/Desktops, headphones with microphone

2. Determine if providing equipment and supplies to families– iPads, therapy boxes

3. Identify your eligibility criteria – Typically 7-18– Safety concerns – Privacy– Supervision

Implementing Telehealth in CACs

4. Develop your policies, procedures, forms, and workflow– Telehealth consent, emergency protocol, loaner

agreements– Step-by-step tip sheets for connecting and using the

platform on different devices– Referral, Screening, Assessment, Treatment

procedures 5. Educate team to ensure they understand this

new model of service and can answer questions and engage families

Telehealth Workflow in CACsBARRIERS

SCREENINGAdvocates

after FI

TELEHEALTH SCREENING

Advocates/MH Providers

ASSESSMENT MH Providers

TREATMENT MH Providers

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P R A C

T I C E

Relaxation

Relaxation skills for the child and caregiver

Affect Regulation

Cognitive Coping

Trauma Narrative

In Vivo Exposure

Enhancing Safety

Psychoeducation and Parenting

(PRWLRQ�UHJXODWLRQ skills adapted to the child, family and culture

Connecting thoughts, feelings, and behaviors

Assisting the child in the sharing of their story and trauma experiences

Mastery of trauma reminders

3UDFWLFH�Vkills and enhance trauma-related discussions

Enhancing future safety with safety planning and social skills training

WHAT IS TF-CBT? TF -CBT is a trauma specific and evidenced-based treatment for children who are having significant diff iculties related to traumatic experiences. Components include:

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Psychoeducation about trauma�DQG�376'

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Telehealth Workflow in CACsBARRIERS

SCREENINGAdvocates

after FI

TELEHEALTH SCREENING

Advocates/MH Providers

ASSESSMENT MH Providers

TREATMENT MH Providers

Flyer

TF-CBT

Screening• Over the phone• Completed by MH provider or advocate• Purpose to quickly screen for appropriateness for telehealth

– Vision or hearing difficulties– Safety/Self-harm/SI concerns– Impulsivity, attention problems, destructive behaviors– Privacy at home– Adult available during session– Equipment needs

• Start process to obtain signed consents, loaner agreements, emergency protocol

Assessment

Trauma Exposure and Symptoms

THQ

CPSS-5

Anxiety and Depression

RCADS

TIPSØPut measures on

PowerPointØOne question

per slideØUse a pictorial

rating scale

Implementing Telehealth in CACs

6. Allow extra time for clinician preparation– Develop resources to use over telehealth to

conduct treatment with similar interaction and activities as in-person• Powerpoint, kindle books

7. Use a dropbox within your chapter or CAC to share resources

Implementing Telehealth in CACs

9. Space appointments out to allow for – Moving, stretching– Troubleshooting tech issues

10. Takes time for it to feel natural and work smoothly … patience J

Conducting EBT with children and adolescents via Telehealth

• Position camera to ensure you are looking at the child so they know you are focused

• More animation and excitement• Build connection and engagement with interactive activities

and props and creating opportunities for them to give input• Convert your worksheets to PowerPoint games and

editable documents• Set ground rules • Allow for adjustment to new modality, but continue with

treatment to maintain fidelity• Mail stickers or a note in-between sessions

THANK YOU