Multidimensional telecare strategies for rural residents with brain injury

Rural residents with brain injury have difficulty in accessing care from qu alified psychologists for consequent cognitive, emotional and behavioural s ymptoms. We examined high-quality videoconferencing to enhance care for per sons with brain injury in three areas: cognitive assessment, psychotherapy and rural mental health training. The assessment study evaluated 52 outpati ents seen for diagnostic visits over videoconferencing, and compared their experiences with those of 52 age- and diagnosis-matched controls seen in pe rson. Persons seen via telemedicine were more likely than controls to want to repeat their experience and more satisfied than were the neuropsychologi sts who examined them. In the psychotherapy study, neurorehabilitation pati ents were seen via videoconferencing for therapy related to brain injury or stroke. Persons receiving psychotherapy were less likely than persons rece iving assessment services to want to repeat their experience. In the traini ng study, 39 rural mental health providers were trained via videoconferenci ng, and trainees demonstrated significant improvement on tests of knowledge about brain injury. Trainees formed a network of mental health provider re ferrals for persons with brain injury in a wide geographic area. Given adeq uate training and ongoing support, rural clinicians can treat many brain-in jury adjustment issues locally, reserving specialist consultation for emerg ency or complex problems.