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.