title: Need for and Steps Toward a Clinical Guideline for the Telemental Healthcare of Children and Adolescents.
abstract: OBJECTIVE
  This article identifies and describes key considerations toward the development of a clinical guideline intended to optimize telemental healthcare (TMH) of children and adolescents.
  
  
  METHODS
  The literature was searched with key terms and title words. Of 2824 articles that met primary or secondary key word search criteria, 326 met both criteria, and 118 thematically related directly to child and adolescent TMH. Only 44 studies met levels of evidence I-III and expert recommendation criteria used in clinical guidelines; review of their references found 8 additional studies (52 total). Data from adult, child, and adolescent in-person psychiatric care and adult TMH were applied to provide context in developing the key considerations.
  
  
  RESULTS
  TMH guidelines for adults are well delineated, and TMH guidelines for children and adolescents are likely to closely overlap in terms of general clinical, technical, and administrative issues. However, for a child and adolescent focus, modifications of existing general guidelines appear necessary; for example, based on developmental status, family involvement, and patient-site modifications for space and sound. Additional clinical issues include specify who, exactly, is the "patient" (i.e., the patient, family, and /or other stakeholders), modalities of care (i.e., age-related psychotherapies such as play therapy or behavior management), and psychopharmacology.
  
  
  CONCLUSIONS
  Specific clinical, administrative, and technical issues are key considerations - based on the nuances of established child and adolescent mental healthcare - and must be considered in developing a clinical guideline for TMH of these patients. Developing such guidance should proceed from a careful review of the growing evidence base, and through expert consensus processes.
authors.affiliation: 1 Kaweah Delta Medical Center, Visalia, California.|2 Department of Psychiatry and Keck School of Medicine at the University of Southern California , Los Angeles, California.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Hilty
authors.affiliation: 2 Department of Psychiatry and Keck School of Medicine at the University of Southern California , Los Angeles, California.|3 Child and Adolescent Services Los Angeles County and University of Southern California Medical Center , Los Angeles, California.
authors.forename: Erica Z
authors.initials: EZ
authors.lastname: Shoemaker
authors.affiliation: 4 Department of Psychiatry and Behavioral Sciences, University of Washington , Seattle, Washington.|5 Telemental Health Service, Seattle Children's Hospital , Seattle, Washington.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Myers
authors.affiliation: 2 Department of Psychiatry and Keck School of Medicine at the University of Southern California , Los Angeles, California.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Snowdy
authors.affiliation: 6 Department of Psychiatry, UC Davis School of Medicine , Davis, California.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Yellowlees
authors.affiliation: 7 Department of Psychiatry, University of Colorado at Denver School of Medicine , Denver, Colorado.
authors.forename: Joel
authors.initials: J
authors.lastname: Yager
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D002648:Child; D002662:Child Health Services / Q000592:standards*; D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D017410:Practice Guidelines as Topic; D017216:Telemedicine / Q000592:standards*