My Therapist on a Screen

One of our early clients, a middle school boy, tentatively knocked on the door of the counseling room for his first session with a therapist.  We introduced the student to the therapist, ensured that they had connected, and left them for their session.  Later that day the school counselor reported that the student, in a group session, exclaimed, “I just had my first session with a counselor.  It was just like Skype.   And it was cool.”

Skype?  Not exactly Skype but the student was not far off in his description of the therapy session.  He was in an office in a school in Southwest Colorado.  His therapist was sitting in his office in Denver, Colorado, 300 miles away.  They connected via a secure video link that allowed therapy to be delivered remotely.  And, judging from the student’s reaction, it was successful—in his words, “cool.”

Since January of 2017 Tri-County Health Network (TCHNetwork) has offered students in three area school districts (Telluride, Norwood, and West End) behavioral health services through our Teletherapy Program.  This program is free of charge for students and their families, and the schools.  We utilize a HIPAA-compliant secure video platform that allows the student and therapist to see and hear one another in real time.

The school-based Teletherapy Program allows students to access a variety of therapists. Our therapists do not live in the same community as the students and the students don’t have to worry about running into their therapist at the grocery store or walking down the street. This combination of choice and privacy in our rural area is important to increase the comfort level of students in seeking treatment and unique.  In addition, by offering treatment during the school day the student does not have to miss additional class time for travel to and from the therapist’s offices.

Most of our therapists have no prior experience with teletherapy, but report being able to form relationships with students over the Internet that are genuine and trusting.  The initial fears of being able to engage patients across a computer screen and the inability to read their body language do not appear to negatively impact the students’ experiences or therapeutic outcomes.  Our therapists report that they feel that the sessions are as effective as face-to-face sessions that they have with adolescents in their own practices.

In addition to the therapy sessions, we are also able to screen the students in the teletherapy program for risk of suicide and depression.  We developed procedures for the screenings and they were put to the test on the day we implemented the screenings.

Our first student completed the electronic screening on a tablet and was engaging with the therapist.  Our on-site teletherapy coordinator automatically received the results of the student’s screening and immediately noted that the system had flagged the student’s results; the student was reporting as being at risk for suicide.  The coordinator immediately contacted the therapist via text message and contacted the school counselor.  The therapist completed the session with the student and discussed the report with the school counselor.  The school counselor implemented the school’s crisis response system, contacted the student and his/her family, and ensured that the student was safely in the hands of family.

The student continued in the Teletherapy Program for the remainder of the semester and was discharged from the therapist’s care.

The Teletherapy Program fills an important void in our communities by expanding access to care in an area with a shortage of mental health services.  Schools are reporting higher rates of adolescent depression and anxiety, and suicide is the leading cause of death among young people ages 10 to 24.  Teletherapy is one model that seeks to address the shortage of mental health professionals in schools in our region and across the state.

Paul Reich, Behavioral Health Programs Manager

If you’d like to learn more or to sign your child up for services, please contact Paul at

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