Nine counselling psychology students were enrolled in a 12-week pilot practicum (i.e. a work placement) for either one hour of course credit (six students) or three hours (three students). Group supervision was provided both in-person and by videoconferencing. Each trainee completed a measure evaluating their satisfaction with supervision (Supervisory Satisfaction Questionnaire, SSQ) and the supervisory relationship (Supervisory Working Alliance Inventory-Trainee Version, SWAI-T). The student's self-efficacy was also tracked during the semester (Counselling Self-Estimate Inventory, COSE). Trainees rated their satisfaction with videoconferencing similarly to the in-person format. The supervisory relationship also did not appear to be affected by the videoconferencing format. The COSE scores indicated that the students increased in counsellor self-efficacy by the end of the semester. Trainees reported that their supervisory needs were met and believed that videoconferencing was a viable format for supervision, although such a format still needed to be augmented by in-person contact. Providing better access to supervision and professional support using technology is one step towards improving health care in rural areas.

Telemedicine can greatly extend the benefits of Dignity Psychotherapy by bringing it to patients who are dying at home. Our very preliminary work suggests that delivering the intervention to patients who are too ill to leave their homes or who are in rural locations may be a feasible way to help them.

Satisfaction with teleconsulting was evaluated for 96 patients using the Kentucky TeleCare telemedicine network. Consultant specialties included psychiatry (41), dermatology (24), clinical nutrition (20), anaesthesia (3), infectious diseases (3), rheumatology (2), internal medicine (1), neurology (1) and paediatric pulmonology (1). The results indicated a high level of patient satisfaction, with a mean score of 6.8 (on a 7-point Likert scale with 1 = strongly disagree and 7 = strongly agree) for the question 'Overall, I was very satisfied with today's consultation'. The results indicated that the majority of patients were satisfied with the telemedicine encounter although a minority, 16%, would have preferred to have seen the specialist in person.

A medical center-based forensic clinic that provides the necessary comprehensive consultation, continuing education, court testimony, and clinical services through an applied model of teleconferencing applications is addressed. Telemedicine technology and services have gained the attention of both legal and clinical practitioners, examining trends and models of health care for underserved populations, and identifying where consultation with a team of professionals may benefit service providers in rural communities. The contribution offered herein provides an understanding of the history of the development of the clinic, a theoretical model that has been applied to a clinical forensic program that employs telepsychiatry services, and the ethical and malpractice liability issues confronted in using teleconferencing services. This model is examined through a child and adolescent forensic evaluation clinic. The goals of this model are offered, as are a number of applications within the broad spectrum of services utilizing telemedicine. Finally, changing patterns are addressed in clinically based health-care delivery for criminal justice, social services, and forensic mental health.