Objective: Clinical video telehealth (CVT) is an innovative modality to provide care directly to Veterans' homes. Despite prior training initiatives, CVT remains underutilized. This project sought to better understand barriers to implementation and to compare responses of CVT utilizers versus nonutilizers. Method: Mental health staff were invited to complete an online anonymous survey on their use of CVT in clinical practice. Results: A total of 159 mental health staff completed the survey. Although the majority of the sample endorsed personal use of a video chat program, less than half reported using CVT for patient care. Among nonutilizers, lack of training was the most frequently endorsed barrier to CVT use whereas administrative burden was the most frequently endorsed barrier by utilizers. Conclusions: This study extends existing literature by determining barriers to CVT adoption. It identifies several barriers among utilizers versus nonutilizers. Discussion includes potential guidelines for overcoming barriers to CVT utilization. K E Y W O R D S clinical video telehealth, telemedicine, telemental health, videoconferencing

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A growing literature base supports the use of telemental health (TMH) as an effective platform for psychological interventions; however, the literature examining the use of telesupervision is limited. Mirroring TMH, telesupervision is potentially advantageous and may offer benefits above and beyond in-person supervision to include increased accessibility of training, reduced cost for travel and improved flexibility of scheduling, and increased access for peer consultation. These benefits may contribute to greater diversity of training and supervision experiences for trainees as well. In this evidence-based practice project, former psychology trainees (N ϭ 12) at 1 Veterans Affairs Health Care System (VA) site were invited to complete an anonymous online questionnaire regarding their supervision experiences utilizing both quantitative and qualitative items to explore trainee perceptions of telesupervision implementation, satisfaction, and efficacy. Both the qualitative and quantitative data suggest equivalence between the telesupervision and in-person supervision experiences with regard to rapport with supervisors and focus on clinical goals and tasks. The qualitative data provide additional insight into the trainee perspective on the benefits related to engaging in telesupervision, challenges related to engaging in telesupervision, and components of successful telesupervision. Telesupervision has the potential to contribute to the sustainability of rural health training programs, to increase access to needed mental health care in geographical areas of mental health shortage, and to allow trainees to receive supervision from supervisors who are culturally competent and expert in providing care to diverse patient populations. This article offers suggestions for optimal practice of telesupervision and discusses implications for training programs going forward. Public Significance StatementTelesupervision is a viable alternative to in-person supervision and offers benefits that could potentially enhance training opportunities, including increased accessibility of training, reduced cost for travel and improved flexibility of scheduling, and increased access for peer consultation. These benefits could contribute to greater diversity of training and supervision experiences for trainees as well as further enhance provision of training within rural settings. This article offers suggestions for optimal practice of telesupervision and discusses implications for training programs going forward.

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As a pioneer of training in the field of psychology, the Veterans Affairs (VA) HealthCare System serves as a leader in the training in and provision of Telemental Health (TMH) services in the United States. To meet goals toward continued expansion of these services, the VA TMH training program includes both web-based didactic courses and a skills competency test at a basic level with supervision and consultation in TMH for more advanced training and is available to staff psychologists and psychologist trainees. Despite these efforts, barriers for training in and implementation of TMH occur at the provider, system, and patient level. At the national level, the VA is actively working to resolve these barriers and we share site-specific examples implemented by the VA Puget Sound Health Care System promoting access through TMH team to further address barriers to training and implementation.