The two case studies suggest that child and adolescent patients, as well as their caregivers, were satisfied with their telepsychiatry experience and reported it was preferable to traveling long distances to visit psychiatrists in other parts of the State. Participating child and adolescent psychiatrists reported that although it was more difficult to establish rapport with patients via telehealth, the decreased rapport did not compromise their ability to provide an accurate consultation. Clinicians reported the equipment was easy to use and was more cost efficient than flying patients to close cities for psychiatric evaluations. The results suggest that telepsychiatry can be an effective treatment modality for youth in rural and remote settings. The two case studies presented involved a 3-year-old girl who was diagnosed with reactive detachment disorder through the telepsychiatry program and a 13-year-old boy who was diagnosed with Asperger’s disorder. The telepsychiatry clinics are offered on a twice-monthly basis by the University of Colorado School of Medicine’s Center for Native American TeleHealth and TeleEducation (CNATT) and the Indian Health Service’s Rapid City Hospital. The program conducted 21 evaluations during the first 12 months of operation from October 2003 through October 2004. Followup evaluations are often conducted via telehealth and telephone. References