Using technology to expand children’s mental health care

Less than half of Americans with a mental disorder receive any treatment for their condition in a given year. Among those who do receive care, the median delay in treatment initiation after initial onset of disorder is typically 1-2 decades. Such failures and delays in the utilization of mental health care can be attributed in large part to problems in care availability. Inadequate numbers of mental health professionals, particularly in rural and other remote regions, impinge on the availability of care. Systematic barriers of geography and treatment availability interfere with the provision of needed treatment for affected youth. Long wait-lists at underfunded clinics can substantially slow the speed with which services are delivered. Quality of care further constrains treatment delivery to affected individuals. Those who do receive psychological treatments are not necessarily receiving evidence-based practices. Regrettably, programs showing the strongest support are not widely disseminated, while many widely used approaches show limited support. Limitations in the availability of supported psychosocial treatments place heavy clinical demands on the pharmacologic dimensions of mental health care. Primary care physicians typically fill geographic workforce gaps in mental health care, but lack the training and time to adequately address the needs of those seeking mental health care.

The MINT Program is actively engaged in a number of funded clinical trials evaluating the enormous potential of harnessing new technologies in order to overcome traditional barriers to mental health care for large numbers of children in need. Much of our research in this regard has focused on telehealth strategies for remotely delivering real-time, therapist-led treatment, digital mental health formats that are largely self-administered, just-in-time adaptive interventions (JITAIs) that provide small doses of support in moments of greatest need, and AI applications that leverage machine learning algorithms to innovate mental health care.

Representative publications on technology and mental health care (para obtener una lista completa de los estudios, haga clic aquí):

Timmons, A.C., Duong, J.B., Walters, S.N., Carta, K.E., Jumonville, G.A., Carrasco, A.S., Romero, D.N., Ahle, M.W., Comer, J.S., Khurd, I., & Chaspari, T. (in press). Bridging fair-aware artificial intelligence and co-creation for equitable mental health. Nature Reviews Psychology.

Duong, J.B., Walters, S.N., Carta, K., Jumonville, G.A., Carrasco, A.S., Fiallo, N.S., Romero, D.N., Khurd, I., Ahle, M.W., Comer, J.S., Frazier, S.L., Chaspari, T., Narayanan, S., & Timmons, A.C. (in press). Caregiver perceptions of healthcare barriers across traditional and digital contexts: A mixed-methods analysis. npj Digital Medicine.

Timmons, A.C., Tutal, A.A., Avramidis, K., Duong, J.B., Carta, K.E., Walters, S.N., Jumonville, G.A., Carrasco, A.S., Freitag, G.F., Romero, D., Ahle, M.W., Comer, J.S., Narayanan, S.S., & Chaspari, T. (2025). Developing personalized algorithms for sensing mental health symptoms in daily life. npj Mental Health Research, 4, 34.

Merrill, S.M., Hogan, C., Bozack, A.K., Cardenas, A., Comer, J.S., Bagner, D.M., Highlander, A., & Parent, J. (2024). Telehealth parenting program and salivary epigenetic biomarkers in preschool children with developmental delay: NIMHD Social Epigenomics Program. JAMA Network Open, 7(7), e2424815.

Sanchez, A. L., Javadi N., & Comer J. S. (2024). Family engagement in a behavioral parenting intervention: A randomized comparison of telehealth versus office-based treatment formats. Journal of Consulting and Clinical Psychology, 92(6), 344-355.

Bagner, D.M., Berkovits, M.D., Coxe, S., Frech, N., Garcia, D., Golik, A., Heflin, B.H., Heymann, P., Javadi, N., Sanchez, A.L., Wilson, M.K., & Comer, J.S. (2023). Telehealth treatment of behavior problems in young children with developmental delay: A randomized controlled trial. JAMA Pediatrics, 177(3), 231-239.

Timmons, A.C., Duong, J.B., Fiallo, N.S., Lee, T., Vo, P.Q., Ahle, M.W., Comer, J.S., Brewer, L., Frazier, S., & Chaspari, T. (2023). A call to action on assessing and mitigating bias in artificial intelligence applications in clinical psychology. Perspectives on Psychological Science, 18(5), 1062-1096.

Carl, J.R., Jones, D.J., Lindhiem, O.J., Doss, B.D., Weingardt, K.R., Timmons, A.C., & Comer, J.S. (2022). Regulating digital therapeutics for mental health: Opportunities, challenges, and the essential role of psychologists. British Journal of Clinical Psychology, 61(S1), 130-135.

Comer, J.S., Furr, J.M., del Busto, C., Silva, K., Hong, N., Poznanski, B., Sanchez, A.L., Cornacchio, D., Herrera, A., Coxe, S., Miguel, E., Georgiadis, C., Conroy, K., & Puliafico, A.C. (2021). Therapist-led, internet-delivered treatment for early child social anxiety: A waitlist-controlled evaluation of the iCALM Telehealth Program. Behavior Therapy, 52(2), 1171-1187.

Comer, J.S. (2021). Rebooting mental health care delivery for the COVID-19 pandemic (and beyond): Guiding cautions as telehealth enters the clinical mainstream. Cognitive and Behavioral Practice, 28, 743-748.

Doss, B.D., Weingardt, K.R., Lindhiem, O.J., Timmons, A.C., Jones, D.J., Comer, J.S., & Carl, J. (2021). Issues in regulating DTx. Psychiatric Times, 38(Supplement), 6-7.

Gurwitch, R., Salem, H., Nelson, M., & Comer, J.S. (2020). Leveraging Parent-Child Interaction Therapy and telehealth capacities to address the unique needs of young children during the COVID-19 public health crisis. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S82-S84.

Comer, J.S., & Timmons, A. (2019). The other side of the coin: Computer-mediated interactions may afford opportunities for enhanced empathy in clinical practice. Clinical Psychology: Science and Practice, 26, e12308.

Comer, J.S., Conroy, K., & Timmons, A. (2019). Ensuring wearable devices don’t wear out their welcome: Cautions for the mental health care road ahead. Clinical Psychology: Science and Practice, 26, e12297

Bry, L.J., Chou, T., Miguel, E., & Comer, J.S. (2018). Consumer smartphone apps marketed for child and adolescent anxiety: A systematic review and content analysis. Behavior Therapy, 49, 249-261.

Carpenter, A.L., Pincus, D.B., Furr, J.M., & Comer, J.S. (2018). Working from home: An initial pilot examination of videoconferencing-based cognitive-behavioral therapy for anxious youth delivered to the home setting. Behavior Therapy, 49, 917-930.

Comer, J.S., Furr, J.M., Miguel, E., Cooper-Vince, C.E., Carpenter, A.L., Elkins, R.M., Kerns, C., Cornacchio, D., Chou, T., Coxe, S., DeSerisy, M., Sanchez, A.L, Golik, A., Martin, J., Myers, K., & Chase, R. (2017). Remotely delivering real-time parent training to the home: An initial randomized trial of Internet-delivered Parent-Child Interaction Therapy (I-PCIT). Journal of Consulting and Clinical Psychology, 85, 909-917.

Comer, J.S., Furr, J.M., Kerns, C.E., Miguel, E., Coxe, S., Elkins, R.M., Carpenter, A.L., Cornacchio, D., Cooper-Vince, C.E., DeSerisy, M., Chou, T., Sanchez, A.L., Khanna, M., Franklin, M.E., Garcia, A.M., & Freeman, J.B. (2017). Internet-delivered, family-based treatment for early-onset OCD: A pilot randomized trial. Journal of Consulting and Clinical Psychology.

Comer, J.S., & Myers, K.M. (2016). Future directions in the use of telemental health to improve the accessibility and quality of children’s mental health services. Journal of Child and Adolescent Psychopharmacology, 26, 296-300.

Myers, K., & Comer, J.S. (2016). The case for telemental health for improving the accessibility and quality of children’s mental health services. Journal of Child and Adolescent Psychopharmacology, 26, 186-191.

Crum, K.I., & Comer, J.S. (2016). Using synchronous videoconferencing to deliver family-based mental health care. Journal of Child and Adolescent Psychopharmacology, 26, 229-234.

Cooper-Vince, C., Chou, T., Furr, J.M., Puliafico, A.C., & Comer, J.S. (2016). Videoteleconferencing early child anxiety treatment: A case study of the Internet-delivered CALM (I-CALM) Program. Evidence-Based Practice in Child and Adolescent Mental Health, 1, 24-39.

Chou, T., Comer, J.S., Turvey, C.L., Karr, A., & Spargo, G. (2016). Technical considerations for the delivery of real-time child telemental health care. Journal of Child and Adolescent Psychopharmacology, 26, 192-197.

Comer, J.S., Furr, J.M., Cooper-Vince, C., Madigan, R.J., Chow, C., Chan, P.T., Idrobo, F., Chase, R.M., McNeil, C.B., & Eyberg, S.M. (2015). Rationale and considerations for the Internet-based delivery of Parent-Child Interaction Therapy. Cognitive and Behavioral Practice, 22, 302-316.

Comer, J.S. (2015). Introduction to the special section: Applying new technologies to extend the scope and accessibility of mental health care. Cognitive and Behavioral Practice, 22, 253-257.

Gallo, K.P., Comer, J.S., Barlow, D.H., Clarke, R.N., & Antony, M.N. (2015). Direct-to-Consumer marketing of psychological treatments: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 83, 994-998.

Comer, J.S., & Barlow, D.H. (2014). The occasional case against broad dissemination and implementation: Retaining a role for specialty care in the delivery of psychological treatments. American Psychologist, 69, 1-18.

Comer, J.S., Furr, J.M., Cooper-Vince, C., Kerns, C., Chan, P.T., Edson, A.L., Khanna, M., Franklin, M.E., Garcia, A.M., & Freeman, J.B. (2014).  Internet-delivered, family-based treatment for early-onset OCD: A preliminary case series. Journal of Clinical Child and Adolescent Psychology, 43, 74-87 .

Barlow, D.H., Bullis, J.R., Comer, J.S., & Armetaj, A.A. (2013). Evidence-based psychological treatments: An update and the way forward. Annual Review of Clinical Psychology, 9, 1-27.

Gallo, K.P., Comer, J.S., & Barlow, D.H. (2013). Direct-to-consumer marketing of psychological treatments for anxiety disorders. Journal of Anxiety Disorders, 27, 793-801.

Comer, J.S., Elkins, R.M., Chan, P.T., & Jones, D.J. (in press). New methods of service delivery for children’s mental health care. In C.A. Alfano & D. Beidel (Eds), Comprehensive evidence-based interventions for school-aged children and adolescents. New York: Wiley.

Elkins, R.M, & Comer, J.S. (in press). Internet-based implementation: Broadening the reach of Parent-Child Interaction Therapy for early child behavior problems. In R.S. Beidas & P.C. Kendall (Eds.), Child and adolescent therapy: Dissemination and implementation of empirically supported treatments. New York: Oxford.