Behavioral health clinicians providing telehealth and hybrid services increasingly encounter clients coping with trauma and systemic inequities. However, many lack structured preparation for delivering trauma-responsive and anti-racist care through virtual platforms. While telehealth expands access, clients from racially and culturally marginalized communities may experience barriers that amplify distress or limit engagement. A recent open-access study, Training in Trauma-Responsive and Anti-Racist Telehealth: A Model for Behavioral Health Clinicians and Providers by Ritchie J. Rubio, introduces a replicable, evidence-informed framework that equips clinicians to integrate trauma-informed and culturally responsive practices into their telehealth work.
The Study and Its Context: A Model for Trauma-Responsive Telehealth Training
Ritchie J. Rubio, affiliated with the San Francisco Department of Public Health and Pepperdine University, developed a nine-part, 27-hour telehealth curriculum to help clinicians provide care that is both trauma-responsive and anti-racist. The program was designed for behavioral health providers in California and aimed to bridge the gap between evidence-based trauma therapy and culturally competent telehealth.
Rubio’s curriculum emerged from evidence that trauma-focused therapies can be successfully adapted for telehealth delivery when clinicians receive proper training. Yet many clinicians lack structured preparation to apply these models in virtual environments, especially for BIPOC clients who experience overlapping stressors from racial and pandemic-related trauma.
Curriculum Design and Frameworks for Trauma-Responsive Telehealth
Structure of the Telehealth Training Program
Each three-hour session integrated theory, practical skill building, and implementation planning. Clinicians engaged in research-based lectures, breakout sessions for skills practice, and reflection exercises to promote real-world application.
Core Frameworks Supporting Trauma-Responsive Telehealth
Rubio grounded the curriculum in two key trauma-informed frameworks:
The Neurosequential Model of Therapeutics underscores the importance of helping clients regulate physiological and emotional states before engaging in deeper cognitive processing. In telehealth, this means establishing calm and safety before trauma exploration.
The Tri-Phasic Model of Trauma Recovery outlines the three stages of trauma treatment: safety and stabilization, remembrance and mourning, and reconnection. The training emphasized starting with safety and coping skills before addressing trauma memories in virtual sessions.
Integrating Anti-Racism and Cultural Responsiveness in Telehealth
The series also addressed systemic racism and cultural trauma, underscoring how racial inequities compound distress and shape the therapeutic alliance. Clinicians examined the digital divide as a social determinant of health and learned to advocate for equitable access to telehealth technology. They also explored culturally grounded interventions—such as mindfulness, storytelling, and community engagement—that aligned with the strengths of BIPOC clients.
For further information on telehealth diversity and cultural competence, see telehealth.org resources: Diversity Telehealth in BIPOC Communities and Are You Legally & Ethically Compliant? Telehealth Cultural Competence.
Rubio recognized that training alone does not ensure behavior change. After each session, each participant completed implementation plans identifying which tools or approaches they would test in their practice. These plans helped translate theoretical learning into clinical routines.
To support this process, the author launched the Tools to Improve Practice (TIPs) portal, a digital resource hub offering manuals, worksheets, and videos organized by topic areas such as trauma recovery, crisis intervention, and CBT-informed telehealth.
Findings and Discussion: Training Impact and Clinician Feedback
Participant surveys revealed high satisfaction and confidence gains. Clinicians praised the emphasis on practical tools, cultural responsiveness, and safe online engagement. The TIPs website was widely noted as an accessible resource supporting long-term skill use.
Strengths of Rubio’s Trauma-Responsive Telehealth Model
Rubio’s training stands out for integrating theory, skill-building, and application. Its trauma-informed and anti-racist foundation aligns with contemporary behavioral health priorities and supports a more inclusive virtual care system.
Limitations and Future Directions for Trauma-Responsive Telehealth
The study lacked formal outcome evaluations of client progress or clinician competencies. Rubio recommends future research with validated measures to assess therapeutic impact, client satisfaction, and cultural safety. Expanding the curriculum for high-risk groups, such as clients in crisis or those receiving DBT online, could further improve safety and effectiveness.
Research cited in the study reinforces that trauma-informed telehealth can yield strong outcomes when adapted for cultural context. Komariah et al. (2022) found that online CBT effectively reduced anxiety and depression during the pandemic, while Uysal et al. (2022) showed similar benefits among youth using videoconferencing CBT.
Practical Takeaways for Telehealth Clinicians
Rubio’s curriculum offers actionable insights for behavioral health professionals:
Prioritize safety and regulation before trauma work. Create calming rituals and teach grounding exercises that can be done virtually.
Address racial and cultural trauma directly. Explore how racial identity, bias, and systemic inequities affect clients’ sense of safety.
Adapt evidence-based therapies flexibly. Modify methods such as CBT and EMDR for online delivery while respecting each client’s pacing.
Advocate for digital equity. Help clients navigate privacy, bandwidth, or access barriers and partner with local resources when needed.
Engage in ongoing reflection and consultation. Peer dialogue helps sustain anti-racist and trauma-informed awareness.
Protect provider well-being. The curriculum emphasizes self-care to reduce burnout and vicarious trauma in clinicians working virtually.
Conclusion: Advancing Equity Through Trauma-Responsive Telehealth
Rubio’s Training in Trauma-Responsive and Anti-Racist Telehealth provides a foundational model for a more equitable behavioral health system. It highlights how trauma-informed and anti-racist frameworks can transform virtual care into a vehicle for healing, belonging, and justice.
Clinicians delivering telehealth to BIPOC and marginalized communities can draw from this model to ensure that safety, empathy, and equity remain central to digital care. As noted in Equitable Access to Healthcare Through Telehealth: Findings from the New RTRC Report, telehealth’s promise of access must be matched by intentional equity and cultural responsiveness.