Table 3.

Core competencies and skills in TMH by Adolescent Mental Health professional.

Basic technical/IT skills	Informatics, notebook, desktop, online videoconferencing, online platforms for offering TMH services, etc. These competencies include as well know and explain to the patients how to connect their devices to the TMH platform, and many other potentially occurring technical issues.
Assessment skills in TMH	When a clinician plans to implement an adolescent TMH service, an assessment should be proposed, also for stratifying patients who need a TMH vs. face-to-face mental health care.
Relational skills in TMH	Relational skills in digital world may differ from that in-person, particularly with adolescents. Understanding and learning how to build a good relationship and therapeutic alliance with the youngsters during TMH sessions. A good way to build a strong and collaborative alliance and interaction may consist in involving the adolescent (and their family, if needed) also in the technical process of setting up TMH session from the beginning.
Communication skills in TMH	Understanding and learning how to communicate via TMH with adolescents (‘how to do’, ‘how not to do’). An adequate training on how to properly use nonverbal communication may play a crucial role in building an authentic experience through expression of empathy, professionalism, and therapeutic intentions. In particular, these communication skills are essential with youngsters, by guaranteeing a good eye contact, using an exaggerated tone of voice, a variegated range of facial expressions, and energetic hand gestures. Clinicians should benefit in previously practicing nonverbal gestures, including facial expressions on camera in advance (before the session) in order to ensure that those are visible in the camera frame during TMH session.
Collaborative and inter-professional skills in TMH	How to collaborate and share professional insights and viewpoints in describing a clinical case, supervision and in providing e-consultations in TMH with other colleagues.
Administrative skills in TMH	How to track TMH intervention (i.e., electronic and/or paper medical diary), prescription (i.e., electronic and/or paper prescription delivered by mail, email or through general practioner), how to manage payments and receipts, etc.
Medico-legal competencies and skills in TMH	Regulatory and ethical issues and how to manage them, with a particular focus on adolescent psychiatry, how to create and obtain an ad hoc informed consent, how to create and obtain an ad hoc plan emergency shared plan; privacy and safety issues, responsibility during a TMH session, with a particular focus on adolescent psychiatry, etc.
Ethno- and cultural psychiatry skills in TMH	Adequately verify and investigate the culturally and religiously determined resistances in offering a TMH session according to the culture and religion of patients, particularly in the case of children and adolescent patients.