Objectives: This study explored a new telehealth educational and development psychologist (EDP) service 10 provided as part of a multidisciplinary team to rural families. We aimed: (1) to examine the role and process changes made in telehealth consults compared to in-person consults, and (2) to evaluate the satisfaction of key stakeholders with the telehealth service. Method: We used an exploratory qualitative case study design involving care observations, semi-structured interviews and satisfaction surveys. Participants were (i) one EDP, four multidisciplinary team (MDT) members and six service managers 15 employed by BUSHkids, a not-for-profit health service in Queensland, Australia; and (ii) 23 parents of 20 children enrolled in the service. Results: Telepsychology involved major additions to in-person roles and processes, including the creation of a telehealth facilitator role. Key role and process changes were identified: (1) extending MDT roles to assist the EDP with clinical data collection and extending parent roles to act as co-therapists; (2) increased clinician processes focused around maintaining 20 therapeutic presence through verbal interaction strategies and creating shared virtual spaces; and (3) increased routines and documentation demonstrated in extra EDP preparation time, additional technology sub-routines, and more correspondence between team members. Service satisfaction was rated as moderate-high by the EDP, MDT, and parents. Conclusions: Telepsychology, while requiring significant practice change, was an acceptable way to delivery educational and developmental psychology services.