Decision-making around psychotropic medications for children in foster care: Perspectives from foster parents. (November 2016)

• Record Type: Journal Article
• Authors: Barnett, Erin R.; Boucher, Elizabeth A.; Neubacher, Katrin; Carpenter-Song, Elizabeth A.
• Is Part Of: Children and youth services review. Volume 70(2016:Nov.)
• Page Start: 206
• Page End: 213
• Publication Date: 2016-11
• Subjects: Psychotropic medications -- Foster care -- Foster children -- Foster parents -- Decision making; Social work with children -- Periodicals; Social work with youth -- Periodicals; Adolescent -- Periodicals; Child Welfare -- Periodicals; Social Work -- Periodicals; Service social aux enfants -- Périodiques; Service social à la jeunesse -- Périodiques; Electronic journals; 362.705
• DOI: 10.1016/j.childyouth.2016.09.012
• Languages: English
• ISSNs: 0190-7409

Abstract

Abstract: Background and objective: Children in foster care have complex mental health needs and receive high rates of psychotropic medications. Rarely can foster parents make legal decisions about treatment, yet they are intricately involved in the child's life and responsible for the child's safety and well-being. We aimed to conduct the first study of foster parent perspectives on decision-making relevant to the use of psychotropics with children in foster care. Methods: We conducted semi-structured phone interviews with 13 parents in a small northeastern state who had fostered a child receiving psychotropics in the past 5 years. The state child welfare agency sent information about the study via email to all foster and adoptive parents for whom they had email contact. Interviews queried parents' knowledge and attitudes toward psychotropics, engagement in decisions, and recommendations for the decision-making process. Interview responses were coded and synthesized using mixed inductive and deductive methods in Dedoose software. Results: Children came into care on an average of four psychotropics. Parents reported receiving little information about the medications and finding information on their own. Parents acknowledged the potential benefits of medications, yet attitudes were largely against their use. Internal and external pressures for and against the use of medications were described. Many parents felt left out of the decisions and recommended team decisions. Conclusions: Efforts to improve foster parents' knowledge of medications, side effects, and monitoring, as well as team decision protocols, are sorely needed to improve decisions for this population. Highlights: Foster parents received little information about the medications or needed monitoring Foster parents found information on their own via the web or pharmacy packets Foster parents described various pressures around the use of psychotropics with children Foster parents felt left out of the decisions and recommended team decision-making Collaborative relationships with clinicians were deemed essential to high quality care