Psychotropic Medications for Youth in Child Welfare: Developing and Pilot-Testing A Field Guide for Team Decision-Making

High rates of children involved with the child welfare system are prescribed psychotropics. In response, federal legislation has mandated state child welfare agencies to develop policies to improve the coordination and oversight around the use of psychotropics. This project aimed to support such policies by developing and pilot-testing a field guide for team discussions and decision-making related to the use of psychotropics among youth in child welfare. We used a community-based participatory research (CBPR) framework to engage a team of local stakeholders, including former youth in foster care and parents, in the research. We developed a field guide to facilitate team discussions and decisions around the individual needs and preferences of youth and families, and we pilot-tested the field guide with child welfare staff, parents, and care team members in seven team meetings. Parents and care team members, in particular, highly valued the guide and found it useful to increase knowledge and improve practices such as side effect monitoring and information sharing. Child welfare responses were more mixed, and some reported feeling burdened by the additional tasks. More work is needed to integrate the guide into routine child welfare practice and reduce burden on staff.