Foster youth and psychotropic treatment: Where next?

Longhofer, Jeffrey; Floersch, Jerry; Okpych, Nate

doi:10.1016/j.childyouth.2010.10.006

Cited by 22 publications

(12 citation statements)

References 123 publications

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“…The presence of these differing causal models seemed to coexist without causing conceptual tensions for participants endorsing both models. This is consistent with the findings of Longhofer, Floersch, and Okpych (2011), who reported that youth in foster care simultaneously endorsed both biomedical and psychosocial explanatory models of their respective mental illness experiences. Participants in the current study, although knowledgeable about and able to relate concepts from biomedical discourse to their illness experiences, clearly privileged their own unique psychosocial explanatory models of their illness experiences as the primary causes of their respective illness experiences.…”

Section: Discussionsupporting

confidence: 91%

Consumer-Operated Service Program Members’ Explanatory Models of Mental Illness and Recovery

Hoy

2014

Qual Health Res

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Incorporating individuals' understandings and explanations of mental illness into service delivery offers benefits relating to increased service relevance and meaning. Existing research delineates explanatory models of mental illness held by individuals in home, outpatient, and hospital-based contexts; research on models held by those in peer-support contexts is notably absent. In this article, I describe themes identified within and across explanatory models of mental illness and recovery held by mental health consumers (N = 24) at one peer center, referred to as a consumer-operated service center (COSP). Participants held explanatory models inclusive of both developmental stressors and biomedical causes, consistent with a stress-diathesis model (although no participant explicitly referenced such). Explicit incorporation of stress-diathesis constructs into programming at this COSP offers the potential of increasing service meaning and relevance. Identifying and incorporating shared meanings across individuals' understandings of mental illness likewise can increase relevance and meaning for particular subgroups of service users.

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Section: Discussionsupporting

confidence: 91%

Consumer-Operated Service Program Members’ Explanatory Models of Mental Illness and Recovery

Hoy

2014

Qual Health Res

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“…15 By 2010, 26 states had guidelines for psychotropic medication use in foster children, and 13 more had guidelines in development. 16 The increase in antipsychotic prescribing for children and adolescents over recent decades has also prompted the National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set (HEDIS) to include the use of multiple concurrent antipsychotics by children and adolescents as one of their outcome measures. 17 It included this measure because youth prescribed antipsychotics are at risk for weight gain, extrapyramidal side effects, hyperprolactinemia, and metabolic effects, so this measure can highlight potentially unsafe use of antipsychotic medications.…”

Section: Covariatesmentioning

confidence: 99%

Characterization of Chronic Multiclass Psychotropic Polypharmacy and Psychotherapy in Foster Care Youth in a State Medicaid Population

Keast

Tidmore

Shropshire

et al. 2019

JMCP

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BACKGROUND: Foster youth have higher rates of psychotropic medication use and concurrent multiclass psychotropic polypharmacy compared with nonfoster youth. However, less is known about the extent of multiclass psychotropic polypharmacy after adjusting for patient factors associated with psychotropic medication use OBJECTIVES: To (a) compare psychotropic medication use and psychotherapy use by youth in foster care to those not in foster care in the Oklahoma Medicaid population across various sociodemographic and clinical factors, and (b) determine if patient-related characteristics are associated with high levels of concurrent multiclass psychotropic polypharmacy. What this study addsmulticlass psychotropic polypharmacy in foster youth can lead to actionable interventions and important policy changes.

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“…The Preparing for the Appointment (PFTA) worksheet appears to effectively illustrate discrepancies in perspectives which may represent potential gaps in communication. Longhofer, Floersch, and Okpych () put forth the concept of arbitrage as a process for integrating discrepant perspectives into practice without necessarily needing the different parties to agree or needing the varying perspectives to align. They argue that through the process of identifying divergent opinions and perspectives, we learn about the true nature of the medication experience for the child and can ultimately negotiate the best plan of care.…”

Section: Discussionmentioning

confidence: 99%

Innovations in Practice: Supporting parent and teen communication during outpatient psychotropic medication appointments

O’Brien

Holmes

Chapman

et al. 2014

Child Adoles Ment Health

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Background: Encouragement of youth participation in mental health treatment is relatively new and there have been few specific interventions to improve engagement, particularly as it relates to medication management. This article describes the development of a tool to support engagement during medication appointments by identifying areas of agreement/disagreement between parents and teens. Method: Data were analyzed from 240 parent/teen dyads visiting an outpatient community mental health center for medication management. Frequencies and percentages were calculated for all items. Kappa scores were used to assess agreement between parent and teen dyads. Results: The level of agreement between parents and teens was low. Overall, teens expressed preference for discussion of 'positive' aspects of treatment such as what is going well, whereas parents preferred to focus on 'negative' aspects of treatment such as problematic symptoms. The lowest level of agreement was found for the item: 'My teen seems to be having problems with energy levels' (Kappa = .19; 95% CI = .05-.34). The strongest level of agreement was for the question 'How has your teen been using the medication since the last appointment?' (Kappa = .56; 95% CI = .44-.69). Conclusions: The findings support the utility of the tool for illustrating the variation in needs of teens and parents during medication appointments. Knowledge of these differences can be used by providers to encourage teen participation and may enhance overall communication. Key Practitioner Message• Parents and teens often have different agendas for medical appointments and value hands-on tools to assist with communication during psychiatric medication appointments.• The Preparing for the Appointment worksheet represents one hands-on option clinicians can use to reveal divergent parent/teen perspectives.• Clinicians can use the worksheet to facilitate communication, to amplify teen voice and to empower both parents and teens to communicate with one another and with providers.

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Foster youth and psychotropic treatment: Where next?

Cited by 22 publications

References 123 publications

Consumer-Operated Service Program Members’ Explanatory Models of Mental Illness and Recovery

Consumer-Operated Service Program Members’ Explanatory Models of Mental Illness and Recovery

Characterization of Chronic Multiclass Psychotropic Polypharmacy and Psychotherapy in Foster Care Youth in a State Medicaid Population

Innovations in Practice: Supporting parent and teen communication during outpatient psychotropic medication appointments

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