Telehealth Reshapes Mental Healthcare for Youth in Foster Care

Photo by National Cancer Institute on Unsplash.

by Sarah Kim

Chances are many of you are familiar with telehealth therapy, a trend prompted in part by the pandemic, which shifted typical in-person engagements, including psychological services for youth in foster care, to online appointments.

If the concept of sharing personal information via a laptop or desktop monitor seems strange to you, you’re not alone. When it comes to navigating sensitive issues like mental health, the legitimacy of telehealth services can raise initial skepticism. However, a 2022 study published in Behavior Analysis in Practice analyzed the effectiveness of telehealth services for psychotropic medication management among youth in foster care and concluded telehealth services do not compromise the quality of care.

Researchers recruited 29 participants, ages 2-18, with active cases before the Alabama Psychiatric Medication Review Team (APRMT). The APRMT regulates psychotropic medication prescribed to youth in foster care and works with caregivers to reduce dosage levels. Ten participants initially received in-person services before switching to telehealth services, and 19 participants received only telehealth services. Virtual sessions included assessments of the participant’s condition, behavioral interventions to reduce challenging behaviors, and training for both the participant and their caregiver. The researchers looked at several factors to determine the impact of telehealth: number of clients, closed cases, completed medication reviews and appointments. The first three factors saw no change, and the number of appointments increased when participants transitioned to telehealth services.

An interview with Jodi Coon (Robeson), one of the primary researchers, provided more insight into the researchers’ findings: “During the beginning of COVID, caregivers were the only ‘therapists’ available. We were required to incorporate the primary person interacting with the child from the very beginning. Progress may have been initially slower; but, the change was more durable. The caregivers were forced to learn the skills more quickly than before, causing the child’s behavior to adjust more quickly to their environment. The results of this study continue to reinforce how important the role of caregivers are in every aspect of their child’s life.”

Because telehealth has become the new normal for health care providers and their patients, it’s an important area for evaluation. In 2011, Congress passed the Child and Family Services Improvement and Innovation Act, which requires each state to develop an oversight plan for youth who have been prescribed psychotropic medication in foster care. The prescription and management of psychotropic medication among these youth has a lengthy and rough track record, thus making the need for appropriate regulation particularly relevant. Telehealth presents both benefits and challenges unique to those in foster care. Children in care may have frequent moves and less access to reliable transportation. Telehealth removes any geographical constraints to accessing care. Researchers write that a major impediment may be the inaccessibility of a reliable internet connection and a desktop or laptop. The 2022 study suggests that telehealth brings promising potential for the future of medication management, despite some challenges, i.e., access to technology.

The abrupt rise of telehealth services can understandably feel disorienting and overwhelming for both the caregiver and the child. When asked what takeaway she’d like for foster/adoptive parents to know from this study, Robeson responded, “Change does not happen overnight and caregiver involvement throughout the treatment process is absolutely crucial to the client’s progress. Being a parent is incredibly hard work, and we really value how much time and effort our foster/adoptive parents put into working with us and their child.”


Read the study in its entirety: “Eight Months of Telehealth for a State-Funded Project in Foster Care and Related Services: Progress Made and Lessons Learned

Learn more about the intersection between foster care, technology and medication:

  1. Free Phone Plans for California Foster Youth Likely to Become Permanent Program
  2. L.A. Uses iPads to Touch the Minds of Vulnerable Youth
  3. Judge OKs Class Action on Overuse of Psych Meds on Missouri Foster Youths
  4. New Hampshire Steps Up Monitoring of Powerful Drugs’ Use on Foster Children
  5. Class-Action Lawsuit Alleges Missouri Failed to Monitor Psychotropic Drugs Prescribed to Foster Youth
  6. California Auditor Blasts Oversight of Psychotropic Medications for Foster Youth
  7. Reducing Psychotropic Prescriptions Requires Systemic Reform