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

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.