Special Challenges Working with Foster Care Youth in the Inpatient Setting

The inpatient treatment of youth in care with severe emotional or behavioral disorders is complicated by systemic factors unique to foster care, for example, placement shortages and relinquishment of custody, and clinically by factors more prevalent in these highly vulnerable youth such as in utero exposure to alcohol, exposure to domestic violence, neglect, and physical, sexual, and emotional abuse. The authors discuss prolonged lengths of stay and boarding in emergency rooms, medical units, government offices, and detention centers. We also discuss working with foster families, biological families, and the child welfare system.