The child and adolescent psychiatrist currently has no specific guidelines to help make treatment decisions when a patient is transferred to their care that is already on four or more medications and may still be exhibiting out-of-control behaviors. This session begins the process of thinking about and working toward published guidelines. Five senior clinicians share their approaches to the problem of polypharmacy and discuss what works best when they decrease or simplify complex medication regimes. Attending this session, child and adolescent psychiatrists learn what treatment approaches may help in the process of decreasing medications, how to work with patients and families toward the goal of simplifying/decreasing medication regimes, and how to use relationship building as a tool when decreasing medications.