Incorporating self‐determination into substance abuse prevention programming for youth transitioning from foster care to adulthood

Youth transitioning from foster care to adulthood are at higher risk for alcohol and substance abuse disorders than general population youth. At the same time, these youths are often recipients of strong clinical intervention, often at levels considered unnecessary, for other mental health or behavioural challenges. Because of this, there is sometimes resistance from providers to offer services such as substance abuse prevention programming as it may be seen as contributing to youths' overclinicalization, stigmatization, or retraumatization. Using thematic content analysis, this qualitative study analysed focus groups with community stakeholders providing recommendations on support services for youth transitioning from foster care to adulthood to derive strategies for delivering substance abuse prevention programming in a way that enhances youth self‐determination. Findings were organized by self‐determination theory's 3 key psychological needs: autonomy, competence, and relatedness. All three needs were represented in stakeholder recommendations, which were translated into strategies for bolstering youths' achievement of each need. Strategies include a mix of those already present in motivational interviewing‐based brief substance abuse prevention interventions as well as more unique strategies that are much less frequently employed but that may better meet the needs of youth with foster care experience.     

Home Street Home: The Interpersonal Dimensions of Adolescent Homelessness

This paper draws on the available literature, as well as unpublished data, to reconstruct the often chaotic early childhood experiences of homeless adolescents and to describe the problematic ways of relating that may result from these troubled life histories. We also examine the processes by which homeless youth become separated from their families, and we make connections between socio-emotional problems on the street and early neglect and abuse at home. The risk-amplification model is offered as a theoretically compelling explanation of the adolescent homeless experience, high rates of victimization on the streets, and mental health problems that arise out of these circumstances. Finally, we present a promising approach for intervening with homeless youth, one that explicitly targets this cycle of ineffective interpersonal relationships.     

AIDS Risk Behaviors among American and Australian Homeless Youth

We examined HIV/AIDS risk behaviors among homeless youth in cross-national data collected in Melbourne, Australia ( n = 398), and Los Angeles, California ( n = 498). Using structural equation modeling, we found that the Australian youth reported greater involvement in AIDS risk behaviors than the American youth and the Australian youth were more involved in intervening risk factors that promote risk behaviors and less involved with protective factors that reduce risk behaviors. Youth reporting the highest rates of delinquent behaviors also had peers engaging in delinquent acts, used alcohol and marijuana, and were more likely to utilize social services. These findings underscore the importance of having a service sector that is able to adequately address the needs of homeless youth .     

Needs of homeless children in the Czech Republic

The needs of homeless children living in shelters and hostels in the Czech Republic have been not sufficiently explored yet. The paper therefore aims to analyse and describe the needs of homeless children living in shelters and hostels in the Czech Republic, thus creating a basis for social work with homeless children and their families. As part of a qualitative research strategy carried out through interviews with parents, children and their social workers, five categories of homeless children's needs (based on Matěj?ek's theory) were identified and described in detail based on a data analysis using Charmaz's Grounded Theory; these categories were the need for stimulation, the need for a meaningful world, the need for love and emotional safety, the need for identity and finding one's own place in society and the need for a life perspective and open future. Based on the identified needs, implications for social work with families were identified, strengthening a sensitive approach of helping professions to the needs of homeless children.     

Preventing Substance Abuse Among American Indian and Alaska Native Youth

Research on the prevention of substance abuse among American Indian and Alaska Native youth offers challenges and demands careful methods. This paper describes such challenges in terms of philosophical, political, and cultural issues surmundiig substance abuse prevention research with American Indian and Alaska Native people. The authors suggest how social work researchers can address these issues through strategies of community 'collaboration, goal sening, and cultural sensitivity. The paper discusses the limits, implications, and future applications of the described strategies for research on the prevention of alcohol and drug abuse among American Indian and Alaska Native youth.     

Changing faces: the story of two Canadian street youth shelters

This study addresses the relationship between street youth shelters and formal child welfare systems in Toronto, Canada. Two case examples, Covenant House (CH) and Youth Without Shelter (YWS), are examined through archival material, participant observations and structured interviews with 21 front-line and managerial shelter workers. The findings suggest that both shelters have formed reciprocal and unequal partnerships with formal child-welfare organisations. The consequences of such an arrangement are threefold: (1) CH and YWS no longer possess an internal environment to support traditional street youths; (2) both shelters have strayed from their original intentions; and (3) many shelter workers express frustration within this dynamic. Several recommendations are put forward to support the survival of youth shelters: advocating increased government daily rates; seeking a balance between building a legitimate public image and an alternative street youth reputation; making every effort to house hard-core street youths; and building innovative internal programmes to act as referral points.     

Youth Experiences Survey (YES): Exploring the Scope and Complexity of Sex Trafficking in a Sample of Youth Experiencing Homelessness

ABSTRACT

In the United States, sex trafficking victims have been identified at ages across the lifespan but young persons (under age 25) have been found to have unique vulnerabilities. At-risk youth, such as those who run away from home or those experiencing homelessness, are also at an increased risk of sexual exploitation. To better understand the scope and complexity of sex trafficking among these at-risk youth, a convenience sample of 131 homeless youth aged 12 to 25 years old experiencing homelessness recruited from Kentuckiana youth service providers completed an enhanced version of the Youth Experiences Survey (YES). Univariate and bivariate analyses were conducted. Results indicated that 41.2% of the homeless youth were victims of sex trafficking. The sex trafficked youth were more likely to report previous self-harm behaviors, suicide attempts, and substance use. This study not only provides support for improved service delivery, but also provides essential statistics that should inform internal policy and procedures for youth serving agencies in Kentucky and Indiana. Findings highlight a need for trauma-informed interventions designed to treat not only females but also males and LGBTQ youth. Additionally, service providers should consider partnering with victim providers and clinicians to offer therapeutic groups, individual therapy, and supportive services that increase prevention, education, and wraparound care for clients. In regards to future research, findings point towards a need to better understand the role that trauma and adverse childhood experiences may play in making young people vulnerable to sex trafficking, and encourage the need for testing prevention and early intervention practices among vulnerable youth.     

‘Meeting them where they are at’: A practice note on implementation of the Child and Family Traumatic Stress Intervention in an emergency family homeless shelter

Families experiencing homelessness report higher rates of traumatic exposure than the general population, and traumatic experiences can often be precipitating factors for entrance into a homeless shelter. Emergency shelter is meant to be a brief, temporary housing intervention to support families toward more stable and permanent living arrangements. Beyond this ecological intervention, there is a frequently unmet need for trauma-specific mental health services. Further still, psychosocial interventions to support sheltered families should be sensitive to both the trauma-specific needs of this population and the constraints of the shelter setting. The Child and Family Traumatic Stress Intervention (CFTSI) is a brief, secondary prevention protocol that aims to prevent PTSD after exposure to a traumatic event, with research demonstrating its effectiveness in acute care settings such as child advocacy centres and emergency departments. This case study illustrates the implementation of CFTSI in an emergency family shelter in a large urban area, highlighting the appropriateness of the intervention for the setting, its adaptability to client needs and its generalizability to other non-traditional intervention settings.     

A Quantitative Evaluation of the Multi-Disciplinary Approach to Prevention Services (MAPS) Program to Protect Children and Strengthen Families

This article presents the results from an evaluation of a state-funded, prevention-based, pilot program called the Multi-Disciplinary Approach to Prevention Services that was designed to reduce the potential for child abuse and neglect. The program served 64 families of various races and ethnicities over two years. A quantitative pretest–posttest design was used to analyze existing program data related to client outcomes including parenting skills, parenting satisfaction, and the use of non-family resources to assist in improving skills and satisfaction. Means comparisons were used to assess the relationship between three standardized instruments (the Parenting Scale, the Eyberg Child Behavior Inventory and the Kansas Parental Satisfaction Scale). Findings indicated a statistically significant improvement regarding resource engagement by families, parenting behaviors and perceptions, and involvement with Child Protective Services. The results from this study offer insight into how to improve parenting behaviors and increase child protective factors for youth who are at risk of maltreatment. In addition, these findings contribute to strengthen the legitimacy of Weiner's Attribution Theory while providing the social work profession with additional data in areas of research targeting the intersection of financially viable prevention programs, family stability, parental education, resources engagement, and the reduction of child abuse and neglect. If additional research supports the efficacy of prevention programs such as MAPS, funding similar programs could lead to improved parenting and decreases in child maltreatment.     

Sexual Health Services for Homeless Youth: A Qualitative Analysis of their Experiences

The sexual health problems experienced by homeless youth bring into question their use of available sexual health services. Using a qualitative typological analysis, this study aims to identify sexual health services utilization profiles for homeless youth, and to understand the role of the homeless experience on the utilization of sexual health services. Individual interviews were conducted with 33 homeless youth (17 men, 16 women) between 18 and 25?years of age. Typological analysis identified four profiles: (1) a targeted use of sexual health services to determine one’s serological status following a relational change during the homeless experience; (2) a limited use of sexual health services to manage sexual emergencies that arise during the homeless experience; (3) a regular use of sexual health services to avoid the risks associated with the homeless experience; (4) a frequent use of sexual health services to obtain support when engaging in prostitution during the homeless experience. This study shows that the precarious and unstable conditions within the homeless experience incite youth to utilize sexual health services in different ways. These findings point to the importance of rethinking sexual health services to better adapt them to the different utilization profiles of homeless youth.     

Homeless young people,families and change: family support as a facilitator to exiting homelessness

The families of homeless young people are most often portrayed as a precipitating factor in their homelessness. However, recent studies, particularly those taking a longitudinal approach, have drawn attention to the enabling role of family members and their positive influence on the housing trajectories of homeless youth. Drawing on selected findings from an ongoing longitudinal qualitative study of homeless young people in Dublin, Ireland, this paper aims to build on this relatively fertile area of research. We demonstrate the supportive role of the families of young people who experience homelessness (often as a consequence of difficult family environments) and specifically examine how family re‐engagement is negotiated and achieved. The findings highlight a number of dimensions of transition and change. Prominent among these is the importance of renewed trust and communication. Young people and their parents also had to accept responsibility for areas of life that previously served to undermine their relationships and were implicated in the circumstances surrounding a young person's premature home‐leaving. Tensions and resistances on the part of young people are highlighted, demonstrating the adaptive mechanisms at work as they attempt to re‐engage with family members. The implications of the findings for social work intervention with homeless youth are discussed.     

Examining the impact of family services on homeless children

This study examined the impact on children of services delivered through a collaborative initiative designed to provide supports to working poor families who are homeless or at immediate risk of becoming homeless. Overall, a number of positive findings can serve to inform the development of promising intervention strategies for children in homeless families and highlight areas for further research. Along with improved housing status, there was a statistically significant improvement in the economic self‐sufficiency of the families served, regardless of whether they completed the full programme cycle. In addition, youth self‐report data indicated significant improvements in externalizing and internalizing behaviour. The ability to combine programme data with school data for participating children also made it possible to explore school performance outcomes. Although these results did not indicate a change in participants’ levels of attendance or reading performance, there was a statistically significant improvement in students’ math scores. Moreover, when participating children were compared with a group of students matched on their level of academic performance at baseline who had not received housing or homeless services, no significant differences were detected between groups post‐intervention, indicating that services may help reduce the risk of homeless students’ falling further behind their peers academically.     

Policeman or Friend? Dilemmas in Working with Homeless Young People in the United Kingdom

This qualitative, phenomenological study examined the relationships between residents and staff in hostels for homeless young people in the UK. Semi-structured interviews were conducted with 12 homeless youth (residents) and 10 hostel staff (keyworkers). The interviews focused on how participants perceived and experienced the keyworker relationship. Qualitative data analysis yielded three core themes, or dimensions, describing central features of the relationship: enforcement versus support, emotional involvement versus distance, and resident-centered versus staff-centered practice. The findings highlight some dilemmas and tensions experienced by both residents and staff, and point to effective ways of working with homeless youth. Issues arising in the relationship between keyworkers and homeless young people are considered in the context of other types of helping relationships .     

Leaving an Institution in Flanders (Belgium): A Road to Homelessness?

People living in an institution will leave this residential context one day and have to proceed to a stable independent way of living. This transition is not without difficulties as it turns out this socially vulnerable group runs an increased risk of becoming homeless. Research in Flanders (Belgium) has shown that a considerable share of the homeless population has previously stayed in an institutional setting, mostly in youth care (48.7%), psychiatric (34.4%) and penitentiary (33.1%) institutions. Moreover, the share of homeless people with a history in one of these institutions has increased in the past decades. Institution leavers, face at least three obstacles to a stable housing situation in Flanders: a lack of affordable housing, a lack of access to (non-residential) social assistance and personal difficulties in coping with living independently. Yet, there are several programs that support institution leavers and prepare them for the transition to an independent living situation and legal developments that strengthen their position in society and on the housing market. In this paper, we explore these initiatives and developments in three case studies (Antwerp, Ghent and Leuven). Based on in-depth interviews with “street-level bureaucrats” who work in these institutions (youth care, psychiatric and penitentiary settings), social support services and social housing organizations, we reconstruct the pathways of institution leavers to the housing market, the support they receive and the experienced difficulties.     

Parenting interventions in shelter settings: a qualitative systematic review of the literature

The aim of this literature review was to critique the state of the research on the effects of implementing parenting programmes in shelters for homeless families. A comprehensive search of multiple databases yielded 12 studies for inclusion. The methodological sophistication of the studies varied, with most investigations based on very small samples and one‐group pre‐post designs. Results indicated that parents generally viewed the interventions as enjoyable and informative, and attendance was good. Incentives were often used to encourage attendance. Evidence was limited in terms of effectiveness of the interventions, but the few studies of evidence‐based parenting programmes showed changes in parenting and child functioning. Suggestions are provided for future investigations in this important yet challenging field of study.     

Contemporary Youth Violence Prevention: Interpersonal-Cognitive Problem-Solving

ABSTRACT

Considerable progress has been made in the past decade in identifying which factors contribute to youth violence. The purpose of this article is to illuminate the issues and group factors that underlie youth violence, assessment and profiling, and prevention programs. Guidelines for predicting youth violence are presented and critiqued. School violence prevention programs, the role of SAMHSA, and interpersonal-cognitive problem-solving are presented.     

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns

ABSTRACT

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.     

Indirect effects of the Family Check‐Up on youth extracurricular involvement at school‐age through improvements in maternal positive behavior support in early childhood

Extracurricular involvement in the school‐age years has widespread potential benefits for children's subsequent socioemotional development, especially for low‐income youth. However, there is a dearth of research on interventions aimed at increasing school‐age extracurricular involvement in low‐income youth. Thus, the present study aimed to test the collateral effect of a brief, family‐focused intervention for low‐income families, the Family Check‐Up, on children's school‐age extracurricular involvement via improvements in maternal positive behavior support (PBS) in early childhood. The sample (n = 630, 50% female, 50% White, 28% Black/African American) represented a subsample of families from the Early Steps Multisite Study. At the age of two, families were randomly assigned to the Family Check‐Up or Women, Infants, and Children Nutritional Supplement Services as usual. Mother‐child dyads participated in observed interaction tasks at child ages 2 and 3 that were subsequently coded to assess PBS. Primary caregivers reported on children's school‐age extracurricular involvement at ages 7.5, 8.5, and 9.5. Results indicated that although there was not a direct path between intervention status and children's school‐age extracurricular involvement, a significant indirect path emerged from intervention group to changes in PBS between ages 2 to 3 to children's school‐age extracurricular involvement. The results are discussed in terms of implications for designing preventive interventions in early childhood that promote extracurricular involvement at school‐age, particularly for children at risk for maladaptive outcomes.     

'School was just a nightmare': childhood abuse and neglect and school experiences

Children who have experienced abuse display significant difficulties in dealing with all aspects of the school environment. This paper examines the experiences at school of a group of respondents who had been subject to abuse and neglect during their childhood and adolescence. A qualitative research approach, utilizing in-depth interviews, was used to explore their perspectives and insights in relation to their experiences. The findings of this study show how the various forms of abuse and neglect experienced in their families had consequences for them in the school setting. A further important finding was a lack of professional student welfare support for the interviewees at school. Implications for prevention and intervention approaches in relation to both policy and service delivery are outlined.