The assessment of early trauma exposure on social-emotional health of young children

Children exposed to traumatic events (e.g., violence in the home, school, community) report more adverse physical and mental health outcomes than children who have not been exposed to trauma. Caregiver reports provide an opportunity for early identification of intervention needs to aid healthy development of children exposed to trauma. The goal of this study was to determine unique social-emotional profiles and examine how traumatic events vary across these developmental profiles among a sample of caregivers who live in socioeconomically disadvantaged neighborhoods. Caregivers (N = 223) provided responses regarding their young children's (aged 3 years through 5 years) social-emotional health. Latent Profile Analysis was used to develop three distinct social-emotional profiles: Typical Social-emotional Health (low-risk), Some Social-emotional Challenges (moderate-risk), and Social-emotional Problems (high-risk). Results revealed that children exposed to increased non-family-based traumatic events had a greater likelihood of being a member of the moderate-risk group, whereas children exposed to increased family-based traumatic events had a greater likelihood of being a member of the high-risk group than of the low-risk group. The high-risk group was more likely to consist of older children and girls as compared to the low-risk group. There were no significant differences across profiles relative to ethnicity, caregiver education, and income. This research may aid in early identification and the distribution of services to youth at risk for trauma exposure and highlight pathways of resiliency.     

Community-based organizations for vulnerable children in South Africa: Reach,psychosocial correlates,and potential mechanisms

Community-based organizations (CBOs) have the potential to provide high quality services for orphaned and vulnerable children in resource-limited settings. However, evidence is lacking as to whether CBOs are reaching those who are most vulnerable, whether attending these organizations is associated with greater psychosocial wellbeing, and how they might work. This study addressed these three questions using cross-sectional data from 1848 South African children aged 9–13. Data were obtained from the Young Carers and Child Community Care studies, which both investigated child wellbeing in South Africa using standardized self-report measures. Children from the Child Community Care study were all CBO attenders, whereas children from Young Carers were not receiving any CBO services, thereby serving as a comparison group. Multivariable regression analyses were used to test whether children attending CBOs were more deprived on socio-demographic variables (e.g., housing), and whether CBO attendance was in turn associated with better psychosocial outcomes (e.g., child depression). Mediation analysis was conducted to test whether more positive home environments mediated the association between CBO attendance and significantly higher psychological wellbeing. Overall, children attending CBOs did show greater vulnerability on most socio-demographic variables. For example, compared to children not attending any CBO, CBO-attending children tended to live in more crowded households (OR 1.22) and have been exposed to more community violence (OR 2.06). Despite their heightened vulnerability, however, children attending CBOs tended to perform better on psychosocial measures: for instance, showing fewer depressive symptoms (B = − 0.33) and lower odds of experiencing physical (OR 0.07) or emotional abuse (OR 0.22). Indirect effects of CBO attendance on significantly better child psychological wellbeing (lower depressive symptoms) was observed via lower rates of child abuse (B = − 0.07) and domestic conflict/violence (B = − 0.03) and higher rates of parental praise (B = − 0.03). Null associations were observed between CBO attendance and severe psychopathology (e.g., suicidality). These cross-sectional results provide promising evidence regarding the potential success of CBO reach and impact but also highlight areas for improvement.     

Concurrent alcohol and cigarette use among school-going adolescents in Korea

BackgroundConrurrent alcohol and tobacco use may increase the risk for substance abuse in adolescents. The aim of this study was to investigate concurrent alcohol and cigarette use and the co-occurrence risks of each substance in school-going adolescents in Korea.MethodsIn a cross-sectional nationally representative survey in 2016, 65,528 students (Mean age = 15.1 years, SE = 0.02) responded to a questionnaire that included measures of substance use and substance use exposure.ResultsIn all, 13.3% of the students were concurrent lifetime smokers and drinkers (19.3% among boys and 6.7% among girls), 25.5% lifetime alcohol users only (24.2% among boys and 26.9% among girls), 3.0% lifetime smokers only (4.7% among boys and 1.1% among girls) and 58.3% never smoked and never used alcohol (52.2% among boys and 47.8% among girls). All measures of more intensive smoking pattern and smoking exposure and more intensive drinking pattern and drinking exposures, respectively, were associated with consistently increased risk of lifetime alcohol use and lifetime smoking, respectively, compared to lifetime never smokers and abstainers. In multinomial logistic regression, compared to students who neither had used alcohol nor tobacco, concurrent lifetime smokers and drinkers were more likely to be male, mixed or boys school, higher school grade, lower paternal and maternal educational level, perceived lower socio-economic status, ever drug user, perceived stress above average, depressive mood, experience of violence victimization, and living in a rural area or medium sized city.ConclusionPrevention and treatment strategies should better incorporate the comorbidity of cigarette smoking and alcohol use in their intervention programmes.     

How an intervention project contributes to social inclusion of adolescents and young people of foreign origin

This article presents the results of the impact study of the Nightingale Project, a social mentoring project, whose aim is to support the welcoming and social inclusion processes of adolescent students of foreign origin who recently arrived in Catalonia and who are currently enrolled in the country's schools. The more than one hundred mentoring pairs (mentor and mentee) that took part in the intervention project were administered a questionnaire (N = 58). This same questionnaire was also given to a group of adolescents with the same profile but who did not participate in the project (N = 128) and who were treated as a control group.After six months of intervention (which corresponds to the duration of the Nightingale Project), results show that students who participate in mentoring learn the language faster, create broader and more diverse networks of friends in school, develop higher educational aspirations and expectations, are better acquainted with the reception context (municipality they live in), and improve standards of self-confidence and self-esteem, among other characteristics. The research also demonstrates that mentoring aimed at adolescents, as is the case of the Nightingale Project, plays a key role in avoiding development of an oppositional identity and, conversely, helps facilitate a process of resilience in adolescents in the new context of reception.     

Factors affecting adoption in Wales: Predictors of variation in time between entry to care and adoptive placement

In the UK, there has been an increasing emphasis in recent years on reducing the delay in making permanent placements for children who cannot remain living with their birth parents. Adoption is one such plan for permanence. This study examined those factors that predicted a lengthier care episode for a national sample of children recently placed for adoption. The data was drawn from the Wales Adoption Study. This is a mixed methods study that analysed information from the adoption reports of all children placed for adoption over a 13 month period during 2014 and 2015 (n = 374). Children were aged between 0 months and 6 1/2 years on entry into care. On average, the time between entering care and moving into an adoptive placement was 528 days. The results of the regression analysis showed that four child-related factors were associated with a longer wait in care before being placed for adoption. These were developmental delay, externalizing behaviour, serious and enduring health problems/disability and exposure to domestic violence. The procedural factors examined showed no association with length of time to placement. The findings from this study make a substantial contribution to further developing what is known about the timeliness of adoption within the current UK context. The implications for policy and practice are discussed.     

Self-report of health problems and health care use among maltreated and comparison adolescents

The study aims were to compare maltreated and comparison adolescents' health problems and to identify how individual, family and home characteristics and maltreatment status affect adolescents' self-report of health status and health care use. The sample was 224 maltreated adolescents (mean age = 18.3 years) and 128 comparison adolescents (mean age = 18.15 years). Comparison adolescents reported more cold and pain symptoms during the previous 30 days but no differences in other physical health problems, self-assessment of their physical and mental health or health care use compared to maltreated adolescents. Girls were more likely to have had a dental checkup, to have seen a psychological counselor, and to self-identify their physical health as poor compared to boys. Older adolescents were less likely to have had a medical checkup or seen a psychological counselor than younger adolescents. A history of maltreatment was not related to health or health care disparities for adolescents growing up in the same low-income environment as adolescents without a maltreatment report. The environmental context and geographical location in which these adolescents grew up may be the primary driver in their health behaviors and health problems and not the experience of maltreatment.     

Internalizing symptoms and safe sex intentions among adolescents in mental health treatment: Personal factors as mediators

Little is known about why some adolescents with internalizing symptoms engage in sexual behaviors that increase their risk for HIV. This study tested a mediation model of internalizing symptoms and safe sex intentions among adolescents receiving mental health treatment. Self-efficacy for HIV prevention, HIV knowledge, and worry about HIV were hypothesized to mediate associations between internalizing symptoms and safe sex intentions among sexually active and non-active adolescents receiving mental health treatment (N = 893, M age = 14.9). Significant indirect effects from internalizing symptoms to safe sex intentions varied according to sexual experience: for sexually non-active adolescents, HIV worry and knowledge mediated this link, whereas for sexually active adolescents, HIV self-efficacy was the significant mediator. Increasing both HIV knowledge and self-efficacy for HIV prevention are important targets for HIV prevention with adolescents with internalizing symptoms, and careful attention should be paid towards targeting these interventions to sexually experienced and inexperienced youth.     

The relationship between parent immigration status and concrete support service use among Latinos in child welfare: Findings using the National Survey of Child and Adolescent Well-being (NSCAWII)

The underutilization of concrete services by immigrants is widely documented across several service sectors, yet evidence is lacking on the use of such services among immigrants reported to child welfare for the purposes of reducing maltreatment. It has been suggested that Latino immigrants involved with the child welfare system may face steep challenges to receiving needed services due to issues surrounding legal status, language and cultural barriers. The purpose of this study was to determine whether referral to and receipt of concrete services by Latino families reported to child welfare agencies, was associated with legal immigration status. The sample included children of Latino parents who participated in the second National Survey of Child and Adolescent Well-being (NSCAWII), who remained in the home following a child welfare investigation (n = 561). Over a third (37%) of Latino families were referred for at least one concrete service, yet only 17% received any. Weighted logistic regression models showed that families in which the primary caregiver was undocumented had significantly lower odds (OR = .24) of receiving services once referred. Families who had trouble paying for basic necessities (OR = 7.52), those with active domestic violence in the home (OR = 4.98), and those receiving ongoing child welfare services (OR = 4.52) had increased odds of referral for services by the caseworker. The odds of receiving services increased when the primary caregiver was unemployed (OR = 5.24), when there was domestic violence in the home (OR = 4.59), and with the receipt of child welfare agency services (OR = 8.83). There appears to be an unmet need for concrete services among Latinos investigated by child welfare, as demonstrated in the gap between overall service referral and receipt. A parent's legal status may be one reason for that unmet need, implying that children of undocumented parents are less likely to have basic needs met to mitigate economic stress and reduce maltreatment risk upon contact with child welfare. Policy recommendations and implications for child welfare practice are discussed.     

Help-seeking and help-offering for teen dating violence among acculturating Mexican American adolescents

Help-seeking sources, motivations, and barriers concerning teen dating violence are rarely co-examined alongside help-offering processes and messages, and both are understudied among minority youth populations. This study sought the perspectives of Mexican American adolescents (ages 15 to 17) concerning their preferences and experiences with both help-seeking and help-offering. Twenty focus groups (N = 64 adolescents) were divided by gender and by acculturation level to allow for group comparisons. Friends and supportive family members were primary sources of help, although adolescents voiced a number of barriers to help-seeking. The most prominent barrier was fear they would be told to leave the relationship, an anticipated message that aligned with their tendency to tell others to do so. Help-seeking was viewed as a weakness, and help-offering was reserved for friends that asked for it. Recommendations for programs and practice with youth include promoting culturally and gender attuned teen dating violence services that emphasize confidentiality, and working at the family, peer, and school levels to foster healthy relationships.     

Factors influencing the development of psychiatric disorders in the victims of sexual abuse: A study on Turkish children

The purpose of this study is to test empirically whether there are sex differences in childhood sexual abuse characteristics and psychiatric disorders, and there is an association with sexual abuse characteristics and psychiatric disorders caused by abuse. Files of 482 cases referred to the Child Surveillance Center due to sexual abuse between September 2012 and September 2014, for whom legal reports were prepared, were investigated retrospectively. Of the abused children, 82.2% (n = 396) were girls and 17.8% (n = 86) were boys. The mean age of girls was 14.1 ± 2.9 years, while that of boys was 11.6 ± 3.8 years. The most common type of abuse was sexual touching in girls, while it was anal penetration in boys. The rate of being diagnosed with at least one psychiatric disorder was found to be 68.9% (n = 273) in girls, while it was 38.4% (n = 33) in boys. When the abuser was from the family or someone close to the victim, when the numbers of abuse incidents and abusers were greater than one, and in cases of force and violence, the rate of being diagnosed with a psychiatric disorder was found to be higher. With greater duration of time passing after the abuse, in those who became pregnant due to abuse, and in those who did not tell their parents about the incident, the rate of psychiatric diagnosis was significantly higher. In addition, it was found that when there were more than one abused people in the same event, the rate of psychiatric diagnosis was lower. Among all these variables, independent variables affecting the development of psychiatric disorders in victims were gender, number of abuse, presence of force and physical violence, and presence of more than one abuse victim in the same event. Because of high rates of psychiatric disorders in children exposed to sexual abuse, it is crucial to evaluate these children in a careful and closely manner by clinicians.     

Abused women and the threat of parental alienation: Shelter workers' perspectives

Based on quantitative and qualitative data collected in 30 domestic violence shelters in the Province of Québec (Canada), the research findings reveal a noticeable increase in the perceived number of women being accused or threatened to be accused of parental alienation; the accusations or threats of accusations reported in the last year by respondents represented 45% of all the accusations reported in the last 5 years (Last year: 4.27, SD = 3.80. Last 5 years: 9.47, SD = 10.04). A large majority of respondents (86.7%) stated that this phenomenon had had an impact on their practices in shelters, and more than half (53.3%) expressed that this issue had been either a priority for their shelters or one of their main concerns. Based on the research findings, the authors argue that domestic violence perpetrators use “parental alienation” as a tactic to discredit reports of abuse by women and children. By embracing this discourse, child protection services and the family court system reproduce the perpetrators' accounts and discredit reports of abuse by women and children, and therefore undermine their core mandate.     

Programmatic effects to modify sources of financial support among Hispanic teenage mothers

This study evaluates whether a randomized school-based intervention for adolescent teenage mothers successfully helped participants achieve better financial independence and economic prospects. Project Mothers and Schools (PMAS) is an initiative intended to modify attitudes and beliefs related to self-sufficiency, parenting, educational goals and achievement, career goals, health behaviors, and interpersonal relationships with family members. PMAS participants were surveyed at baseline and 12 months after intervention enrollment to evaluate the receipt of financial support from 11 sources. The 48 “core group” participants received a basic level of services, whereas the 43 “core-plus group” participants received the same basic services and additional enhanced services. Wilcoxon signed-rank tests were used to identify statistically significant changes in participant responses from baseline to 12 months post-intervention. Both groups reported higher levels of employment 12 months post-intervention compared to baseline (z = − 3.162, p = 0.002 and z = − 2.646, p = 0.008, respectively). The core-plus group used more Food Stamps (z = − 2.673, p = 0.008) and reported receiving more child support (z = 2.236, p = 0.025) 12 months post-intervention versus baseline. PMAS benefited all participants by promoting employment 12 months post-intervention versus baseline. The enhanced services offered to the core-plus group appeared to also increase participant access to Food Stamps and child support, sources which assist participants down the path toward eventual financial independence.     

Development of an innovative process evaluation approach for the Families Improving Together (FIT) for weight loss trial in African American adolescents

This study demonstrates how a multi-theoretical, multilevel process evaluation was used to assess implementation of the Families Improving Together (FIT) for weight loss intervention. FIT is a randomized controlled trial evaluating a culturally tailored, motivational plus family-based program on weight loss in African American adolescents and their parents. Social Cognitive, Self Determination, Family Systems theories and cultural tailoring principles guided the conceptualization of essential elements across individual/family, facilitator, and group levels. Data collection included an observational rating tool, attendance records, and a validated psychosocial measure.ResultsAttendance records (0 = absent, 1 = present, criteria = ≥70%) indicated that 71.5% of families attended each session. The survey (1 = false, 6 = true, criteria = ≥4.5) indicated that participants perceived a positive group climate (M = 5.16, SD = 0.69). A trained evaluator reported that facilitator dose delivered (0 = no, 1 = yes, criteria = ≥75%) was high (99.6%), and fidelity (1 = none to 4 = all, criteria = ≥3) was adequate at facilitator (M = 3.63, SD = 0.41) and group levels (M = 3.35, SD = 0.49). Five cultural topics were raised by participants related to eating (n = 3) and physical activity (n = 2) behaviors and were integrated as part of the final curriculum.DiscussionResults identify areas for program improvement related to delivery of multi-theoretical and cultural tailoring elements. Findings may inform future strategies for implementing effective weight loss programs for ethnic minority families.     

Physical abuse after child protective services investigation and adolescent substance use

The longitudinal pathways connecting physical abuse and substance use in child welfare-involved adolescents, a population with multiple risk factors for substance use problems, remain unclear. This study examined the relation between self-reported physical abuse among adolescents investigated by Child Protective Services (CPS) and later substance use, with a particular focus on exposure to physical abuse after CPS investigation as a potential contributing factor to this relation. Using data from the first National Survey of Child and Adolescent Well-being (NSCAW-I), a path analysis was conducted on a sample of 1079 adolescents aged 11–15 years who had recently been investigated by CPS. At baseline and 18-month follow-up, youths self-reported past-year physical abuse using the Parent-Child Conflicts Tactic Scale and past 30-day substance use frequency. At baseline, youths self-reported current internalizing and externalizing problems to the Youth Self Report. Path analysis revealed no significant relation between physical abuse at baseline and substance use at 18 months. Physical abuse at baseline was associated with higher levels of concurrent substance use and externalizing problems, which in turn predicted higher substance use at 18 months. Furthermore, physical abuse and externalizing problems at baseline predicted physical abuse at 18 months, which in turn was related to higher substance use at 18 months. The findings suggest that physical abuse after CPS investigation contributes to the development of adolescent substance use behaviors. Results indicate a need for innovative efforts to prevent physical abuse after CPS investigation, as well as assessment and treatment of substance use and externalizing problems at the point of investigation, to reduce future substance use in child welfare-involved adolescents.     

Cost effectiveness of a school readiness intervention for foster children

ObjectiveMany young children in foster care suffer from emotional and behavior problems due to neglect and abuse. These problems can lead to difficulties in school, and functioning in school is linked to long-term health and development. Early intervention to reduce emotional and behavioral issues can help children successfully transition to school, which can improve long-term outcomes. However, communities need information on relative costs and benefits associated with programs to make informed choices. The objective of this study was to assess cost effectiveness, over 12 months, of the Kids in Transition to School (KITS) intervention compared to usual services available to children in a foster care control group (FCC).MethodRandomized controlled trial of 192 children in foster care entering kindergarten who were randomized to KITS (n = 102) or FCC (n = 90). KITS includes school readiness groups and parent training over 4 months. Main outcomes were days free from internalizing symptoms (IFD), days free from externalizing behavior (EFD), intervention costs, public agency costs, and incremental cost effectiveness.ResultsKITS significantly increased IFD and EFD compared to FCC. Average total cost of the intervention was $932 per family. The intervention did not significantly impact usual services. Average incremental cost effectiveness was $64 per IFD and $63 per EFD.ConclusionsThe cost of KITS is comparable to, or less than, similar programs, and the intervention is likely to provide significant emotional and behavioral benefit and improvement in school readiness for young children in foster care.     

The relationship between the type of smartphone use and smartphone dependence of Korean adolescents: National survey study

The purpose of this study is to verify the relationship between the type of smartphone use and smartphone dependence. We analyzed 2212 data of middle and high school students of the survey on internet addiction by the Korea Information Society Agency in 2016. We conducted a hierarchical multiple regression analysis to examine the effects of smartphone use for information seeking, entertainment seeking, gaming, mobile SNS, and mobile instant messenger on smartphone dependence after controlling smartphone usage frequency, and smartphone usage time. As a result of the analysis, the frequency of smartphone use of weekday (p < 0.001) and weekend (p < 0.001) was related to the dependence on smartphones. In addition, the amount of smartphone use for information seeking (p < 0.01), entertainment seeking (p < 0.05), and gaming (p < 0.001) were associated with the dependence of smartphone. The amount of smartphone use for mobile SNS and mobile instant messenger are not related to smartphone dependence. The results suggest that different strategies need for the psychological intervention of smartphone dependence according to the main type of smartphone use of adolescents.     

Parents,friends, and depression: A multi-country study of adolescents in South Asia

PurposeThis study investigates the association between social support networks, as measured by parental involvement and close friendships, and depression among adolescents in South Asia.MethodsNationally representative samples of adolescents between the ages of 12 and 16 + years (n = 16,592) from the Global School Based Health Surveys from India, Sri Lanka, Pakistan, and Myanmar were analyzed to provide prevalence rates of depression. Additionally, differences in past year depressive symptoms were compared cross-sectionally by social support from parents and friends, separately. This was done by computing prevalence ratios adjusting for potential confounders and demographic factors.ResultsOf all adolescent respondents in the study, 14.5% met the criteria to be screened for depression, while 50% reported having three or more close friends, and 80% reported having very involved parents. Adjusted prevalence ratios indicated that those with close friendships were much less likely to be screened for depressive symptoms compared to their counterparts, as were adolescents with very involved parents. However, low and moderate levels of parent involvement were not found to be significantly associated with adolescents' propensity for being screened for depressive.ConclusionSocial support is a social determinant of adolescent mental health in South Asia that has received little scholarly attention to date. This study highlights the importance of research and interventions involving parents and close friends in building programs for adolescents that target mental health.     

The role of fathers in reducing dating violence victimization and sexual risk behaviors among a national sample of Black adolescents

PurposeStructural equation modeling (SEM) was used to explore the impact of father-figures' involvement on reducing both dating violence and sexual risk among a national sample of Black American youth well as the possible mediating effect of dating violence on the relationship between father figure involvement and sexual risk behaviors.MethodsTo explore this phenomenon, sexually active Black adolescents between the ages of 13–21 with a romantic partner in the previous 18 months were selected (N = 422) from wave II of the National Longitudinal Study of Adolescent Health.ResultsThe analyses indicated that overall, perceived closeness to father figures reduced dating violence victimization among Black youth. When separated by gender, our hypothesis for male respondents was supported indicating that perceived closeness with their father figures resulted in a reduction in dating violence. However, the same hypothesis was not supported for female respondents. On the other hand, perceived closeness to father figures resulted in lower sexual risk behaviors for girls.ConclusionGiven the study's findings, researchers, practitioners, and policy makers should consider the importance of the father–child relationship in reducing problem behaviors among Black adolescents. In particular, emphasis should be given to the quality of the father–child relationship rather than general father involvement in reducing dating violence victimization and risky sexual behavior among sexually experienced Black adolescents.     

‘Reach Out,Rise Up’: The efficacy of text messaging in an intervention package for anxiety and depression severity in young people

BackgroundDepression and anxiety are among the most commonly experienced mental health issues faced by young people in Aotearoa, New Zealand. Considerable barriers exist that prevent young people from engaging with face-to-face mental health services. Young people's preference for technology-based counselling mediums such as text messaging opens up new pathways for intervention.ObjectiveA pilot text message-based intervention package was trialled for use by young people to evaluate the potential efficacy of the text package as an intervention for depression and anxiety symptoms.MethodThe text package was piloted using a 10-week longitudinal cohort pilot with 21 young participants (12–24 years) who demonstrated mild to moderate anxiety and/or depression symptoms.ResultsParticipants' post-package scores were significantly lower than their pre-package scores for both anxiety (Z = − 2.83, p = .005, r = − 0.65) and depression (Z = − 2.49, p = .013, r = −.056). ‘Feeling encouraged and supported’ increased as a result of receiving support from a trained supporter (Z = − 2.06, p = .039, r = − 0.45), but not from friends/family (Z = − 1.72, p = .130, r = − 0.37). Anxiety and depression scores did not change as a result of support from either trained supporters or friends/family.ConclusionsFindings support the potential efficacy of the text package, justify wider trials of the text package, and support the use of text message-based interventions as potentially effective therapies for young people.     

Keeping it in the family: The impact of a Family Finding intervention on placement,permanency, and well-being outcomes

Child-centered recruitment via Family Finding has gained national attention as an approach to search, discover, and engage kin and fictive kin to support the attachment and permanency needs of children in foster care. However, despite its promise it has received scant attention in the empirical literature. The current study compared the outcomes of a front-end Family Finding intervention (n = 196) and a comparison group (n = 262) among children in foster care in Cook County Illinois between the ages of 6 and 13. Results showed that there were no differences between the intervention and comparison group on reunification rates, placement stability, or on longitudinal externalizing behavior and internalizing symptoms. However, the intervention found close to 75% more relatives than the control group, and many of these relatives were significant figures in the children's lives. The intervention was also associated with a higher proportion of relative placements to total placements for a subgroup of children with five or more placements. Further, the effect of the intervention on this proportion (relative placements to total placements) was mediated by the greater number of relatives found in the intervention. Finally, the intervention was associated with relatively better Concurrent Planning. These results suggest that Family Finding has the potential to impact proximal outcomes related to discovery, engagement and planning but is currently not impacting more distal outcomes such as permanency and well-being. Family Finding approaches should continue to innovate, possibly through integration with psychosocial interventions, to affect more distal variables such as well-being outcomes.