Effectiveness of Multisystemic Therapy for gang-involved youth offenders: One year follow-up analysis of recidivism outcomes

The objective of this investigation was to examine the longer-term (12 months post-discharge) outcomes of gang involved and uninvolved youth who were referred for Multisystemic Therapy by their local justice authorities. This is the first systematic investigation of longer-term outcomes for gang-involved youth in treatment. From an initial sample of 421 youth, we applied an intent-to-treat analysis to 409 youth with available recidivism data (97% retention). We analyzed data on re-arrests using nonparametric and event history analytic methods. Overall, we observed a re-arrest rate of 30%. This rate did not differ significantly as the function of gang involvement (gang re-arrest: 35%; nongang re-arrest: 29%). We also observed no significant differences between gang and nongang youth in the numbers of re-arrests, nor in the time to arrest. Although gang youth had higher rates of violent arrests (18%) than did nongang youth (13% overall), this difference also was not statistically significant. This first study examining longer-term impacts of treatment for gang-involved youth suggests that evidence-based intervention can be effective in this population. Future research is needed to examine whether there are particular components of or different approaches to intervention necessary to support positive change among gang-involved youth.     

A cost–benefit analysis of transitional services for emancipating foster youth

Over 24,000 youth “aged out” of the nation's foster care system in FY 2005. While independent living programs and other services are available to foster youth, and almost all states allow dependency courts to retain jurisdiction of foster youth beyond age 18, outcomes for former foster youth are disturbing. This paper describes a program to address these challenges by providing extended foster care benefits and support to former foster youth from their 18th to 23rd birthdays. A detailed cost–benefit methodology documents expected costs and key benefits of the program. According to this cost–benefit analysis, a program providing funding and guardian support for former foster youth is projected to result in net benefits to the State of California over the 40-year careers of participating former foster youth. The program, if successful for all youth, would increase lifetime earnings and taxes paid due to increased education and would lower use of TANF and prison, resulting in a benefit–cost ratio of 1.5 to 1, using discounted present value dollars. Even at 75% success, the ratio is 1.2 to 1, showing a net benefit to society. This methodology can also be used to assess the costs and benefits of similar programs.     

Change in externalizing problems over time among ethnic minority youth exposed to violence

Youth exposed to violence, many of whom are from racial/ethnic minority backgrounds, are at high risk for externalizing problems such as aggressive and oppositional behavior, conduct problems, and delinquency. Most interventions target youth with already high levels of such problems, while selective prevention efforts have received less attention. It is important for researchers, policy makers and practitioners to understand how such problems develop and change over time, and how selective prevention may impact externalizing problems. In this study, we examined one-year trajectories of externalizing problems in 883 low-income, ethnic minority youth exposed to violence who participated in randomized controlled trials testing a prevention program for high-risk youth called the Strengthening Families Program. We found three trajectories of externalizing problems: Low Externalizing (43% of the sample had consistently low levels of externalizing symptoms), Persisters (39% of the sample had consistently high levels of externalizing symptoms), and Improvers (18% of the sample had initially high levels of externalizing symptoms that decreased over time). There were demographic differences between the three trajectories with individuals in the Low Externalizing trajectory more likely to be female and younger than those in the other two trajectories and Persisters and Improvers had significantly more problems with baseline internalizing symptoms, family conflict, and parenting behavior compared to the Low Externalizing trajectory. Logistic regressions then tested several predictors of membership in the Persisters trajectory compared to the Improvers trajectory, controlling for all covariates simultaneously. Only baseline parenting behavior and intervention group membership significantly predicted trajectory membership, and these were small and unreliable effects. Thus, children with varying levels of violence exposure, co-occurring emotional/behavioral problems and family issues, and varying demographics (e.g., age and gender) may do equally well over time, but engagement in this type of intervention may increase the likelihood that high levels of externalizing problems are ameliorated over time.     

Psychosocial Treatment of Oppositional Defiant Disorder

Abstract

Objective:To review and describe empirical outcome studies on the psychosocial treatment of children and adolescents meeting the criteria for Oppositional Defiant Disorder (ODD).Method:To locate these treatment outcome studies, an extensive review of the literature using the PsycINFO database was conducted. Results:Psychosocial treatments designed solely for youth meeting the criteria for ODD are rare. Rather, it seems that most of the intervention studies have involved youth with Conduct Disorder as well as ODD, even though these two disorders have distinct differences. Selected psychosocial interventions, including anger control and stress inoculation training, assertiveness training, multisystemic therapy, and rational emotive therapy, have produced favorable outcomes in the studies conducted and published to date. Conclusions:Social workers serving ODD youth should seek training in these provisionally supported evidence-based practices. Given the scarcity of treatments designed solely for ODD with adolescents, there is a need for more outcome studies on this specific population, and for more studies of social work practice involving such youth.     

A national evaluation of community-based youth cessation programs: design and implementation

Although widely available, little is known about the effectiveness of youth cessation treatments delivered in real-world settings. The authors recruited a nonprobability sample of 41 community-based group-format programs that treated at least 15 youth per year and included evidence-based treatment components. Data collection included longitudinal surveys of youth participants (n = 878); posttreatment surveys of program leaders (n = 77); and one-time surveys of organizational leaders (n = 64)and community leaders in education, health, and juvenile justice (n = 94). Information about smoking-related ordinances was collected at the state and local levels. The framework, evaluation design, and implementation strategies described in this article provide a template for large-scale real-world program evaluations.     

Effects of an Expressive Art Intervention with Urban Youth in Low-Income Neighborhoods

Various forms of expressive arts are known to have associations with positive academic, social, and behavioral outcomes in addition to offering important therapeutic benefits for children and adolescents. However, very limited knowledge has been developed regarding specific expressive arts interventions for promoting positive youth development and preventing problematic behaviors in youth from urban, low socioeconomic neighborhoods. Therefore, the purpose of the current study was to expand the nascent research area in arts interventions by evaluating an expressive art intervention offered to youth through a positive youth development program located in several public housing neighborhoods. Quasi-experimental design was applied to test the impact of a poetry-focused art intervention on self-reported perceptions of academics, social competence, and multicultural attitudes of a culturally diverse sample of 40 urban sixth to eighth grade youth. Participants were recruited through a positive youth development program located in the public housing neighborhoods where they reside. Pre and post data were collected. Prior to the arts intervention, there were no statistically significant differences between the youth on self-report measures of academic capacity and social competence. The first group of youth who participated in the intervention reported enhanced capacity on all three measures when compared to peers who had not yet participated in the program. However, the second group of youth to receive the program showed no statistically significant gains when compared to their peers who received the intervention first. The study provides compelling support to further explore the efficacy of expressive arts on influencing attributes of positive youth development among urban adolescents. In addition, the study offers valuable insights into the process and complexities involved in developing agency partnerships and conducting research on after-school programs.     

Implementing Cognitive Behavioral Intervention for Trauma in Schools (CBITS) with Latino Youth

Objective

Many Latino youth are often unable to access mental health services and support following exposure to traumatic and stressful events. This study assesses the benefits and effectiveness of utilizing Cognitive Behavioral Intervention for Trauma in Schools (CBITS), a school based intervention, with Spanish speaking, Latino youth residing in New Orleans, Louisiana, in effort to address presenting symptoms of trauma and depression.

Method

Twenty three children and adolescents ages 10 to 14, in fifth, sixth and seventh grades, presenting with symptoms of trauma and depression, participated in a 10 week program of CBITS which was primarily conducted in Spanish.

Results

Children who participated in CBITS reported significantly fewer symptoms of trauma and depression following the intervention; however, no differences were noted between genders. Significant differences were observed between older boys and girls (12–14), as they were more likely to report higher levels of exposure to trauma than younger boys and girls (10–11). The effect sizes for the intervention were large.

Conclusions

Findings of this study suggest that CBITS is a practical and effective school based intervention available to mental health providers as a resource to be used with Spanish speaking, Latino youth who have been exposed to different forms of stress and trauma.

     

Fostering Higher Education: A postsecondary access and retention intervention for youth with foster care experience

Most youth in foster care aspire to obtain higher education, but face daunting obstacles in doing so. While societal interest and effort to support foster youth in achieving higher education has grown, very few supports have evidence to show that they are effective at improving postsecondary outcomes. In an effort to address the dearth of clearly articulated, evidence-based postsecondary support approaches for foster youth, we have developed Fostering Higher Education (FHE), a comprehensive, structured, and evaluable postsecondary access and retention intervention composed of elements (professional educational advocacy, substance abuse prevention, mentoring) that are either evidence based or promising based on the scientific literature and their ability to address the outcomes of interest. This paper describes the development and youth usability and practitioner feasibility testing of the FHE intervention approach, which was developed through funding from the National Institute on Drug Abuse. Youth usability feedback was primarily positive, with the majority of participants indicating they found the FHE activities interesting and useful, and were comfortable participating in them. Practitioner feasibility feedback was also primarily positive, with almost unanimous ratings of the FHE intervention components as very important to provide to youth and that all would be feasible for an organization to implement, though the mentoring components were seen as slightly less feasible than other components. Next steps and implications of this intervention development process are discussed.     

UPSTREAM! Together evaluation results from community efforts to prevent mental,emotional, and behavioral health problems

Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.     

Effects of Africentric Socialization on Psychosocial Outcomes in Black Girls: The Critical Role of Gender

African American social work scholars recommend rigorous research and evaluation of Africentric interventions as one approach to building culturally appropriate, evidence-based treatments for the Black community. Following this approach, this pilot study evaluates the Imani Rites of Passage program, a 15-week Africentric curriculum with 10 Black adolescent females (mean age = 12.40), comparing their pre- and post-intervention data to that of a no-intervention group of 13 Black males (mean age = 12.08). The program evaluation is based on the degree of correspondence between theory and the measurement model spelled out by the cognitive-cultural view of African-American identity. The findings for Black females were consistent with the cognitive-cultural model in some ways but not in others, and they were more complex than the predictions. Future Africentric interventions guided by the cognitive-cultural model must consider gender differences in the outcomes. Implications for social work research and practice are discussed.     

A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings

Prior theoretical and empirical research suggests that multiple aspects of an organization's context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown.Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization's readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization's readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization's morale was also found to be a strong predictor of an organization's readiness. The findings of the current study are discussed in terms of implications for prevention and intervention.     

The Influence of Family Structure on Sexual Activity in a Randomized Effectiveness Trial for Minority Youth

This study examined the influence of family structure on the outcomes of a sex education program in Miami, Florida. Using an experimental design, data collection occurred at pretest, 3-month, and 6-month follow-up with a sample of teenagers from high schools with a large majority of minority youth, assigned into treatment (n = 549) and control (n = 424) groups. Results indicated family structure had no influence on predicting teen sexual activity at pretest or at 3- or 6-month follow-up. Additional research using experimental designs is needed to assess the influence of family structure on other areas of adolescent development.     

Sexual Orientation–Based Depression and Suicidality Health Disparities: The Protective Role of School‐Based Health Centers

This study's purpose was to examine whether school‐based health centers (SBHCs) support mental health indicators among sexual minority youth (SMY). Data came from the 2015 Oregon Healthy Teens Survey with 13,608 11th graders in 137 public high schools in Oregon. Regression results revealed significant SBHC by SMY status interactions indicating relative reductions in likelihood of depressive episodes (30%), suicidal ideation (34%), and suicide attempts (43%) among SMY in schools with SBHCs. SMY students in SBHC schools reported lower likelihood of a past‐year depressive episode, suicidal ideation, and suicide attempt versus those attending non‐SBHC schools. Conversely, no differences in these outcomes were observed for non‐SMY by SBHC status. SBHCs may help reduce mental health disparities among SMY, a marginalized, underserved population.     

Exploring Minority Youths’ Police Encounters: A Qualitative Interpretive Meta-synthesis

Recent deaths by police of unarmed minority youth have raised important questions about the nature and outcomes of involuntary minority youth-police encounters. Youth are the most surveilled group of Americans and minority youth frequently live in neighborhoods disproportionately targeted for proactive policing (i.e., using broad police discretion to “target” those most likely to be engaged in criminal activity before criminal acts become apparent). Understanding the experiences of minority youth who encounter police officers is of critical concern for social workers in many practice and research areas. Social workers must examine how a minority person’s perceptions are formed through repeated, frequent, involuntary encounters with the police. The purpose of this qualitative interpretive meta-synthesis was to capture these experiences through the voices of minority youth in recounting their contacts with the police. Four themes were identified: dangerous, controlling, prejudiced, and ineffective. Further reduction of these themes resulted in an overarching theme that captures the essences of these youth’s experiences: dehumanization. These results enhance understanding of minority youth experience with police officers and, thus, inform social work advocacy efforts around this issue in both practice and research arenas.     

Sexual minority youth in romantic relationships: Associations with youth well-being

This study investigated differences in depressive symptoms, loneliness, and self-esteem for monosexual (lesbian, gay) and plurisexual (bisexual, pansexual, queer) sexual minority youth (SMY) by relationship status (single, partnered) and relationship configuration (same-gender partner, different-gender partner). Participants included 338 SMY (M_age = 19.10 years) who reported on their relationship status, partner's gender identity, well-being, and ability to confide in partner about LGBTQ issues. Results indicated that for plurisexual youth, single status was associated with greater loneliness; plurisexual youth with same-gender partners reported fewer depressive symptoms and marginally greater ability to confide in their partner about LGBTQ issues than those with different-gender partners. Findings reveal similarities across SMY while also highlighting some unique challenges among plurisexual youth with different-gender partners.     

Lighthouse Independent Living Program: Predictors of client outcomes at discharge

This study examined clinical risk factors and their association with client outcomes at discharge among 385 emancipating foster youth in Cincinnati, Ohio, who entered the Lighthouse Independent Living Program during the period 2001-2005. These youth averaged 18 years of age and remained in the program an average of 10 months. At the time of discharge at age 19, 58% of these young adults had completed high school, 32% were employed, and 38% were living independently; 11% had achieved all three aforementioned outcomes. An exploratory principal components factor analysis of nineteen dichotomous risk factor items assessed by clinical staff at the time of admission yielded four types of risk: mental health problems, delinquency issues, teen parenting, and cognitive impairment. Logistic regression analysis revealed a number of significant relationships between each of these four clinical risk factors and client outcomes after adjusting for demographic and program characteristics. Those with mental health problems were only half as likely as others to have attained all three outcomes. Parenting youth were only half as likely to have completed high school or to be employed as others. Those with delinquency issues were only one-fourth as likely than others to be independently housed at discharge. Finally, older youth and those remaining in the program longer showed more favorable outcomes than others. Implications for child welfare policy and practice pertaining to independent living are discussed.     

Recruitment and retention strategies for out-of-school-time programs

Many out-of-school-time (OST) practitioners seek ways to maximize enrollment, enhance frequency of participation, and ensure retention in OST programs, so that the multiple potential benefits of these programs are realized. Three critical areas of program quality are important underpinnings for success in recruitment and retention of youth in OST programs: a sense of safety and community; committed program staff; and challenging, age-appropriate, and fun activities. In addition, a review of over sixty OST evaluations reveals five promising recruitment strategies to boost enrollment: (1) matching the program to participants' needs (offering activities not readily available elsewhere or offering flexible schedules), (2) demonstrating the importance of participation to young people and their families, (3) reaching out directly to youth and their families in their homes and communities, (4) recruiting in peer circles, and (5) making a special effort to recruit at-risk youth. Finally, the evaluation literature points to five promising strategies to enhance regular participation and longterm program retention: (1) sending a clear message that regular attendance is important; (2) setting realistic goals to promote regular attendance, especially as youth grow older; (3) finding a balance among academic and other activities; (4) using incentives; and (5) keeping teens involved with opportunities for leadership, community service, and paid employment.     

Supporting systemic social and emotional learning with a schoolwide implementation model

A strong body of research indicates that evidence-based programs designed to promote social and emotional learning (SEL) can lead to positive developmental outcomes for children and youth. Although these evidence-based programs have demonstrated benefits for students, it is also well-established that programs must be implemented with quality and sustained to maximize positive outcomes. To support schools in implementing SEL that is integrated into all aspects of a school community, the CASEL School Guide implementation model was developed to guide school leadership teams in establishing a vision; selecting, implementing, and sustaining evidence-based programs; and integrating SEL schoolwide. The School Guide model is based on CASEL’s School Theory of Action which includes planning, implementing, and monitoring schoolwide SEL. This paper describes findings about the feasibility and degree of implementation of this model as carried out by 14 school leadership teams who were supported by SEL coaches. The participating schools implemented an evidence-based SEL program as the foundation of their efforts to promote schoolwide SEL. Findings demonstrate the feasibility of implementing this model in urban schools that primarily serve students of color, as all teams successfully carried out the implementation model and demonstrated increased levels of capacity related to supporting schoolwide SEL.     

Nonmetropolitan sexual and gender minority youths' friendships: Perceptions of social support among SGM and non-SGM peers

ABSTRACT

Sexual and gender minority (SGM) youth are at risk of victimization which can lead to poor outcomes. Social support can mitigate the effects of minority stressors, yet little is known about social support among nonmetropolitan SGM youth. This study utilized minority stress theory (Meyer, 2003) and Weeks' (1996) theory of how sexual minority communities are constructed to understand how nonmetropolitan SGM youth perceive the support they receive from SGM and non-SGM friends. Qualitative interviews were conducted with nonmetropolitan SGM youth. Youth received general emotional support, relationship advice, and protection from SGM and non-SGM friends. From their SGM friends, participants reported receiving greater closeness and emotional intimacy and assistance with SGM identity development. Participants indicated that receiving acceptance for their SGM identity was important from their non-SGM friends. Participants also discussed the limits to support their non-SGM friends could offer. Implications for practice and research are discussed.     

Family Functioning and Mental Health of Transgender and Gender-Nonconforming Youth in the Trans Teen and Family Narratives Project

Transgender and gender-nonconforming (TGN) youth are at increased risk for adverse mental health outcomes, but better family functioning may be protective. This study describes TGN youth’s mental health and associations with family functioning in a community-based sample. Participants were from 33 families (96 family members) and included 33 TGN youth, ages 13 to 17 years; 48 cisgender (non-transgender) caregivers; and 15 cisgender siblings. Participants completed a survey with measures of family functioning (family communication, family satisfaction) and mental health of TGN youth (suicidality, self-harm, depression, anxiety, self-esteem, resilience). TGN youth reported a high risk of mental health concerns: suicidality (15% to 30%), self-harm (49%), clinically significant depressive symptoms (61%); and moderate self-esteem (M = 27.55, SD = 7.15) and resiliency (M = 3.67, SD = 0.53). In adjusted models, better family functioning from the TGN youth’s perspective was associated with better mental health outcomes among TGN youth (β ranged from ?0.40 to ?0.65 for self-harm, depressive symptoms, and anxious symptoms, and 0.58 to 0.70 for self-esteem and resiliency). Findings from this study highlight the importance of considering TGN youth’s perspectives on the family to inform interventions to improve family functioning in families with TGN youth.