family interventions for runaway youth david e. pollio, phd; sanna j. thompson, phd; norweeta...
TRANSCRIPT
FAMILY FAMILY INTERVENTIONS INTERVENTIONS FOR RUNAWAY FOR RUNAWAY
YOUTHYOUTH
FAMILY FAMILY INTERVENTIONS INTERVENTIONS FOR RUNAWAY FOR RUNAWAY
YOUTHYOUTH
David E. Pollio, PhD; Sanna J. Thompson, PhD; Norweeta Milburn, PhD
THE FAMILY: AN IMPORTANT THE FAMILY: AN IMPORTANT FACTOR IN SUCCESSFUL YOUTH FACTOR IN SUCCESSFUL YOUTH OUTCOMESOUTCOMES
THE FAMILY: AN IMPORTANT THE FAMILY: AN IMPORTANT FACTOR IN SUCCESSFUL YOUTH FACTOR IN SUCCESSFUL YOUTH OUTCOMESOUTCOMES
• Less likely to use substances
• Less likely to have legal problems
• Decreased days on the run
Youth returning home after a Youth returning home after a runaway episode are:runaway episode are:
Pollio, Thompson & North, 2001Pollio, Thompson & North, 2001
HHOWEVER…OWEVER…HHOWEVER…OWEVER…
• substance use decreased likelihood of returning home post shelter discharge, including use of stimulants (OR=.10), depressants (OR=.22) and multiple substances (OR=.36).
• involvement with legal system decreased likelihood of returning home, including being on probation (OR=.70), in DJS custody (OR=.10), and involvement in prostitution (OR=.34) Thompson, Safyer, & Pollio, 2001; Thompson, Pollio & Bitner, 2000Thompson, Safyer, & Pollio, 2001; Thompson, Pollio & Bitner, 2000
MODEL OF SHELTER “SUCCESS”MODEL OF SHELTER “SUCCESS”
Youth Youth Acting OutActing Out
Family systemFamily systemDisruptedDisrupted
Parents atParents atWits EndWits End
Child Child experiences experiences Structure & Structure &
FreedomFreedom
Family Family experiencesexperiences
RespiteRespite
Family Family Reconnected &Reconnected &
Re-involvedRe-involved
Youth returns Youth returns homehome
HOMEHOME SHELTERSHELTER RETURN HOMERETURN HOME
Nebbitt, House, Thompson & Pollio, In Nebbitt, House, Thompson & Pollio, In presspress
FFAMILY AMILY RRE-INVOLVEDE-INVOLVEDFFAMILY AMILY RRE-INVOLVEDE-INVOLVED
“Sometimes it’s the first chance they have to talk with their families …a lot of it is around communication, not being able to understand where the other person is coming from, a child, a parent, either one...they start talking to each other more, and whether it’s good communication or bad communication, if they’re even talking to each other as opposed to yelling and screaming and creating chaos, that’s one step towards … making a positive change at home.”-- Shelter Staff
Youth doing well: -Focus on youth problems
Youth doing badly:-Focus on family/ environment-Family fewer resources
AT THE SHELTERAT THE SHELTERAT THE SHELTERAT THE SHELTER
ShelterStay
POST-DISCHARGEPOST-DISCHARGEPOST-DISCHARGEPOST-DISCHARGE
Youth doing well:-Youth gives socially desirable responses-Family normalizes
Youth doing badly:-No socially desirable responses-Family remains negative
FAMILY NORMALIZESFAMILY NORMALIZES• Before: “…she was constantly keeping chaos
up between me and my mom…constantly giving problems at school and she was sneaking and doing things…being very disagreeable.”
• After: “Well, the main thing is just for me to give her a chance and…start the slate off clean. And I’ve stopped bringing up the past, because the past is in the past…I’m dealing with what she’s doing now and trying to gear up towards continuing to do better.”-family member
SSTUDY TUDY PPURPOSEURPOSESSTUDY TUDY PPURPOSEURPOSE
•To present three NIH-funded new interventions aimed at families of runaway and homeless youth
INTERVENTIONSINTERVENTIONSINTERVENTIONSINTERVENTIONS
•RHY-PERF (PsychoEducation Responsive to Family for Runaway Homeless Youth) PI: Pollio
•Home-based, engagement focused family therapy PI: Thompson
•Project STRIVE (Support to Reunite, Involve, and Value Each other) PI: Milburn
• youth recruited at shelter, groups conducted post-discharge
• meets twice monthly for 6 months
• facilitated by social worker and psychiatric specialist
• families choose curriculum in first session (“family responsive”)
• curriculum provided through manual, thus assuring quality of information
PPsycho-sycho-EEducationducationRResponsive esponsive to to FFamiliesamiliesFor For RRunaway-unaway-HHomeless omeless YYouthouth(RHY- PERF)(RHY- PERF)
PPsycho-sycho-EEducationducationRResponsive esponsive to to FFamiliesamiliesFor For RRunaway-unaway-HHomeless omeless YYouthouth(RHY- PERF)(RHY- PERF)
Structure of each session1. Recent experiences (15
minutes) 2. Lecture on topic chosen by
family (20 minutes)3. Discussion of how topic
impacts on family life (20 minutes)
4. Brainstorming on strategies to address topic (20 minutes)
5. Wrap-up (5 minutes)
PPsycho-sycho-EEducationducationRResponsive esponsive to to FFamiliesamiliesFor For RRunaway-unaway-HHomeless omeless YYouthouth(RHY- PERF)(RHY- PERF)
PPsycho-sycho-EEducationducationRResponsive esponsive to to FFamiliesamiliesFor For RRunaway-unaway-HHomeless omeless YYouthouth(RHY- PERF)(RHY- PERF)
North, et al., 1997; Pollio, North & Osborne, 2002North, et al., 1997; Pollio, North & Osborne, 2002
HHOME-OME-BBASED, ASED, EENGAGEMENT NGAGEMENT FFOCUSED OCUSED FFAMILY AMILY TTHERAPYHERAPYHHOME-OME-BBASED, ASED, EENGAGEMENT NGAGEMENT FFOCUSED OCUSED FFAMILY AMILY TTHERAPYHERAPY• Home-based family therapy
intervention to prevent/reduce youth substance use.
• Eighteen “Engagement Activities” were developed – one activity was implemented
during each of 12 sessions delivered to families in the home.
Examples of “Engagement Activities”Examples of “Engagement Activities”
• Meaningful Events – recording/sharing memories of events that were meaningful to parent and youth
• Downward Spiral– board game that takes players on a journey that is plagued with pitfalls of drug
use
• Garbage Bag– family decorates a bag together and writes on slips of paper personal qualities or
hurtful feelings that each person wants to overcome – bag is disposed.
• Rush Hour Traffic Jam – get a designated car out of a congested game board requires the family
members working together
• 3-D Storytelling – Play-doh is used to create 3-dimensional characters and develop a story
about these characters as a family
Project Project STRIVE: STRIVE: SSupport upport tto o RReunite, eunite, IInvolve and nvolve and VValue alue EEach ach OtherOther
Project Project STRIVE: STRIVE: SSupport upport tto o RReunite, eunite, IInvolve and nvolve and VValue alue EEach ach OtherOther
• Runaway behavior: Response to Runaway behavior: Response to unresolved family conflictunresolved family conflict
• Family interventionFamily intervention– Family strengthsFamily strengths– Problem solvingProblem solving– Conflict negotiationConflict negotiation– Role clarificationRole clarification
• 5 sessions5 sessions
• Adaptation of SNAP (Successful Adaptation of SNAP (Successful Negotiation, Acting Positive)*Negotiation, Acting Positive)*
• Cognitive-behavioral/family Cognitive-behavioral/family systems interventionsystems intervention
*SNAP focuses on improving conflict resolution strategies, eliminating suicide attempts as a method of resolving future conflict, promoting positive family interaction, and reframing the family’s understanding of their problems.
Project Project STRIVE:STRIVE: SessionsSessionsProject Project STRIVE:STRIVE: SessionsSessions
1 – Create positive family atmosphere1 – Create positive family atmosphere
2 – Identifying problem situation2 – Identifying problem situation
3 – Analysis of medium size problem3 – Analysis of medium size problem
4 – Cope, negotiate, and problem solve4 – Cope, negotiate, and problem solve
5 – Evaluate solutions and problem 5 – Evaluate solutions and problem solvesolve
DISCUSSIONDISCUSSIONDISCUSSIONDISCUSSION
CCHALLENGESHALLENGESCCHALLENGESHALLENGES
• Racial/ethnic diversity• Identification of appropriate families• Recruitment• Determining success• Addressing multiple needs/problems
in limited intervention• Coordination of care
CCAVEATS…AVEATS…CCAVEATS…AVEATS…
• Family interventions are not appropriate for all runaway youth…– Families must be involved and
appropriate– Youth with longer history of more
severe problems are probably less likely to benefit from brief interventions
– Both family and youth must be motivated to participate
MMULTIPLE ULTIPLE PPOPULATIONSOPULATIONSMMULTIPLE ULTIPLE PPOPULATIONSOPULATIONS
Youth in crisis: first episode(s) of running away; family involved
Family in crisis: multiple challenges across family system
Street youth: no available family; “independent” or “throwaway” youth
Homeless families: entire family together in homelessness
CONTACT INFORMATIONCONTACT INFORMATION• David E Pollio, PhD
Washington University in St Louis
• Sanna Thompson, PhD University of Texas at Austin
• Norweeta Milburn, PhD University of California at Los Angeles