Residential placement is considered the most severe sanction for adjudicated youth, yet there is little consensus on best practices and interventions in residential settings. Demographic trends in the juvenile justice system further exacerbate challenges in studying residential placements. Disparities among minority youth, diverging state definitions of juvenile sex offenses, discrepancies in recidivism measures, and variations in local and state juvenile courts have contributed to a convoluted system that has struggled to identify the meaning of "success" in residential settings. Building on theories of engagement in residential care and program theory of change, this mixed methods study explores how various components of a residential program for adjudicated young males contribute to time in the program leading up to transition out of the program. Event history analysis was used to examine administrative program data. Then, follow-up interviews were conducted with program employees to gather further insight to supplement quantitative findings. Findings indicated that juvenile sex offenses and home visits played a significant role. Additionally, race, ethnicity, and duration and engagement in family, individual, and group sessions also played varying roles in youths' transition out of the program. Findings from the employee interviews further supported that race, ethnicity, culture, and family are all critical parts of residential treatment. The interviews also discussed the role that Collaborative and Proactive Solutions, a behavioral modification approach used in this program, plays in youths' overall engagement during their time in the program.

Sexual behavior is a normative part of adolescence and it is important to understand how familial factors influence Latina/o adolescents’ sexual health. The current study examined two structural equation models (SEM) and the associations between familial cultural values (i.e., familismo and filial piety), maternal and paternal monitoring (i.e., disclosure and solicitation) and Latina/o adolescent’s sexual behavior (i.e., intentions to have sex, sexual behavior, sexual responsibility). A hypothesized SEM examined whether paternal/maternal monitoring mediated the relation between familial cultural values and adolescents’ sexual health, while an alternative SEM examined whether familial cultural values mediated the association between paternal/maternal monitoring and adolescents’ sexual health. Participants included 1,024 Mexican adolescents (54% female) between the ages 12-18. Results showed that the overall hypothesized SEM had excellent fit indices. Filial piety was associated with favorable sexual health outcomes and increased parental monitoring. Maternal disclosure was associated with lower intention to have sex and more sexual responsibility, while paternal solicitation was associated higher intention to have sex. Sex differences were found after conducting a chi-square difference tests and partially constraining the model. For Latino adolescents, paternal child disclosure and solicitation was associated with intentions to have sex. For Latina adolescents, familismo was associated with more maternal disclosure. Mediational analysis showed that for Latino adolescents, more reported filial piety was associated with more paternal solicitation and disclosure, which was then associated with lower and higher intentions to have sex, respectively. The alternative SEM had excellent fit indices, however, no sex differences were found. Mediational analyses were conducted with the unconstrained model while controlling for sex. Mediational pathways showed that maternal disclosure was positively associated with filial piety, which was associated with lower intention to have sex sexual intention and more sexual responsibility. Findings indicate that family cultural values and paternal monitoring may influence Latino adolescent’s intention to have sex. Additionally, filial piety should be considered as a protective factor for Latina/o adolescents’ sexual health. These findings can inform prevention programs targeting Latina/o families. Furthermore, a greater emphasis should be placed on the importance paternal monitoring and filial piety given their associations with Latino adolescents’ sexual health.

Additional out-of-home placement rates for adolescents in long-term regional treatment center (LTRT) programs in the United States are between 50% and 75%. There appears to be a failure to generalize treatment to home and community in programs that do not fully integrate family involvement. The collaborative intensive bridging services (CIBS) treatment model uses intensive family therapy and brief residential treatment center (RTC) placement to reduce or eliminate use of LTRT. Using family systems theory, the purpose of this study was to determine whether participation in CIBS provided better outcomes than LTRT programs. The study used archival data collected by Family Adolescents and Children's Family Services, Inc. and children's mental health providers in a certain Minnesota county over approximately 5 years. There were 33 adolescents in the CIBS group and 33 in the LTRT group. The 3 research questions were (1) did the CIBS group have significantly fewer total out-of-home placements than the LTRT group, (2) did gender have any effect on this, and (3) were there any interaction effects on total out-of-home placement days from the combination of gender and program participation. Results of two-way ANOVA analyses showed a significant main effect for the first research question (p = .00, partial ɳ-² = .40), no significant main effect for the second (p = .46, partial ɳ-² = .01), and no significant main effect for the third (p = .15, partial ɳ-² = .03). These findings supported the position that participation in CIBS treatment resulted in statistically fewer total out-of-home placement days (TPD) than participation in LTRT. Social change implications include improved individual and family functioning for families in need as well as reduced financial expenditure for treatment.

Teenage pregnancy is both a social and a public health problem in the United States, with approximately 750,000 young women between the ages of 15 and 19 becoming pregnant each year. In addition, teen pregnancy is more prevalent in the African American (15%) and Hispanic (14%) communities than it is in White communities (5%). The purpose of this study was to identify risk factors contributing to teen pregnancy among racially diverse teenagers 15 to 19 years of age living in the rural south. This study, guided by social cognitive theory, used a quantitative, cross-sectional research design to determine whether living environment, educational resources, and access to healthcare impact risk of teenage pregnancy. A quantitative survey assessed factors such as sex-related attitudes, parent/peer communication, living environment, and educational attainment. Two primary research questions and 8 related hypotheses were formulated for investigation. Using binary logistic regression, the data in this study revealed that an increase in positive environmental factors (household income and parental education) and an increase in positive personal factors (parental/peer communication, teen's academic achievement, and attitudes toward sex) decreased negative behaviors (risks of teen pregnancy). This study may promote positive social change by providing information on relevant social and educational factors to those responsible for the design of comprehensive pregnancy prevention programs that target at-risk teenagers. Provision of comprehensive social and health services to teenage parents and their children may help to reduce rates of first-time and repeat teenage pregnancies and thus prevent the negative social consequences of these pregnancies.

The purpose of this research was to identify risk factors for future substance abuse (SA) and/or substance dependence (SD) among young boys with attention deficit/hyperactivity disorder (ADHD). The prevalence of childhood ADHD among adult substance abusers has been well documented and stimulant medication therapy is considered to be a protective factor. However, this population remains at high risk for developing SA disorder in adulthood. Thus, since stimulant therapy alone does not eliminate the risk of future SA, it is important to determine other factors that contribute to this problem in this population. The specific questions addressed in this research were 1) What risk factors predict SA problems in later life for adolescent boys who were diagnosed with ADHD? ; 2) Do boys diagnosed with ADHD and receiving stimulant medication have the same risk factors for SA as undiagnosed/unmedicated (normal) boys? and 3) Is the medication effect at reducing SA in later years dependent or independent of the response to the pharmacological treatment for behavioral symptoms of ADHD? This study evaluated data collected in a longitudinal study (1968 to present) of boys diagnosed with ADHD at the University of Iowa Hospital outpatient psychiatric clinic. Longitudinal regression and odds-ratios were used to measure the strength of correlation of risk factors to adult SD outcomes in three groups: diagnosed medicated boys, diagnosed unmedicated boys and a comparison group of undiagnosed, unmedicated (normal) boys. It was hypothesized that specific risk factors could be identified in the two groups of diagnosed boys (medicated and unmedicated). It was further hypothesized that poor response to medication would predict higher rates of adult substance abuse. and thus be an indicator for early prevention/intervention need for the poor responders. Results indicated that few of the evidence-based risk factors identified for the general adolescent population were significant predictors of adult SD for these adolescents diagnosed with ADHD. Other identified risk factors did not appear to be influenced by the effects of the medication. Response to stimulant medication was not related to the outcome of adult substance dependence, indicating that the protective factor exists regardless of medication response.

A year after the mysterious death of Petra, her twin sister Dash convinces the scattered and estranged members of her Scout troop to re-form in order to return to Exploration Expedition, the site of her sisters passing. Though the troop have all been dealing with the loss of their defacto leader in different ways, their arrival at Expedition forces them to work together to confront their guilt in the events surrounding Petra’s death and its effect on their own lives and friendships.

Connectedness has been identified as a powerful protective factor for adolescents. This study focused on the extent to which secondary students at the American International School of Utah (AISU) report perceptions of connectedness. Specifically, this work focused on school-level factors. It examined the extent to which participation in the school-wide interventions of Crew and Intensives influence perceptions of connectedness among AISU secondary students. Data collected provided insights about perceptions of connectedness within the AISU environment that may be used to inform current practices, identify additional student support needs, and improve future implementations. An Explanatory Sequential research design was used. This method included the use of quantitative measure administered and analyzed first, followed by a qualitative measure used to learn more about the quantitative results. The Hemingway Measure of Adolescent Connectedness Short Form by Michael Karcher served as the quantitative measure for this study. A semistructured interview protocol, created by the researcher, was used as the qualitative instrument. Results indicated that overall, study participants reported high-levels of connectedness on the Hemingway. Analysis of the Hemingway Subscales revealed that the Friends subscale had the highest levels of connectedness, followed by connectedness to Teacher. Connectedness to School was slightly lower than connectedness to Teachers. Connectedness to Peers showed moderate levels of connectedness. To learn more about the results of the quantitative stage of this study, semistructured interviews were conducted and analyzed using traditional deductive coding techniques. Results showed high-levels of connectedness associated with AISU as a school and with participation in Crew. Findings on the questions asking about Intensives showed that students appear to value the unique learning opportunities and ability to choose what they learn, more than they associated Intensives with connectedness.

There is growing support for the use of acceptance and commitment therapy (ACT) as a treatment for adults with obsessive-compulsive disorder (OCD). No research has been published to date on the use of ACT as a treatment for adolescent OCD. To begin investigating ACT for youth OCD, a multiple baseline study was conducted. The primary measure was self-monitoring of compulsions and assessor completed (CYBOCS). Three adolescent participants, ages 12 to 17, were treated with 8 to 10 sessions of ACT (without exposure). Results showed that the intervention was successful for all participants, with a 40% mean reduction in self-reported compulsions. Near absence of compulsions was reported by two of three participants at posttreatment. CY-BOCS ratings decreased by an average of 28.2%. Treatment procedures were rated by participants and parents as highly acceptable. Experimental and clinical implications of results are discussed. Data suggest that ACT may be a viable treatment as an alternative or an adjunct to exposure-based treatments.

The purpose of this study was to explore perceptions of adolescent's motivation to change in therapy, specifically while residing in a residential treatment center (RTC) and participating in family therapy. Motivation for change was examined in three contexts. The first context for examining the adolescent's motivation for change was in re lat ion to their stage of therapy. The second and third contexts for examining the adolescent 's motivation for change was in relation to perceptions the adolescent's therapi st and parent had of their motivation to change. In addition, the study explored whether there was a relationship between the congruence of perceptions of motivation to change between adolescent and therapist, and adolescent and his or her parent with the adolescent's progress in therapy. A sample of I 0 adolescent clients in a RTC completed the University of Rhode Island Change Assessment (U RICA). The sample also included the adolescents' I 0 parents and four therapists. Parents and therapists completed revised lr versions of the URICA developed to obtain therapists' and parents' perceptions of adolescents' motivation to change. The findings indicated that most adolescents reported scores suggesting that their level of motivation would be classified as in the preparation stage of change. Data from the study also suggested that therapists and parents perceived adolescents as higher on the pre contemplation sub scale ofURICA than the adolescents perceived themselves. No support was found for the theoretical relationship between congruence in perceptions of motivation and progress in therapy, but future research needs to determine if a relationship exists given the inability to examine this relationship statistically due to limitations of the study. Considerations for future research are given along with implications for marriage and family therapy.

Demographic, historical, psychometric, and clinical data were obtained from the psychiatric files of all patients manifesting schizophrenic symptomatology who were hospitalized in an adolescent psychiatric facility during a five year period (N= 71). Factor analysis of the usable data resulted in three interpretable factors, which included: (1) aggressive behavior; (2) disturbed family functioning; and, (3) thought disorder. Age of first hospitalization correlated positively with factor three. The results provide support for concerns expressed by a number of scientists and clinicians that schizophrenia may not be a discrete, unitary disorder; and that uncritical downward extension of adult diagnoses to adolescents and prepubescent children may be questionable. The results further suggest that current DSM-III and DSMIII- R subtypes of schizophrenia (which are clinically derived and symptom based), are not validated by empirically derived subtypes that include objective indices of behavior along with clinical symptoms. The correlation of "age of first hospitalization" with one of the three factors suggests that developmental level at the onset of illness may represent an important mediating variable in the severity and prognosis of certain subtypes of schizophrenia.