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This study presents a tiered conceptualization of family partnership developed by the Family-Run Executive Director Leadership Association (FREDLA) with examples of strategies from the literature. This sub-study was part of an overarching systematic review project that aimed to review the literature on family partnership in relation to youth outcomes. The tiers of family partnership include family involvement (i.e. family's inclusion in their child's care); family engagement (i.e. collaboration between TRC and families); family-driven (i.e. families as full partners). This review included thirty studies (n = 23 family involvement, n = 7 family engagement, n = 0 family-driven). The most common family involvement methods were family therapy and family visits to the program, primarily, delivered face-to-face. The most common family engagement method was activities, therapies, and skill building occurring at the home with family present. Methods of measuring family partnership primarily included the use of administrative data. Implications for research and practice include the provision of research that evaluates the effects of family partnership on outcomes important in the TRC setting and the development of research-practice and family-research collaborations to increase the uptake of effective family partnering methods. [ABSTRACT FROM AUTHOR]

Despite intensive treatment, adolescents discharged from residential treatment (RT) often do not maintain treatment gains in the community. Providing support and education to caregivers through parent training may ameliorate the loss of treatment gains. Successful parent training programs have been delivered to this population; however, these interventions were delivered in-person, posing significant barriers affecting reach, access, and engagement. A convergent mixed methods design was used to assess the acceptability, appropriateness, and feasibility of a web-based parent training in a sample of parents (N = 20) with adolescents admitted to RT. Parents completed two interviews and an end-of-program survey. Parents completed at least 80% of the assigned modules and felt that PW was easy to use and that the features facilitated learning. Parents reported practicing the skills in their daily lives and found it beneficial to have a partner to practice with. Consistent with previous studies, parents perceived the delivery method as a strength because the web-based delivery circumvented multiple known barriers to in-person interventions. A large subset of parents related to the scenarios, while a small subset of parents felt the modules were challenging to relate to because of the severity of their adolescent's mental health challenges. Overall, findings indicate that web-based parent training programs may be an acceptable, appropriate, and feasible adjuvant evidence-based support. However, tailoring the intervention content is necessary to create a more relatable intervention that captures the breadth and severity of mental health challenges adolescents in RT face. Highlights: Web-based delivery increases access, reach, and engagement. Parents reported practicing logical consequences, effective communication, and active listening with their adolescent. Parent training while the adolescent was in RT allowed parents the time and space to engage with the material. Parent training needs to be tailored to address the breadth and severity of mental health challenges in the RT setting. [ABSTRACT FROM AUTHOR]

Previous studies have suggested that parents with adolescents in residential treatment (RT) may struggle with their own mental health. However, few have comprehensively described parents' mental health using valid and reliable measures and examined parent mental health in reference to other contextual factors that may be intertwined and intervenable. Therefore, the purpose of this exploratory study was to describe the perceived stress, symptoms of anxiety and depression, and post-traumatic stress disorder (PTSD) in parents with adolescents in RT in the United States. This cross-sectional study included a sample of parents (N = 71) with adolescents in RT. On average, parents reported elevated depressive symptoms, moderate stress, mild-to-moderate anxiety symptoms, and subthreshold PTSD symptoms. However, there were differences in mental health based on gender, race, ethnicity, adolescent living location, and adolescent psychiatric diagnoses (e.g., bipolar, depressive, and substance use disorders). Findings provide a more comprehensive description of parents' mental health during the RT admission, underscoring the bidirectionality of parent-adolescent mental health and well-being. Practice Implications Parent mental health screening and treatment may be necessary because of elevated depressive symptoms, anxiety, and stress Parent stress is chronically elevated across the treatment trajectory, highlighting the need for parent preparation, support, and stress management Assessment of trauma and social support is needed because PTSD scores were higher in unpartnered parents Parent and adolescent mental health is bidirectional and providing treatment and support to parents benefits adolescents [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the experiences and perspectives of mothers with children in residential treatment (RT) regarding parenting, discharge planning, and home-based safety. One-hour interviews were conducted over the phone with 15 mothers. Transcripts were analyzed using a content analysis approach. Three themes were generated including parenting a child in RT, unprepared for discharge, and crisis intervention in the home. This study contributes insight into the lives of an underserved population with implications to inform future research interventions and clinical guidelines to address the needs of families with children in RT. [ABSTRACT FROM AUTHOR]

• Child's insurance coverage does not align with where RT funding will come from. • Publicly insured/funded families navigated complex systems to gain access. • Some families faced additional hardships including relinquishing custody. • Privately insured/funded families could send their child to a different state. There are well-documented disparities in access to mental health care for children and youth with significant behavioral health needs. Few studies that explored the differential experiences of families who use private vs public sources of financing (i.e., insurance and funding) in accessing residential treatment (RT) for children and youth. This study aimed to examine the lived experiences of families accessing psychiatric residential treatment (RT) and contextualize these experiences based on source of financing. Twenty parents completed two interviews about their experiences with RT including the process for gaining access, length of stay, and aftercare. Parents were also asked about barriers (e.g., custody relinquishment), and facilitators (e.g., policies in the state) to accessing RT. Data were analyzed using content analysis. There were three distinct groups of families in the study. The first group includes lower income families whose children had public health coverage before needing RT. The second group comprises middle-income families whose children had private coverage but lived in states where there were no RTs that accepted private insurance or private payment and who did not have the means to send their child to RT in another state. The final group included higher income families with private insurance and enough private resources to overcome the limitations of insurance and state policies. This study illuminates key barriers and hardships for families accessing RT: 1) waiting long waiting periods and navigating complex systems; 2) inadequate lengths of stay; and 3) inadequate aftercare and support in the community transition. This study is among the first to examine how access to RT differs by whether a family has access to public or private resources. Taken together, these findings support the importance of insurance and financing for families accessing RT for their children and the need for systemic changes in policies and practices to reduce disparities in access. [ABSTRACT FROM AUTHOR]

• Mothers sustained multiple traumas (childhood, IPV) and require trauma-informed care. • Trauma influenced their caregiving, well-being, and relationship with their child. • Mothers report that RTs underassessed IPV in the home and were unable to provide help. • Positive youth outcomes hinge on RTs engaging parents in youth treatment. • Mothers were isolated, needed support, and found community through social media. Mothers of adolescents in residential treatment (RT) experience the highest rates of intimate partner violence (IPV; emotional, physical, and/or sexual abuse by a partner or ex-partner) in the child welfare system. Few studies have investigated the intersection of IPV and parenting in the context of RT. The purpose of this study was to: a) to understand how mothers' past trauma experiences (i.e. IPV) influence their caregiving, well-being, and relationships with adolescents in RT; b) to explore supportive services mothers need to enhance their well-being before, during, and after their adolescent was in RT. This cross-sectional study consisted of 15 mothers of adolescents currently or previously in RT. Participants were recruited via Facebook and completed one hour semi-structure interviews over the phone. Data were analyzed by two investigators using content analysis. The following themes emerged from the interviews: "different from the other kids", "when she goes into a rage her eyes are black...they do remind me of her dad", and "by supporting the parents, you are supporting the child.". Women reported stigmatization and disempowerment and coped by compartmentalizing the multiple traumas they sustained from caregiving as well as in their personal lives (i.e., IPV). All women reported that they regularly shared their stories with others in online support groups. Mothers of children in RT are an understudied and underserved population. Supportive, online interventions for this population to share their experiences is critical to maintaining their health. [ABSTRACT FROM AUTHOR]