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Shelter-recruited adolescents are known to have high rates of substance abuse and co-occurring internalizing and externalizing problem behaviors. Many studies have documented these mental health concerns, but only a small number of studies have tested interventions that may be useful for ameliorating these vulnerabilities. The current study compared three empirically supported psychotherapy interventions, Motivational Interviewing (MI), the Community Reinforcement Approach (CRA), and Ecologically-Based Family Therapy (EBFT) with 179 substance abusing runaway adolescents (47% female, 74% minority) and their primary caretaker recruited through a Midwestern runaway crisis shelter. Examining both child and primary caretaker reports, each treatment was associated with significant reductions in internalizing and externalizing behaviors to 24 months post-baseline. However, the trajectory of change differed among the treatments. Adolescents receiving MI showed a quicker reduction in internalizing and externalizing behaviors but also a quicker increase in these behaviors compared to adolescents receiving EBFT, who continued to evidence improvements to 24 months. The findings provide support for continued evaluation of these treatments for use with this vulnerable population of adolescents.

This study examined the relation between maternal depressive symptoms and adolescents' problem behaviors, moderated by adolescent gender, as well as the association between maternal depressive symptoms and the family environment characteristics above and beyond child variables. Data were collected from 137 mothers of runaway adolescents with alcohol and/or substance abuse problems. Results showed that both internalizing and externalizing problem behaviors of adolescent girls, as opposed to problem behaviors of boys, were significantly associated with maternal depressive symptoms. In addition, higher family cohesion was significantly related to lower maternal depressive symptoms even after controlling for adolescent problem behaviors. However, no significant relationship was found between family conflict and maternal depressive symptoms. These findings indicate that both adolescents' problem behaviors and mothers' perceptions of the family environment are associated with maternal depressive symptoms, highlighting the potential utility of the family systems theoretical framework for understanding and intervening mothers' emotional problems in the family context. (Contains 2 figures, 4 tables, and 1 footnote.)

Objectives: The current study sought to test hard drug use outcomes for youth receiving a strengths-based outreach and advocacy intervention that linked youth to either a shelter or a drop-in center. Methods: Homeless youth (14–24 years old) were engaged by research assistants (RAs) at soup kitchens, parks, libraries, and other locations that homeless youth were known to frequent. Youth were randomly assigned to receive six months of advocacy that focused on linking youth to a drop-in center (n = 40) or to a crisis shelter (n = 39). Follow-up assessments were conducted at 3, 6, and 9 months post-baseline. Hard drug use over time was the main outcome. Intervention condition and service connection were used as predictors for the baseline level and the slope of change in hard drug use over time. Data analysis was conducted with Bernoulli Hierarchical Generalized Linear Modeling in HLM7. Results: The current study found that those who were in the drop-in linkage condition exhibited a greater reduction in their odds of using hard drugs during the follow-up points than their counterparts in the shelter linkage condition. And finally, those who utilized services more often during the follow-ups were those who exhibited less hard drug use at baseline and less reduction in their odds of using hard drugs. Conclusions: This study suggests that drop-in centers, which are often characterized by low-demand programming and few behavioral restrictions, are effective for addressing hard drug use among homeless youth. [ABSTRACT FROM AUTHOR]

Abstract: Given high levels of health and psychological costs associated with the family disruption of homelessness, identifying predictors of runaway and homeless episodes is an important goal. The current study followed 179 substance abusing, shelter-recruited adolescents who participated in a randomized clinical trial. Predictors of runaway and homeless episodes were examined over a two year period. Results from the hierarchical linear modeling analysis showed that family cohesion and substance use, but not family conflict or depressive symptoms, delinquency, or school enrollment predicted future runaway and homeless episodes. Findings suggest that increasing family support, care and connection and reducing substance use are important targets of intervention efforts in preventing future runaway and homeless episodes amongst a high risk sample of adolescents. [Copyright &y& Elsevier]

The current study sought to identify information that may inform treatment providers regarding services for, and engagement of, substance-abusing homeless mothers. Shelter-recruited, substance-abusing homeless mothers' desires for treatment in several commonly reported problem areas including substance use, parenting, depressive symptoms/mood, physical health, and childhood abuse history were assessed. The correspondence between mother's desire for treatment and self-reported problem severity was also examined. The majority of mothers reported at least some desire (versus no desire at all) for assistance with substance use, depressive symptoms/mood, and parenting. A series of independent-sample t tests and chi-square tests showed that mothers indicating any treatment desire in the areas of substance use, depressive symptoms/mood, health problems, and sexual abuse also reported higher levels of severity in the corresponding problem areas. The findings imply that psychosocial treatment should be available to all homeless mothers entering the shelter system, especially given that problem severity appears to be a fair indicator of interest in treatment. [ABSTRACT FROM AUTHOR]