Negotiating Ethical Paradoxes in Conducting a Randomized Controlled Trial: Aligning Intervention Science with Participatory Values

In this article, we describe ethical tensions we have faced in the context of our work as intervention scientists, where we aim to promote social justice and change systems that impact girls involved in the juvenile legal system. These ethical tensions are, at their core, about resisting collusion with systems of control while simultaneously collaborating with them. Over the course of designing and implementing a randomized controlled trial (RCT) of an ecological advocacy intervention for girls, called ROSES, ethical paradoxes crystalized and prompted us to engage in critical reflection and action toward the aim of moving away from conducting research on legal‐system‐involved girls and moving toward a more democratic, participatory process of inquiry with girls. Our experience revealed two intertwined paradoxes that ultimately served generative purposes. First, in collaborating with legal system stakeholders, we observed a single story of girls’ pathology narrated for girls, without girls, and ultimately internalized by girls. Second, in reflecting critically on the ethical implications of our study design, it became clear that the design was grounded in a medical model of inquiry although the intervention we sought to evaluate was based, in part, on resistance to the medical model. We describe emergent ethical tensions and the solutions we sought, which center on creating counternarratives and counterspaces that leverage, extend, and disrupt our existing RCT. We detail these solutions, focusing on how we restructured our research team to enhance structural competence, shifted the subject of inquiry to include the systems in which youth are embedded, and created new opportunities for former research participants to become co‐researchers through formal roles on an advisory board.     

Shedding Dialectical Tiers: A Social-Epistemic View

Is there a duty to respond to objections in order to present a good argument? Ralph Johnson argues that there is such a duty, which he refers to as the “dialectical tier“ of an argument. I deny the (alleged) duty primarily on grounds that it would exert too great a demand on arguers, harming argumentation practices. The valuable aim of responding to objections, which Johnson 's dialectical tier is meant to satisfy, can be achieved in better ways, as argumentation is a social-epistemic activity.     

A Typology of Youth Participation and Empowerment for Child and Adolescent Health Promotion

Research suggests that increasing egalitarian relations between young people and adults is optimal for healthy development; however, the empirical assessment of shared control in youth–adult partnerships is emerging, and the field still requires careful observation, identification, categorization and labeling. Thus, our objective is to offer a conceptual typology that identifies degrees of youth–adult participation while considering the development potential within each type. We use an empowerment framework, rooted in evidence-based findings, to identify five types of youth participation: (1) Vessel, (2) Symbolic, (3) Pluralistic, (4) Independent and (5) Autonomous. The typology is constructed as a heuristic device to provide researchers, practitioners and policy-makers with a common language for articulating degrees of youth participation for optimal child and adolescent health promotion.     

Inside the Black Box: Assessing and Improving Quality in Youth Programs

Over the past decade, structured programming for children and youth during the non-school hours has expanded exponentially. A confluence of recent research studies and program evaluations backs the publicly perceived notion that after-school programs can positively influence important developmental and learning outcomes. The rapid expansion of the field and the potential of programs to contribute to child and youth development have made defining what high quality programs look like and learning how to improve program quality key challenges facing the field. This paper describes what is known about the relation between youth program quality and youth developmental outcomes, summarizes different quality assessment tools being used in the field, and discusses how such tools are being used to drive systemic quality improvement efforts.     

The self-concept of traumatized children and adolescents with or without PTSD

This study compared the Piers-Harris 2 scores of youth with PTSD (n=30) to the scores of traumatized youth without PTSD (n=60) and a non-traumatized comparison group (n=39). In the absence of major comorbid disorders, youth with PTSD evidenced significantly lower scores than the traumatized PTSD negatives and controls on five of six Piers-Harris 2 scales. With the exception of scores on an index of perceived parental acceptance of child behavior, trauma exposure in the absence of PTSD was not associated with lower Piers-Harris 2 scores.     

A Solution-Focused Intervention with a Youth in a Domestic Violence Situation: Longitudinal Evidence

This article reports on a 4-year therapeutic intervention combining in-person and email communication with a 13-year-old Greek-Cypriot teenager who witnessed and later was the victim of severe domestic violence. The intervention is based on an empowerment philosophy and solution-focused strategies, and its usefulness is evaluated by three standardized measures at five time points between the years 1999 and 2003. Pertinent cultural and ethical dynamics of the interventional context are highlighted. The intervention may have helped to produce better perpetrator–youth relations, remission of the client’s depression and post-traumatic stress symptoms, and improvement in his academic performance. Implications and limitations are discussed.     

Learning from experience: Examining the impact of client work upon two trainee therapists

This qualitative research study, focusing on the learning and change of two trainee therapists over a nine‐month period, was conducted by the trainees themselves. In collecting and analysing their data, the researchers made use of the heuristic methodology, to which some of the principles of the co‐operative inquiry methodology were added. The findings shed light on some of the ways in which trainee counsellors and psychotherapists might learn through their work with clients, the forms and contexts in which this learning may arise, and how the learning might affect the trainees. The findings additionally highlight some of the possible benefits of engaging in research for trainee counsellors and psychotherapists, in terms of their roles as practitioners. These include positive changes in the ways in which they work with clients, and changes in the ways they think about their practice.     

The relationship between violence and youth suicide indicators among Asian American and Pacific Islander youth

The literature documents a relationship between interpersonal violence and suicide. One tool used to understand interpersonal violence is the Power Wheel, developed from clinical experience and originally used in domestic violence education. We examine the relationship between Teen Power and Control Wheel domains and suicidal indicators (seriously considered suicide, made a suicide plan, and attempted suicide) among Asian American and Pacific Islander high school students, in terms of both victimization and perpetration. Data from a 2007 survey of two multi-ethnic high schools on the island of O'ahu, Hawai'i were used. The survey assessed interpersonal youth violence and a multitude of risk and protective factors. It found that females were significantly more likely to seriously consider suicide and attempt suicide, compared to males. There were no statistically significant differences in seriously considering suicide, making a suicide plan, and attempting suicide by ethnic group, employment status, or hours worked per week. Using the Wheel, we found that all dimensions for victimization and perpetration were associated with the three suicidal indicators. However, the magnitude of this association was dramatically higher for victims than for perpetrators. School- and healthcare-based prevention strategies should ensure that both suicide and violence intervention components are addressed. Professionals who work with youth should be trained to feel comfortable, confident, and competent in discussing suicide and violence, and be willing and capable to assess and intervene.     

Striving for a culturally responsive process in training health professionals on Asian American and Pacific Islander youth violence prevention

The quality of youth violence prevention practice is dependent on the quality of education and training of professionals who will care for disadvantaged and/or underserved youth. The authors propose that culturally responsive youth violence prevention curricula, focused on Asian Americans and Pacific Islanders, should: 1) target institutions that train health professionals likely to serve Asian Americans and Pacific Islanders; 2) promote the professional development of Asian American and Pacific Islander students and enhance all students' comfort in addressing behavioral, social, and cultural concerns; 3) cover specific issues relevant to Asian Americans and Pacific Islanders, including the role of acculturative stress, socioeconomic hardship, and other risk factors that may account for mental health disparities; and 4) continuously engage researchers, educators, and community stakeholders in cooperatively and creatively applying new knowledge to clinical challenges. The authors summarize resources for youth violence prevention education that have been used for training healthcare professionals in a multicultural context.