Parent-School and Community Partnerships in Children's Mental Health: Networking Challenges, Dilemmas, and Solutions

Inter-agency collaboration, service coordination, and the creation of successful partnerships among parents, teachers, and human services professionals continues to be a challenge for the development of responsive community-based systems of care for at-risk youth and their families. We explore how one inner-city neighborhood struggles to create successful community partnerships through traditional networking strategies. Our findings identify networking strategies that appear to work and those that do not. Recommendations for improving communication are provided.     

Stories as indicators of practical knowledge: Analysing project workers' talk from a study of participation in a youth inclusion programme

The paper deals with the issue of practical knowledge for enabling participation. Participation as a strategy for change is widespread in community, health and human service contexts. Research to date has focused on the mechanisms of beneficiaries' participation (e.g. identity, empowerment, activity, gender, space). However, participation as an engagement strategy is action oriented and requires high levels of interaction between those creating the conditions for participation and those participating. These conditions need to be continuously adjusted and outcomes are often unpredictable. This process of ‘working with’ is often dealt with as a technical issue and captured in metaphorical language. Less emphasis has been given to the type of knowledge modalities that might be necessary in order to enable participation. Drawing on an ethnographic case study of participation in a youth inclusion programme the paper explores the role of stories as potential indicators of practical knowledge. The paper argues that enabling young people's participation requires intuition and imagination, patience and perseverance, and judgement for acting under uncertainty. It concludes that stories only partially fulfil their potential as indicators of such knowledge modalities. Copyright © 2010 John Wiley & Sons, Ltd.     

The Effect of Religious Short‐Term Mission Trips on Youth Civic Engagement

Religious short‐term mission trips are an increasingly popular form of American religious practice, especially among young people. Both organizers and participants often emphasize their transformative nature. However, scholarly efforts to evaluate systematically the social consequences of religious short‐term mission trips are lacking. To address this neglect, our article investigates whether going on a religious short‐term mission trip significantly differentiates youth who engage in civic actions from those who do not. Based on quantitative analysis of Wave I of the National Survey of Youth Religion (NSYR), we find that, controlling for other important factors, taking a mission trip significantly increases the likelihood of adolescents participating in various forms of civic activity, particularly religious‐based volunteer work. Drawing on prior scholarship on religious short‐term mission and similarly focused trips and in‐depth interview data from trip participants, we outline several theoretical mechanisms that likely explain the link between taking a mission trip and civic engagement.     

青年颈心综合征避免误诊为冠心病的临床诊疗策略

通过对临床收集的187例青年(≤45岁)颈心综合征患者的临床资料进行分析。探讨青年颈心综合征临床误诊为冠心病的原因及避免误诊的诊疗策略。目的在于帮助临床医师对青年颈心综合征进行识别,注意如何与冠心病心绞痛相鉴别,对防止病情延误,尽早明确诊断积极治疗,排除冠心病,减少诊疗费用及避免冠脉造影的风险意义很大。     

Substance Use and Health and Safety among Homeless Youth

This study examines how substance use is associated with the health and safety of homeless youth using cross-sectional, self-report data from 285 homeless adolescents. Path models were used to examine concurrent relationships between youth’s substance use and multiple aspects of their health and safety, including measures of psychological distress, housing risk and instability, and medical problems. Substance use was examined with both global (i.e., a composite of days of use across various drugs and alcohol) and specific (i.e., rates of use of specific drugs, injection drug use) measures. After controlling for demographic and historical variables, number of days of use was significantly related to psychological distress, whereas injection drug use was significantly related to housing risk. Examination of specific drugs revealed relationships between psychological distress and the use of alcohol, cocaine, and amphetamines, and a specific relationship between housing risk and the use of heroin. None of the measures of substance use was significantly related to youth’s medical problems. Implications for interventions with homeless adolescents are discussed.     

Treatment for Youth in Short-Term Care Facilities: The Impact of a Comprehensive Behavior Management Intervention

We describe a comprehensive program to train emergency shelter staff in effective methods for dealing with youth who have behavioral and emotional problems; assess the degree to which staff implemented the treatment approach; measure the impact of the intervention on shelter-wide incidents such as out-of-control behavior, runaways, and violence against other youth; and examine pre-post changes in staff experiences at the shelter via anonymous surveys. Overall, the short-term shelter staff indicated adequate implementation of the intervention. The rate of youth incidents at the shelter significantly declined from pre to post assessment. Direct-care staff ratings of their satisfaction with their proficiency in behavior management and teaching youth skills increased significantly from pre to post implementation. These findings suggest that it is feasible to deliver an effective staff-training program to improve the behavior management and social skills of youth residing in short-term care facilities within the child welfare system.     

Social networking site use: Linked to adolescents' social self‐concept,self‐esteem,and depressed mood

Adolescents spend a substantial amount of time using social networking sites (SNSs); however, little is known regarding whether such use is associated with indicators of adjustment. The present study employed a multidimensional measure of SNS use to investigate the link between Australian adolescent SNS use and indicators of adjustment. Youth (N = 1,819, 55% female) from 34 diverse high schools across Western Australia were surveyed. The results showed that frequency of SNS use was linked to higher social self‐concept while investment in SNSs was associated with lower self‐esteem and higher depressed mood. Furthermore, having an SNS was linked to more negative indicators for female adolescents compared with male adolescents, although the link between frequency of use and investment in SNSs to indicators of adjustment was not moderated by gender. The present study highlights the complexity of the relationship between adolescent SNS use and indicators of adjustment, and offers insight into the diverse types of adolescent use of SNSs.     

Can a Single Measure Estimate Protocol Adherence for Two Psychosocial Treatments for Youth Anxiety Delivered in Community Mental Health Settings?

Treatment adherence measurement can be time and resource-intensive in clinical trials, so the ability to measure protocol adherence for two distinct treatment programs with a single measure may benefit the field. The present study sought to determine if the Therapy Process Observational Coding System – Revised Strategies Scale (TPOCS-RS) could assess protocol adherence to two youth treatment programs. Treatment sessions (N = 796) from 55 youth (M age = 9.89 years, SD = 1.71; range 7–15 years; 55.0% White; 46.0% female) with primary anxiety problems treatment by 39 clinicians (M age = 40.54 years, SD = 9.56; 50.0% White; 80.0% female) were independently scored by coders using observational treatment adherence and alliance measures. The youth received one of three treatments: (a) Standard (i.e., cognitive-behavioral treatment program), (b) Modular (i.e., a program with cognitive-behavioral and parent training components), or (c) Usual Care. Consultants filled out a self-report measure of protocol adherence within the Standard and Modular conditions. Interrater reliability, ICC(2,2) for the various items for the full sample ranged from .17 to .92 (M ICC = .67; SD = .17). Scores from a TPOCS-RS subscale that mapped onto the specific content of the treatment protocols used in the Standard and Modular conditions evidenced convergent validity with the consultant-report adherence measure and discriminant validity with the alliance measure. The model-specific TPOCS-RS subscales also discriminated between the Standard and Modular treatments and Usual Care. This study provides initial evidence that (a) the TPOCS-RS has utility in estimating protocol adherence in different treatment programs and (b) support the score validity of the self-report consultation records.     

A Randomized Trial to Identify Accurate Measurement Methods for Adherence to Cognitive-Behavioral Therapy

Clinician fidelity to cognitive behavioral therapy (CBT) is an important mechanism by which desired clinical outcomes are achieved and is an indicator of care quality. Despite its importance, there are few fidelity measurement methods that are efficient and have demonstrated reliability and validity. Using a randomized trial design, we compared three methods of assessing CBT adherence—a core component of fidelity—to direct observation, the gold standard. Clinicians recruited from 27 community mental health agencies (n = 126; M age = 37.69 years, SD = 12.84; 75.7% female) were randomized 1:1:1 to one of three fidelity conditions: self-report (n = 41), chart-stimulated recall (semistructured interviews with the chart available; n = 42), or behavioral rehearsal (simulated role-plays; n = 43). All participating clinicians completed fidelity assessments for up to three sessions with three different clients that were recruited from clinicians’ caseloads (n = 288; M age = 13.39 years SD = 3.89; 41.7% female); sessions were also audio-recorded and coded for comparison to determine the most accurate method. All fidelity measures had parallel scales that yielded an adherence maximum score (i.e., the highest-rated intervention in a session), a mean of techniques observed, and a count total of observed techniques. Results of three-level mixed effects regression models indicated that behavioral rehearsal produced comparable scores to observation for all adherence scores (all ps > .01), indicating no difference between behavioral rehearsal and observation. Self-report and chart-stimulated recall overestimated adherence compared to observation (ps < .01). Overall, findings suggested that behavioral rehearsal indexed CBT adherence comparably to direct observation, the gold-standard, in pediatric populations. Behavioral rehearsal may at times be able to replace the need for resource-intensive direct observation in implementation research and practice.     

Psychometric Properties of the Beck Depression Inventory-II in a Clinically-Identified Sample of Mexican American Adolescents

We examined the internal consistency reliability, convergent and divergent validity, and factor structure of the Beck Depression Inventory-II (BDI-II) in a sample of 131 Mexican American youth. The BDI-II demonstrated excellent internal consistency reliability (α=.90) and solid convergent and divergent validity with various clinical scales of the Adolescent Psychopathology Scale. Two factors, Cognitive-Somatic and Affective, emerged from an exploratory factor analysis and suggested that depressive symptomology may manifest somewhat differently in Mexican American youth. In sum, results provide tentative support for the use of the BDI-II as a measure of depression for this sample.