A comparison of three interventions for homeless youth evidencing substance use disorders: results of a randomized clinical trial.

While research on homeless adolescents and young adults evidencing substance use disorder is increasing, there is a dearth of information regarding effective interventions, and more research is needed to guide those who serve this population. The current study builds upon prior research showing promising findings of the community reinforcement approach (CRA) (Slesnick, Prestopnik, Meyers, & Glassman, 2007). Homeless adolescents and young adults between the ages of 14 to 20 years were randomized to one of three theoretically distinct interventions: (1) CRA (n = 93), (2) motivational enhancement therapy (MET, n = 86), or (3) case management (CM, n = 91). The relative effectiveness of these interventions was evaluated at 3, 6, and 12 months post-baseline. Findings indicated that substance use and associated problems were significantly reduced in all three interventions across time. Several moderating effects were found, especially for sex and history of childhood abuse. Findings show little evidence of superiority or inferiority of the three interventions and suggest that drop-in centers have choices for addressing the range of problems that these adolescents and young adults face.

Predictors of follow-up completion among runaway substance-abusing adolescents and their primary caretakers.

Follow-up rates reported among longitudinal studies that focus on runaway adolescents and their families are relatively low. Identifying factors associated with follow-up completion might be useful for improving follow-up rates and therefore study validity. The present study explored how individual- and family-level constructs, as well as research project activities, influence the follow-up completion rate among runaway adolescents (N = 140) and their primary caregiver. Results showed that follow-up completion rates decreased as the number of research assistants (RA) assigned to each case increased and as participants' address changes increased. Additionally, among adolescents, more frequent alcohol use was associated with lower follow-up rates. The current findings suggest that researchers should (1) design their research so that one RA is assigned to each specific case, and (2) adjust their retention strategies to account for the differences in follow-up rates based upon the participants' drug of choice and residential stability.

Troubled parents, motivated adolescents: predicting motivation to change substance use among runaways.

Runaway adolescents engage in high rates of substance use and report significant family and individual problems. However, in general, adolescents report low motivation to change their substance use. Because a higher level of motivation for changing substance use is associated with greater substance abuse treatment success, identifying variables associated with motivation for change can be useful for enhancing treatment success. In this study, predictors of motivation for changing substance use were examined among 140 shelter-recruited adolescents and their parents/primary caretakers. Several findings were noteworthy. A perceived negative family environment increased parents' and adolescents' depressive symptoms, which increased adolescent's motivation to change. Also, greater severity of adolescent substance use predicted higher motivation to change. Consideration of the family environment and parent problems when addressing motivation for changing substance use among these adolescents might be important foci for motivational interventions and future research.

Problem Behaviors of Homeless Youth: A Social Capital Perspective.

Homeless youth are one of the most marginalized groups in our society. Many researchers identify much higher levels of various problem behaviors among these youth compared to their non-homeless peers. The current study examined the utility of social capital in predicting problem behaviors among homeless youth. Overall, the theoretically derived social capital variable significantly predicted substance use frequency, sexual risk behavior, depression, delinquent behavior as well as number of days homeless. Thus, social capital was useful in understanding and predicting the current life situation among these youth and may be worthy of further study. Findings suggest that meaningful change should utilize interventions that go beyond the individual and are geared towards modifying the social context of individuals' lives.

How to open and sustain a drop-in center for homeless youth.

Drop-in centers have the potential to facilitate engagement of homeless youth into treatment and back into the mainstream. However, little guidance was found in the literature regarding how to open and sustain a drop-in center for homeless youth. This paper offers such guidance, including information that may be useful for developing a change philosophy that guides the center structure, and for identifying a building and location conducive to facilitate activities and access for the youth. Guidance for structuring the drop-in center and for hiring and training staff is also offered. Since the U.S. suffers from a dearth of services for homeless youth, the direction offered in this paper may help guide those who seek to provide services to these vulnerable and underserved youth.