Addressing a Mental Health Intervention Gap in Juvenile Detention: A Pilot Study.

Research suggests that 60-70% of adolescents detained in the juvenile justice system meet criteria for a mental health disorder compared to 20% of the general adolescent population; however, the vast majority do not receive services. Unfortunately, mental health symptoms often worsen during detainment, and detainment is linked to lower levels of educational attainment and increased risk of adult recidivism. Thus, not only are these adolescents unlikely to receive needed mental health care, but also the lack of interventions in detention may exacerbate inequities of contact with the criminal justice system in adulthood. In addition to these youth being an underserved population broadly, youth of color are also disproportionately incarcerated compared to their white counterparts. The current paper describes results of a pilot study of an Acceptance and Commitment Therapy (ACT)-based behavioral skills intervention, aimed at providing evidence-based mental health treatment for an adolescent population at risk of long-term adverse mental health outcomes. The study included 128 males aged 14-17 who resided in juvenile detention. Results demonstrated that the intervention was acceptable to participants, feasible to provide in detention, and could be implemented with fidelity and competency. Intervention participants demonstrated declines in symptoms of mental health, and ACT-specific constructs of experiential avoidance, cognitive fusion, and perceived barriers to moving toward their values. These results have important implications for the possibility of an effective intervention that could disrupt systemic inequity in youth mental health, and thus support further testing of this intervention in a randomized controlled trial.

Developing an ACT-based intervention to address lung cancer stigma: Stakeholder recommendations and feasibility testing in two NCI-designated cancer centers.

Objective: Few psychosocial interventions have been tailored to meet the unique needs of patients diagnosed with lung cancer. This pilot study developed and tested a six-week intervention for reducing lung cancer stigma.Design and Subjects: Guided by qualitative interviews conducted with 9 lung cancer patients and 5 thoracic oncology care providers, Acceptance and Commitment Therapy was adapted for treatment of lung cancer stigma (ACT-LCS). In a subsequent single arm pilot study, 22 lung cancer patients reporting high levels of stigma completed the intervention.Setting: NCI-designated cancer centers in the Southwestern and Eastern United States.Results: Of 46 eligible patients, 22 provided consent, with 20 completing the intervention (10 in-person, 10 telehealth). Overall stigma decreased across timepoints, largely driven by reductions in internalized stigma. There were also significant reductions in social isolation, sleep disturbance, and fatigue.Conclusions: The ACT-LCS protocol demonstrates preliminary feasibility and acceptability. This intervention may be particularly suited for helping patients navigate feelings associated with internalized stigma.

Understanding the perception of stakeholders in reducing adolescent-to-parent violence/aggression.

INTRODUCTION: Adolescent-to-parent violence/aggression (APV/A) is an understudied yet increasingly common social problem for adolescents and families, particularly those involved in the juvenile justice system. The current study focused on improving interventions for this population by gathering qualitative data from stakeholders to inform treatment targets. METHODS: Participants (N = 23) comprised of court professionals (n = 7), parents/guardians (n = 9), and their male adolescent children (n = 7) in the United States. Parent and adolescent participants were recruited through monthly court-mandated domestic violence education classes offered by the juvenile court. Parent/guardian participants were between the ages of 38 and 77 and consisted of four males and five females. Adolescents were between the ages of 14 and 17. Court professional participants consisted of judges, probation officers, and court psychologists. Semi-structured interviews were analyzed qualitatively using grounded theory. RESULTS: Results indicated that, from the perspective of key stakeholders, an effective intervention to reduce APV/A likely involves a two-pronged approach: (1) address specific and theoretically modifiable emotional, behavioral, and psychological factors at the adolescent-level; and (2) induce change in the family system by addressing environmental barriers to seeking treatment and by creating positive family relationships. CONCLUSIONS: The present study aimed to gather the perspectives of court professionals, adolescents, and parents/guardians regarding the development of an effective intervention for APV/A-involved families. This study represents the first step toward the development of a feasible, acceptable, sustainable, and effective intervention for adolescents and their families who are involved in the juvenile justice system due to APV/A.

Multidisciplinary partnership: Targeting aggression and mental health problems of adolescents in detention.

Justice-involved adolescents meet diagnostic criteria for mental health disorders at much higher rates than their counterparts, and this increased risk persists into young adulthood (Abram et al., 2015; Teplin, Abram, McClelland, Dulcan, & Mericle, 2002). Despite growing recognition of this problem, there remains a dearth of adequate therapeutic services in juvenile detention and marked variation in the quality and availability of community-based services (Kretschmar, Butcher, Flannery, & Singer, 2016). This article presents the development of a multidisciplinary partnership among clinical research psychologists and court professionals to address aggressive behaviors and unmet mental health needs of adolescents in the juvenile justice system. We describe the early stages of collaboration, in which experts from disparate disciplines joined forces to address a mounting problem in the juvenile justice system that represented both a gap in the research-practice continuum and a lack of vital mental health resources in the local community. We delineate the team composition, outline key players' roles and contributions, and describe the principles that guided our collaboration across disciplines and agencies. We were effective in developing a sustainable multidisciplinary team, developing a new intervention, and implementing this new intervention in a challenging setting. The challenges we encountered throughout the process as well as the solutions that were generated and the lessons learned are discussed in detail. We discuss the substantive outcomes of our research and conclude with recommendations for readers interested in organizing similar academic-research/community partnerships. (PsycINFO Database Record (c) 2019 APA, all rights reserved).