Mental Health Service Experiences Among Transition-Age Youth: Interpersonal Continuums that Influence Engagement in Care.

Purpose. Transition-age youth (TAY) who have experienced or are experiencing complex trauma, system involvement and homelessness are at increased risk for serious mental health needs and related challenges. However, these vulnerable and historically marginalized TAY typically have low rates of mental health service engagement. This study examines how and why TAY experiencing system involvement, homelessness, and serious mental health and substance use symptoms engage in mental health services, and what facilitates and/or hinders their engagement in services. Methods. Twenty-one TAY completed a virtual interview about their previous and current mental health service experiences, and why they did or did not engage with mental health services. A modified grounded theory qualitative analysis approach was used to understand how participants' personal sense of meaning interacted with programmatic factors to construct participant experiences with mental health services. Results. Most participants (81%, n = 17) received mental health services, namely psychiatry (76%, n = 16) and counseling/therapy (48%, n = 10), and peer support (10%, n = 2). Participants described their mental health service experiences along three interpersonal and relational continuums between themselves and their providers: feeling (mis)understood, being treated with (dis)respect, and experiencing (dis)trust. Discussion. Study findings reveal that for these particularly vulnerable and marginalized TAY, relational and interpersonal factors significantly influenced their engagement in mental health services. Study findings call for providers to re-imagine their working alliance with highly vulnerable TAY through culturally-attuned practices that promote understanding, respect, and trust. Findings also call for TAY-serving programs and policies to re-imagine peer support as a mental health service option for this highly vulnerable population.

Implications of the COVID-19 Pandemic for Youth Housing and Homelessness Services.

Youth homelessness is a growing crisis in the United States that is associated with a range of adverse outcomes. A variety of social service programs exist to address youth homelessness and its consequences, such as street outreach and diversion services, emergency shelters, transitional housing programs, and rapid rehousing services, among others. The coronavirus disease 2019 (COVID-19) pandemic reached the United States in early 2020, altering nearly every facet of daily life, including the way social service organizations structure and deliver their programming. To understand the implications of the pandemic on housing and homelessness services for youth, the current study examines data from interviews conducted with staff from a large non-profit in Austin, Texas, serving vulnerable transition-age youth. Through these interviews, programmatic changes that occurred as a result of COVID-19-as well as challenges and facilitators to service delivery-were identified. This article provides an overview of these key learnings, as well as recommendations derived from these key learnings, for other organizations adapting their housing and homelessness services in response to the COVID-19 pandemic.

Does Sex Really Matter? Examining the Connections Between Spouses' Nonsexual Behaviors, Sexual Frequency, Sexual Satisfaction, and Marital Satisfaction.

We examined the interplay between husbands' and wives' positive and negative nonsexual interpersonal behaviors, frequency of sexual intercourse, sexual satisfaction, and feelings of marital satisfaction. To do this, we conducted an in-depth face-to-face interview and completed a series of telephone diaries with 105 couples during their second, third, and fourteenth years of marriage. Consistent with the argument that women's sexual response is tied to intimacy (Basson, 2000), multilevel analyses revealed that husbands' positive interpersonal behaviors directed toward their wives-but not wives' positivity nor spouses' negative behaviors (regardless of gender)-predicted the frequency with which couples engaged in intercourse. The frequency of sexual intercourse and interpersonal negativity predicted both husbands' and wives' sexual satisfaction; wives' positive behaviors were also tied to husbands' sexual satisfaction. When spouses' interpersonal behaviors, frequency of sexual intercourse, and sexual satisfaction were considered in tandem, all but the frequency of sexual intercourse were associated with marital satisfaction. When it comes to feelings of marital satisfaction, therefore, a satisfying sex life and a warm interpersonal climate appear to matter more than does a greater frequency of sexual intercourse. Collectively, these findings shed much-needed light on the interplay between the nonsexual interpersonal climate of marriage and spouses' sexual relationships.

Individual differences in the relationship transition context: links to physiological outcomes.

The identification of relationship-relevant individual differences is central to elucidating how relationship experiences differentially impact individuals' health. To this end, we highlight the utility of studying the influence of individual differences on physiological outcomes (e.g., cortisol reactivity and recovery) in the context of normative relationship transitions. We argue that relationship transitions, such as falling in love and the process of committing to marry one's partner, amplify the influence of individual differences on relationship processes and, by extension, on physiological outcomes. Two such individual differences are highlighted-namely, relationship-focused processing and dependence-and suggestions for future work are provided.

I do do you? Dependence and biological sex moderate daters' cortisol responses when accommodating a partner's thoughts about marriage.

We examined how daters' levels of relationship dependence interact with men's and women's degree of accommodation during a likelihood of marriage discussion to predict cortisol levels at the conclusion of the discussion. Upon arriving at the laboratory, couple members were separated and asked to graph their perceived likelihood of one day marrying each other. Couples were reunited and instructed to create a joint graph depicting their agreed-upon chance of marriage. For the majority of couples, negotiating their likelihood of marriage required one or both partners to accommodate each other's presumed likelihood of marriage. Multilevel analyses revealed a significant Dependence×Accommodation×Sex interaction. For women who increased their likelihood of marriage, feelings of dependence predicted heightened levels of cortisol relative to baseline; we suggest such a response is indicative of eustress. Among men, those who accommodated by decreasing their likelihood of marriage experienced significantly lower levels of cortisol to the extent that they were less dependent on their partners. Discussion focuses on why men and women show different physiological reactions in response to seemingly favorable outcomes from a relationship discussion.

Do men and women show love differently in marriage?

In Western societies, women are considered more adept than men at expressing love in romantic relationships. Although scholars have argued that this view of love gives short shrift to men's ways of showing love (e.g., Cancian, 1986; Noller, 1996), the widely embraced premise that men and women "love differently" has rarely been examined empirically. Using data collected at four time points over 13 years of marriage, the authors examined whether love is associated with different behaviors for husbands and wives. Multilevel analyses revealed that, counter to theoretical expectations, both genders were equally likely to show love through affection. But whereas wives expressed love by enacting fewer negative or antagonistic behaviors, husbands showed love by initiating sex, sharing leisure activities, and doing household work together with their wives. Overall, the findings indicate that men and women show their love in more nuanced ways than cultural stereotypes suggest.