Modifying a Risk Assessment Instrument for Youthful Offenders.

High rates of incarceration in the United States are compounded by high rates of recidivism and prison return. One solution is more accurate identification of individual prisoner risks and needs to promote offender rehabilitation and successful community re-entry; this is particularly important for youthful offenders who developmentally are in late adolescence or early adulthood, and who struggle to reengage in education and/or employment after release. Thus, this study examined the feasibility of administration and initial psychometric properties of a risk and needs assessment instrument originally created for a juvenile justice population (the Global Risk Assessment Device or GRAD) with 895 male youthful offenders in one adult correctional system. Initial feasibility of implementation within the correctional system was demonstrated; confirmatory factor analyses support the invariance of the modified GRAD factor structure across age and race. Future studies are needed to examine the predictive validity and the sensitivity of the instrument.

Measuring Family Caregiver Perceptions of Support in Caring for Children and Youth With Mental Health Concerns.

This correlational study assessed how families of children with mental illness perceived the levels of support they received from informal and formal resource providers and the associations between perceived support and child outcomes. Adult caregivers (N = 904) of youth receiving public mental health care services were administered the Family Caregiver Perceptions of Support Scale developed by the authors to assess family caregiver perceptions of support prior to and at termination of services. Factor analysis identified three types of caregiver anticipated supports: informal support resources, support for treatment plan influence, and health care resources. The domains were significantly and positively associated with one another but did not uniformly correlate with youth mental health outcomes. The study provides preliminary evidence that treatment gains in youth mental health outcomes are observed when caregivers perceive support in treatment processes. Suggestions for future research are made, stressing the importance of caregivers and providers working together and describing needs related to future scale improvements.

Juvenile delinquency and adolescent fatherhood.

This study examined ecological risk factors associated with teen paternity in a sample of 2,931 male adolescents coming to the attention of juvenile courts across five midwestern counties. In contrast to previous studies documenting significantly higher rates of teen paternity among African American youth, we found that the European American court-involved youth in our sample were as likely to be teen fathers as their African American counterparts. However, an in-depth examination of the social ecologies of these court-involved youth revealed significant racial differences (regardless of the paternity status), with African American males reporting more prior offenses, delinquent peer associations, traumatic pasts, risky sexual behaviors, and educational risks as compared to European American youth, who reported greater involvement in substance use. Furthermore, logistic regression analyses revealed that after controlling for age and racial background, youth who reported greater exposure to trauma and prior offenses had significantly greater odds of having fathered a child. Surprisingly, youth who were teen fathers reported lower rates of behavioral problems as compared to their nonfathering peers. Given the cross-sectional nature of our data, interpretation of this result is limited. Overall, our findings underscore the need for developing a comprehensive understanding of the ecological risk and protective factors present in the lives of teen fathers coming in contact with the juvenile justice system, as an essential first step in designing effective and relevant intervention programs and services for this at-risk population.

Parent advocates in children's mental health: program implementation processes and considerations.

Children's mental health service systems are increasingly utilizing peer support services to support families experiencing serious child mental illness. The literature provides few detailed accounts of such peer-based approaches. This study qualitatively examined the approaches and processes of "parent advocate" programs implemented in two Ohio counties for children served through publicly funded mental health services. Descriptions of each county's program, the background and roles of parent advocates, reasons families decline advocate services, and challenges to advocates' work with families are provided. Implications for the field in developing clear and effective administrative and practice structures for peer support services are discussed.

Examining the impact of gender, race/ethnicity, and family factors on mental health issues in a sample of court-involved youth.

Faced with anywhere between one half and two thirds of its youth having a diagnosable mental illness, the identification and treatment of mental health concerns is a critically important endeavor for professionals working with youth who have contact with the juvenile justice system. In addition, the literature suggests that factors related to both the family and to the gender of the adolescent must be incorporated into any approach to assessment and intervention within this special population. Further, prior work that has documented the interaction of gender and family issues with adolescent race/ethnicity warrants further empirical attention, as does the intermediary role that the family may play in the development of both internalizing and externalizing behaviors. The present study extends this literature by examining factors related to gender, race/ethnicity, family factors, and mental health issues in a sample of 2,549 Caucasian and African American youth coming to the attention of juvenile courts. Multivariate analysis of variance results indicated significant main effects for gender and race/ethnicity, as well as a significant gender x race/ethnicity interaction for the family and externalizing variables. A multiple group structural equation modeling procedure was employed in order to test the hypothesis that family environment mediates the relationship between gender and mental health problems, as well as to test for potential differences in these relationships as a function of race/ethnicity. Results indicated support for the mediation model in the sample of African American youth but not in the sample of Caucasian youth.

Global risk factors and the prediction of recidivism rates in a sample of first-time misdemeanant offenders.

This article examines the prediction of recidivism using the Global Risk Assessment Device (GRAD), a reliable and valid measure of dynamic factors associated with family characteristics, peers, mental health, substance abuse, trauma exposure, educational concerns, accountability, and health risks. Using a sample of adult caregivers of first-time misdemeanant offenders, two factors-education and accountability-were significantly associated with recidivistic behavior, supporting the use of GRAD data in correctly identifying first-time offenders who have the greatest and the least likelihood for future offending behavior. Additional analyses utilizing parent reports on African American males indicate that the GRAD provides discrimination in the prediction of recidivism in a group typically seen as being high risk simply because of their gender and race. The assessment drives intervention approach of the GRAD is discussed in terms of using reports from adults to accurately place youth into appropriate levels of supervision and treatment.

Ethnicity, gender, and global risk indicators in the lives of status offenders coming to the attention of the juvenile court.

The present study examined the risks and needs of status offenders in comparison to an at-large juvenile court sample, with specific attention paid to factors related to gender and ethnicity. Status offenders displayed significantly higher risk scores than the comparison sample in domains associated with both family and parenting concerns and educational concerns. In addition, females displayed higher risk levels than males and White youth displayed significantly higher risk levels than minority youth across a wide variety of risk domains. Further analyses were conducted regarding the participation of African American males and females in a program designed as an alternative to detention. For both groups, successful program completion was accompanied by little or no further court involvement, whereas failure to complete the program was related to a variety of negative outcomes. However, African American females and males successfully completing program requirements displayed different risks and needs at the outset of their participation.

Multi-family psychoeducation groups in the treatment of children with mood disorders.

This study examined the impact of adjunctive multi-family psychoeducation groups (MFPG) on mood-disordered children aged 8 to 11 and their families. Participants were 35 children and 47 parents from families randomly assigned to either immediate MFPG plus treatment as usual (n = 18) or a 6-month wait-list condition plus treatment as usual (n = 17). At the 6 month follow up, immediate treatment families reported: Increased parental knowledge about childhood mood symptoms; increased positive family interactions as reported by the parent; increased perceptions of parental support as reported by children; and increased utilization of appropriate services by families. Expected impact on decreasing negative family interactions was not found. Results are largely consistent with hypothesized findings and support the need to further investigate the adjunctive role of psychoeducation in the treatment of childhood mood disorders.

Building bridges between the parole officer and the families of serious juvenile offenders: a preliminary report on a family-based parole program.

Responding to a model of juvenile offender case supervision that called for a new intervention paradigm to guide the work of probation and parole officers, the present article reports on the use of a family-based parole initiative known as the Growing Up FAST program. Developed in part as a tool for use within this new intervention paradigm, the Growing Up FAST parole program targets serious youthful offenders who have been released from juvenile correctional facilities and their families. Based on elements contained within the "what works" literature and the Balanced and Restorative Justice model, this program recognizes the central role that field staff can play in rehabilitation efforts. Demographic information and formative data regarding the first set of families to participate in this program are presented, then program limitations and lessons learned as part of the initial offering of this parole initiative are discussed.

Family psychoeducation: an adjunctive intervention for children with bipolar disorder.

Childhood onset bipolar disorder is associated with significant morbidity and mortality, yet effective treatment strategies have remained underdeveloped and understudied. While some headway is being made vis-a-vis pharmacologic treatments, empirical efforts have not focused on adjunctive psychosocial interventions for childhood bipolar disorder. In this review, we discuss psychoeducation, delivered via workshops, multifamily psychoeducation groups, or individual-family psychoeducation, as an adjunct to the ongoing pharmacotherapy, psychotherapy, and school-based interventions for children with bipolar disorder. We review the theoretical rationale for psychoeducation, including expressed emotion and caregiver concordance; summarize findings in the adult literature; and then describe our development and testing of psychoeducational interventions for mood-impaired children. Data from three pilot studies are reviewed, and progress on two studies currently underway is presented. We conclude with current limitations of psychoeducation and recommendations for future study to develop psychoeducation as an empirically supported adjunctive intervention for children with bipolar disorder.

Toward conceptual development and empirical measurement of global risk indicators in the lives of court-involved youth.

This paper reports work related to the conceptual development and empirical use of global risk indicators meant to measure rapidly and reliably potential threats to the overall development and well-being of adolescents in the juvenile justice system. The development of these indicators and initial data regarding their use with court involved samples are presented. Analysis of data gathered from a sample containing 248 families of adolescents who participated in a family-based diversion program identified a seven-factor structure that corresponded to theoretically derived dimensions of risk in domains associated with prior offenses, family/parenting, education/work, peers, substance use, personality/behavior problems, and attitudes/orientation. Analysis of data gathered from a second sample containing 373 families of adolescents who came into contact with the intake/diversion department of a county juvenile court confirmed the original seven factors of the battery and generated support for an eighth dimension composed of items that reflected leisure activities. The use of these global risk indicators are discussed as part of a practical and effective assessment battery for professionals working with court-involved youth and their families.

Brief report on predictive validity evidence of global risk indicators in the lives of court-involved youth.

Previous work has reported the psychometric properties and evidence for concurrent validity of a battery of items measuring global risk indicators in the lives of court-involved adolescents. The present study reports additional data on the predictive validity of this battery in a sample of 224 families of adolescents who were assessed by intake workers in a juvenile court and subsequently referred for services. Analysis yielded significant differences between groups of youth who were and were not referred to more intensive mental health-based treatment on all domains of risk in his battery.

Advances in measurement of global risk indicators in lives of court-involved youth: brief evidence for concurrent validity.

The present study reports data on the concurrent validity for the Global Risk Assessment Device, a measure of global risk indicators for a sample of 37 families of adolescents who participated in a family-based program designed to divert youth out of the justice system. Significant correlations among three domains of risk (family/parenting, substance use, and personality/behavior problems) and other measures generated preliminary evidence for concurrent validity of this global risk measure.

Multifamily psychoeducation groups (MFPG) for families of children with bipolar disorder.

OBJECTIVES: Multi-family psychoeducation groups (MFPG) have been developed and tested for adults, but not for children with bipolar disorder (BPD). We present data from a pilot study of our manual-driven MFPG treatment for families of children with mood disorders and address two questions: Do families of children with BPD and families of children with major depressive disorder/dysthymic disorder (MDD/DD): 1) differ at treatment entry?; 2) benefit equally from intervention? METHOD: A total of 35 children (n=16, BPD; n=19, MDD/DD) aged 8-11 years and their parents were randomized into immediate MFPG plus treatment as usual (TAU) or wait-list + TAU and assessed periodically. RESULTS: At baseline, there was a trend toward parents in BPD families being more knowledgeable about mood symptoms than parents in MDD/DD families (p < 0.04). Additionally at baseline, children with BPD evidenced greater mood severity historically and a trend toward more hospitalizations, day treatment, outpatient treatment, medication trials, and placement in special education classrooms than children with MDD/DD. Immediately following and 4 months post-treatment, both BPD and MDD/DD families described having gained knowledge, skills, support, and positive attitudes during treatment. MDD/DD families increased their knowledge of symptoms to the same level as BPD families. CONCLUSIONS: While BPD families enter treatment with more impaired children and more extensive treatment histories, both BPD and MDD/DD families benefit from intervention. The clinical issues concerning combining families of children with bipolar and depressive spectrum illnesses in groups are discussed. Clinical impressions suggest that such combinations are clinically feasible and potentially beneficial.