reconnecting homeless youth and their families: the role of family … · 2014. 8. 27. ·...
TRANSCRIPT
Reconnecting homeless
youth and their
families: The role of
family-based
interventions
Norweeta G. Milburn, Ph.D.
Affiliations & Support UCLA Department of Psychiatry and Biobehavioral Sciences
Semel Institute for Neuroscience and Human Behavior
Nathanson Family Resilience Center
Department of Medicine
University of California, Los Angeles
Supported by grants from NIMH MH61185, MH70322, and MH080664,
NIMHD P20MD000182, and NIDA DA035692.
Workshop Presentation at the National Alliance to End Homelessness
National Conference on Ending Homelessness, Washington, DC July 30,
2014.
Overview
Family-based interventions
Project STRIVE
Adaption
2
Family-Based Interventions
STRIVE: Support to Reunite, Involve and Value Each Other
4
Family-Based Intervention (5 Sessions) Built Upon:
Family Strengths
Problem Solving
Conflict Negotiation
Role Clarification
STRIVE: Support to Reunite, Involve and Value Each Other
5
Program Elements
Tokens Feeling
Thermometer
Problem Solving
Role
Playing Reframing
STRIVE Randomized Control Trial
(RCT): Findings
⬆Mental Health
⬇Substance abuse and HIV sexual risk
6
Milburn, Iribarren, Rice et al. (2012)
Adaptation/Implementation for Re-Entry Youth: Design
Sample
N = 300 re-entry youth + parents/guardians
Phase 1
Adapt STRIVE
Phase 2
RCT of STRIVE
Baseline, 3, 6, and 12 months
Adaptation: Re-entry youth
8
Adapted STRIVE
Parents
Youth
Juvenile Justice
Adaptation: Re-entry youth
9
Navigation
Help with access to services
Link to services
Therapeutic Alliance
Establish trust
Build rapport
Systems of Care
Cross disciplinary collaboration
Facilitate relationships
Critical Intervention Period
Before release
Family visitation
Family-Based Approach
Different family constellations
Strengths-based
Reconnection
10
Theme Quote Group
System of Care “The court is a point of contact for all young offenders and would be a good
place to offer your services but the whole mandating thing that could be a
difficult thing because it’s another thing, another thing they’re making me
do…but also might be a good way to catch the less motivated individuals
because then it’s court-mandated and it’s part of the stipulation of your
freedom. So that could be a good thing for it.”
Group 1
Establishing a Therapeutic Alliance “I think a lot of people are distrustful…So I think you’d have to reassure people
that somehow they can trust the counselors or program or you’re not going to
rat them out at the court if they’re going to appear in court. I mean, they have
stuff. We don’t tell our stuff.”
Group 3
Critical Intervention Period “When kids get released from camp or even custody, I call it like a celebration
period…Usually, those couple of weeks they’re doing well, except they forget
they’re still on probation. Then you have like a violation early on. So maybe
that could be something this program could help with, also to remind them to do
all the things they need to do, doing it slowly, also.”
Group 3
Navigation “It’d be different if there were a one-stop shop that dealt with probation issues,
and mental issues, health, education where they can go and deal with all that in
one place. But instead, they’re having to go to so many different places, report
to so many different people and it’s just so hard to keep track of those people.
It’s hard to have time to do all that and they’re lugging all the little siblings
around too. It’s just…it’s completely overwhelming.”
Group 3
Family-Based
Approach
“I think another thing too if a family does participate in this, is there going to be
some kind of follow-up or referral if it turns up that the family is actually
interested in getting more counseling? … Because that’s a huge need for most
of our kids and their families that we’re constantly shopping around to try to find
services, something for the kids. Lots of times it’s a struggle to find those
programs for people that want them.”
Group 3
Implementation Conclusions
11
Five elements for success
1. Intervene early
2. Family-centered approach
3. Reentry navigation component
4. Therapeutic alliance
5. Embedded in the system of care
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EXPORT/STRIVE
Eraka Bath, M.D.
W. Scott Comulada, Dr.P.H.
Bita Amani, Ph.D.
Angela Young-Brinn, B.S.
Alex Lee, M.S.W.
Norweeta G. Milburn, Ph.D.
Francisco Javier Iribarren, Psy.D.
Alex Lee, B.A.
Kwame Alexander, B.A.
Kate Desmond, M.S.
Phillip Batterham, M.P.H.
Norweeta G. Milburn, Ph.D.
UCLA Semel Institute for Neuroscience
& Human Behavior
UCLA Center for Community Health