A Test of Outreach and Drop-in Linkage Versus Shelter Linkage for Connecting Homeless Youth to Services.

Outreach and service linkage are key for engaging marginalized populations, such as homeless youth, in services. Research to date has focused primarily on engaging individuals already receiving some services through emergency shelters, clinics, or other programs. Less is known about those who are not connected to services and, thus, likely the most vulnerable and in need of assistance. The current study sought to engage non-service-connected homeless youth (N = 79) into a strengths-based outreach and advocacy intervention. Youth were randomly assigned to receive 6 months of advocacy that focused on linking youth to a drop-in center (n = 40) or to a crisis shelter (n = 39). All youth were assessed at baseline and 3, 6, and 9 months post-baseline. Findings indicated that youth prefer drop-in center services to the shelter. Also, the drop-in center linkage condition was associated with more service linkage overall (B = 0.34, SE = 0.04, p < 0.01) and better alcohol-l [B = -0.39, SE = 0.09, t(75) = -4.48, p < 0.001] and HIV-related outcomes [B = 0.62, SE = 0.10, t(78) = 6.34, p < 0.001] compared to the shelter linkage condition. Findings highlight the importance of outreach and service linkage for reconnecting service-marginalized youth, and drop-in centers as a primary service option for homeless youth.

A Multilevel Analysis of Individual and Community Factors Associated With Case Dispositions Following Child Maltreatment Investigations.

Understanding service disposition pathways is critical to provide deeper insight into why certain subgroups of the population are at risk for recurrent Child Protective Services (CPS) involvement and may highlight disparities across groups or geographic areas. Using the Decision-Making Ecology Framework as a lens, the present study examines whether service disposition pathways are influenced by risk assessment, safety concerns, child age, maltreatment type, previous CPS involvement, and/or county-level structural vulnerability. We linked administrative data from New Mexico's Department of Children, Youth and Families (DCYF) to data from the American Community Survey. Multilevel models examining associations between case (N = 12,960) and county (N = 33) characteristics revealed that both case (age, maltreatment type, risk/safety assessments, previous CPS involvement) and county-level factors (transportation and housing) were associated with service disposition. Additionally, we observed considerable variation at the county level in both the provision of services and the relationship between risk assessment and service provision. By linking different factors of the decision-making process in child welfare cases to intervention strategies, the analysis reveals that the perception of risk can vary based on geographical context resulting in different outcomes for families who have similar risks but different county-level vulnerabilities.

Understanding how peers respond to online child maltreatment disclosures: A qualitative content analysis of family violence discussions on social media.

BACKGROUND: Positive, supportive responses to child maltreatment disclosure are critical for victims to receive appropriate resources and support for healing. Young people often prefer to disclose to their peers, frequently on social media platforms. OBJECTIVE: We assessed young people's use of TalkLife, an online peer-to-peer support platform, to respond to the disclosure of child maltreatment. METHODS: We conducted a qualitative content analysis of 1090 comments on childhood maltreatment-related posts on TalkLife between 2013 and 2020. We used an iterative, team-based qualitative content analysis approach to understand how peers responded to maltreatment disclosure. FINDINGS: Peer responses tended to be supportive, including asking questions about the abuse and offering advice, emotional support, and other positive responses. Most commonly, peers advised the victim to report, focus on their strengths instead of the abuse, reach out to adults for more support, or confront the perpetrator. On occasion, however, peers began an irrelevant discussion, joked about the situation, or even directly attacked the discloser. CONCLUSIONS: Learning about child maltreatment disclosures on social media builds the foundation for research to assist in identifying and applying interventions on online platforms. Further, these findings can inform programs that teach how to provide healthy responses to child maltreatment disclosures.

"They Aren't Going to Do Jack Shit": Text-Based Crisis Service Users' Perceptions of Seeking Child Maltreatment-Related Support From Formal Systems.

Many of the children reported to child protective services (CPS) exhibit signs and symptoms that allow others to recognize their abuse or neglect and intervene; others, especially adolescents, must disclose their experiences to be identified. Relatively little is known about young people's disclosure experiences, but individual, interpersonal, and cultural factors appear to influence when and how young people disclose. Technology-facilitated approaches, such as text- or chat-based hotlines or crisis services, may be one way to help young people share their maltreatment experiences and seek help. The current study contributes to the small body of literature that includes nonsexual maltreatment disclosures and sheds some light on how to support young people during their disclosures. We conducted a qualitative content analysis of all conversations from a text-based crisis service that resulted in a report to CPS (n = 244). Many of the texters had previously sought support from their peers or parents, and some had engaged with more formal systems. Many young people were hesitant to reach out to formal systems in the future, in part because of negative experiences during past disclosure experiences. Young people may be more likely to seek support through their preferred communication medium, so providing text- and chat-based communication may be one way to encourage and facilitate disclosure. As these resources become increasingly available, determining best practices for receiving disclosures through technology-facilitated platforms will be critical.

Child maltreatment data: A summary of progress, prospects and challenges.

BACKGROUND: In 1996, the ISPCAN Working Group on Child Maltreatment Data (ISPCAN-WGCMD) was established to provide an international forum in which individuals, who deal with child maltreatment data in their respective professional roles, can share concerns and solutions. OBJECTIVE: This commentary describes some of the key features and the status of child maltreatment related data collection addressed by the ISPCAN-WGCMD. METHODS: Different types of data collection methods including self-report, sentinel, and administrative data designs are described as well as how they address different needs for information to help understand child maltreatment and systems of prevention and intervention. RESULTS: While still lacking in many parts of the world, access to child maltreatment data has become much more widespread, and in many places a very sophisticated undertaking. CONCLUSION: The ISPCAN-WGCMD has been an important forum for supporting the continued development and improvement in the global effort to understand and combat child maltreatment thus contributing to the long term goals of the UN Convention on the Rights of the Child. Nevertheless, based on what has been learned, even greater efforts are required to improve data in order to effectively combat child maltreatment.

"I'm here to listen and want you to know I am a mandated reporter": Understanding how text message-based crisis counselors facilitate child maltreatment disclosures.

BACKGROUND: Emerging research suggests technology-facilitated crisis services are a promising method to support young people during child maltreatment disclosure. Little is known about how employees/volunteers respond to child maltreatment disclosure in these platforms and how they may support young victims through the disclosure process. OBJECTIVES: We sought to determine how crisis counselors respond to child maltreatment disclosures using a content analysis of all conversations within a text-based crisis organization that resulted in a mandatory report. METHODS: We conducted an iterative team-based content analysis of 244 conversations (24,730 text messages) between a young person and a crisis counselor from an anonymous text-based crisis service. All conversations included in the sample resulted in a mandatory report to child protective services. RESULTS: There were two crucial points in maltreatment disclosure conversations. The first occurred immediately after the disclosure. At this point, crisis counselors most often provided sympathy and affirmation. The second crucial point after disclosure was the discussion of mandatory reporting. In many cases, crisis counselors confirmed both parties understood mandatory reporting and encouraged young people to consider the repercussions of their decision to share identifiable information that would permit a mandatory report. CONCLUSION: Understanding how crisis counselors responded to young people in one text-based crisis service, particularly characteristics of well-received conversations, may inform the policies and processes for other organizations. Continued exploration of crisis text-based services may improve the disclosure process for young victims.

What College Students Post About Depression on Facebook and the Support They Perceive: Content Analysis.

BACKGROUND: College students frequently use social media sites to connect with friends. Increasingly, research suggests college students and other young adults seek mental health-related support on social media, which may present a unique venue for intervention. OBJECTIVE: The purpose of this study was to examine college students' perceptions about displaying feelings of depression on Facebook and, in turn, how their social media friends responded. METHODS: A primarily quantitative online survey with open response questions was distributed to students at four US universities. Qualitative responses were analyzed using content analysis. RESULTS: A total of 34 students provided qualitative responses for analysis, these students were 85.3% female, mean age 20.2 (SD=1.4) and 20.6% racial/ethnic minority. Students who reported posting about depression often expressed an emotion or feeling but did not use the word "depression" in the post. Approximately 20% posted language about a bad day, and 15% posted a song or music video. Only one person reported posting a statement that directly asked for help. When friends responded to the posts, students generally perceived the responses as supportive or motivating gestures. Nearly 15% of friends contacted the individual outside of Facebook. One individual received a negative response and no responses suggested that the individual seek help. CONCLUSIONS: This study found that college students who post about depression often do so without directly referencing depression and that friends were generally supportive. However, no participants reported their social network suggested they seek help, which may suggest increasing mental health literacy, for both support seekers and responders, would be an opportunity to improve online mental health-related support.

Screening for economic hardship for child welfare-involved families during the COVID-19 pandemic: A rapid partnership response.

BACKGROUND: Pandemics have a wide range of economic, health and social consequences related to both the spread of a disease and efforts made by government leaders to contain it which may be particularly detrimental for the child welfare-involved population. This is because child welfare agencies serve some of the highest needs children and families. A significant proportion of these families face economic hardship, and as a result of containment measures for COVID-19, more families inevitably will. OBJECTIVE: Given the range of negative consequences related to the pandemic and the evolving supports available to families, child protection workers needed a clinical tool to guide and support work with families informed by an understanding of economic hardship. The objective of this paper is to report on the development and implementation strategy of a tool to be used for practice intervention during the pandemic. METHODS: Action research methodology was utilized in the creation of the clinical tool. The tool's development and implementation occurred through an academic/child welfare sector partnership involving child welfare agencies representing diverse regions and populations in Ontario, Canada. Factor analysis of representative child welfare data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 (OIS-2018) on economic hardship was used to inform the development of questions on the clinical tool. RESULTS: The development and implementation strategy of the clinical tool are described, including the results from analyses of the OIS-2018. CONCLUSIONS: Future directions for the project are discussed, including considerations for using this tool beyond the pandemic.

Epidemiology of youth suicide and suicidal behavior.

PURPOSE OF REVIEW: Suicide is the third leading cause of death among young people in the U.S. and represents a significant public health problem worldwide. This review focuses on recent developments in our understanding of the epidemiology and risk factors for adolescent suicide and suicidal behavior. RECENT FINDINGS: The suicide rate among children and adolescents in the U.S. has increased dramatically in recent years and has been accompanied by substantial changes in the leading methods of youth suicide, especially among young girls. Much work is currently underway to elucidate the relationships between psychopathology, substance use, child abuse, bullying, internet use, and youth suicidal behavior. Recent evidence also suggests sex-specific and moderating roles of sex in influencing risk for suicide and suicidal behavior. SUMMARY: Empirical research into the causal mechanisms underlying youth suicide and suicidal behavior is needed to inform early identification and prevention efforts.

Child Maltreatment Disclosure to a Text Messaging-Based Crisis Service: Content Analysis.

BACKGROUND: Disclosure is a difficult but important process for victims of child maltreatment. There is limited research on child maltreatment disclosure. Young people have been reluctant to disclose victimization to adults, but short message service (SMS) crisis services may represent one novel method of engaging young people around sensitive topics. OBJECTIVE: The purpose of this study was to determine characteristics of child maltreatment disclosure to an SMS-based crisis service. METHODS: We conducted a content analysis of all conversations (N=244) that resulted in a mandatory report by an SMS-based crisis service between October 2015 and July 2017. We coded characteristics of the disclosure process, including the reason for initial contact, phrase used to disclose abuse, perpetrator, type of abuse, and length of victimization. After identifying terms used by young people to disclose child abuse, we randomly selected and analyzed 50 conversations using those terms to determine if use of the terms differed between conversations that did and did not result in mandatory report. RESULTS: Parents were the most common perpetrator. Physical abuse was the most common form of abuse discussed in the initial abuse disclosure (106/244, 43.4%), followed by psychological abuse (83/244, 34.0%), sexual abuse (38/244, 15.6%), and neglect (15/244, 6.1%). More than half of the texters discussed abuse or other significant family issues in the first message. An explicit description of the experience or definite language, such as abuse, rape, and molested, was common in disclosures. CONCLUSIONS: Early disclosure, combined with explicit language, may suggest at least a portion of young victims are actively seeking safe ways to talk about their experiences with abuse, rather than incidentally sharing experiences while seeking support for other issues. SMS text messaging may be a valuable way to engage with young people around sensitive topics, but these approaches will require careful consideration in their development, implementation, and evaluation to ensure a positive experience for young people.

Risk assessment with actuarial and clinical methods: Measurement and evidence-based practice.

Child welfare agencies have adopted assessment tools and instruments to inform the level of risk and guide the agency's level of intervention with the family. Actuarial assessments may be more uniform but inflexible with respect to practice wisdom whereas clinical or consensus-based assessments are more comprehensive and intuitive but lack objectivity. The purpose of the current study is to compare clinical and actuarial methods of risk assessment used by child welfare workers to make decisions about substantiation and services. The current study examined the (1) association between clinical and actuarial dimensions, (2) association between actuarial dimensions and outcomes, (3) association between clinical dimensions and outcomes, (4) caseworker primary use of actuarial dimensions, and (5) caseworker supplementary use of actuarial dimensions. Findings indicated that the actuarial may not be solely predictive of agency intensity with respect to case decision and service provision. Our findings suggest that dual-measurement does inform intensity, and we speculate from these findings that the measures may be involved with decision-making in a complex way. This study may be best viewed as a means by which researchers begin to parse how decisions are made; with this information, instruments may be better tailored to facilitate clinical, critical thought.

Modeling treatment motivation in substance-abusing women with children.

OBJECTIVES: Children are often considered a primary motivator for women seeking substance abuse treatment. This study tested a model predicting treatment motivation in substance-abusing mothers. METHODS: This study was a secondary analysis of the Drug Absue Treatment Outcome Study (DATOS). It used structural equation modeling to describe factors influencing motivation for treatment. DATOS is a national study of substance abusers entering treatment. Treatment was provided by a sampling of community-based programs, free-standing hospitals, hospital units, county-funded programs, modified therapeutic communities, and criminal justice programs. The subsample of women with children under the age of 18 for whom custody of children could be determined was selected (n=1371). The variables comprising each factor were based on self-report, and standardized scales measuring level of drug involvement, psychological functioning, children, and a desire to stop using drugs were used. RESULTS: Drug involvement was positively related to poorer psychological functioning, child custody issues, and the desire to stop using drugs. Child custody issues had a negative influence, while poorer psychological functioning and a desire to stop using drugs positively influenced treatment motivation. CONCLUSIONS: The negative influence that children have on treatment motivation may reflect the practical or emotional difficulties of having to leave children behind or in some instances having children placed in foster care. Specifically, losing custody of children, particularly with little expectation they will be reunified, may serve as a detriment to motivation. Popular beliefs hold that children serve as a primary source of a mother's treatment motivation; however this study found the opposite was true. Children should not automatically be considered a primary source of motivation for participation in treatment.

An ecological model of maternal substance abuse and child neglect: issues, analyses, and recommendations.

This study examined an ecological model of maternal substance abuse and child neglect. Data are presented that identified an interplay among family history, interpersonal risk factors, current family functioning, and community networks in examinations of child neglect in a sample of substance-abusing women entering treatment.

Validation of the Strengths and Stressors Tracking Device with a child welfare population.

The Strengths and Stressors Tracking Device (SSTD) is a rapid assessment measure of family well-being that assesses the particular strengths and needs of families at intake to help guide case planning and evaluate the effectiveness of treatment. The device assesses families from an ecological perspective in the domains of environmental conditions, social support, caregiver skills, and child well-being, and may be used at multiple points during treatment to assess change. SSTD has high internal consistency in all domains, distinguishes between physical abuse and neglect, and is sensitive to specific changes made by families across the duration of treatment.

Adolescent suicide statements on MySpace.

The use of social networking sites (SNSs) has proliferated throughout the last several years for all populations, but especially adolescents. Media reports have also identified several instances in which adolescents broadcast their suicidal behaviors via the Internet and/or SNSs. Despite the increase in the usage of SNSs, there has been little research conducted on how adolescents use SNSs to communicate these behaviors. The objective of this study was to explore the ways in which adolescents use MySpace to comment on their suicidal thoughts and intentions. Content analysis was used to identify suicidal statements from public profiles on MySpace. The original sample consisted of 1,038 comments, made by young people ages 13-24 years old. The final sample resulted in 64 comments, where Potential Suicidality was identified. Through content analysis, the following subthemes (within the Potential Suicidality theme) were found: Relationships, Mental Health, Substance Use/Abuse, Method of Suicide, and Statements without Context. Examples and discussion for each subtheme are identified. The comments referenced a significant amount of hopelessness, despair, and desperation. This study provides support that adolescents use public Web sites to display comments about their suicidal thoughts, behaviors, and possible intentions. Future research is warranted to explore the relationship between at-risk behaviors and suicidality as expressed on SNSs.

Institutionalization, behavior and international adoption: predictors of behavior problems.

Since the mid-1990s, over 10,0000 children have immigrated to the United States annually via international adoption. These children bring to their families unique strengths, as well as the possibility, for some, of physical, emotional and behavioral health risks, and challenges. This article presents predictive models on behavioral health problems for one group of international adoptees from Romania (n = 216). It is a companion piece to an earlier article that described behavior issues and compared the international adoptees to a group of children adopted through the public child welfare system using a cross-sectional approach. This article illustrates that a history of institutionalization had minimal long-term adverse effects on a child's behavioral health. The parent-child relationship was a strong resource for parents at both time periods. However, there was a strong relationship between parental negative reports with the relationship and child behavior problems.