Longitudinal Patterns of Strengths Among Youth with Psychiatric Disorders: A Latent Profile Transition Analysis.

A better understanding of variability in the strengths of youth with psychiatric disorders is critical as a strength-based approach can lead to recovery. This study aimed to identify subgroups of strengths among youth with mental disorders and determine whether subgroups changes were associated with mental health recovery. Youth with mental disorders (N = 2228) from a statewide database were identified in the state fiscal year of 2019. Using the latent profile analysis and latent transition analysis, we identified three strength profiles (i.e., essential, usable, and buildable). Over 90% of youth sustained or developed strengths over time. Positive transitions were associated with mental health recovery, symptom reduction, and personal recovery. Buildable strengths supported youth's personal recovery independent of improving mental health needs. The findings suggest that subgroups of strengths may be a promising source for planning and tracking youth's progress and guiding clinicians to more efficiently allocate community-based resources.

The Child and Adolescent Needs and Strengths as an Outcome Measure in Community Mental Health: Factor Analysis and a Validation of the Short Form.

The goal of the study was to create a short-form measure based on the child and adolescent needs and strengths assessment tool. The measure was designed to be short and easy to use, relevant to youth treated in community-based mental health settings, useful for both treatment planning and program evaluation, and psychometrically valid. Factor analyses of the chosen items revealed two mental health factors and four functioning factors. The mental health factors included internalization and externalization, and the functioning factors included family, social, caregiver, and educational functioning. In support of validity, internalization and externalization subscales distinguished between clients diagnosed with internalizing and externalizing disorders and correlated with caregiver and self-report scores on the Youth Outcome Questionnaire.

Creating the necessary infrastructure for a trauma-informed system of care for children and youth.

Understanding and addressing the impact of adverse life events is an important priority in the design of helping systems. However, creating trauma-informed systems requires efforts to embed effective trauma-informed work in routine practice. This article discusses a model for developing trauma-informed systems using the Transformational Collaborative Outcomes Management (TCOM) framework, a strategy for engineering person-centered care. Person-centered care is naturally congruent with trauma-informed care. We describe the initial stages of implementation of a trauma-informed standardized assessment process to support the sustained evolution of trauma-informed care. Distinguishing between traumatic experiences and traumatic stress is fundamental to an effective trauma-informed system. We describe two sets of analyses-one in a statewide child welfare system and the other in a statewide behavioral health system. These projects found opportunities in the analysis of the detection of traumatic stress based on traumatic experiences to inform practice and policy. Being trauma-informed in child welfare is distinct from being trauma-informed in behavioral health. In child welfare, it appears that a number of children are resilient in the face of traumatic experiences and do not require trauma treatment interventions. However, delayed and missed traumatic stress responses are common. In behavioral health, misses often occur among adolescents, particularly boys, who engage in acting out behavior. Opportunities for the ongoing development of trauma-informed systems using the TCOM framework are discussed.