Skip to main content

Advertisement

SpringerLink
Log in

Reconnecting Homeless Adolescents and Their Families: Correlates of Participation in a Family Intervention

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

Behavioral family interventions are an effective way to intervene to prevent negative developmental outcomes for adolescents. Participation in family interventions encompasses behavioral and cognitive/attitudinal dimensions, among others, indicated by retention and engagement, respectively. Two dimensions of participation, retention and engagement, in a family intervention were examined in a sample of newly homeless adolescents and their parents or guardians. Correlates of participation included parents with more income and less perceived family conflict and adolescents with higher endorsement of depression, anxiety, somatization, obsessive-compulsive, phobic, and psychotic symptoms on the Brief Symptom Inventory (BSI). Stronger therapeutic alliance was correlated with being more distressed (i.e., lower income, more hostility), being a female adolescent participant, and having greater comfort discussing sex with parents. Furthermore, parents and adolescents with greater distress and thus greater need were more apt to finish the intervention. The finding that families who were experiencing more distress had higher alliance scores suggests that there is an additional need for development of interventions for families in crisis. Both participant and provider perceptions are also important in development of a strong therapeutic alliance. This study’s findings have implications for further exploration of the development of cultural humility and improving mental health literacy among facilitators of behavioral interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bloom, B. L. (1985). A factor analysis of self-report measures of family functioning. Family Process, 24, 255–239. https://doi.org/10.1111/j.1545-5300.1985.00225.x.

    Article  Google Scholar 

  • Bray, J. H., & Pequegnat, W. (2012). Statistical challenges in studying complex and changing families. AIDS and Behavior, 16, 441–451. https://doi.org/10.1007/s10461-011-9881-6.

    Article  PubMed  Google Scholar 

  • Busseri, M. A., & Tyler, J. D. (2003). Interchangeability of the working alliance inventory and working alliance inventory, short form. Psychological Assessment, 15, 193–197.

    Article  Google Scholar 

  • Coatsworth, J. D., Duncan, L. G., Pantin, H., & Szapocznik, J. (2006). Patterns of retention in a preventive intervention with ethnic minority families. The Journal of Primary Prevention, 27, 171–193. https://doi.org/10.1007/s10935-005-0028-2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Coatsworth, J. D., Hemady, K. T., & George, M. S. (2018). Predictors of group leaders’ perceptions of parents’ initial and dynamic engagement in a family preventive intervention. Prevention Science, 19, 609–619.

    Article  Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.

    Article  CAS  Google Scholar 

  • Collins, N. L., & Read, S. J. (1990). Adult attachment, working models, and relationship quality in dating couples. Journal of Personality and Social Psychology, 58, 644–663.

    Article  CAS  Google Scholar 

  • Derogatis, L. R. (1993). BSI brief symptom inventory: Administration, scoring, and procedure manual (4th ed.). Minneapolis: National Computer Systems.

    Google Scholar 

  • Donenberg, G. R., Emerson, E., Bryant, F. B., Wilson, H., & Weber-Shifrin, E. (2001). Understanding AIDS-risk behavior among adolescents in psychiatric care: Links to psychopathology and peer relationships. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 642–653.

    Article  CAS  Google Scholar 

  • Elvins, R., & Green, J. (2008). The conceptualization and measurement of therapeutic alliance: An empirical review. Clinical Psychology Review, 28, 1167–1187.

    Article  Google Scholar 

  • Fryer, C. S., Passmore, S. R., Maietta, R. C., Petruzzelli, J., Casper, E., Brown, N. A., et al. (2016). The symbolic value and limitations of racial concordance in minority research engagement. Qualitative Health Research, 26, 830–841. https://doi.org/10.1177/1049732315575708.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Lau, A. S., Yeh, M., McCabe, K. M., Hough, R. L., & Landsverk, J. A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162, 1336–1343.

    Article  Google Scholar 

  • Gavin, D. R., Ross, H. E., & Skinner, H. A. (1989). Diagnostic validity of the drug abuse screening test in the assessment of DSM-III drug disorders. British Journal of Addiction, 84, 301–307.

    Article  CAS  Google Scholar 

  • Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54.

    Article  Google Scholar 

  • Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 65–70.

    Google Scholar 

  • Ingoldsby, E. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19, 629–645. https://doi.org/10.1007/s10826-009-9350-2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kapungu, C., Nappi, C., Thakral, C., Miller, S., Devlin, C., McBride, C., et al. (2012). Recruiting and retaining high-risk adolescents into family-based HIV prevention intervention research. Journal of Child and Family Studies, 21, 578–588.

    Article  Google Scholar 

  • Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 453–463.

    Article  CAS  Google Scholar 

  • Martino, S., Grilo, C. M., & Fehon, D. C. (2000). Development of the drug abuse screening test for adolescents (DAST-A). Addictive Behaviors, 25, 57–70.

    Article  CAS  Google Scholar 

  • Mauricio, A. M., Gonzales, N., & Sandler, I. N. (2018). Preventive parenting interventions: Advancing conceptualizations of participation and enhancing reach. Prevention Science, 19, 603–608.

    Article  Google Scholar 

  • McConnaughy, E. A., Prochaska, J. O., & Velicer, W. F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research, and Practice, 20, 368–375.

    Article  Google Scholar 

  • Milburn, N. G., & Lightfoot, M. (2016). Improving the participation of families of color in evidence-based interventions: Challenges and lessons learned. In N. Zane, G. Bernal, & F. L. Leong (Eds.), Evidence-based psychotherapy practice with ethnic minorities: Culturally informed research and clinical strategies (pp. 273–287). Washington, DC: American Psychological Association. https://doi.org/10.1037/14940-013.

    Chapter  Google Scholar 

  • Milburn, N. G., Rosenthal, D., Rotheram-Borus, M. J., Mallett, S., Batterham, P., Rice, E., & Solorio, R. (2007). Newly homeless youth typically return home. Journal of Adolescent Health, 40, 574–576. https://doi.org/10.1016/j.jadohealth.2006.12.017.

    Article  PubMed  Google Scholar 

  • Milburn, N. G., Rice, E., Rotheram-Borus, M. J., Mallett, S., Rosenthal, D., Batterham, P., et al. (2009). Adolescents exiting homelessness over two years: The risk amplification and abatement model. Journal of Research on Adolescence, 19, 762–785.

    Article  Google Scholar 

  • Milburn, N. G., Iribarren, F. J., Rice, E., Lighfoot, M., Solorio, R., Rotheram-Borus, M. J., et al. (2012). A family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth. Journal of Adolescent Health, 50, 358–364. https://doi.org/10.1016/j.jadolhealth.2011.08.009.

    Article  PubMed  Google Scholar 

  • Murry, V. M., Berkel, C., & Liu, N. (2018). The closing digital divide: Delivery modality and family attendance in the pathways for African American success (PAAS) program. Prevention Science, 19, 642–651. https://doi.org/10.1007/s11121-018-0863-z.

    Article  PubMed  PubMed Central  Google Scholar 

  • Orrell-Valente, J. K., Pinderhughes, E. E., Valente Jr., E., Laired, R. D., Bierman, K. L., Coie, J. D., et al. (1999). If it’s offered, will they come? Influences on parents’ participation in a community-based conduct problems prevention program. American Journal of Community Psychology, 27, 753–784.

    Article  CAS  Google Scholar 

  • Parker, G., Tupling, H., & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52, 1–10. https://doi.org/10.1111/j.2044-8341.1979.tb02487.x.

    Article  Google Scholar 

  • Pergamit, M., Gelatt, J., Straford, B., Beckwith, S., & Martin, M. C. (2016). Family interventions for youth experiencing or at risk of homelessness. Washington, DC: Urban Institute.

    Google Scholar 

  • Rotheram-Borus, M. J., Goldstein, A. M., & Elkavich, A. S. (2002). Treatment of suicidality: A family intervention for adolescent suicide attempters. In S. G. Hofmann & M. C. Thompson (Eds.), Treating chronic and severe mental disorders: A handbook of empirically supported interventions (pp. 191–212). New York: Guilford Press.

    Google Scholar 

  • Selzer, M. L. (1971). The Michigan alcoholism screening test (MAST): The quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 1653–1658.

    Article  CAS  Google Scholar 

  • Selzer, M. L., Vinokur, A., & van Rooijen, L. (1975). A self-administered short Michigan alcoholism screening test (SMAST). Journal of Studies on Alcohol, 36, 117–126.

    Article  CAS  Google Scholar 

  • Skinner, H. A. (1982). The drug abuse screening test. Addictive Behaviors, 7, 363–371.

    Article  CAS  Google Scholar 

  • Snell-Johns, J., Mendez, J. L., & Smith, B. H. (2004). Evidenced-based solutions for overcoming access barriers, decreasing attrition, and promoting change with underserved families. Journal of Family Psychology, 18, 19–35. https://doi.org/10.1037/0893-3200.18.1.19.

    Article  PubMed  Google Scholar 

  • Spoth, R., & Redmond, C. (2000). Research on family engagement in preventive interventions: Toward improved use of scientific findings in primary prevention practice. The Journal of Primary Prevention, 21, 267–284. https://doi.org/10.1023/A:1007039421026.

    Article  Google Scholar 

  • Spoth, R., Rohrbach, L. A., Greenberg, M., Leaf, P., Brown, C. H., Fagan, A., et al. (2013). Addressing core challenges for the next generation type 2 translational research and systems: The translation science to population impact (TSci Impact) framework. Prevention Science, 14, 319–351.

    Article  Google Scholar 

  • Staudt, M. (2007). Treatment engagement with caregivers of at-risk children: Gaps in research and conceptualization. Journal of Child and Family Studies, 16, 183–196.

    Article  Google Scholar 

  • Steinberg, A. M., Brymer, M., Decker, K., & Pynoos, R. S. (2004). The UCLA PTSD reaction index. Current Psychiatry Reports, 6, 96–100.

    Article  Google Scholar 

  • Strauss, M. A. (1979). Measuring intrafamily conflict and violence: The conflict tactics scales. Journal of Marriage and the Family, 41, 75–88.

    Article  Google Scholar 

  • Thompson, S., Bender, K., Lantry, J., & Flynn, P. (2007). Treatment engagement: Building therapeutic alliance in home-based treatment with adolescents and their families. Contemporary Family Therapy: An International Journal, 29, 39–55.

    Article  Google Scholar 

  • Tyler, K. A., & Schmitz, R. M. (2013). Family histories and multiple transitions among homeless young adults: Pathways to homelessness. Children and Youth Services Review, 35, 1719–1726. https://doi.org/10.1016/j.childyouth.2013.07.014.

    Article  PubMed  PubMed Central  Google Scholar 

  • Winslow, E. B., Bonds, D., Wolchik, S., Sandler, I., & Braver, S. (2009). Predictors of enrollment and retention in a preventive parenting intervention for divorced families. Journal of Primary Prevention, 30, 151–172. https://doi.org/10.1007/s10935-009-0170-3.

    Article  PubMed  Google Scholar 

Download references

Funding

This research was supported by grants from the National Institute on Drug Abuse (DA035692, DA024955), the National Institute of Mental Health (MH70322), and the National Institute on Minority Health and Health Disparities (P20MD000182).

Author information

Authors and Affiliations

  1. Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Room A8-159, Los Angeles, CA, 90024, USA

    Norweeta G. Milburn, Alexandra M. Klomhaus, W. Scott Comulada, Susana A. Lopez, Eraka Bath, Jessica Jackson & Alan Semaan

  2. Charles Drew University of Medicine and Science, Los Angeles, CA, USA

    Bita Amani

  3. University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA

    Alex Lee, Eric Rice & Bo-Kyung Elizabeth Kim

Authors
  1. Norweeta G. Milburn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexandra M. Klomhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Scott Comulada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Susana A. Lopez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eraka Bath
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bita Amani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jessica Jackson
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alex Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Eric Rice
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alan Semaan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Bo-Kyung Elizabeth Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Norweeta G. Milburn.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All data collection procedures were carried out with approval from, and in compliance with, the Institutional Review Board of the University of California, Los Angeles.

Informed Consent

Informed consent was obtained from all individual participants in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOC 115 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Milburn, N.G., Klomhaus, A.M., Comulada, W.S. et al. Reconnecting Homeless Adolescents and Their Families: Correlates of Participation in a Family Intervention. Prev Sci 21, 1048–1058 (2020). https://doi.org/10.1007/s11121-020-01157-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-020-01157-9

Keywords

Search

Navigation