Intervention

Youth runaway behavior and homelessness (RHY) in the U.S. is increasingly common, with prevalence estimated at 1–1.7 million youth. RHY have multiple, overlapping problems often including poor physical and mental health, frequent street victimization, and histories of physical and sexual abuse. Further, current street victimization interacts with childhood abuse to produce complex, unique presentations of traumatic symptoms and related disorders in runaway and homeless youth. This review paper explores (1) the role of childhood trauma in the genesis of runaway and homeless behavior, and (2) how childhood trauma interacts with street victimization to create vulnerability to psychopathology. In response to the trauma needs of RHY, we conducted a systematic review of the state of the current literature on trauma-informed interventions for RHY. We conclude that the field currently lacks empirically validated trauma interventions in RHY. However, theoretically plausible frameworks do exist and could be the basis for future research and intervention development.

"Purpose: The aim of this study is to determine the effectiveness of a brief intervention to promote responsible substance use and safe sex behaviors in youths experiencing homelessness (YEH).
Methods (DESIGN): A Solomon four-group (double randomized controlled trial) longitudinal design with repeated measures (3- and 6-month follow-ups) was used in drop-in centers for YEH in Austin, Texas and Columbus, Ohio from which 602 youths, 18-24 years-old (M = 21 ± 1.8), 50% white; 69.9% heterosexual were recruited. A manualized one-on-one intervention consisted of six modules delivered via laptop computers. Modules focused on communication, goal-setting, substance use refusal, safe sex behaviors, enhanced psychological capital (hope, optimism, resilience, self-efficacy, gratitude), and life satisfaction. Valid and reliable measures of hope, optimism, future time perspective, resilience, social connectedness, gratitude, condom intention, self-efficacy for safe sex, safe sex behaviors, self-efficacy for substance use refusal, and life satisfaction were used to collect data for which three hypotheses were tested, using intent to treat, with multi-level modeling (R).
Results: The analysis showed partial support for all hypotheses: (1) post-test outcomes were greater than pretests; (2) intervention group outcomes were greater than control group measures; and (3) significant effects for pretesting. YEH in Ohio completed significantly more sessions than YEH in Texas (p = .001), but took significantly longer to complete all six sessions (p = .001).
Discussion: This brief intervention had significant effects on YEH to promote healthy attitudes and behaviors that merit further testing in larger samples."

In this meta-synthesis of current findings on youth interventions, the authors explore common programmatic or contextual factors that researchers and/or practitioners identify as contributing to the successful implementation of an intervention for homeless and unstably housed youth; and (2) that youth and practitioners identify as hindering successful implementation of an intervention for these youth? Two primary themes regarding factors that support successful implementation and engagement were identified: (1) Organizational and system-wide policies can shape the quality and duration of interventions, and (2) Staff behaviors and training are paramount to the success of many interventions. Results further highlight organizational and system-wide policies and staffing behaviors and training needs. The authors conclude that their review supports services that emphasize empowerment and anti-paternalism, and increased attention to racial and LGBTQ equity in future exploration of implementation and engagement within programs designed for youth experiencing homelessness. (author abstract modified)

Outdoors-based youth development programs demonstrate the efficacy to improve indicators of personal growth and mental health in a range of disadvantaged young people. However, the most marginalized young people in society, who stand to benefit the most from such initiatives, remain underrepresented in the research. My Strengths Training for Life (MST4Life) is a positive youth development (PYD) intervention for young people experiencing homelessness that incorporates a life skills program and an outdoor adventure education (OAE) course. The current study presents a qualitative investigation of the OAE course to understand its role in promoting positive changes for participants. Reflexive thematic analysis led to the development of inductively driven themes which were conceptualized based on relevant theories (e.g., relational developmental systems) and models (e.g., 5 Cs of PYD). Findings highlight the benefits of a preceding life skills program to psychologically prepare participants to thrive in the unfamiliar setting of the outdoors and related challenges. During the course, adaptive developmental regulations supported participants’ basic psychological needs and fostered personal growth. Improvements in social competence was a common theme across participants and played a pivotal role in facilitating balanced development across the 5 Cs. In addition, experiences during the course promoted indicators of mental health and intentions to make positive lifestyle changes. Implications of these findings are discussed in relation to making outdoors based youth development courses more accessible for marginalized young people, as well as how OAE and PYD programs can add value to the youth homeless sector.

Homelessness is a pervasive problem among youth aging out of the foster care system. Many of these youth exit the system without any concrete plans for their future and wind up suffering bouts of homelessness. Although a growing body of literature has begun to look at the factors that contribute to homelessness among this population, less has been written about the factors that guard against homelessness. Furthermore, most of the studies have been confined to a particular geographic area. Using data from the National Youth in Transition Database (NYTD), combined with the Adoption and Foster Care Analysis Reporting System (AFCARS), the present study provides an analysis of the risk and protective factors contributing to homelessness among a nationwide sample of foster care youth at age 21, 29% of whom had experienced homelessness. The findings indicate that the strongest protective factors against homelessness were having a connection to an adult and remaining in foster care until age 21. Other protective factors included having at least a high school education, being currently enrolled in school, and having a full-time job. On the other hand, the strongest risk factors contributing to homelessness were having been incarcerated, as well as having been referred for substance abuse. Other significant risk factors were having a runaway history, having received public food assistance, and being emotionally disturbed. Given these findings, child welfare agencies should make greater efforts to ensure that youth have an adult in their life whom they can trust and turn to for help, as well as encourage youth to remain in care until they are better prepared for life on their own.