Trauma

Homeless youth experience high rates of suicidal ideation and attempts, yet limited research has examined predictors of treatment engagement among this population. Suicidal homeless youth (N = 150) between the ages of 18 and 24 years were recruited from a drop-in center in Columbus, Ohio. Participants were randomly assigned to Cognitive Therapy for Suicide Prevention + treatment as usual through a local drop-in center (CTSP + TAU) (N = 75) or TAU alone (N = 75), and treatment attendance among those assigned to CTSP + TAU was examined in this study. As expected, among youth engaged in CTSP + TAU, those with a history of intimate partner violence (IPV) showed decreased odds of treatment attendance. Additionally, youth randomized into CTSP + TAU with higher acquired capability for suicide (ACS) scores and those identifying as Black were more likely to attend treatment sessions. Findings suggest that effective treatment implementation must consider youth’s trauma history, demographics and severity of suicidal ideation and behaviors.

Background: Though research finds that youth experiencing homelessness (YEH) have high rates of substance use, which can lead to numerous long-term negative health effects, less is known about both risk and protective factors for substance use. Moreover, even less is known about whether these factors differ for lesbian, gay and bisexual (LGB) youth compared to non-LGB youth. In the current study, we compared risk and protective factors for binge drinking, marijuana use, and illicit drug use (i.e. substance use) among heterosexual and sexual minority YEH.
Methods: The sample included 322 young people experiencing homelessness in the Midwestern United States and who were between 16 and 26 years of age. Almost one-half of our sample were female (N = 146; 45%) and 68 youth (21%) identified as LGB.
Results: Youth who experienced more child physical abuse, ran away from home more frequently, and those who had a parent(s) with drug problems were more likely to have reported binge drinking in the past 30 days. Additionally, having parents with drug problems was associated with the use of marijuana and illicit drugs. Conversely, having higher parental monitoring while growing up reduced the likelihood of using marijuana and illicit drugs. Tests for interactions revealed that while self-efficacy had no relationship with the probability of binge drinking for heterosexual youth, as self-efficacy increased, the probability of binge drinking declined drastically for sexual minority youth suggesting this protective mechanism operates differently for these two groups of youth. Additionally, tests of interactions showed that the probability of binge drinking among heterosexual and sexual minority youth also varied by child sexual abuse and street sexual victimization.
Conclusion: Study results have implications for service providers who serve YEH.

LGBTQ+ individuals are at increased risk of suicide. Homelessness further increases the risk, as does family-of-origin rejection. A model that combines suicidal risk factors and minority stress theory is useful in clinical practice. An openness to “hearing” the lived experiences of LGBTQ+ individuals is essential to treatment. An LGBTQ+ affirming therapeutic approach is recommended. It is also frequently helpful to rebuild family relationships and support for the LGBTQ+ individual, particularly with younger youth. Principles of practice are described and illustrated.

The ongoing COVID-19 pandemic has led to unprecedented disruptions and stress in the lives of children and families internationally. Heightened family stress and turmoil can increase risk for, and exacerbate, child maltreatment. As a result, child maltreatment experts are concerned that there will be an influx of children requiring trauma assessment and treatment during and after COVID-19. As physical distancing measures have been implemented and will likely persist into 2021, organizations providing trauma treatment to children and their families have had to rapidly pivot to telemental health to maintain service delivery with clients. While the benefits of telemental health have been identified, including reduced barriers to access, increased cost effectiveness, and broad availability of services, there are unique limitations to its implementation within a child maltreatment population, such as challenges with attention and emotion regulation skills, difficulties identifying dissociative symptoms, and increased time with perpetrators of abuse due to shelter in place orders. These limitations are exacerbated for children and families who are most marginalized and facing the highest levels of social and economic barriers. Lack of access to reliable technology, lack of a private or confidential space for sessions, and reluctance to process trauma in the absence of a safe environment, are all barriers to conducting effective trauma treatment over telemental health. This article discusses both the benefits and barriers to telemental health in a child maltreatment population and offers considerations for child trauma service provision, program development, and policy during and post the COVID-19 pandemic.

Poverty, hunger, and homelessness have been shown to be perhaps the greatest adverse biological and
social risk factors for mental health problems and disorders worldwide. They also have significant
adverse impact on cognitive, psychological, psychosocial, and physical development in children
and youth. This article reviews the psychosocial effects of poverty, hunger, and homelessness on
children and youth, including their impact on psychopathology and mental health. It also includes
recommendations for governmental entities, advocates, and care providers on mitigating their adverse
effects.

The purpose of this study was to gather in-depth information from unaccompanied homeless youth (UHY) regarding how they perceived that a wraparound intervention in which they had been involved for at least one year had impacted their lives. Towards this end, we conducted individual face-to-face interviews with nine unaccompanied homeless youth (UHY) who were receiving services from Starting Right, Now (SRN), a unique, multifaceted, grassroots initiative located in the southeastern U.S. that provides multiple services to UHY who have remained in high school. These services include housing, one-to-one mentoring, tutoring, assistance with applying to college, and specialized trainings to support academic and personal development. In each interview, participants described how their lives had changed since they entered SRN and what they had learned from the program. Using thematic analysis across participants, we identified eight themes that we saw as fitting within three broad categories: (1) constructing new models of relationships, (2) learning adaptive strategies for living, and (3) increasing hope, direction, and purpose. These three themes coalesced into an overall essence that we termed “lifted.” We chose this term because the totality of participants’ experiences suggested that SRN had lifted participants out of the poverty and trauma of their childhoods and, through a comprehensive approach with personalized supports, helped them get to a place where they could focus on higher-level needs like individual growth and educational attainment. Implications for providing services to UHY are described, and avenues for continuing research to support this population are highlighted.

Homeless female adolescents in the United States have disproportionately high rates of pregnancy compared to general population youth. Little is known about how homeless youth decide whether to use birth control and which birth control method to select. The current study explores how homeless female youth participating in a holistic sexual health program called Wahine (“woman”) Talk experience this process, using data from in-depth interviews (N = 3) with 11 homeless adolescent girls. Data were analyzed using Interpretative Phenomenological Analysis, proceeding through reading and re-reading, initial noting, forming emergent and super-ordinate themes, repeating steps for each interview, and developing final themes and subthemes. Four final themes emerged, which, for most participants, were experienced sequentially: Getting Acclimated, Becoming Close and Building Trust, Addressing Fear, and Making the Choice. Study findings suggest that for homeless female youth, basic needs and relationship building must be addressed prior to the delivery of trauma-informed birth control-related content and effective linkage to (sexual) healthcare. Implications for practice, policy, and future research are discussed.

"Purpose
This study aimed to explore the association between direct exposure, indirect exposure, and perpetration of gun violence and suicidal ideation among young adults experiencing homelessness (YAEH).

Methods
YAEH (n = 1,426) in seven cities across the U.S. were surveyed. Logistic regression analyses were conducted to examine the association between lifetime gun violence exposure and suicidal ideation in the past 12 months.

Results
Forty-five percent (n = 641) of YAEH had experienced direct or indirect gun violence, whereas 17% (n = 247) had engaged in gun violence perpetration. Gun violence perpetration is associated with elevated suicidal ideation risk (odds ratio = 1.46; 95% confidence interval = 1.02–2.01) among YAEH.

Conclusions
A high percentage of YAEH were exposed to firearm violence. Cross-sector, multiagency collaborations are warranted to reduce firearm violence exposure among this vulnerable population. Homeless service providers should screen for gun violence exposure and suicide risk and target prevention efforts on YAEH with a history of gun violence perpetration."

"Objective: To determine whether biopsychosocial factors are associated with sexual activity and
contraceptive utilization among homeless shelter adolescents.
Methods: A retrospective study of 440 adolescents at a shelter in Pennsylvania between February 2015 and
September 2019 was conducted. The cohort was evaluated to determine what relationship age, gender
identity, substance use, and trauma history have with sexual activity and contraceptive utilization.
Results: Sexual activity was significantly related to age; remote history of self-harm behavior, history of aggressive behavior, history of trauma, and substance use.
Conclusions: Females self-reported sexual activity using contraception more than males. After adjustment,
older age and substance use were associated with sexual activity. By better understanding the impact these
factors can have on contraceptive utilization, informed policy and practice interventions can be developed
and implemented to help increase safe sex practices in spaces where homeless adolescents access
healthcare."

"Background
Teen homelessness confers risk for victimization experiences, and teens that identify as lesbian, gay, bisexual, or transgender (LGBT) are at an even greater risk of experiencing victimization and homelessness.

Methods
Using the 2019 Youth Risk Behavior Surveillance System, we evaluated the association of experiencing homelessness with physical and sexual victimization and we examined whether LGBT identification moderated this relationship. We also evaluated if the odds of experiencing sexual and physical victimization differed depending on the reported sleeping location.

Results
Students who reported homelessness had increased odds of having experienced physical and sexual victimization. LGBT identity was related to increased risk for physical and sexual victimization; however, LGBT identity did not moderate the relationship between homelessness and victimization. Considering nighttime sleeping arrangement, students who reported having no usual place to stay had the highest odds of experiencing sexual or physical victimization, followed by car, park, campground, hotels/motels, emergency housing, and doubled-up with family or friends. Notably, all homeless sleeping locations were associated with increased odds of experiencing victimization relative to sleeping at a parent or guardian's home.

Conclusions
Our findings confirm links between teen homelessness and sexual and physical victimization, as well as increased risk for victimization experienced by LGBT youth. Special considerations should be made when developing and implementing interventions for teens experiencing homelessness and teens who identify as LGBT."