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Sheerin KM, Williamson-Butler S, Vieira A, Grant M, Kemp KA. The association between caregiver psychiatric distress and perceived barriers to behavioral health treatment participation for youth in the juvenile legal system. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:218-232. [PMID: 37986105 PMCID: PMC10842162 DOI: 10.1111/jmft.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
Youth in the juvenile legal system (JLS) evidence high rates of behavioral health concerns but struggle to access services. Given that caregivers are often tasked with helping their child to initiate and persist with services, it seems important to understand how their own well-being impacts their experiences of barriers to treatment participation for their child. The present study examined the link between caregiver (N = 196; 89% female) psychiatric concerns and experiences of treatment barriers among a sample of youth involved in the JLS. A cluster analysis revealed a cluster of caregivers with clinically significant levels of psychiatric distress and a cluster with low levels of psychiatric distress. Hierarchical regression analyses revealed that belonging to the high-distress cluster was predictive of experiencing certain types of barriers to treatment participation. These findings have implications for interventions for addressing barriers to treatment participation for caregivers of legally involved youth.
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Affiliation(s)
- Kaitlin M Sheerin
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, Rhode Island, USA
| | | | - Alyssa Vieira
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Miyah Grant
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Kathleen A Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, Rhode Island, USA
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Olsen EM, Whiteley LB, Giorlando KK, Beausoleil N, Tolou-Shams M, Esposito-Smythers C, Brown LK. The Role of Family Factors in the Outcomes of Court-Involved Youth. YOUTH VIOLENCE AND JUVENILE JUSTICE 2023; 21:309-324. [PMID: 38274153 PMCID: PMC10809991 DOI: 10.1177/15412040231179110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Court-involved youth (CIY) comprise a significant portion of the U.S. population and have a high prevalence of psychiatric illness and substance use. Youth delinquency has also been associated with family variables and parenting practices. However, it is not known which family factors are most relevant to behavioral outcomes in CIY mandated to outpatient mental health treatment. Self-report measures from 163 CIY (M = 15.19 years; 58.3% male) starting psychiatric care in two U.S. cities were utilized in a cross-sectional analysis to examine the association of parental monitoring and family functioning with the severity and variety of delinquent acts. Results demonstrate that parental monitoring is significantly associated with the delinquent behavior of CIY in mental health treatment, beyond that of psychiatric symptoms and substance use. Improved understanding of influential family factors can enhance tailoring of existing interventions to ensure that they are relevant to the needs of CIY, especially those in psychiatric treatment.
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Affiliation(s)
- Elizabeth M. Olsen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
- Department of Child and Adolescent Psychiatry, Bradley Hospital, East Providence, RI
| | - Laura B. Whiteley
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - Kayla K. Giorlando
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI
| | - Nancy Beausoleil
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA
| | | | - Larry K. Brown
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
- Department of Child and Adolescent Psychiatry, Bradley Hospital, East Providence, RI
- Young Adult Behavioral Health Program, Rhode Island Hospital, Providence, RI
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Kemp K, Micalizzi L, Becker SJ, Cheaito A, Suazo NC, Fox K, Hernandez L, Spirito A. Intervention for marijuana using, court-involved non-incarcerated youth. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209100. [PMID: 37315797 PMCID: PMC10529931 DOI: 10.1016/j.josat.2023.209100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/22/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Justice-involved youth (JIY) are at elevated risk for substance use and for substance use-related harm compared to non-JIY. Marijuana use is of significant concern in this population, as it is tied to reoffending. Motivational enhancement therapy (MET) and electronic interventions show promise in reducing youth substance use; the degree to which these findings extend to JIY requires additional research attention. Thus, the purpose of this study was to test the preliminary feasibility and effectiveness of a combined brief electronic parenting intervention plus a brief MET-based electronic intervention for JIY adolescents, followed by feedback and development of a change plan with a court worker, on marijuana use. METHODS Participants were 83 parent-youth dyads recruited from a diversionary family court program who screened positive for past-year marijuana use. At baseline and 3- and 6-month follow-ups, youth self-reported on their substance use, parental monitoring, peer substance use, and dyads completed a discussion task querying parental monitoring, limit setting, and substance use. The study randomized dyads to psychoeducation or the experimental intervention condition post-baseline. The MET-based intervention involved the self-administered e-TOKE (an electronic, marijuana-specific assessment and feedback tool) and a brief follow-up meeting with court staff counselors to review feedback and create a marijuana use change plan. Caregivers completed a computer program aimed at improving parenting and communication with their adolescents. The study administered feasibility and acceptability measures for both conditions. RESULTS Feasibility of study procedures was demonstrated through recruitment and retention (∼75 % success). Acceptability ratings from youth, parents, and court staff were high and positive. While levels of parental monitoring, as assessed by an observational task, improved over the course of the study, the intervention did not result in a significant change in any of the outcomes tested. CONCLUSIONS Despite high acceptability and feasibility ratings for the use of an electronic plus in-person MET intervention, reduction of marijuana and other substances was limited for most youth. This suggests that a more intensive intervention, such as stepped care, may be necessary for JIY who are not specifically referred for court proceedings due to marijuana use or those with already well-established use patterns.
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Affiliation(s)
- Kathleen Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States; Rhode Island Family Court Mental Health Clinic, 1 Dorrance Street, Providence, RI 02903, United States
| | - Lauren Micalizzi
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02903, United States
| | - Sara J Becker
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02903, United States
| | - Aya Cheaito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Nazaret C Suazo
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Kara Fox
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States
| | - Lynn Hernandez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States; UMass Chan Medical School, 55 N Lake Avenue, Worcester, MA 01655, United States
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States.
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Sheerin KM, Brodell R, Huey SJ, Kemp KA. Applying ecological systems theory to juvenile legal system interventions outcomes research: a measurement framework. Front Psychol 2023; 14:1177568. [PMID: 37425162 PMCID: PMC10327555 DOI: 10.3389/fpsyg.2023.1177568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Intervention research and development for youth in the juvenile legal system (JLS) has often focused on recidivism as the primary outcome of interest. Although recidivism is an important outcome, it is ultimately a downstream marker of success and is affected by changes in other domains of youths' lives (e.g., family and peer relations, neighborhood safety, local and state-level policies). Thus, the present manuscript proposes the application of ecological systems theory to selecting outcomes to assess intervention effects in JLS intervention research to better capture proximal and distal influences on youth behavior. To that end, we first provide an overview of the strengths and limitations of using recidivism as an outcome measure. Next, the current application of social ecology theory to existing research on both risk and protective factors of JLS involvement is discussed, as well as existing work on assessing social-ecological domains within intervention studies. Then, a measurement framework is introduced for selecting pertinent domains of youths' social ecologies to assess as intervention outcomes, moderators, and mediators. To facilitate this, we provide examples of concrete constructs and measures that researchers may select. We conclude with potential new avenues of research to which our proposed framework could lead, as well as potential limitations of implementing our framework.
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Affiliation(s)
- Kaitlin M. Sheerin
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
| | - Regina Brodell
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Stanley J. Huey
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Kathleen A. Kemp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, RI, United States
- Bradley-Hasbro Children’s Research Center, Rhode Island Hospital, Providence, RI, United States
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Vroom EB, Johnson ME. The nexus between gender, parental supervision, and opioid misuse among justice-involved adolescents. JOURNAL OF COMMUNITY PSYCHOLOGY 2022:10.1002/jcop.22973. [PMID: 36525545 PMCID: PMC10272286 DOI: 10.1002/jcop.22973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/14/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
Justice-involved adolescents (JIA) are at higher risk for opioid misuse (OM) and opioid-related overdose than nonoffending adolescents. Untreated OM can lead to severe consequences (e.g., trauma), which may be harsher for female JIA. Therefore, examining risk and protective factors, such as parental supervision, is essential to identify factors that may impact OM. The current study used a statewide, cross-sectional dataset including 79,960 JIA from the Florida Department of Juvenile Justice. Stratified logistic regression analyses were conducted. Results indicated that JIA who experienced sporadic or inadequate supervision had 2.14 and 3.54 higher odds, respectively, of misusing opioids compared to JIA who experienced consistent supervision. Female JIA who experienced sporadic or inadequate supervision had 2.23 and 3.70 higher odds, respectively, of misusing opioids. Results suggest parental supervision is an important protective factor that should be considered in developing prevention and treatment efforts that serve JIA who misuse opioids, especially females.
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Affiliation(s)
- Enya B. Vroom
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Micah E. Johnson
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
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Chen CYC, Byrne E, Vélez T. A Preliminary Study of COVID-19-related Stressors, Parenting Stress, and Parental Psychological Well-being Among Parents of School-age Children. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:1558-1569. [PMID: 35502365 PMCID: PMC9045686 DOI: 10.1007/s10826-022-02321-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 05/07/2023]
Abstract
The COVID-19 pandemic has had substantial health, social, and economic effects on families. Consequent lockdowns and school closures heightened the burden on parents of school-age children. Many parents, while working from home, had to care for their children with restricted access to caregiver resources and to support their children's education through homeschooling or remote learning provided by their schools. These duties created challenges and pressures on parents. Using online survey data collected from 197 parents of school-age (Prek-12) children during the first three months of the COVID-19 pandemic in the U.S., this preliminary study examined the relations among COVID-19-related stressors, including fear of COVID-19 and problems associated with school closures, parenting stress, and parental psychological well-being. Fear of COVID-19 and various issues associated with school closures were related to parenting stress and parental well-being. Parents with less instrumental and emotional support reported higher levels of parenting stress and lower levels of psychological well-being. The results of hierarchical multiple regressions revealed that parenting stress was the strongest predictor of parental psychological distress. Social support was associated with parental well-being but did not mediate the relation between parenting stress and parental well-being. The findings suggest that parenting stress during the COVID-19 lockdowns might take a toll on the mental health of parents of school-age children. Parents of school-age children need multiple layers of support, including targeted support addressing stressors related to school closures and parenting under quarantine.
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Affiliation(s)
- Cliff Yung-Chi Chen
- Educational and Community Programs, Queens College of the City University of New York, 65-30 Kissena Blvd, Flushing, New York City, NY 11367 USA
| | - Elena Byrne
- Educational and Community Programs, Queens College of the City University of New York, 65-30 Kissena Blvd, Flushing, New York City, NY 11367 USA
| | - Tanya Vélez
- Educational and Community Programs, Queens College of the City University of New York, 65-30 Kissena Blvd, Flushing, New York City, NY 11367 USA
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Folk JB, Brown LK, Marshall BDL, Ramos LMC, Gopalakrishnan L, Koinis-Mitchell D, Tolou-Shams M. The Prospective Impact of Family Functioning and Parenting Practices on Court-Involved Youth's Substance Use and Delinquent Behavior. J Youth Adolesc 2019; 49:238-251. [PMID: 31399895 DOI: 10.1007/s10964-019-01099-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/29/2019] [Indexed: 01/03/2023]
Abstract
Court-involved youth exhibit high rates of psychiatric symptoms, substance use, and delinquency, yet little is known about the contributing roles of caregiver and family factors. The current study examined whether family functioning and parental monitoring mediate the relationship between caregiver and youth psychiatric symptoms (at first court contact) and youth substance use and delinquency (two years later). Participants were 400 first-time offending court-involved youth (Mage = 14.5 years; 57.3% male; 45.6% non-Latinx White, 42.0% Latinx) and an involved caregiver (Mage = 41.0 years; 87.2% female; 53.0% non-Latinx White, 33.8% Latinx). Structural equation modeling revealed that caregiver and youth psychiatric symptoms were prospectively associated with worse family functioning, which was in turn related to higher levels of youth delinquency and greater likelihood of substance use. The results support the notion of addressing the needs of justice-involved youth and families holistically rather than treating youth as "the problem" in isolation.
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Affiliation(s)
- Johanna B Folk
- Department of Psychiatry, University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA.
| | - Larry K Brown
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Brandon D L Marshall
- School of Public Health, The Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Lili M C Ramos
- Department of Psychiatry, University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Lakshmi Gopalakrishnan
- Department of Psychiatry, University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA
| | - Daphne Koinis-Mitchell
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Marina Tolou-Shams
- Department of Psychiatry, University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA, 94110, USA
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Tolou-Shams M, Brogan L, Esposito-Smythers C, Healy MG, Lowery A, Craker L, Brown LK. The role of family functioning in parenting practices of court-involved youth. J Adolesc 2018; 63:165-174. [PMID: 29310009 DOI: 10.1016/j.adolescence.2017.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 12/14/2017] [Accepted: 12/30/2017] [Indexed: 01/02/2023]
Abstract
Court-involved youth engage in risky sex behaviors at higher rates than non-offending peers and are at particular risk for adverse sexual health outcomes. Parenting practices, such as parent-child sexual communication and parental monitoring, may protect court-involved youth from engaging in risky sexual behavior. Parent psychological distress and family dysfunction may, however, compromise parenting practices for court-involved youth. This study examined associations among parent mental health symptoms, family functioning, and parenting practices within 157 parent-youth dyads who were court-referred for mental health treatment. Results revealed that greater parent mental health symptoms were directly related to greater family dysfunction and indirectly associated with poorer parental monitoring through worse family functioning. Findings suggest that directly addressing parent mental health needs in family-based adolescent sexual health programming for court-involved youth may be effective in improving parent-child relationships and family processes that support long term sexual health outcomes for adolescents.
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Affiliation(s)
- Marina Tolou-Shams
- UCSF Department of Psychiatry & Weill Institute for Neurosciences, Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Bldg 5, Room 7M18, San Francisco, CA, USA 94110.
| | - Leah Brogan
- Violence Prevention Initiative, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, 2716 South Street, Room 13-251, Philadelphia, PA 19146, USA.
| | | | - Meredith G Healy
- Department of Psychiatry, Rhode Island Hospital, CORO East, 167 Point Street, Suite 161, Providence, RI, USA 02903.
| | - Ashley Lowery
- Department of Psychiatry, Rhode Island Hospital, CORO East, 167 Point Street, Suite 161, Providence, RI, USA 02903.
| | - Lacey Craker
- Department of Psychiatry, Rhode Island Hospital, CORO East, 167 Point Street, Suite 161, Providence, RI, USA 02903.
| | - Larry K Brown
- Department of Psychiatry, Rhode Island Hospital, CORO East, 167 Point Street, Suite 161, Providence, RI, USA 02903; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, CORO East, 167 Point Street, Suite 161, Providence, RI, USA 02903.
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