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Lanni S, Stone M, Berger AF, Wilson RLH, Wilens TE, Philpotts LL, Burke CW. Design, Recruitment, and Implementation of Research Interventions Among Youth Experiencing Homelessness: A Systematic Review. Community Ment Health J 2024; 60:722-742. [PMID: 38332393 PMCID: PMC11017793 DOI: 10.1007/s10597-023-01224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/23/2023] [Indexed: 02/10/2024]
Abstract
Transitional age youth experiencing homelessness (TAY-EH) represent an underserved and understudied population. While an increasing number of empirical interventions have sought to address the high burden of psychopathology in this population, findings remain mixed regarding intervention effectiveness. In this systematic review of behavioral health interventions for TAY-EH, we sought to examine the structural framework in which these interventions take place and how these structures include or exclude certain populations of youth. We also examined implementation practices to identify how interventions involving youth and community stakeholders effectively engage these populations. Based on PRISMA guidelines, searches of Medline, PsycInfo, Embase, Cochrane Central, Web of Science, and ClinicalTrials.gov databases were conducted, including English language literature published before October 2022. Eligible studies reported on interventions for adolescent or young adult populations ages 13-25 years experiencing homelessness. The initial search yielded 3850 citations; 353 underwent full text review and 48 met inclusion criteria, of which there were 33 unique studies. Studies revealed a need for greater geographic distribution of empirically based interventions, as well as interventions targeting TAY-EH in rural settings. Studies varied greatly regarding their operationalizations of homelessness and their method of intervention implementation, but generally indicated a need for increased direct-street outreach in participant recruitment and improved incorporation of youth feedback into intervention design. To our knowledge, this is the first systematic review to examine the representation of various groups of TAY-EH in the literature on substance use and mental health interventions. Further intervention research engaging youth from various geographic locations and youth experiencing different forms of homelessness is needed to better address the behavioral health needs of a variety of TAY-EH.
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Affiliation(s)
- Sylvia Lanni
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Mira Stone
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Amy F Berger
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Ronan L H Wilson
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Timothy E Wilens
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Lisa L Philpotts
- Treadwell Library, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Colin W Burke
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
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Royter E, Sudak D, Plakun EM. Cognitive Behavioral Therapy Approaches for Chronic Suicidality. J Psychiatr Pract 2024; 30:46-50. [PMID: 38227727 DOI: 10.1097/pra.0000000000000757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
This review provides an overview of research evidence from the past 5 years concerning cognitive behavioral therapy for suicide prevention. The authors then discuss the clinical implementation of this approach in patients with chronic suicidal behavior.
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Wu Q, Zhang J, Walsh L, Slesnick N. Heterogeneous trajectories of suicidal ideation among homeless youth: predictors and suicide-related outcomes. Dev Psychopathol 2023; 35:1671-1683. [PMID: 35440358 PMCID: PMC9582044 DOI: 10.1017/s0954579422000372] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The current study examined heterogeneous trajectories of suicidal ideation among homeless youth experiencing suicidal ideation over 9 months in a randomized controlled intervention study. Suicidal homeless youth (N = 150) were randomly assigned to Cognitive Therapy for Suicide Prevention (CTSP) + Treatment as Usual (TAU) or TAU alone. Youth reported their suicidal ideation four times during a 9-month period. We also assessed pretreatment mental health, demographic information and session attendance as predictors of the subgroups, as well as suicide-related factors as outcomes at the 9-month follow-up. Growth mixture models suggested three distinct trajectory groups among youth: Fast Declining (74.7%), Chronic (19.3%), and Steadily Declining (6.0%). Youth in the Chronic group used more substances at baseline than the Steadily Declining group, were more likely to be White, non-Hispanic than the Fast Declining group, and attended more CTSP sessions than other groups. Contrastingly, youth in the Steadily Declining group all experienced childhood abuse. Finally, youth in the Chronic group showed significant higher risk for future suicide compared to those in the Fast Declining group at 9 months. Findings support the heterogeneity of treatment responses in suicide intervention among homeless youth, with implications to improve treatment efforts in this very high-risk population.
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Affiliation(s)
- Qiong Wu
- Department of Human Development & Family Science, College of Health and Human Sciences, Florida State University
| | - Jing Zhang
- Department of Human Development and Family Studies, School of Lifespan Development and Educational Sciences, Kent State University
| | - Laura Walsh
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University
| | - Natasha Slesnick
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University
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Clarke A, Rose TA, Meredith PJ. Language skills and interpersonal trust in adolescents with and without mental illness. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:589-607. [PMID: 35614858 DOI: 10.1080/17549507.2022.2075466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The primary aim was to compare adolescents with mental illness and non-clinical adolescents on vocabulary, social problem-solving, trust in parents, attachment and mentalisation. A secondary aim was to investigate whether adolescents' language skills were associated with trust in parents. METHOD Seventy-eight adolescents (16-18 years) participated in this cross-sectional quantitative study: a clinical sample (n = 28, M = 16.7 years, 19F) recruited from a mental health service and a non-clinical sample (n = 50, M = 17.0 years, 28F). Standardised language measures and self-report measures of trust in parents; communication quality; attachment; and mentalisation were used. Primary and secondary aims were addressed through independent samples t-tests and Pearson's correlation analyses, respectively. RESULT Adolescents experiencing mental illness reported significantly poorer vocabulary, less trust in mother/father, greater attachment anxiety/avoidance, and poorer reflective functioning, than non-clinical adolescents. Expressive vocabulary of clinical (but not non-clinical) adolescents significantly negatively correlated with trust in mother (but not father). CONCLUSION Results highlight a role for speech-language pathologists (SLPs) in supporting communication needs of adolescents with mental illness. SLPs should consider trust by: i) understanding adolescents with mental illness may have difficulty trusting them potentially impacting therapeutic engagement; and ii) delivering services in ways that might build trust, such as involving adolescents in treatment planning.
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Affiliation(s)
- Angela Clarke
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Assertive Mobile Youth Outreach Service, Child and Youth Mental Health Services, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Pamela J Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
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