Needs of Youth Enrolled in a Statewide System of Care: A Latent Class Analysis

Objective

Access to wraparound care coordination within systems of care (SOC) is increasing nationwide for youth with emotional and behavioral disorders and their families. Though wraparound care coordination serves a broad population of youth who experience a variety of complex needs, less is known about the impact of wraparound services based on these specified needs. Using latent class analysis, the current study aimed to first identify classes of youth based on their presenting needs and then examine the impact of class membership on treatment experiences and outcomes at baseline and six-month follow-up.

Method

Caregiver-reported data from 1,243 youth enrolled in wraparound care coordination services within a statewide SOC were used. Latent class analysis was used to determine classes of youth needs and regression results examined whether baseline characteristics, child and family team meeting characteristics, mental health outcomes, and perceptions of care differed based on identified classes.

Results

Results revealed five distinct classes of youth needs: Behavioral Needs, ADHD-related Behavior Needs, Educational Needs, Mental Health Needs, and Multi-Needs. Overall participants saw improvement in all follow-up outcomes. Significant between-class differences were also found in all outcome categories measured.

Conclusion

The current results further solidify the benefits of comprehensive wraparound care within a SOC. Additionally, understanding youth's needs and their impact on treatment services allows for more targeted care for youth and their families.

The state of evidence for social and emotional learning: A contemporary meta-analysis of universal school-based SEL interventions

This article provides a systematic review and meta-analysis of the current evidence for universal school-based (USB) social and emotional learning (SEL) interventions for students in kindergarten through 12th grade available from 2008 through 2020. The sample includes 424 studies from 53 countries, reflecting 252 discrete USB SEL interventions, involving 575,361 students. Results endorsed that, compared to control conditions, students who participate in USB SEL interventions experienced significantly improved skills, attitudes, behaviors, school climate and safety, peer relationships, school functioning, and academic achievement. Significant heterogeneity in USB SEL content, intervention features, context, and implementation quality moderated student experiences and outcomes. Strengths and limitations of this evidence and implications for future USB SEL research, policy, and practice are discussed.

Measuring social and emotional learning implementation in a research-practice partnership

The measurement of social and emotional learning (SEL) implementation is a critical part of enhancing and understanding the effects of SEL programming. Research has shown that high-quality SEL implementation is associated with social, emotional, and academic outcomes. Schools achieve these outcomes in part through organizational practices that emphasize ongoing communication, collaboration, coordination, shared decision making, and strategic planning, processes that are ideally informed by evidence. The application of implementation science to SEL has advanced our understanding of the role of implementation in achieving student outcomes. However, the development of practical approaches for measuring and supporting SEL implementation have lagged behind work on measuring student SEL outcomes. Research-practitioner partnerships (RPP), long-term, mutually-beneficial collaborations geared toward identifying problems of practice and testing solutions for improvement, are a promising means for addressing this important gap. Though implementation science and RPPs have complementary aims, there has been limited attention to the integration of these approaches in the context of SEL programming. The goal of this paper is to offer practical strategies for measuring and using SEL implementation data in schools, using the example of an RPP that used implementation science practices to guide SEL implementation. We give special attention to structures that can support the collection and use of implementation data to improve practice, as well as considerations around developing measures, considering trade-offs of data collection decisions, and conducting data analysis.

Needs of Caregivers of Youth Enrolled in a Statewide System of Care: A Latent Class Analysis

Objective

Systems of care (SOC) provide a coordinated array of services to youth with serious emotional and behavioral problems and their families. Little is known about what caregiver-specific needs at presentation to care may contribute to use of and engagement with care coordination and subsequent youth and family outcomes. This study aimed to determine latent classes of youth enrolled in wraparound care coordination within a statewide SOC based on caregiver needs impacting youth functioning and identify the relationship between class membership and characteristics of participation in Child and Family Team meetings (CFTs) and mental health outcomes at six-month follow-up.

Method

Participants were 703 youth (Mage = 11.21, SD = 3.67) and their caregivers that had information about caregiver needs and received a six-month follow-up assessment. Latent class analysis determined latent classes of families based on caregiver service needs at presentation to care, and differences in participation in care coordination and youth outcomes at 6-month follow up based on class membership was examined.

Results

Results indicated four classes of caregivers: Physical Health Needs, No Needs, Basic Needs, and Mental Health/Trauma Needs. Class membership was associated with size of the CFT, number of CFTs attended by the youth, percentage of CFTs with a natural support present, and percentage of CFTs that occurred in the family's home. Class membership was associated with caregiver ratings of objective strain at 6-month follow-up.

Conclusion

Assessing caregiver needs at presentation to care can provide direction for care coordinators to more directly target areas of family need through wraparound and individualize services.

"What Does it Mean to be Trauma-Informed?": A Mixed-Methods Study of a Trauma-Informed Community Initiative

Trauma during childhood has the potential to adversely affect one's physical, cognitive, emotional, and social development across the life span. However, the adverse effects of trauma can be prevented and mitigated through holistic services and supports that are trauma-informed. The Pottstown Trauma-Informed Community Connection (PTICC) is a community-based initiative that aims to build a trauma-informed community through training diverse stakeholders (e.g., school staff, providers, community leaders, parents) on the potential signs and symptoms of child trauma and how to create safe physical and emotional environments for children and families. This paper presents findings from a mixed-methods study of education and community partners' (N = 82) experiences in PTICC and their understandings of what it means to become trauma-informed. Paired sample t-tests found significant changes in participants' beliefs about trauma-informed practice, but there were no changes in participants' perceptions of the impacts of PTICC on their use of trauma-informed practices and supports. Focus groups with education (n = 6) and community (n = 5) partners found that participants regarded being "trauma-informed" as reframing one's perspective, being more self-reflective, acquiring skills to respond more effectively to others who have experienced trauma, and having a sense of hope for the future. Findings also revealed perceived benefits of trauma training and challenges associated with getting others to buy-in to trauma-informed work. Potential methodological considerations for future community-engaged research in building trauma-informed communities are discussed. These considerations include the need to address ceiling effects, disaggregate data, and mitigate challenges associated with participant engagement.

Educators' implementation and use of social and emotional learning early in the COVID-19 pandemic

The coronavirus disease of 2019 (COVID-19) has had multifaceted effects on students, their families, and the educators who support their learning. Early in the COVID-19 pandemic, one of the most notable changes for schools was the sudden move to distance learning-an unprecedented disruption to academic, social, and emotional instruction. Social and emotional learning (SEL) skills play an important role in human development by supporting academic success and overall well-being, including skills for effectively coping with stressors such as those imposed by the COVID-19 pandemic. Building on previous work, we created the Crisis Response Educator SEL Survey (CRESS) to examine predictors of SEL implementation during the pandemic. Structural equation models (SEMs) were used to predict: (a) educators' reported challenges implementing SEL during distance learning; (b) educator SEL implementation with students and use of social and emotional (SE) strategies for themselves; and (c) educator self-judgment and emotional exhaustion. Predictors included school/district guidance to support SEL, school/district support of educator SE needs, and the priority on SEL for the school and the educator. Our sample consisted of 219 educators committed to SEL who reported on their experience with SEL during distance learning toward the end of the 2019-2020 school year. Findings suggest that school/district support of educator SE needs predicts lower levels of challenge implementing SEL during distance learning and lower levels of educator burnout and self-judgment, whereas greater school/district guidance to support SEL was associated with more SEL implementation with students and more educator use of SE strategies for themselves. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Experiences With COVID-19 Stressors and Parents' Use of Neglectful, Harsh, and Positive Parenting Practices in the Northeastern United States

OBJECTIVES

To estimate household exposure to COVID-19 related stress and the association with parent report of neglectful, harsh, and positive discipline practices.

METHODS

Cross sectional survey data was collected from 2,068 parents in the Northeastern US. Parents reported personal and household experiences of COVID-19 stressors, their level of distress, and use of neglectful parenting and discipline practices for a randomly selected child in their home. Analyses estimated rates of COVID-19 related stress and parenting practices. Logistic regression was used to assess the relation of COVID-19 stress to parenting behaviors.

RESULTS

Individual and household stressor level, as well as distress were each positively associated with likelihood of neglect. Personal exposure to stressors was minimally related to discipline, but household stressor level and parents' distress were positively associated with harsh and positive discipline.

DISCUSSION

Indicators of COVID-19 stress (e.g., exposure to stressors and distress) each uniquely predicted parents' use of neglect, particularly physical and family-based sub-types, and use of harsh and positive discipline practices. Results suggest that parents may require additional support to provide appropriate care for their children while coping with the increased rates of stress associated with the pandemic and the resulting public health response.

Population Health and Trauma-Informed Practice: Implications for Programs, Systems, and Policies

Population studies indicate that trauma exposure is ubiquitous and has a significant impact on health. Trauma-informed practice seeks to address the health consequences of trauma through integrative responses that incorporate an understanding of the effects of trauma, the multiple pathways to recovery, and the potential for re-traumatization. Current trauma-informed practice considers trauma exposure an individual clinical problem rather than a societal problem with population health consequences. Population health refers to the aggregated health status of individuals who share some characteristic, such as trauma exposure, and includes the study of determinants that shape the distribution of health outcomes in specific populations. In this paper, we describe a population health perspective for trauma-informed practice that complements the current clinical perspective, and then discuss implications of that perspective for programs, systems, and policies. We summarize essential concepts about trauma over the life course and describe principles of population health science relevant to trauma-informed practice. We then discuss implications of these principles by identifying four priorities for trauma-informed practice from a population health perspective: (a) adopting trauma-informed policies to prevent trauma exposure and to foster resilience in the aftermath of trauma; (b) infusing trauma-informed practice into everyday activities so it is a routine part of interpersonal transactions; (c) incorporating trauma-informed practices into existing service systems; and (d) adapting existing treatments to incorporate trauma-informed principles for population health impact.

A Community's Response to Adverse Childhood Experiences: Building a Resilient, Trauma-Informed Community

Adverse childhood experiences, or ACEs, may be mitigated by trauma-informed social environments-programs, services, systems, communities-that offer responses to trauma that promote healing, recovery, and resilience. However, there is currently little empirical evidence to support the use of specific approaches to do so. Guided by a population health perspective, this paper describes a participatory community change process in response to ACEs that seeks to build a resilient, trauma-informed community in Pottstown, PA. We examine the initial implementation phase of this change process, centered originally on the education sector and the social and behavioral health services sector, and then eventually expanding to 14 community sectors across two years. A variety of data sources and methods are used to track individual and organizational processes, as well as service system network processes. A central feature of this research is the use of data to generate hypotheses rather than test them. Data were also used to guide understanding and decision-making during implementation. The results show that moving forward the community is well-positioned to establish stronger inter-agency and system supports for trauma-informed practice in the service system and in the broader community. We discuss results for their implications for building resilient, trauma-informed communities.

Reflections on a Community Psychology Setting and the Future of the Field

The 50th anniversary of the Swampscott Conference offers an opportunity to reflect on a community psychology setting, The Consultation Center at Yale, that was formed in response to the 1963 Community Mental Health Act and the 1965 Swampscott Conference. The Center has flourished as a community psychology setting for practice, research, and training for 39 of the 50 years since Swampscott. Its creation and existence over this period offers an opportunity for reflection on the types of settings needed to sustain the field into the future.

Newcomer Immigrant Adolescents and Ambiguous Discrimination

Cognitive appraisal has been shown to mediate the relationship between stressors and internalizing symptoms, but not among newcomer immigrant youth facing ambiguous discrimination. Using a mixed-methods design with a sample of newcomer adolescents from African, Arab, Asian, Caribbean, European, and Latin American countries, this study measured the perceived occurrence of discrimination (attribution to discrimination) and its perceived degree of severity (cognitive appraisal) in relation to internalizing symptoms and academic achievement. Attribution to discrimination predicted greater internalizing symptoms, and appraisal mediated this relationship. The mediation effect was found for younger, but not older adolescents. Quantitative results suggest that perceiving discrimination to be threatening, not just that it occurred, relates to psychological health. Qualitative results suggest that for newcomer adolescents, discrimination is a highly prevalent and complex stressor with multiple psychosocial ramifications.

Intractable Self-Fulfilling Prophecies Fifty Years After Brown v. Board of Education

The civil rights struggle for equal educational opportunity has yet to be achieved at the start of the 21st century. Inequality persists but problem and remedy are refrained from integrating schools, to ensuring equal access in resegregated settings, to closing the performance gap. As seen through ecological theory (R. S. Weinstein, 2002b), complex, multilayered, and interactive negative self-fulfilling prophecies create or perpetuate educational inequities and unequal outcomes. Society has failed to grapple with its entrenched roots in the achievement culture of schools. If this insidious dynamic is to be changed, an educational system that sorts for differentiated pathways must be replaced with one that develops the talents of all. Psychology has a critical role to play in promoting a new understanding of malleable human capabilities and optimal conditions for their nurturance in schooling.