FAMILY INTERVENTIONS FOR RUNAWAY YOUTH

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FAMILY INTERVENTIONS FOR RUNAWAY YOUTH
David E. Pollio, PhD Sanna J. Thompson, PhD
Norweeta Milburn, PhD
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THE FAMILY AN IMPORTANT FACTOR IN SUCCESSFUL
YOUTH OUTCOMES
Youth returning home after a runaway episode are

• Less likely to use substances
• Less likely to have legal problems
• Decreased days on the run

Pollio, Thompson North, 2001
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HOWEVER

• substance use decreased likelihood of returning
  home post shelter discharge, including use of
  stimulants (OR.10), depressants (OR.22) and
  multiple substances (OR.36).
• involvement with legal system decreased
  likelihood of returning home, including being on
  probation (OR.70), in DJS custody (OR.10), and
  involvement in prostitution (OR.34)

Thompson, Safyer, Pollio, 2001 Thompson,
Pollio Bitner, 2000
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MODEL OF SHELTER SUCCESS
Nebbitt, House, Thompson Pollio, In press
HOME
SHELTER
RETURN HOME
Youth Acting Out
Child experiences Structure Freedom Family
experiences Respite
Youth returns home
Parents at Wits End
Family Reconnected Re-involved
Family system Disrupted
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FAMILY RE-INVOLVED

• Sometimes its the first chance they have to
  talk with their families a lot of it is around
  communication, not being able to understand where
  the other person is coming from, a child, a
  parent, either one...they start talking to each
  other more, and whether its good communication
  or bad communication, if theyre even talking to
  each other as opposed to yelling and screaming
  and creating chaos, thats one step towards
  making a positive change at home.-- Shelter Staff

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AT THE SHELTER
POST-DISCHARGE
Youth doing well -Focus on youth problems
Youth doing well -Youth gives socially
desirable responses -Family normalizes
Shelter Stay
Youth doing badly -Focus on family/
environment -Family fewer resources
Youth doing badly -No socially desirable
responses -Family remains negative
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FAMILY NORMALIZES

• Before she was constantly keeping chaos up
  between me and my momconstantly giving problems
  at school and she was sneaking and doing
  thingsbeing very disagreeable.
• After Well, the main thing is just for me to
  give her a chance andstart the slate off clean.
  And Ive stopped bringing up the past, because
  the past is in the pastIm dealing with what
  shes doing now and trying to gear up towards
  continuing to do better.
• -family member

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STUDY PURPOSE

• To present three NIH-funded new interventions
  aimed at families of runaway and homeless youth

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INTERVENTIONS
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• RHY-PERF (PsychoEducation Responsive to Family
  for Runaway Homeless Youth) PI Pollio
• Home-based, engagement focused family therapy
  PI Thompson
• Project STRIVE (Support to Reunite, Involve, and
  Value Each other) PI Milburn

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Psycho-EducationResponsive to Families For
Runaway- Homeless Youth (RHY- PERF)

• youth recruited at shelter, groups conducted
  post-discharge
• meets twice monthly for 6 months
• facilitated by social worker and psychiatric
  specialist
• families choose curriculum in first session
  (family responsive)
• curriculum provided through manual, thus assuring
  quality of information

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Psycho-EducationResponsive to Families For
Runaway- Homeless Youth (RHY- PERF)
Structure of each session 1. Recent experiences
(15 minutes) 2. Lecture on topic chosen by
family (20 minutes) 3. Discussion of how topic
impacts on family life (20 minutes) 4.
Brainstorming on strategies to address topic (20
minutes) 5. Wrap-up (5 minutes)
North, et al., 1997 Pollio, North Osborne, 2002
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HOME-BASED, ENGAGEMENT FOCUSED FAMILY THERAPY

• Home-based family therapy intervention to
  prevent/reduce youth substance use.
• Eighteen Engagement Activities were developed
• one activity was implemented during each of 12
  sessions delivered to families in the home.

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Examples of Engagement Activities

• Meaningful Events
• recording/sharing memories of events that were
  meaningful to parent and youth
• Downward Spiral
• board game that takes players on a journey that
  is plagued with pitfalls of drug use
• Garbage Bag
• family decorates a bag together and writes on
  slips of paper personal qualities or hurtful
  feelings that each person wants to overcome bag
  is disposed.
• Rush Hour Traffic Jam
• get a designated car out of a congested game
  board requires the family members working
  together
• 3-D Storytelling
• Play-doh is used to create 3-dimensional
  characters and develop a story about these
  characters as a family

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Project STRIVE Support to Reunite, Involve and
Value Each Other

• Runaway behavior Response to unresolved family
  conflict
• Family intervention
• Family strengths
• Problem solving
• Conflict negotiation
• Role clarification
• 5 sessions

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• Adaptation of SNAP (Successful Negotiation,
  Acting Positive)
• Cognitive-behavioral/family systems intervention

SNAP focuses on improving conflict resolution
strategies, eliminating suicide attempts as a
method of resolving future conflict, promoting
positive family interaction, and reframing the
familys understanding of their problems.
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Project STRIVE Sessions

• 1 Create positive family atmosphere
• 2 Identifying problem situation
• 3 Analysis of medium size problem
• 4 Cope, negotiate, and problem solve
• 5 Evaluate solutions and problem solve

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DISCUSSION
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CHALLENGES

• Racial/ethnic diversity
• Identification of appropriate families
• Recruitment
• Determining success
• Addressing multiple needs/problems in limited
  intervention
• Coordination of care

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CAVEATS

• Family interventions are not appropriate for all
  runaway youth
• Families must be involved and appropriate
• Youth with longer history of more severe problems
  are probably less likely to benefit from brief
  interventions
• Both family and youth must be motivated to
  participate

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MULTIPLE POPULATIONS

• Youth in crisis first episode(s) of running
  away family involved
• Family in crisis multiple challenges across
  family system
• Street youth no available family
  independent or throwaway youth
• Homeless families entire family together in
  homelessness

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CONTACT INFORMATION

• David E Pollio, PhD
  Washington University in St Louis
• depollio_at_wustl.edu
• Sanna Thompson, PhD University
  of Texas at Austin
• sannathompson_at_mail.utexas.edu
• Norweeta Milburn, PhD
  University of California at Los Angeles
• nmilburn_at_mednet.ucla.edu