Reconnecting homeless

youth and their

families: The role of

family-based

interventions

Norweeta G. Milburn, Ph.D.

Affiliations & Support UCLA Department of Psychiatry and Biobehavioral Sciences

Semel Institute for Neuroscience and Human Behavior

Nathanson Family Resilience Center

Department of Medicine

University of California, Los Angeles

nmilburn@mednet.ucla.edu

Supported by grants from NIMH MH61185, MH70322, and MH080664,

NIMHD P20MD000182, and NIDA DA035692.

Workshop Presentation at the National Alliance to End Homelessness

National Conference on Ending Homelessness, Washington, DC July 30,

2014.

Overview

Family-based interventions

Project STRIVE

Adaption

2

Family-Based Interventions

STRIVE: Support to Reunite, Involve and Value Each Other

4

Family-Based Intervention (5 Sessions) Built Upon:

Family Strengths

Problem Solving

Conflict Negotiation

Role Clarification

STRIVE: Support to Reunite, Involve and Value Each Other

5

Program Elements

Tokens Feeling

Thermometer

Problem Solving

Role

Playing Reframing

STRIVE Randomized Control Trial

(RCT): Findings

⬆Mental Health

⬇Substance abuse and HIV sexual risk

6

Milburn, Iribarren, Rice et al. (2012)

Adaptation/Implementation for Re-Entry Youth: Design

Sample

N = 300 re-entry youth + parents/guardians

Phase 1

Adapt STRIVE

Phase 2

RCT of STRIVE

Baseline, 3, 6, and 12 months

Adaptation: Re-entry youth

8

Adapted STRIVE

Parents

Youth

Juvenile Justice

Adaptation: Re-entry youth

9

Navigation

Help with access to services

Link to services

Therapeutic Alliance

Establish trust

Build rapport

Systems of Care

Cross disciplinary collaboration

Facilitate relationships

Critical Intervention Period

Before release

Family visitation

Family-Based Approach

Different family constellations

Strengths-based

Reconnection

10

Theme Quote Group

System of Care “The court is a point of contact for all young offenders and would be a good

place to offer your services but the whole mandating thing that could be a

difficult thing because it’s another thing, another thing they’re making me

do…but also might be a good way to catch the less motivated individuals

because then it’s court-mandated and it’s part of the stipulation of your

freedom. So that could be a good thing for it.”

Group 1

Establishing a Therapeutic Alliance “I think a lot of people are distrustful…So I think you’d have to reassure people

that somehow they can trust the counselors or program or you’re not going to

rat them out at the court if they’re going to appear in court. I mean, they have

stuff. We don’t tell our stuff.”

Group 3

Critical Intervention Period “When kids get released from camp or even custody, I call it like a celebration

period…Usually, those couple of weeks they’re doing well, except they forget

they’re still on probation. Then you have like a violation early on. So maybe

that could be something this program could help with, also to remind them to do

all the things they need to do, doing it slowly, also.”

Group 3

Navigation “It’d be different if there were a one-stop shop that dealt with probation issues,

and mental issues, health, education where they can go and deal with all that in

one place. But instead, they’re having to go to so many different places, report

to so many different people and it’s just so hard to keep track of those people.

It’s hard to have time to do all that and they’re lugging all the little siblings

around too. It’s just…it’s completely overwhelming.”

Group 3

Family-Based

Approach

“I think another thing too if a family does participate in this, is there going to be

some kind of follow-up or referral if it turns up that the family is actually

interested in getting more counseling? … Because that’s a huge need for most

of our kids and their families that we’re constantly shopping around to try to find

services, something for the kids. Lots of times it’s a struggle to find those

programs for people that want them.”

Group 3

Implementation Conclusions

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Five elements for success

1. Intervene early

2. Family-centered approach

3. Reentry navigation component

4. Therapeutic alliance

5. Embedded in the system of care

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EXPORT/STRIVE

Eraka Bath, M.D.

W. Scott Comulada, Dr.P.H.

Bita Amani, Ph.D.

Angela Young-Brinn, B.S.

Alex Lee, M.S.W.

Norweeta G. Milburn, Ph.D.

Francisco Javier Iribarren, Psy.D.

Alex Lee, B.A.

Kwame Alexander, B.A.

Kate Desmond, M.S.

Phillip Batterham, M.P.H.

Norweeta G. Milburn, Ph.D.

UCLA Semel Institute for Neuroscience

& Human Behavior

UCLA Center for Community Health