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Math Circles are designed to allow students to explore mathematics using a problem-solving/inquiry approach. Many of the students attending our Math Circle are mathematically talented and curious. This study examines the perspectives of the students and their families in determining why students attend Math Circle, what they enjoy about Math Circle, and what they perceive as differences in Math Circle from their classroom mathematics instruction. Findings indicate that students and parents feel that our Math Circle offers more challenging work than students are finding in their regular classroom and that the Math Circle provides a scholarly camaraderie among participants. [ABSTRACT FROM AUTHOR]

Group homes are a frequently used but controversial treatment setting for youth with mental health problems. Within the relatively sparse literature on group homes, there is some evidence that some models of treatment may be associated with more positive outcomes for youth. This article explores this possibility by examining differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Data come from a longitudinal quasi-experimental study that included 554 youth. Results suggest that youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Post-discharge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months post-discharge. Results also discuss youth-level factors that may influence outcomes as well as need for additional work to more fully understand processes and practices that are key for maximizing and maintaining youths’ positive outcomes during and after group home placements. [ABSTRACT FROM AUTHOR]

This article proposes and examines a parsimonious framework for assessing quality in therapeutic residential care. The synthesized conceptual framework includes four potentially critical domains of quality: setting, staffing, safety, and treatment. Data from a recently completed quasi-experimental study of group homes were used to examine prevalence of various key indicators within each of these domains and to explore relationships between these indicators and youth-level outcomes. Findings suggest that, among this sample of licensed homes in a southeastern state, licensure may be an initial indicator of baseline quality. Beyond this most basic level, utilization of an evidence-informed model (in this case, the teaching family model) was associated with better outcomes. Net of model, findings suggest that positively focused motivational systems, youth’s perceptions of staff’s fairness and helpfulness, provision of age/interest-appropriate toys/books/games, more preservice training, and prohibition of physical restraint were all associated with better outcomes for youth. Additional work is needed to assess the generalizability and utility of this framework for assessing quality in group homes. [ABSTRACT FROM AUTHOR]

Despite their widespread use as a placement option for youth with mental health problems, there is relatively little research on group homes for youth. Available data highlight concerns with practices and treatment within group homes and mixed results on youth-level outcomes. However, existing research appears to collapse a wide range of group residential settings into a single amorphous category. This article explores potential variations among group homes to examine whether different programs are systematically serving different types of youth. It examines, in particular, placement in homes using the teaching family model (TFM) versus homes that do not. Findings suggest that demographics are not significantly associated with TFM placement. However, custody status, types of mental health problems, and use of psychotropic medications are. Homes appear to be serving distinct niches within a geographic area. Implications for future research and policy/practice are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND:A number of states have implemented Assertive Community Treatment (ACT) teams statewide. The extent to which team-based care in ACT programs substitutes or complements primary care and other types of health services is relatively unknown outside of clinical trials. OBJECTIVE: To analyze whether investments in ACT yield savings in primary care and other outpatient health services. DESIGN: Patterns of medical and mental health service use and costs were examined using Medicaid claims files from 2000 to 2002 in North Carolina. Two-part models and negative binomial models compared individuals on ACT (n = 1,065 distinct individuals) with two control groups of Medicaid enrollees with severe mental illness not receiving ACT services (n = 1,426 and n = 41,717 distinct individuals). RESULTS: We found no evidence that ACT affected utilization of other outpatient health services or primary care; however, ACT was associated with a decrease in other outpatient health expenditures (excluding ACT) through a reduction in the intensity with which these services were used. Consistent with prior literature, ACT also decreased the likelihood of emergency room visits and inpatient psychiatric stays. CONCLUSIONS: Given the increasing emphasis and efforts toward integrating physical health and behavioral health care, it is likely that ACT will continue to be challenged to meet the physical health needs of its consumers. To improve primary care receipt, this may mean a departure from traditional staffing patterns (e.g., the addition of a primary care doctor and nurse) and expansion of the direct services ACT provides to incorporate physical health treatments. [ABSTRACT FROM PUBLISHER]

This study examines the prevalence and correlates of heightened posttraumatic stress (PTS) symptoms in a nationally representative sample of 1,848 children and adolescents (ages 8-14) who were referred to child welfare for investigation of abuse or neglect based on the National Survey of Child and Adolescent Well-Being. The severity of current PTS symptoms was assessed using the PTS subscale of the Trauma Symptom Checklist for Children, a standardized child-report scale evaluating common symptoms associated with trauma. The overall prevalence of clinically significant PTS symptoms was 11.7% (overall mean T score = 49.5). The prevalence was higher for cases that were placed in out-of-home care (19.2%) than those maintained at home (10.7%). Multivariate hierarchical regression identified four contributors to heightened PTS symptoms: younger child age, abuse by a nonbiological parent, violence in the home, and child depression. The authors discuss the modest but still lower than expected prevalence of self-reported, clinically significant PTS symptoms and the variables associated with greater risk for heightened PTS symptoms found among cases referred to child welfare services. [ABSTRACT FROM AUTHOR]

Youth entering residential care possess significant emotional and behavioral needs; yet, it is uncertain whether these needs have remained constant or are changing over time. This study examined mental health variables from the admission files of 1,047 youth entering residential group home care in 1995 and 2004. Sequential logistical regression analyses revealed that the mental health needs of youth admitted in 2004 were greater than those for youth in 1995 with regard to having multiple psychiatric diagnoses, being prescribed two or more psychotropic medications, and using alcohol or drugs. As such, these analyses should be replicated in other group homes as well as in other placement settings within the system of care. [ABSTRACT FROM AUTHOR]

Recent work suggests that out-of-home placements continue to be relatively common for youth with mental health problems, even within systems of care. The current work examines rates and predictors of movement back home and stability of reunifications. During the focal period, 1,778 youths experienced out-of-home placements; 61% moved back home, and 22% of those reunited were placed out of home again. Race was related to likelihood of reunification and instability: American Indian youth were least likely to return home, whereas Hispanic youth were at increased risk of unstable reunifications. Older youth and boys were more likely to return home, whereas youth from families with higher incomes were slightly more likely to be placed out of home but also most likely to be stably reunited. Higher (i.e., worse) total Child Behavior Checklist score was related to moving back home, whereas decreased strengths and more child-level risk factors predicted instability of reunification. [ABSTRACT FROM AUTHOR]

This article examines out-of-home placements for youth with mental health problems in community-based systems of care. Longitudinal data come from the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. One third of youth residing at home when they enrolled in the system of care were placed out of home during the 2-year follow-up period. As expected, youth who were placed out of home displayed more problems, fewer strengths, and more risk factors than youth who remained at home. However, results suggested few differences between youth placed in foster care and those placed in more restrictive settings. In addition, there was increased placement instability for Hispanic and older youth. Findings suggest that out-of-home placements remain a common component in systems of care. This suggests the immediate need for additional work on effectiveness of these settings for youth within systems of care. [ABSTRACT FROM AUTHOR]

This study examined outcomes for 320 youth in a Center for Mental Health Services system-of-care demonstration site. Youth received wraparound-only (n = 213),MST-only (n = 54),or wraparound + MST (n = 53). Participants were 12 years old on average and mostly White (90%), and 75% were Medicaid-eligible. Service use and functional and clinical outcomes were examined at 6-month intervals out to 18 months. All three groups improved over the study period. The MST-only group demonstrated more clinical improvement than the other groups. Functional outcomes did not differ significantly across groups. Youth in wrap + MST had higher baseline severity and experienced less clinical and functional change than the other two groups, despite more mental health service use. Targeted, evidence-based treatment may be more effective than system-level intervention alone for improving clinical symptoms among youth with serious emotional disorders served in community-based settings. New or amended approaches may be needed for youth with the most severe disorders. [ABSTRACT FROM AUTHOR]

Despite a decline in the incidence of child abuse over the last decade, victimization rates remain troubling. This study used a subset of data from the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program to investigate and compare the demographic, psychosocial, and service use characteristics and outcomes of children with varying abuse histories referred into community-based mental health services. The lifetime estimate of abuse histories—physical, sexual, or both—among these children is 36.5%. A high level of clinical need across abuse subtypes and a gradient of increasing child and family risk factors differentiated children with and without an abuse history. Children with a reported history of both physical and sexual abuse consistently presented a more troublesome picture of personal and family challenges. Implications for the assessment of clinical needs and the identification of evidence-based interventions to meet the unique needs of these children are discussed. [ABSTRACT FROM AUTHOR]

This study examines the experiences of treatment foster mothers. It is part of an ongoing longitudinal study of the use, implementation, and effectiveness of treatment foster care. The study sample is 43 treatment foster mothers. Study data are from in-person interviews with mothers in which each is asked to talk about the youth in her care and her experience of being the youth’s treatment foster mother. Mothers’ responses were analyzed through an inductive and iterative process. The analysis yielded six mutually exclusive categories of experience. Each category was labeled with a name that reflected a critical element of its definition: Strategic, Struggle, Satisfaction, Mothering, Rejection, and ‘Other’. Findings suggest wide variation in how treatment foster mothers experience their role and relationships with youth. Study strengths, limitations, and relevant theoretical frameworks for further work are discussed. [ABSTRACT FROM PUBLISHER]

Assesses conformity to standards for treatment foster care (TFC) in the United States. Option for youth with emotional and behavioral disorders; Variations of TFC in real-world practice; Identification of TFC programs.

• Summary: In recent years, the plight of refugees and asylum seekers has garnered significant public attention. Yet many social workers find they have made limited preparations for meeting the needs of refugee clients. This article presents the results of a study conducted at the largest refugee shelter in the US. Fifty-eight adult asylum seekers staying at the shelter were interviewed about their experiences, including trauma and subsequent physical and emotional symptoms. • Findings: Most respondents experienced trauma in their home country. Additionally, nightmares were often reported as psychological sequelae attributed to these traumatic events. • Applications: Helping professionals can learn from this information and become sensitized to some of the struggles of this population. Understanding that some refugee clients 'shout with fear at night' can help us to appreciate the lasting impact trauma can have and can guide our work with this vulnerable yet resilient population. Helping professionals are challenged to become better versed in the at-risk position of asylum seekers and engage in advocacy to encourage greater protection of this population. [ABSTRACT FROM AUTHOR]

Presents a study that examined the potential of outpatient commitment (OPC) to reduce the risk of arrest among people with severe mental illness and those with a history of dual system recidivism. Discussion of OPC; Significance of extended OPC; Mediating factor in the association between OPC and arrest.

Comments on the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. Sustainability of the systems of care; Role of families in research; Benefits of the system of care to children and families.

Discusses dimensional interactions in early visual processing by the examination of individual differences in the texture-segregation task. Assessment whether individual differences measured by Witkin's Embedded Figures differentiate attentional processes in early visual processing; Importance in considering aspects of stimulus structure and individual processing.

Examines the relationship between the impact of child's mental health problems on caregivers and patterns of mental health service use. Role of parents in accessing their children's mental health services; Differences in family impact between service users and nonusers.

Presents the challenges faced by child mental health services research in the United States. Research priorities relevant to mental health services for adolescents; Service systems interventions; Service components; Interferences on randomized clinical trials; Suggested criteria for research studies.