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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]

The authors consider school violence from a dynamic systems conceptualization of aggression. This perspective suggests that aggression and school violence involve the contributions of both school social dynamics and the developmental histories of youth who are at risk for involvement in antisocial behavior. The authors present the concept of correlated constraints to describe the systematic alignment of developmental factors and their role in behavioral continuity and realignment. Building from this perspective, the authors present a theoretical framework that complements public health models of prevention to guide the establishment of comprehensive programs for preventing aggressive and violent behavior in schools. This framework suggests that three distinct but complementary levels of intervention are required to effectively reduce school violence: (a) universal strategies to address contextual factors, including the social dynamics of aggression and the activities of "conventional" peers that promote interpersonal conflict; (b) selective strategies for supporting the strengths of at-risk youth to prevent the negative reorganization of their developmental systems; and (c) indicated strategies involving coordinated services from multiple providers to reorganize the developmental systems of high-risk youth (i.e.,youth with emotional and behavioral disorders). [ABSTRACT FROM AUTHOR]

This study examined preliminary effectiveness of one of the first Project Re-ED (Reeducation of Emotionally Disturbed children) residential treatment centers for children. Data were collected at admission, at discharge, and up to 6 months postdischarge. Findings show substantial decreases in problem behaviors and improvements in personal strengths during treatment for children ages 6-12. Despite some deterioration of outcomes in the postdischarge period, improvement compared to baseline continued to be evident at 6 months postdischarge. Multivariate analysis showed that relatively few factors were associated with differential change while in treatment. Younger age, however, was related to more substantial change during treatment and longer length of stay was associated with more positive outcomes by 6 months postdischarge. [ABSTRACT FROM AUTHOR]

Current views of the role of social relations in the development of aggressive and disruptive behavior are presented, and advances in social development research are summarized. The primary points of the articles in this special issue are considered against this backdrop and synthesized with regard to implications for the development of preventative interventions and positive behavioral supports for aggressive youth with or at risk of emotional and behavioral disorders. Together these articles suggest that the social growth of such youth is highly complex and involves multiple factors, including the social goals and characteristics of the student, the affiliative patterns and social roles of the student, and the interactional dynamics among students and between students and teachers. School-based interventions should focus not only on the behavior of the student, but also on social-cognitive processes and social contextual factors that support aggressive and disruptive behavior. [ABSTRACT FROM AUTHOR]

Background. Dietary intervention to reduce fat consumption and increase fiber consumption has been recommended by the National Cancer Institute, but there is little evidence concerning the effectiveness of self-help materials. The purpose of this study was to evaluate such self-help materials, introduced by a nurse in a primary care setting. Methods. A randomized controlled trial involving 242 subjects was conducted in two primary care clinics in Chapel Hill, NC, in 1987. Changes in fat and fiber consumption in the intervention and control groups during the 3-month interval between interviews were compared using analysis of covariance. Results. The estimated reduction in fat 3.8g larger for the intervention group than for the control group, but the confidence interval included zero. For those individuals who had some responsibility for meal preparation there was a larger difference (-6.9g) in favor of the intervention group, although the difference using calorie-adjusted values was -3.8g with a 95% confidence interval (-7.1, -0.4). The differences for fiber change were smaller. Conclusions. We found significant small but consistent differential changes associated with a minimal self-help intervention, but we cannot rule out the possibility of some response bias. Nonetheless, this study demonstrates that the use of self-help materials for dietary change is feasible, and may be effective. [ABSTRACT FROM AUTHOR]

An increasing number of custodial grandparents are raising grandchildren, and intensive childcare is stressful with many negative personal, interpersonal, economic, and health implications. Grandparents' strengths, including resilience, positive caregiving appraisal, and social support should be considered in the face of parenting stress and adversity. Guided by the stress and resilience model, the current study investigated the associations of parenting stress and coping resources with life satisfaction and mental wellness among custodial grandparents ( N  = 76). Data were collected between December 2020 and April 2021, through collaborations with community-based agencies located in two metropolitan areas, which provide supportive services to custodial grandparents and their families. Findings showed that more parenting stress was associated with less life satisfaction and worse mental health, and that stress management boosted life satisfaction and mental wellness. Grandparents with more informal social support and social service utilization fared better than their counterparts with less social support and no experience of service use. The results of this study suggest that social work interventions should focus on improving stress management to cope with daily and caregiving stressors. Social workers can help with informal social support and formal social services utilization to address caregiving needs among custodial grandparents.

Patterns of Axis I psychiatric diagnosis and maltreatment history were explored among youth in group homes, including match of clinical need to level or restrictiveness of care. Data on demographics, diagnoses, maltreatment, and group home level of care (Level I, II, or III homes, representing lower to higher intensity of supervision and treatment) were obtained from 523 youth who participated in a quasi-experimental study of group homes. Three quarters of youth had a diagnosis and two-thirds of youth had a maltreatment history. Youth in higher level homes had more diagnoses and higher rates of all disorders except adjustment disorders. Youth in Level I homes had a history of more maltreatment types, particularly high rates of neglect. Sexual abuse, physical abuse, and emotional abuse were most common among youth in higher level homes. Regardless of diagnosis history, comparable proportions of youth had a maltreatment history, and similar patterns were found across levels of care. Together, findings indicate that group homes with varying degrees of restrictiveness serve youth with different psychiatric diagnosis and maltreatment histories. Youth triaged to higher level homes had more diagnoses, while youth placed in the least restrictive homes had a history of more maltreatment subtypes. Further, distinct patterns of diagnosis types and maltreatment subtypes were seen across homes. Implications include the importance of assessing unique clinical needs of youth to promote an appropriate match to level of care and treatment plan., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: This article focuses on caseworkers' assessments of risk of maltreatment recurrence among families in contact with social services. Specifically, the article has two primary goals: (1) to examine the association between caseworkers' risk assessments and demographic, child, parent and family-level risk factors; and (2) to examine agreement between caseworkers' risk assessments and any subsequent report, or reports, of maltreatment., Method: Data are from the baseline, 12-month, and 18-month assessments of the National Survey for Child and Adolescent Well-Being (NSCAW), a nationally representative sample of youth and families who were the subjects of allegations of maltreatment investigated by child welfare agencies. The sample consisted of a subset of NSCAW participants: cases with a report of child physical abuse or neglect who were not placed in out-of-home care (N=2,139)., Results: Analyses indicated that parent-level risk factors and a prior report of maltreatment were most strongly associated with caseworkers' assessments of risk for both physical abuse and neglect cases. A smaller set of factors, which varied by the type of maltreatment, were associated with a subsequent report of maltreatment. Despite some overlap in correlates of risk assessment and subsequent reports, analyses indicated that agreement between caseworkers' assessments of risk and re-reports was low., Conclusions: Findings suggest that although caseworkers' assessments were associated with a limited set of risk factors from the literature, few of these factors also were associated with a recurrent report of maltreatment. Correspondence between caseworkers' assessments of risk and a subsequent report of maltreatment was low, suggesting that considerable work may be needed to improve accuracy and identification of cases most at risk., Practice Implications: This study provides information to assist caseworkers, administrators, and policymakers in thinking critically about risk assessment policies and procedures. Although caseworkers' assessments of risk were associated with some of the empirical predictors of recurrent maltreatment, their assessments were only slightly better than guessing. Agreement between caseworkers' risk assessments and actual subsequent reports was better for low-risk cases, but primarily because the majority of cases did not have a subsequent report during the study period. Clearly, considerable improvement in risk assessment is needed so that at-risk families can be better identified and the limited services available can be directed toward those most in need.

This article reviews the evidence base for community-based interventions from a systems of care perspective. The article summarizes previous reviews and provides updates and current directions for recent and ongoing studies. As expected, the evidence base is strongest for multisystemic therapy and treatment foster care. A relatively well-developed evidence base is also revealed for case management. The article concludes with recommendations for future directions within each of the designated types of interventions.