Primary Sources: What Leads Many Runaway and Homeless Youth to Harm Themselves or Consider Suicide?

The Mediating Roles of Stress and Maladaptive Behaviors on Self-Harm and Suicide Attempts Among Runaway and Homeless Youth” (abstract). Amanda Moskowitz, Judith A. Stein & Marguerita Lightfoot. Journal of Youth and Adolescence, Vol. 42, No. 7 (July 2013).

What it’s about: Researchers wanted to learn what leads many runaway and homeless youth to harm themselves or attempt suicide.  The researchers hypothesized that aspects of young people’s backgrounds lead to and combine with stress and problem behaviors, which in turn affect the likelihood of youths’ self-harm and suicide attempts. The study was based on interviews with 474 young people, ages 12 to 24, who were using drop-in centers or shelters in Los Angeles County.

In the study, background variables included gender, age, sexual minority status, parents’ drug-use history, and emotional distress. Problem behaviors included substance abuse, stealing, bullying and starting fights.

Why read it: As the authors of the study write, “It is abundantly clear, as evidenced by prior research, that the homeless and runaway youth population is at higher risk of suicidality and self-harm than housed youths.” This study tries to uncover further information about what leads to that risk, with the ultimate goal of preventing self-harm and suicide among runaway and homeless youth.

Biggest takeaways for family and youth workers: The authors used something called the “stress process paradigm” to describe the relationships they found among background variables, stress and problem behaviors, and the ultimate outcomes of young people harming themselves or attempting suicide.

The researchers found that

  • Girls and young women and lesbian, gay, bisexual and transgender youth were more likely than other youth to have harmed themselves and attempted suicide.
  • Younger participants reported more self-harming than older youth.
  • All the background factors studied seemed to lead to increased stress levels for young people.
  • Older youth, those whose parents had used drugs, and those with greater emotional distress were more likely than other youth to have drug problems.
  • Boys and young men, young youth, and those with greater emotional distress were more likely than other youth to do things like steal, bully, and get into fights.
  • Both young people with problem behaviors and those who had recently been under stress were more likely than other youth to harm themselves.
  • Young people who had recently been under stress were more likely than other youth to attempt suicide.

Based on their findings, the authors encourage mental health professionals who work with runaway and homeless youth to consider working to recognize and stop problem behaviors and help young people reduce and cope with stress.

Additional references: We’ve reported on an Iowa runaway and homeless youth program that prioritizes suicide prevention at its shelter and a Tennessee program that uses “neurofeedback” to help youth relax their brains.

(Publications discussed here do not necessarily reflect the views of NCFY, FYSB, or the Administration for Children and Families. Go to the NCFY literature database for abstracts of this and other publications.)

Research Roundup: Understanding How Violence Spreads Across Generations

Violence begets violence, as the saying goes. Recently, researchers have been looking more closely at how violence is passed from one generation to another -- and from adolescence to adulthood -- in order to understand more about breaking the cycle.

Individual and family risk factors influence intergenerational psychological violence

Four researchers at Iowa State University’s Department of Human Development and Family Studies collected data from individuals and their partners participating in both the Iowa Youth and Families Project and Family Transitions Project. They focused on three time points—adolescence (14-18), emerging adulthood (19-23), and adulthood (27-31)—to understand how children of violent families grow up to form violent families of their own.

The authors contend that previous similar studies have not accounted for individual and family behaviors experienced during adolescence. Their new research assesses individual risk factors (substance use, sexual activity, low self-esteem, etc.) and family risk factors (psychological violence, family stress over income, etc.) during adolescence, and psychological violence in older ages.

Their findings include:

  • Adolescents whose parents directed psychological violence towards them were more likely to experience or perpetrate later intimate partner violence.
  • Family stressors, such as economic pressure and parental mental health problems, were not associated with intimate partner violence in emerging adulthood, but they were in adulthood.

The authors suggest creating programs that reduce family stress and violent behaviors in the family of origin.

Focusing on verbal and physical violence in adolescence is critical

Research on verbal and physical violence reveals somewhat different findings. Ming Cui, Melissa Gordon, Koji Ueno, and Frank Fincham wanted to know whether adolescents who experience or perpetrate this type of intimate partner violence are more likely than their peers to endure and perpetrate it when they become young adults. Using data from the National Longitudinal Study of Adolescent Health, the researchers followed participants from seventh grade into their mid-30s, examining the degree of violence in their adult and childhood relationships.

They found that:

  • Experiencing violence from intimate partners as an adolescent was a significant predictor of becoming a victim of violence once again in young adult relationships.
  • Adolescent intimate partner violence also significantly predicted future violent behavior during young adult relationships.

Cui and her colleagues recommend that youth workers create interventions promoting healthy adolescent relationships for young people in order to curb the continuum of violence that may be triggered by adolescent intimate partner violence.

Addressing emotional regulation as a result of traumatic experiences to address intergenerational violence

Judith Siegel from the Silver School of Social Work at New York University provides an overview of neuroscience research on the inability to process and control one’s emotions. She describes how children’s exposure to traumatic experiences can result in so-called “emotional dysregulation,” which in turn can lead to later intimate partner violence as well as substance use or psychiatric problems.

Siegel writes that emotional dysregulation may manifest in children as angry outbursts or aggression, but also as less-apparent, dissociative behavior, leaving  trauma symptoms unrecognized and untreated.

For programs that prevent and respond to family violence, Siegel recommends applying evidence-based models that work in the treatment of trauma-related disorders, including Dialectical Behavior Therapy, Mindfulness-Based Cognitive Therapy, and Emotion-Focused Therapy. Treatments should strengthen security and improve family emotional regulation, with particular attention to children who internalize their distress.

Read the articles

Understanding Adolescent and Family Influences on Intimate Partner Psychological Violence During Emerging Adulthood and Adulthood (abstract). Brenda Lohman, Tricia Neppl, Jennifer Senia, and Thomas Schofield. ) Journal of Youth and Adolescence, Vol. 42, No. 4, April 2013.

The Continuation of Intimate Partner Violence From Adolescence to Young Adulthood (abstract). Ming Cui, Melissa Gordon, Koji Ueno, and Frank Fincham. Journal of Marriage and Family, Vol. 75, No. 2, April 2013.

Breaking the Links in Intergenerational Violence: An Emotional Regulation Perspective (abstract). Judith Siegel. ). Family Process, Vol. 52, No. 2, June 2013.

NCFY Reads: Paul Tough's "How Children Succeed"

"How Children Succeed: Grit, Curiosity and the Hidden Power of Character"

by Paul Tough

Journalist and father Paul Tough explores various studies and school settings to figure out what children need to succeed and how adults can help them.

Why do some children do well and others not? Many adults believe young people will succeed in life if they learn all that they can from school books, test well and get good grades. In “How Children Succeed: Grit, Curiosity and the Hidden Power of Character,” Paul Tough challenges that assumption, arguing that other factors, like young people’s ability to regulate their emotions and behavior, their curiosity and their perseverance play a role in how successful they become.

Though much of Tough’s book focuses on school-based programs, his investigation of the importance of personal characteristics and resilience will resonate with anyone working to prepare youth for adulthood. And from the science of stress to successful school structures, there is much to support Tough’s claims.

He starts his investigation by looking at the causes of failure. Mining findings from the Adverse Childhood Experiences Study, known as ACES, Tough explains the impact negative experiences in childhood and adolescence, such as physical abuse and neglect, can have on educational and health outcomes in adulthood. The study is based on the questionnaires of more than 17,000 adults enrolled in the Kaiser HMO  in the 1990s. Those adults received a score based on their answers and the higher the ACE score the lower the chances the person had enough resilience and support from adults to handle difficult situations. And without those positive factors, children are more likely to misbehave in the classroom and to have impaired social skills and an inability to concentrate. To get these young people back on track, Tough argues, we need to nurture their social and emotional skills.

Tough finds the ingredients for success at academic programs that aim to build the ability to think, learn and excel. He highlights two such programs, Tools of the Mind and the KIPP Academies model. With long-term success in mind, Tools of the Mind teaches Pre-K and kindergarten students to stay focused, manage their feelings and control their impulses, among other things.

“The founders of Tools of the Mind believe that these skills, which they group together under the rubric of self regulation, will do more to lead to positive outcomes for their students, in first grade and beyond, than the traditional menu of pre-academic skills,” Tough writes.

Similarly, the curriculum at KIPP Academies mixes academics with lessons in character and resilience for middle and high school students. These are skills founder David Levin found helped his students succeed in college. Students are even evaluated on character development.

Through it all, Tough weaves in stories from people who personify the statistics and processes, like 16-year-old Thomas “Mush” Gaston, who was involved in a Chicago gang, was disruptive in high school and had a long history of exposure to violence. Or Elizabeth Spiegel’s work teaching chess to sixth graders in Brooklyn.

While Tough doesn’t offer many concrete action steps, “How Children Succeed” presents a compelling way to think about, and approach, success.

Q&A: Jessica Nunan of Caminar Latino on Listening to and Empowering Youth Affected by Domestic Violence

Since its founding more than two decades ago, Atlanta domestic violence support center Caminar Latino has taken its cues from the women who come there for help. For mothers escaping domestic violence, the health and well-being of their children ranks high on the list of priorities. So in 1993, the organization launched comprehensive services for children of survivors. Among the offerings are therapy groups in which young people who’ve witnessed domestic violence can talk about anything on their minds.

Executive Director Jessica Nunan helps facilitate the groups. She talked to us about the roles listening, resilience and youth empowerment play in the therapy sessions.  

NCFY: How does it help these young people to talk in a group of their peers?

Nunan: Especially with the older kids, we want them to understand that this is their space, their place to talk about stuff. It doesn’t even have to be what’s happening at home. And we’re also confidential—what’s said in here stays in here. The kids respond to that but [at the beginning] they don’t know whether they can trust us. For the first week or two they kind of just listen. They see how I or the other facilitators react to the others, and when they see that we listen and want a conversation, they’re more likely to stay engaged. A lot of the kids, no one ever sits down with them and tells them what a healthy relationship is. They may know that their mom being abused is wrong, but they might not have a better model.

NCFY: What do kids with this kind of traumatic experience need from an advocate or therapeutic group?

Nunan: In Latino culture there’s a notion of pobrecito: “You poor thing.” They might hear, “Oh of course you get bad grades because of all you’ve been through.” It sets them up for failure, so we don’t do that. Instead, we focus on resiliency: “Look at how incredible you’ve done, how capable you are in spite of what’s going on at home.” We’ve seen more of a positive response and they feel a lot better about themselves that way.

[Without that], they often have a hard time being able to deal with any kind of conflict, or being able to handle their anger and frustration. Especially the younger kids will start complaining about stomachaches, headaches, inability to sleep. They don’t have a way to deal with the stress that they’re experiencing. And the longer you ignore it, the more susceptible they are to continue the cycle of violence.

We demand a six-month commitment from our volunteer group leaders because the most important thing is that the kids feel comfortable and trust you. That’s when they become much more willing to talk about what’s going on at home.

NCFY: What should youth and family services workers know about this population?

Nunan: The biggest thing is giving the kids credit. We have a group of adolescents who did their own research about the best ways to respond to domestic violence. These were kids who weren’t doing very well in school, but they partnered with a local university and shared their findings at national conferences. Now that research has been incorporated into police trainings and used by interpreters. Don’t shortchange these kids. The more you keep them involved, the more you ask them, “How can we improve this?” the more effective you will be.

Caminar Latino is a member of the National Latin@ Network coordinated by Family and Youth Services Bureau grantee Casa de Esperanza. Read about Caminar Latino’s work with one domestic violence survivor, and learn more about FYSB’s Family Violence Prevention and Services Program.

Access This Online Toolkit to Help Your Community Stop Bullying

National Bullying Prevention Month may be over, but it's always a good time to talk about bullying and how it affects those around you. Family and youth workers can unite communities against bullying all year with an online toolkit published by the Health Resources and Services Administration.

The Community Action Toolkit (PDF, 3.4MB) lays out the steps for planning an anti-bullying event, engaging stakeholders and finding local and federal funders. Users can print out a sample event agenda complete with talking points, or customize an action planning matrix to help them brainstorm and assign tasks.

Family and youth workers may be particularly interested in the cautionary section on bullying and suicide, which are often linked in the press without any conversation about the role of mental health. Anti-bullying advocates can help educate the media and the public about the complexity of the issue by:

Learn more about the Community Action Toolkit, and best practices for bullying prevention and response, by checking out this archived presentation. Prefer to read it yourself? Access the  PowerPoint presentation and speaker notes (PPT, 5.4MB) used in the presentation on

Partnership for Freedom Offers $1.8 Million for Innovative Ways to Help Trafficking Survivors

Following the release of its new guidance for working with trafficked youth, the Administration for Children & Families has announced a new contest to develop creative solutions for trafficking survivors.

Reimagine: Opportunity is the first of three competitions sponsored by Partnership for Freedom, a public-private partnership made up of the Departments of Justice, Health and Human Services and Housing and Urban Development, along with peace-building foundation Humanity United. The contest encourages members of the anti-trafficking community to suggest new ideas for sustainable housing, economic empowerment and social services for survivors. Up to three organizations will receive grant awards totaling $1.8 million.

Here are some things to consider if you're interested in applying:

  • Submissions must focus on domestic, rather than international, solutions. Because the contest aims to build support for trafficking victims in the United States, the judging panel will only consider ideas that can be implemented here.
  • Solutions should be innovative and bold, but also “doable.” Successful applications will include groundbreaking, yet feasible ideas that clearly demonstrate how they will improve quality of life for survivors. Submissions that discuss methods for collecting and sharing data with the field will receive additional consideration.
  • There are multiple stages to the application process. Contest participants must email their six-page initial applications to Partnership for Freedom by 6 p.m. PST on November 17th. Finalists will be asked to attend a four-day innovation workshop and submit a second application before the winners are announced in March 2014. 

Learn more and request an application on the Partnership for Freedom website.

Watch This Online Training to Learn More About the New Health Insurance Marketplace

Want to help youth and families understand how to get insurance through the new Health insurance Marketplace, authorized by the Affordable Care Act and launched by the federal government on October 1? An online training from the Centers for Medicare and Medicaid Services can give you the information you need to explain the benefits of the marketplace.

We watched the video (embedded below, so you can watch it, too), and here are a few of the things we learned:

  • The marketplace enables people to compare plans. Insurance plans listed in the marketplace must cover certain “essential health benefits” across 10 categories, including preventive and wellness services, mental health and substance use disorders, and maternity and newborn care.
  • People can choose different types of coverage. Marketplace plans fall into one of four categories, with differing levels of cost when it comes to premiums and deductibles. Young people under age 30 and those who cannot afford regular coverage can purchase lower-priced catastrophic plans that cover basic preventive services but have higher deductibles.
  • More people may now qualify for Medicaid. Part of the Affordable Care Act lets states expand Medicaid eligibility. Not every state has taken advantage of the option, but the new marketplace streamlines the process by reducing the amount of paperwork needed for eligibility and enrollment. Coverage will also be easier to renew from year-to-year, unless an applicant has been flagged by an agency for additional review.

In addition to learning about the marketplace, you may want to connect youth and families to local navigators and application counselors or to the marketplace’s toll-free, 24-hour-a-day hotline.

Q&A: Katherine TePas of Alaska’s Choose Respect Campaign

This is the first in a series of articles for National Domestic Violence Awareness Month, highlighting statewide efforts to combat family and sexual violence.

The biggest state in the union, Alaska has a domestic violence rate to match its size: a recent survey found that 58.6 percent of Alaska women had experienced domestic or sexual abuse in their lifetimes, more than twice the national rate.

Katherine TePas is the head of Choose Respect, a governor’s initiative that spearheads efforts to stop domestic violence, strengthen families and protect children. TePas’s job has included everything from talking to constituents, creating an anti-violence curriculum for young teens, advising the governor on policy, and sending out thrice-yearly resource packets to a growing number of civilian leaders in Alaska’s many far-flung rural towns. For the past several years, Choose Respect also has inspired over 150 Alaska communities to call attention to the issue of domestic violence at marches and rallies held the last Thursday in March.

TePas spoke to NCFY about promoting respect, educating community members and working with the criminal justice system.

NCFY: What is the main issue that Choose Respect was created to address in Alaska?

TePas: We’re trying to change the social norms. Trying to bring back the norm of respect, and valuing human life and dignity. I say “bring back” because when I work with our native populations, every single one of their traditional beliefs includes respect.

It takes time to accomplish this, so keeping people involved over the long haul is so important. We’re trying to create a sense of urgency for everyone in the state around domestic violence: “We need you, you can do something about this.”

And actual service delivery is one of our biggest challenges. We have to increase offender accountability, increase self-reporting and bystander intervention.

NCFY: How do your resource boxes and the March events achieve these goals?

TePas: We have a lot of resources in our larger hub communities, but if we’re just engaging in our urban centers, we’re not engaging all Alaskans.

Inspired by Community Cafes, a popular model for guided conversations that strengthen families, we developed a toolkit to help communities have a dialogue around domestic violence and protective factors. The resource boxes include that toolkit, as well as books, brochures, signs and information for “positive parenting.”

The March event is just a way to bring all these ideas together in public. We chose the last Thursday so it can lead into April, which is sexual abuse awareness month and child abuse awareness month. And the state legislature is in session by then, so it gives legislators a chance to participate in Juneau.

NCFY: What do you hear from constituents who contact the Choose Respect office?

TePas: Many of the concerns they express have to do with the criminal justice system. In Alaska we have numerous remote communities with zero law enforcement present, for example. Troopers are stationed in one hub community and may serve more than 50 surrounding communities, and they often have to fly or take a snow machine to respond—plus deal with the weather. So from these conversations, we’ve increased our number of Village Public Safety Officers. We went from having 47 officers in the state to now having almost 100.

Several of our recent crime bills included language based on conversations with constituents as well, things like changing “prostitution” to “sex trafficking” and putting more emphasis on victims’ rights. We can’t yet have a domestic violence advocate in every community, but Choose Respect is a way for local voices to be heard, get help and make a difference.

Primary Sources: How Are Young People Affected by Their Mothers' Mental Health?

The Role of Child Gender, Problem Behaviors, and the Family Environment on Maternal Depressive Symptoms: Findings From Mothers of Substance Abusing Runaway Adolescents” (abstract). Journal of Community Psychology Vol. 39, No. 7 (September 2011).

What it's about: The authors of this article wanted to know how a mother's (or other female caregiver's) depression influences her teen's behavior problems. The researchers measured symptoms of depression among the mothers or primary caregivers of 137 substance-abusing adolescents. At the same time, the researchers assessed caregivers’ perceptions of the family environment and the child's problem behavior.

Why read it: It goes without saying: Every young person is a product of his or her family. Youth and family service professionals may find that the results of this study confirm their own observations about the interplay between young people's behavior and conditions at home.

Biggest take away for family and youth workers: Ultimately, a more cohesive family environment meant caregivers were less likely to have symptoms of depression. Their children also had fewer behavior problems. Other observations from the study included the following:

  • Both boys and girls with highly depressed caregivers were more likely to act out than to withdraw.
  • Girls with depressed caregivers were more likely than boys to also experience depression. 
  • Boys were more likely to act out if their family environments were chaotic and less likely if their families were more cohesive.

Based on these results, programs that work with runaway and homeless youth should consider family cohesion, as well as conflict, when determining the best strategy for safely placing and treating youth.

Additional reference: Screening and assessment tools used by the researchers included Beck's Depression Inventory (PDF, 17KB), the Family Environment Scale, and the Child Behavior Checklist (PDF, 39KB).

(Publications discussed here do not necessarily reflect the views of NCFY, FYSB or the Administration for Children and Families. Go to the NCFY literature database for abstracts of this and other publications.)


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