While few studies have identified predictors of exiting homelessness among adults, even fewer studies have attempted to identify these predictors among homeless youth. The current study explored predictors of change in homelessness among 180 homeless youth between the ages of 14 and 22, recruited through an urban drop-in center. All youth were assessed at baseline, 3 and 6 months. The sample included 118 males and the reported ethnicity included Latino (n = 54), Anglo (n = 73), Native American (n = 24), African American (n = 6) and mixed ethnicity or "other" (n = 23). Four distinct patterns of change in homelessness were identified among youth which included those who (1) had fairly low rates of homelessness at each follow-up point, (2) started in the mid-range of homelessness, increased at 3 months and sharply declined at 6-months (MHL), (3) reported high rates of homelessness at baseline and low rates at each follow-up point (HLL), and finally, (4) remained consistently homeless across time (HMH). These patterns of change were most strongly predicted by social connections and engagement in HIV risk behaviors. The findings from this study suggest that developing trust and linkages between homeless youth and service providers may be a more powerful immediate target of intervention than targeting child abuse issues, substance use and mental health problems.

Treatment engagement and retention is a significant challenge for those who serve adolescent substance abusers. Homeless youth are considered especially challenging to engage and maintain in intervention efforts given their lack of residence and range of associated problems. This study examined predictors of treatment attendance and its impact on substance use outcome among a sample of substance abusing homeless youth (n = 133). Stepwise regression results indicated that a history of sexual abuse and suicide attempts were the two strongest predictors of the treatment attendance rate, higher attendance among those with these histories. Youths who attended greater than 6 treatment sessions showed a significant reduction in alcohol use at post-treatment, but attendance rates did not impact other substance use. Identifying predictors of treatment attendance among this subgroup of adolescents is vital given that much research suggests that treatment attendance alone is associated with better short and long term outcomes.