Change in Parent- and Child-Reported Internalizing and Externalizing Behaviors Among Substance Abusing Runaways: The Effects of Family and Individual Treatments

Abstract

Shelter-recruited adolescents are known to have high rates of substance abuse and co-occurring internalizing and externalizing problem behaviors. Many studies have documented these mental health concerns, but only a small number of studies have tested interventions that may be useful for ameliorating these vulnerabilities. The current study compared three empirically supported psychotherapy interventions, Motivational Interviewing (MI), the Community Reinforcement Approach (CRA), and Ecologically-Based Family Therapy (EBFT) with 179 substance abusing runaway adolescents (47% female, 74% minority) and their primary caretaker recruited through a Midwestern runaway crisis shelter. Examining both child and primary caretaker reports, each treatment was associated with significant reductions in internalizing and externalizing behaviors to 24 months post-baseline. However, the trajectory of change differed among the treatments. Adolescents receiving MI showed a quicker reduction in internalizing and externalizing behaviors but also a quicker increase in these behaviors compared to adolescents receiving EBFT, who continued to evidence improvements to 24 months. The findings provide support for continued evaluation of these treatments for use with this vulnerable population of adolescents.

The Relationship Between Caregivers and Youth in Foster Care: Examining the Relationship for Mediation and Moderation Effects on Youth Behaviors

“…Penney and Skilling (2012) found that caregiver's reports of internalizing behaviors were not correlated with clinical diagnoses of mood or depressive disorders. In addition, while there are some evidence-based interventions for mood and anxiety disorders among children (Slesnick, Guo, & Feng, 2013;Tompson, McNeil, Rea & Asarnow, 2000;Uliaszek, Wilson, Mayberry, Cox, & Maslar, 2014), the majority of research regarding evidence-based psychotherapies for children and adolescents focus on externalizing behaviors such as attention-deficit hyperactivity disorder and conduct disorder (Weisz & Kazdin, 2010). This may be because externalizing behaviors "demand" more attention.…”

Family Therapy for Child and Youth Mental Health: A Scoping Literature Review

“…This review identified several studies which compared the effectiveness of family therapy with other interventions for various child and youth mental health diagnoses (Garoff et al, 2012;Horigian et al, 2013;Slesnick, Guo, & Feng, 2013;Trowell et al, 2007). Although the focus of this review is family therapy only, it is important to know how family therapy compares to other interventions in order to ensure ongoing evidence-based practice.…”

Cumulative contextual risk and behavior problems among children with substance using mothers: The mediating role of mothers’ and children’s coping strategies.

“…Fourth, this study relied on self-report measures that may involve some level of response bias. However, some studies have shown that mothers are relatively good at estimating their children’s behavior problems (Phares, 1997), and parent and child reports are generally similar to each other (Slesnick, Guo, & Feng, 2013). Even so, observational data and teacher reports of child behaviors, for example, could strengthen confidence in the conclusions.…”