Predicting Youth Improvement in Community-Based Residential Settings with Practices Derived from the Evidence-Base

Abstract

Several of these committee members met with me on multiple occasions to teach me new statistical procedures and ensure that this dissertation was scientifically valid and completed to the best of my abilities. I want to especially thank Dr. Brad Nakamura, my advisor, for his dedication in my development as a scientist. Dr. Nakamura's support, encouragement, and motivation greatly influenced the progress and completion of this dissertation.My sincerest thanks are also given to Hilary Gould, Kaitlin Hill, Priya McLennan, Albert Mah, and Amanda Vincent for their support with edits and consultation. Additionally, I would like to extend my appreciation to the therapists and youth in Hawai'i's Child and Adolescent Mental Health Division, who completed and allowed for the collection of data that comprised my archival analyses. I hope that my analyses will help with large scale quality improvement efforts for Hawai'i's youth mental health system. Lastly, I would like to thank my family and my partner for all of the emotional support that they provided me during this challenging process.

Predicting substance use treatment progress for geographically isolated adolescents in community care.

“…Further, studies should continue to explore novel service modalities for rural families, such as telehealth, and ways to build rural workforce capacity, such as Project ECHO (Extension for Community Healthcare Outcomes; https://hsc.unm.edu/echo/). The finding that both individual and family interventions are significant predictors of youth outcomes, the "multiple PE use approach," is consistent with prior community care research (e.g., Izmirian et al, 2019) and indicates future work is still needed to determine what works for whom and under what constraints. It is imperative that future studies examine community care within geographically isolated settings, to close the gap between research and practice, and improve dissemination and implementation efforts for these residents.…”

“…Despite a large amount of variance occurring on the therapist level, this study found that none of the available therapist variables were significant predictors of improvement. Previous research examining these therapist variables (i.e., professional specialty, degree, licensure status) found similar nonsignificant predictors in the context of significant variance at this level of the model (Izmirian et al, 2019;Wilkie et al, 2018). Other therapist variables might be related to substance use treatment progress, such as theoretical orientation, prior training in and fidelity of evidencebased practices, and the ability to develop an effective therapeutic alliance.…”