Treating Homeless Young People Produces Results

January 2007 - Innovative new research to establish the best ways of engaging with homeless young people who are without parents or carers has found that a comprehensive intervention program can dramatically improve their mental health and life circumstances.

The six-month study by Natasha Slesnick and Michael Glassman, both associate professors of human development and family science at Ohio State University, together with Jillian Prestopnik and Robert Meyers of the University of New Mexico appears online and will be published in Addictive Behaviors.

The researchers studied 180 young people aged 14 to 22 who used a drop-in center for homeless youth in Albuquerque between 2001 and 2005. They found that compared to participants offered standard intervention, those completing an intensive "Community Reinforcement Approach" (CRA) program had significantly reduced levels of substance abuse and depression and increased social stability, measured by the number of days living off the streets, in education or work, or receiving medical care.

Natasha Slesnick, lead author of the study said:

"Homeless youth are often seen as difficult to engage and difficult to treat, but what this study shows is that we can be successful in helping a group that is often seen as unreachable. We can successfully reduce their alcohol and drug use, and improve their social stability and psychological functioning."

All the participants completed questionnaires to establish levels of drug use, social stability and depression. About half were assigned to standard treatment involving food, rest and the opportunity to engage with case managers who could refer them to other appropriate services.

The remainder were offered the CRA program involving 12 individual therapy sessions and four HIV education/skills practice sessions. The approach acknowledged the particular circumstances of homelessness. For example, participants could arrive without an appointment and wait in a safe setting if their counsellor was unavailable. The initial aim was to stabilize their situation and help them address basic needs. Sessions then sought to clarify goals that participants identified as priorities with an emphasis on coping, skills development and problem solving.

Natasha Slesnick commented:

"The youth then had to apply these skills in the real world, maintain those skills, and see how they could improve their own situation."

Participants were tested three months and six months after beginning treatment. Both groups showed improvements after six months but those in the CRA program did significantly better. This intensive intervention produced a 37 per cent reduction in substance abuse, compared to a 17 per cent reduction for those offered standard support. Depression scores fell by 40 per cent for those in CRA compared to 23 per cent for the others. CRA participants demonstrated a 58 per cent increase in social stability, compared to only 13 per cent for those in the standard group.

Other research confirms that the cost of such programs is considerably less than keeping young people in the criminal justice system, a likely alternative destination. One Colorado study found it cost about US$5887 to permanently move a homeless young person off the streets, compared to US$53 665 to maintain a youth in the criminal justice system for a year.

Natasha Slesnick said:

"While the CRA program was successful, I think what we do in treatment is less important than the process. The content is not as important as having these teens come in and talk to a therapist and develop a new, positive experience with an adult. That is what they really need."

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