Understanding Burnout in Child and Youth Care Workers

Burnout is a major concern in human service occupations as it has been linked to turnover, absenteeism, a reduction in the quality of services, numerous physical and psychological disorders, and a disruption in interpersonal relations (Maslach et al. 2001). Child and youth care workers are especially susceptible to burnout as the inherent challenges of working within the life-space of high-risk children and youth causes difficulties in attracting and retaining qualified employees. In the present study, burnout was measured in a group of 94 child and youth care workers from 8 agencies in a Western Canadian city using the three dimensional model of the Maslach Burnout Inventory (MBI). The MBI conceptualizes burnout as emotional exhaustion, depersonalization, and a lack of a sense of personal accomplishment. Among these child and youth care workers each of the three dimensions of burnout was predicted by a combination of work environment, personality, and social support.     

Positive and Negative Childhood and Adolescent Identity Memories Stemming from One’s Country and Culture-of-origin: A Comparative Narrative Analysis

The initial cognitive ability to coordinate experience into a hierarchically organized, multi-episode narrative occurs in youth, beginning a narrative record of ego identity development that continues throughout the life span (Habermas and Bluck in Psychological Bulletin 126:748–769, 2000; Habermas and de Silveira in Developmental Psychology 44:707–721, 2008). The following case studies explore how two high-functioning women integrate potentially conflicting bicultural identity expectations in adulthood by causally connecting identity memories stemming in youth from their country and culture-of-origin to their current life values and structures. It is hypothesized that the co-constructivist nature of meaning-making, described by Erikson (Insight and responsibility. Norton, New York, 1964; Identity and the life cycle. W.W. Norton & Co., New York, 1980) as the ego, personal and socio-organismic features of ego synthesis, includes inter-related factors of personal and cultural others which affect both individual and future generational bicultural identity integration.     

Models to Guide System Reform for At-Risk Youth

Policy reform for at-risk youth is complicated by involvement of various service sectors. Issues related to coordinating systems of care in a dynamic policy environment are not new, but surprisingly little has been written to guide practitioners and policymakers in addressing them (Friedman in Journal of Emotional and Behavioral Disorders 11:11–18, 2003). To that end, a social worker, community psychologist, and nurse, working as part of a multidisciplinary team reviewed the practice literature on models to guide policy reform in justice and behavioral health systems. Five models are presented to assist community practitioners assessing similar policy reform.     

The Impact of Age and Type of Intervention on Youth Violent Behaviors

This study compared the impact of the Aban Aya Youth Project (AAYP; Archives of Pediatric and Adolescent Medicine 158: 377–384, 2004) social development classroom curriculum (SDC), school/family/community (SC) intervention curriculum, and a health enhancement curriculum (HEC) attention placebo control on changes over time in violent behaviors among participating youth. Grade 5 pretest and grades 5–8 posttest data were used to investigate the possibility of differential intervention effects, especially the extent to which the SDC and SC interventions were differentially efficacious across age. Unlike most previous investigations of AAYP intervention effects, this study included youth who joined the study after baseline data collection in the outcome analyses. Findings indicated that, regardless of age level, the SDC limited the growth of violence of participating students when compared to students in the control condition. In the SC, however, reduction in the growth of violence emerged only among older participants. Importantly, this included joiners who received less exposure to the intervention. Findings for the SDC are consistent with recent meta-analyses of school based programs, whereas SC findings suggest that violence prevention curricula alone are not sufficient for highly mobile students and that interventions for such populations need to engage multiple social ecological systems. Editors’ Strategic Implications: The authors present promising violence prevention findings, and they also provide important answers to dosage and developmental timing questions with their analyses of these longitudinal data.     

Conceptual Application of the Discrimination Model of Clinical Supervision for Direct Care Workers in Adolescent Residential Treatment Settings

This article applies the tenets of Bernard’s in Counselor Edu Supervision 19:60–68, (1979) discrimination model of clinical supervision to the supervision needs of those who provide direct care to adolescents in residential treatment due to abuse, neglect, behavioral, or emotional problems. The article focuses on three areas (intentionality, flexibility, and professionalism) in which the model may be particularly effective in meeting the needs of youth care workers serving adolescents in residential treatment in the United States.     

Continuing the Discussion: A Commentary on “Wilderness Therapy: Ethical Considerations for Mental Health Professionals”

Wilderness therapy programs continue to be a possible treatment modality for at-risk youth who require out-of-home care. Issues associated with wilderness therapy also continue to be a spirited topic with professionals in the field and the general public. This commentary will add additional considerations, and continue the discussion concerning wilderness therapy not addressed in the Becker (Child Youth Care Forum, doi. , 2010 this issue) article. Issues related to cost, safety of clients, effectiveness of programs and proper training of staff will be discussed. Ethical issues faced by mental health providers working with wilderness therapy programs, as discussed in Becker’s article, will also be reviewed.     

Sexual Identity and Sexual Well-Being in Female Heterosexual University Students

Sexual identity has generally been studied with a focus on sexual orientation and has not incorporated a general identity framework. Low levels of identity exploration and commitment have been shown to predict poor well-being in adolescents, but the relationship between sexual identity and sexual well-being has not been examined. The current cross-sectional survey was administered to 293 heterosexual female undergraduate students from a mid-sized university in Ontario, Canada. Participants completed the Measure of Sexual Identity Exploration and Commitment (Worthington, Navarro, Savoy, & Hampton, 2008), as well as several measures to assess sexual well-being. These included the Sexuality Scale (Snell & Papini, 1989), the Sexual Awareness Questionnaire (Snell, Fisher, & Miller, 1991), the Body Esteem Scale for Adolescents and Adults (Mendelson, Mendelson, & White, 2001; Mendelson, White, & Mendelson, 1997), and four individual items assessing sexual satisfaction (Laumann et al., 2006). Confirmatory factor analysis was used to test the measurement models of sexual identity and sexual well-being, and structural equation modeling was used to examine the relationship between sexual identity and sexual well-being. Results indicated that higher levels of sexual identity exploration and commitment predicted sexual well-being. However, other aspects of sexual identity, such as synthesis and sexual orientation identity, were not predictive of sexual well-being. The implications of using an identity framework for measuring sexual identity are discussed.     

Struggles,strengths, and strategies: an ethnographic study exploring the experiences of adolescents living with an ostomy

Background  

Adolescents with IBD requiring ostomy surgery experience perioperative needs that may exceed those of patients experiencing other major abdominal surgery [1]. This procedure requires ongoing and vigilant daily care and management. Gastrointestinal symptoms and complications impose psychological and social stresses on young patients [2], and the procedure results in body image changes and daily regimens of self-care. This study aimed to explore adolescents' experiences and quality of life following ostomy surgery.     

Health technology assessment (HTA): ethical aspects

“HTA is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused, and seek to achieve best value” (EUnetHTA 2007). Even though the assessment of ethical aspects of a health technology is listed as one of the objectives of a HTA process, in practice, the integration of these dimensions into reports remains limited. The article is focused on four points: 1. the HTA concept; 2. the difficult HTA-ethics relationship; 3. the ethical issues in HTA; 4. the methods for integrating ethical analysis into HTA.     

The Utility of Clinicians Ratings of Anxiety Using the Pediatric Anxiety Rating Scale (PARS)

Clinician ratings of anxiety hold the promise of clarifying discrepancies often found between child and parent reports of anxiety. The Pediatric Anxiety Rating Scale (PARS) is a clinician-administered instrument that assesses the frequency, severity, and impairment of common pediatric anxiety disorders and has been used as a primary outcome measure in several landmark treatment trials. However, no data on nonanxious youth have been published. The purpose of this study was to address this gap by examining clinician’s ratings of anxiety on the PARS in a volunteer sample of youth without anxiety disorders (n = 84; ages 7–12; 51% female, 75% Caucasian). The nonanxious sample was comprised of youth with (At-risk; n = 36) and without (Healthy; n = 48) anxious parents. Data were also used to evaluate the reliability (i.e., internal consistency), convergent, and divergent validity of the clinician-rated PARS. In addition, a receiver operating curve analysis was used to determine optimum cut off scores indicative of clinical levels of anxiety by comparing PARS scores between these nonanxious youth and a clinically anxious sample (n = 77) randomized in the Research Units of Pediatric Psychopharmacology (RUPP) anxiety study (RUPP 2001). Results indicated that anxious and nonanxious youth were significantly different on all PARS severity items. Optimum cutoff scores of 11.5 (5-item total score) and 17.5 (7-item total score) discriminated youth with and without anxiety disorders. Cronbach alphas for the Healthy and At-risk sample were .90 and .91 and .75 and .81 for the 5- and 7-item total PARS scores respectively, supporting the measure’s internal consistency among nonanxious youth. PARS total scores were positively correlated with other measures of anxiety (i.e., the Screen for Child Anxiety Related Emotional Disorders) for the At-risk but not Healthy subsample. PARS scores were not significantly correlated with depressive symptoms (i.e., Children’s Depression Inventory). Overall, findings support the utility of clinician’s assessments of anxiety symptoms for nonanxious youth. Using the PARS can help facilitate determining whether a child’s anxiety level is more similar to those with or without an anxiety disorder.     

Exploring the Impact of Racism on Black Youth: A Multidimensional Examination of Discriminatory Experiences Across Place and Time

PurposeCommunity violence disproportionally impacts Black youth. Experiences of racism and discrimination may create additional challenges for youth recovering from violence exposure. This study used ecological momentary assessment to elucidate how perceptions of racism and social support influence health and safety outcomes among Black youth following violence exposure.MethodsTwenty-five Black youth (14–19 years old, 60% female) who had witnessed violence within the past three months completed a baseline survey that assessed discrimination experiences, social support, post-traumatic stress symptoms (PTS), and perceived safety. Youth completed ecological momentary assessments three times daily for two weeks about the place they were in, people they were with, their current emotional state, and in-the-moment racism perceptions. Multilevel models estimated the relationship between overall and time-varying perceptions of racism and social support, PTS symptoms, and perceived safety.ResultsOverall, 76% of youth reported at least one discrimination experience at baseline. Prior discrimination was associated with higher PTS (B = 1.86, p = .001) and depressive symptoms (B = 0.13, p = .013) at baseline. Youth who reported higher overall perceptions of racism in-the-moment reported higher PTS (B = 0.50, p = .002) and lower perceived safety (B = ?0.53, p = .001). In-the-moment perceptions of racism were associated with lower perceived safety in that place (B = ?0.09, p < .01). Emotional and instrumental support were associated with lower PTS and higher perceived safety (p < .05).DiscussionExperiences of racism and being in discriminatory places impacted youth’s depressive symptoms, PTS symptoms, and perceived safety. Interventions attuned to in-the-moment experiences of racism, and that leverage social support, are needed to support Black youth exposed to violence and discrimination.     

Inclusion and its implementation: Youth workers' perspectives on an experimental social–business initiative for ‘at-risk’ youth in Israeli community centres

Abstract

This paper presents the perspectives of youth workers on an experimental social-business initiative programme designed to bring about the inclusion of ‘at-risk’ youth in community centres. The programme was implemented in three community centres that are part of a nationwide organization of community centres which provide social–educational–cultural activities for the general population within the community. The uniqueness of the programme lies in its effort to integrate ‘at-risk’ youth into universal and unstigmatized, structured leisure activities. The sample included all the youth counsellors implementing the programme. The paper describes the inclusion of the youth from their selection and recruitment to the programme, through their introduction into the community centres, and during the processes associated with the implementation of the programme. The findings indicate the challenges and difficulties that arise in implementing an inclusive programme, the importance of the counsellors in implementing the programme and the relationship between the youth and the centre's staff members. Finally, operational conclusions are presented and discussed.     

Effects of the Communities That Care Model in Pennsylvania on Change in Adolescent Risk and Problem Behaviors

Despite the public health burden of adolescent substance use, delinquency, and other problem behavior, few comprehensive models of disseminating evidence-based prevention programs to communities have demonstrated positive youth outcomes at a population level, capacity to maintain program fidelity, and sustainability. We examined whether the Communities That Care (CTC; Hawkins and Catalano 1992) model had a positive impact on risk/protective factors and academic and behavioral outcomes among adolescents in a quasi-experimental effectiveness study. We conducted a longitudinal study of CTC in Pennsylvania utilizing biannual surveillance data collected through anonymous in-school student surveys. We utilized multilevel models to examine CTC impact on change in risk/protective factors, grades, delinquency, and substance use over time. Youth in CTC communities demonstrated less growth in delinquency, but not substance use, than youth in non-CTC communities. Levels of risk factors increased more slowly, and protective factors and academic performance decreased more slowly, among CTC community grade-cohorts that were exposed to evidence-based, universal prevention programs than comparison grade cohorts. Community coalitions can affect adolescent risk and protective behaviors at a population level when evidence-based programs are utilized. CTC represents an effective model for disseminating such programs.     

Mental health of youth orphaned due to AIDS in South Africa: biological and supportive links to caregivers

This research explored the biological and social support relationship between youth orphaned due to AIDS and his/her caregiver to identify protective factors that are related to positive mental health outcomes. These youth have significantly higher levels of depression, anxiety, and post-traumatic stress (PTS) symptoms compared to those orphaned due to other causes and non-orphans. Using a 2009 cross-sectional data-set from South Africa, 254 youth orphaned due to AIDS were purposively selected from the overall sample of 732 to further examine this caregiver relationship. Caregiver relation was analyzed in several combinations to determine if it was significantly related to mental health outcomes, with only anxiety showing significance. Those living with a biological parent had significantly higher anxiety symptoms than those living with a grandparent, other kin, or non-kin. Anxiety was also significantly related to an increased age, lower levels of emotional support, and lower levels of instrumental/financial support (R² = .153). Age was the only significant variable from the model that was related to depression symptoms (R² = .111). PTS symptoms were related to increases in age, lower levels of emotional support, instrumental/financial support, and satisfaction with the caregiver (R² = .194). Gender and age were related to suicidal tendencies, specifically boys were 2.26 times more likely to exhibit suicidal tendencies compared to girls, and every yearly increase in age results in the youth being 1.22 times more likely to exhibit suicidal tendencies. Strengthening the caregiver’s ability to provide social support for the child is critical, irrespective of any biological kin relationship.     

A Social Capital Approach to Identifying Correlates of Perceived Social Support Among Homeless Youth

Background

The ability of homeless youth to accumulate resources through their personal relationships with others (i.e. social capital) is often associated with improved outcomes across multiple domains. Despite growing evidence documenting the heterogeneity of homeless youths’ relationships, many youth still experience adversities or lack access to resources. Thus, a more comprehensive investigation of homeless youths’ sources of social capital and the factors associated with these networks is needed.

Objective

This current study aimed: (1) to delineate the composition of social support networks of homeless youth and (2) to identify salient correlates of these different sources of social support.

Methods

A sample of 1046 youth, ages 13–24, were recruited from three homeless youth drop-in-centers. Youth completed a computerized self-administered survey and a social network interview. Multivariate logistic regression analyses were conducted to examine whether youths’ homelessness backgrounds, victimization experiences, and risky behaviors were associated with different emotional and instrumental forms of social capital.

Results

Overall rates of homeless youths’ social support from all sources were low. Rates of emotional support were greater than instrumental support, with youth with histories of physical abuse, street victimization, and foster care reporting more emotional support from some sources. Street victimized youth were significantly more likely to report having emotional and instrumental support from all sources of capital.

Conclusion

Findings suggest the need for careful consideration of youths’ support systems when providing services to homeless youth. Specifically, it may be important to assess the common supports utilized by youth in order to maximize youths’ social networks.

     

Natural Language Processing Insight into LGBTQ+ Youth Mental Health During the COVID-19 Pandemic: Longitudinal Content Analysis of Anxiety-Provoking Topics and Trends in Emotion in LGBTeens Microcommunity Subreddit

BackgroundWidespread fear surrounding COVID-19, coupled with physical and social distancing orders, has caused severe adverse mental health outcomes. Little is known, however, about how the COVID-19 crisis has impacted LGBTQ+ youth, who disproportionately experienced a high rate of adverse mental health outcomes before the COVID-19 pandemic.ObjectiveWe aimed to address this knowledge gap by harnessing natural language processing methodologies to investigate the evolution of conversation topics in the most popular subreddit for LGBTQ+ youth.MethodsWe generated a data set of all r/LGBTeens subreddit posts (n=39,389) between January 1, 2020 and February 1, 2021 and analyzed meaningful trends in anxiety, anger, and sadness in the posts. Because the distribution of anxiety before widespread social distancing orders was meaningfully different from the distribution after (P<.001), we employed latent Dirichlet allocation to examine topics that provoked this shift in anxiety.ResultsWe did not find any differences in LGBTQ+ youth anger and sadness before and after government-mandated social distancing; however, anxiety increased significantly (P<.001). Further analysis revealed a list of 10 anxiety-provoking topics discussed during the pandemic: attraction to a friend, coming out, coming out to family, discrimination, education, exploring sexuality, gender pronouns, love and relationship advice, starting a new relationship, and struggling with mental health.ConclusionsDuring the COVID-19 pandemic, LGBTQ+ teens increased their reliance on anonymous discussion forums when discussing anxiety-provoking topics. LGBTQ+ teens likely perceived anonymous forums as safe spaces for discussing lifestyle stressors during COVID-19 disruptions (eg, school closures). The list of prevalent anxiety-provoking topics in LGBTQ+ teens’ anonymous discussions can inform future mental health interventions in LGBTQ+ youth.     

Healthy spaces: Exploring urban Indigenous youth perspectives of social support and health using photovoice

Ongoing injustices perpetrated by colonization and racism have resulted in a disproportionate burden of health disparities among Indigenous peoples, with youth being particularly vulnerable. However, very little is known about the health experiences of Indigenous youth, particularly how they understand and interpret such experiences. In collaboration with an Indigenous-led youth program, this research explored the relationship between social support and health among a unique group of Indigenous youth living in Winnipeg, Canada. Through Photovoice, youth revealed how residential mobility and racism negatively influenced the types of social support and relationships formed, and called for improved access to health-promoting social programs.     

Parent Perceptions of Neighborhood: Relationships with US Youth Physical Activity and Weight Status

Context is important for understanding and making change to improve health outcomes. The purpose of this study was to examine the relationship between parent perceptions of neighborhood and youth aerobic physical activity and weight. This study is a secondary data analysis of 64,076 parents and guardians of children and adolescents (6–17 years) participating in the 2007 National Survey of Children’s Health. Logistic regression models were used to evaluate the relationship between neighborhood characteristics, including constructs for social capital, physical condition, resource availability, and safety, and youth likelihood of meeting healthy standards for physical activity and weight. Neighborhood characteristics, including social capital, resource availability, and safety were significantly associated with increased likelihood of youth achieving healthy physical activity and normal weight parameters even with adjustment for individual and family-level demographic and behavioral characteristics. Findings support neighborhood assessment during behavioral counseling and continued exploration of neighborhood context as a means to positively impact youth physical activity and weight outcomes.     

Non-Erotic Thoughts and Sexual Functioning

This study sought to replicate and extend investigations of current models of sexual dysfunction (Barlow, 2002; Janssen, Everaerd, Spiering, & Janssen, 2000) which implicate factors such as spectatoring, failure to use ameliorative strategies, and information processing biases in the development and persistence of sexual difficulties. A sample of 165 (n = 71 men) undergraduates completed measures of sexual dysfunction and relationship satisfaction, and reported on the content and frequency of non-erotic thoughts during sex with a partner (i.e., spectatoring), the emotional impact of non-erotic thoughts, and the strategies used to manage them. They also reported on their main sexual functioning difficulties and the strategies they used to manage those difficulties. Finally, participants were presented with a series of hypothetical sexual scenarios and were asked to report their immediate interpretation of events in the scenario. The content of non-erotic thoughts was similar to previous work (Purdon & Holdaway, 2006), although gender differences in thought content were less pronounced. As in previous research, greater frequency of, and anxiety evoked by, non-erotic thoughts was associated with poorer sexual functioning, but we found that this was over and above relationship satisfaction. Participants both high and low in sexual functioning reported using a variety of strategies to manage their non-erotic thoughts, thought suppression being the least effective, and also used a variety of strategies to manage sexual difficulties. Poorer sexual functioning was associated with more negative interpretations of ambiguous sexual scenarios, but this was mediated by relationship satisfaction. However, positive interpretations were predicted by sexual functioning. Results were discussed in terms of their theoretical and clinical implications.