Jacqueline Sohn, PhD
This brief is posted with permission of the Homeless Hub
“Family” can be comprised and defined differently depending on individual circumstances and cultural contexts.
For example, there are different attachment styles within Indigenous nations and ways of conceptualizing and supporting family. This will determine the nature of supports offered and should be established in consultations with the appropriate services and supports in the community.
WHY IT MATTERS
Research shows the potential for youth at risk of or experiencing homelessness to have better outcomes when their families and/or natural supports are engaged in their lives – when it is safe, possible and appropriate to do so (e.g., Mayock, 2011; McConnell et al., 2016; Morris et al., 2017; Smolkowski, et al., 2017; Valentino, 2017; Write et al., 2017; Gaetz, et al., 2018; Tyler, et al., 2018).
As communities increasingly adopt the Family and Natural Supports approach to supporting youth at risk of or experiencing homeless- ness, they will need to be prepared to support youth in (re)engaging with their families and/or natural supports. This endeavour can be complex and challenging. While research and knowledge about the effectiveness of family and natural supports is emerging, very little has been written about how to facilitate the involvement of family and natural supports and considerations in the process.
This research brief provides key considerations, complexities and op- portunities involved in the process of connecting to family and natural supports for youth at-risk of and experiencing homelessness based on the literature. It is intended to contribute research knowledge to frontline practice in engaging family and natural supports to prevent young people from becoming homeless or transitioning them out of homelessness.
WHAT THE RESEARCH SAYS
In a systematic review of the research on the effectiveness of interven- tions for preventing youth homelessness, Morton et al. (2020) found that the largest evidence base in this area focuses on interventions to address mental health or health risk behaviours that are associated with youth homelessness.
Among studies on evidence-based, family-focused programs, five evaluations demonstrated promising results for youth outcomes in behavioural health and well-being. Ecologically Based Family Therapy (EBFT); Functional Family Therapy (FFT); Support to Reunite, Involve and Value Each (STRIVE); Family Reconnect Program and Home Free are all aligned to Family Systems Theory (Broderick, 1993), which is based on the understanding that family members have a mutually influencing role on each other through their interactions.
The available research focuses on the outcomes of family-focused interventions on particular risk factors for homelessness (such as high-risk behaviours including suicide attempts, substance use and justice involvement), highlighting the potential for engaging family and natural supports in interventions to prevent homelessness (e.g., Milburn et al., 2012; McCallops et al., 2020; Milburn et al., 2020; Wu et al., 2020). However, studies on best practices in these interventions and the long-term effects on young people’s home lives and housing situations are scarce.
Despite these gaps, we can apply insights from these and other family-focused interventions to support evidence-based practice for (re)engaging families and natural supports in preventing youth homeless- ness, in light of the promising evidence on better outcomes for youth well-being.
Following are implementation lessons for frontline practitioners to consider when implementing family intervention approaches, aligned to Family Systems Theory and the aforementioned evidence-based programs (e.g., Mayock et al., 2011; Pergamit et al. 2016).
Trust-building: Thoughtful consideration to and recognition of families’ unique contexts, experiences and situations and how these factors might affect their willingness or capacity to engage as supporters. For example, begin conversations to assure supporters that they will not be blamed, and instead, emphasize their roles as allies.
Critical enablers include:
• A shift in thinking among youth, their families and/or natural supports – from blame, to new interpretations and reframing behaviour in light of relational interpretations and patterns.
• Willingness and motivation to resolve conflicts.
• Developing plans that focus on the interconnected needs of young people and their families/natural supports early on.
Acceptance of roles and responsibilities: youth and their families must be able to understand and acknowledge their own roles in leading to the problem; based on an understanding of family systems principles. A shift to understanding problems as an outcome of interactions must occur.
Joint decision-making: Based on agreed upon goals and boundaries established by youth and their families/natural supports, in collaboration with involved service providers.
Manage expectations: youth, their families and natural supports and frontline practitioners/service providers should expect an extended period of negotiations and compromise with boundaries. They should also anticipate a process that is incremental, fluctuating and challenging.
Frequent and continuous support: the most effective approaches require regular, frequent coach- ing and check-ins from service providers throughout and beyond reunification or (re)engagement with families and/or natural supports.
ABOUT THE RESEARCH BRIEF SERIES
This research brief series was created as part of the efforts of MtS DEMS to build stronger links be- tween research and practice, towards improving program processes and outcomes in preventing youth homelessness. Topics are established based on the identified needs and interests of our Communi- ties of Practice through documentary analysis of meeting minutes, refined based on the literature and confirmed in consultation with members. The research is conducted through a systematic process that is based on a modified scoping review framework (Arksey & O’Malley, 2005). Literature across fields such as prevention, social services, health, and homelessness are included and themes are extracted based on the objectives of the brief.
For more information on the process to
develop the research briefs, please contact
the author at: firstname.lastname@example.org
Phase One of this project is funded in part by the Government of Canada’s Youth Employment and Skills Strategy.
Arksey H. & O’Malley, L. (2005). Scoping studies: Towards a Methodological Framework. Internation- al Journal of Social Research Methodology. Vol.8, 19-32. Doi: 10.1080/1364557032000119616.
Borato, M., Gaetz, S., and McMillan, L. (2020). Family and Natural Supports: A Program Framework. Toronto, ON: Canadian Observatory on Homelessness Press.
Broderick, C. B. (1993). Understanding family process: Basics of family systems theory. Sage Publi- cations, Inc.
Cully, L., Wu, Q. & Slesnick, N. Ecologically Based Family Therapy for Adolescents Who Have Left Home. (2018). In Kidd, S., Slesnick, N., Frederick, N., Karabanow, J. & Gaetz, S. (eds). Mental Health and Addictions Interventions for Youth Experiencing Homelessness: Practical Strategies for Front- Line Practitioners. Toronto, Canada: Canadian Observatory on Homelessness Press. https://www. homelesshub.ca
Gaetz, S., Schwan, K., Redman, M., French, D., & Dej, E. (2018). The Roadmap for the Prevention of Youth Homelessness. A. Buchnea (Ed.). Toronto, ON: Canadian Observatory on Homelessness Press.
Heerde, J. A., & Hemphill, S. A. (2019). Exploration of associations between family and peer risk and protective factors and exposure to physically violent behavior among homeless youth: A meta-analy- sis. Psychology of Violence, 9(5), 491–503. https://doi.org/10.1037/vio0000181
McConnell, E., Birkett, M. ,Mustanski, B. (2016). Families Matter: Social Support and Mental Health Trajectories Among Lesbian, Gay, Bisexual and Transgender Youth. Journal of Adolescent Health, vol.56(6), 674-680.
Milburn, N.G., Klomhaus, A.M., Comulada, W.S. (2020). Reconnecting Homeless Adolescents and Their Families: Correlates of Participation in a Family Intervention. Prev Sci, vol. 21, 1048–1058. https://doi.org/10.1007/s11121-020-01157-9
Milburn, N.G., Iribarren, F., J., Rice, E., Lightfoot, M., Solorio, R., Rotheram-Borus, N.J. (2012). Family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth. Journal of Adolescent Health, vol.50(4), 358-364.
Morris, A., Robinson, L., Hays-Grudo, J., Claussen, A., Hartwig, S., Treat, A. (2017). Targeting Par- enting in Early Childhood: A Public Health Approach to Improve Outcomes for Children Living in Poverty. Child Development, vol. 88(2), 388-397.
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Smolkowski, K., Seeley, J., Gau, J., Dishion, T., Stormshak, E., Moore, K., Falkenstein, C., Forco, G., Garbacz, A., (2017). Effectiveness evaluation of the Positive Family Support intervention: A three- tiered public health delivery model for middle schools. Journal of School Psychology, vol.62, 103-126.
Trout, A.L., Tyler, P.M., Stewart, M.C., Epstein, M.H. (2012). On the way home: Program description and preliminary findings. Children & Youth Services Review, vol.34(6), 1115-1120.
Tyler, K., Schmitz, R., Ray, C. (2018). Role of Social Environmental Protective Factors on Anxiety and Depressive Symptoms Among Midwestern Homeless Youth. Journal of Research on Adolescence. Vol.28(1), 199-210.
Valentino, K. (2017). Relational Interventions for Maltreated Children. Child Development, vol. 88(2), 359-367.
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Wu, Q., Zhang, J., Walsh, L. & Slesnick, N. (2020). Family network satisfaction moderates treatment effects among homeless youth experiencing suicidal ideation. Behaviour Research and Therapy. Vol. 125 https://doi.org/10.1016/j.brat.2019.103548
Wright, E.R., Attell, B.K., Ruel, E. (2017). Social Support Networks and the Mental Health of Run- away and Homeless Youth. Social Sciences. Vol.6(4)