Using Life Coaches to Provide Vocational Supports to Emerging Adults

Findings presented on using life coaches to provide vocational supports to emerging adults including statistics, types of services, a curriculum and skills inventory

Treatment Retention Intervention for Emerging Adults in Outpatient Psychotherapy

We developed Motivational Enhancement Therapy (MET) treatment for emerging adults

Testing Whether Multisystemic Therapy for Emerging Adults Can Reduce Their Justice System Involvement

Drs. Maryann Davis of the Transitions to Adulthood Center for Research at the University of Massachusetts Medical School and Ashli Sheidow and Michael McCart of the Oregon Social Learning have previously demonstrated that Multisystemic Therapy for Emerging Adults (MST-EA) is an intervention that successfully engages and retains young adults with serious mental health conditions in treatment. This Research in the Works is about a new trial awarded by NIMH called Effectiveness Trial of Treatment to Reduce Serious Antisocial Behavior in Emerging Adults with Mental Illness. This study builds on Drs. Davis and Sheidow’s previous work and is a randomized controlled trial comparing outcomes of 240 participants assigned to either the MST-EA intervention or enhanced treatment as usual. This study will determine if MST-EA is a more effective treatment than the enhanced usual treatment for this population. Currently, there is no intervention with proven efficacy to reduce criminal behavior for emerging adults with serious mental health conditions and this study is an important step in developing one

The Power of Community: The Role of Community-Based Organizations in Mitigating COVID-19-Related Impacts on Well-Being Among South Florida's Minoritized Populations

The rapid closure of schools and businesses during the COVID-19 pandemic has had a significant impact in South Florida, highlighting diverse challenges to community well-being. Community-based organizations (CBOs) have served as a source of support for community members, particularly in stressful times. Using a combination of quantitative and qualitative methods, and in collaboration with Breakthrough Miami, a CBO committed to addressing the educational opportunity gap in Miami-Dade County, we conducted a study to assess challenges to the well-being of systematically minoritized families during the heart of the COVID-19 pandemic. The study included longitudinal survey data collected via ecological momentary assessment and in-depth interviews with Breakthrough Miami families to gather richer and nuanced data regarding indicators of well-being and CBO engagement. Quantitative results indicated that as perceived stress increased over time, so too did emotional and informational support. Follow-up qualitative interviews indicated that 100% of families identified Breakthrough Miami as a source of academic support during the pandemic. Additionally, families cited the important role Breakthrough Miami played beyond their standard academic programs and services in coping with the most significant sources of stress reported through the pandemic: meeting basic needs and threats to socioemotional well-being. Implications for CBOs are addressed

The Power of Community: The Role of Community-Based Organizations in Mitigating COVID-19-Related Impacts on Well-Being Among South Florida's Minoritized Populations

The rapid closure of schools and businesses during the COVID-19 pandemic has had a significant impact in South Florida, highlighting diverse challenges to community well-being. Community-based organizations (CBOs) have served as a source of support for community members, particularly in stressful times. Using a combination of quantitative and qualitative methods, and in collaboration with Breakthrough Miami, a CBO committed to addressing the educational opportunity gap in Miami-Dade County, we conducted a study to assess challenges to the well-being of systematically minoritized families during the heart of the COVID-19 pandemic. The study included longitudinal survey data collected via ecological momentary assessment and in-depth interviews with Breakthrough Miami families to gather richer and nuanced data regarding indicators of well-being and CBO engagement. Quantitative results indicated that as perceived stress increased over time, so too did emotional and informational support. Follow-up qualitative interviews indicated that 100% of families identified Breakthrough Miami as a source of academic support during the pandemic. Additionally, families cited the important role Breakthrough Miami played beyond their standard academic programs and services in coping with the most significant sources of stress reported through the pandemic: meeting basic needs and threats to socioemotional well-being. Implications for CBOs are addressed

Tumour micro-environment elicits innate resistance to RAF inhibitors through HGF secretion.

Drug resistance presents a challenge to the treatment of cancer patients. Many studies have focused on cell-autonomous mechanisms of drug resistance. By contrast, we proposed that the tumour micro-environment confers innate resistance to therapy. Here we developed a co-culture system to systematically assay the ability of 23 stromal cell types to influence the innate resistance of 45 cancer cell lines to 35 anticancer drugs. We found that stroma-mediated resistance is common, particularly to targeted agents. We characterized further the stroma-mediated resistance of BRAF-mutant melanoma to RAF inhibitors because most patients with this type of cancer show some degree of innate resistance. Proteomic analysis showed that stromal cell secretion of hepatocyte growth factor (HGF) resulted in activation of the HGF receptor MET, reactivation of the mitogen-activated protein kinase (MAPK) and phosphatidylinositol-3-OH kinase (PI(3)K)-AKT signalling pathways, and immediate resistance to RAF inhibition. Immunohistochemistry experiments confirmed stromal cell expression of HGF in patients with BRAF-mutant melanoma and showed a significant correlation between HGF expression by stromal cells and innate resistance to RAF inhibitor treatment. Dual inhibition of RAF and either HGF or MET resulted in reversal of drug resistance, suggesting RAF plus HGF or MET inhibitory combination therapy as a potential therapeutic strategy for BRAF-mutant melanoma. A similar resistance mechanism was uncovered in a subset of BRAF-mutant colorectal and glioblastoma cell lines. More generally, this study indicates that the systematic dissection of interactions between tumours and their micro-environment can uncover important mechanisms underlying drug resistance

Tumor microenvironment induces innate RAF-inhibitor resistance through HGF secretion

Drug resistance remains a vexing problem in the treatment of cancer patients. While many studies have focused on cell autonomous mechanisms of drug resistance, we hypothesized that the tumor microenvironment may confer innate resistance to therapy. Here we developed a co-culture system to systematically assay the ability of 23 stromal cell types to influence the innate resistance of 45 cancer cell lines to 35 anti-cancer drugs. We found that stroma-mediated resistance is surprisingly common – particularly to targeted agents. We further characterized the stroma-mediated resistance of BRAF-mutant melanoma to RAF inhibition because most of these patients exhibit some degree of innate resistance1-4. Proteomic analysis showed that stromal secretion of the growth factor hepatocyte growth factor (HGF) resulted in activation of the HGF receptor MET, reactivation of the MAPK and PI3K/AKT pathways, and immediate resistance to RAF inhibition. Immunohistochemistry confirmed stromal HGF expression in patients with BRAF-mutant melanoma and a statistically significant correlation between stromal HGF expression and innate resistance to treatment. Dual inhibition of RAF and MET resulted in reversal of drug resistance, suggesting RAF/MET combination therapy as a potential therapeutic strategy for BRAF-mutant melanoma. A similar resistance mechanism was uncovered in a subset of BRAF-mutant colorectal and glioblastoma cell lines. More generally, these studies indicate that the systematic dissection of tumor-microenvironment interactions may reveal important mechanisms underlying drug resistance

Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S

Although adolescents are the primary focus of juvenile justice, a significant number of young people involved with this system are considered transition age youth (i.e., 16-25 years of age). The aim of this review is to summarize the specific needs of transition age youth with mental health conditions involved with the juvenile justice system, identify the multiple service systems relevant to this group, and offer recommendations for policies and practice. A comprehensive search strategy was used to identify and synthesize the literature. Findings highlight the paucity of research specific to transition age youth. Thus, we also summarized relevant research on justice-involved adolescents, with a focus evaluating its potential relevance in the context of the unique milestones of the transition age, including finishing one\u27s education, setting and working towards vocational goals, and transitioning from ones\u27 family of origin to more independent living situations. Existing programs and initiatives relevant to transition age youth with mental health conditions are highlighted, and nine specific recommendations for policy and practice are offered

Transdiagnostic Motivational Enhancement Therapy to Reduce Treatment Attrition: Use in Emerging Adults

Improving outcomes of youth with mental health (MH) needs as they transition into adulthood is of critical public health significance. Effective psychotherapy MH treatment is available, but can be effective only if the emerging adult (EA) attends long enough to benefit. Unfortunately, completion of psychotherapy among EAs is lower than for more mature adults (Edlund et al., 2002; Olfson, Marcus, Druss, and Pincus, 2002). To target the high attrition of EAs in MH treatment, investigators adapted a developmentally appropriate brief intervention aimed at reducing treatment attrition (TA) in psychotherapy and conducted a feasibility study of implementation. The intervention employs motivational interviewing strategies aimed at engaging and retaining EAs in outpatient MH treatment. Motivational enhancement therapy for treatment attrition, or MET-TA, takes only a few sessions at the outset of treatment as an adjunct to usual treatment. Importantly, it can be used for TA with psychotherapy for any MH condition; in other words, it is transdiagnostic. This article presents the first description of MET-TA, along with a case example that demonstrates important characteristics of the approach, and then briefly describes implementation feasibility based on a small pilot randomized controlled trial

Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18-21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n = 41) were aged 17-20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post-analyses revealed significant reductions in participants\u27 MH symptoms, justice system involvement, and associations with antisocial peers