The Relationship Between Service Utilization and Psychiatric Hospitalization Among People Diagnosed with Borderline Personality Disorder

This exploratory study was conducted to determine the relationship between service utilization and the psychiatric hospitalization among people diagnosed with borderline personality disorder (BPD). Secondary analysis was performed on the case files of 12 female adult clients of a rural county social service mental health department who are diagnosed with BPD. Results indicate that service utilization by this population is comparable regardless of time spent in acute psychiatric hospitals. Results further indicate that history of childhood sexual abuse was a predictor of hospitalization in this sample. A replication of this study which utilizes multiple methods is recommended. Implications for direct social work practice and policy are described

Child mental health in Jordanian orphanages: effect of placement change on behavior and caregiving

Background: To assess the mental health and behavioral problems of children in institutional placements in Jordan to inform understanding of current needs, and to explore the effects of placement change on functioning and staff perceptions of goodness-of-fit. Methods: An assessment was completed of 134 children between 1.5? 12 years-of-age residing in Jordanian orphanages. The Child Behavior Checklist was used to assess prevalence rates of problems across externalizing and internalizing behavior and DSM-IV oriented subscales. Also included was caregiver perceived goodness-of-fit with each child, caregiving behavior, and two placement change-clock variables; an adjustment clock measuring time since last move, and an anticipation clock measuring time to next move. Results: 28% were in the clinical range for the internalizing domain on the CBCL, and 22% for the externalizing domain. The children also exhibited high levels of clinical range social problems, affective disorder, pervasive developmental disorder, and conduct problems. Internalizing problems were found to decrease with time in placement as children adjust to a prior move, whereas externalizing problems increased as the time to their next age-triggered move drew closer, highlighting the anticipatory effects of change. Both behavioral problems and the change clocks were predictive of staff perceptions of goodness-of-fit with the children under their care. Conclusions: These findings add to the evidence demonstrating the negative effects of orphanage rearing, and highlight the importance of the association between behavioral problems and child-caregiver relationship pathways including the timing of placement disruptions and staff perceptions of goodness-of-fit

Impact of probation intervfentions on drug use outcomes for youths under probation supervision

Use of drugs and alcohol by justice-involved youths is a longstanding concern for juvenile justice policy-makers and researchers. However, little explored in this research is how the tactics and strategies employed by probation officers with this population impacts drug use outcomes. This study explored the effects of four types of probation strategies (positive pressure, negative pressure, parental involvement, treatment referrals) on 12-month drug use trajectories in a sample of 144 youths under probation supervision. Multilevel negative binomial regression models found that positive pressures (incentives & rewards) reduced drug use when negative pressures (threats & confrontation) were minimized. More frequent parental involvement early in the course of probation was associated with reduced drug use for girls, and was associated with increased drug use for both boys and girls later during the probation period. Finally, early referral to drug treatment programs was associated with reduced drug use outcomes. These findings suggest practical program and policy strategies to reduce drug use among probation-involved youths

Strengthening the integration of actuarial risk assessment with clinical judgment in an evidence based practice framework

Traditional discussions of actuarial risk assessment utility in child welfare and juvenile justice emphasizes its comparative predictive validity with clinical methods of prediction. While important, it ignores how actuarial risk assessment instruments actually influences the clinical deliberations of their users. Recent literature extends the discussion of their clinical utility by invoking evidence based practice principles. Implicit in this discussion is a traditional model of structured decision making, common in child welfare and juvenile justice agencies, whereby actuarial risk assessment is supplemented with contextual needs assessment. This article critiques the traditional model of structured decision making and argues that its limitations are inconsistent with the spirit of evidence based practice. Instead, a revised model of structured decision making, grounded in research on risk and resilience, promises a more complete integration with evidence based practice.Risk assessment Structured decision making Evidence based practice Resilience

Condition comprehension predicts compliance for adolescents under probation supervision

Noncompliance is a chronic problem among youth court ordered to probation supervision, often placing them in jeopardy of deeper involvement with the juvenile justice system. Legal comprehension theory and goal setting theory suggests that youth understanding of their probation requirements may predict compliance. This study explored the effect of condition comprehension on short-term compliance with probation requirements in a sample of probation youths (n = 101). Results of the multilevel logistic regression analysis demonstrated that youth with a detailed understanding of their conditions were more likely to comply with probation requirements, but that this effect was moderated by age and by emotion regulation. Understanding was not related to compliance for youth younger than 14 and for youth who scored low on a measure of emotion regulation. Results of this study provide support for efforts by probation departments to foster youth comprehension of their conditions, and reveal the need to establish probation strategies suited to younger youth and youth with poor emotion regulation

Mapping the social service pathways of youth to and through the juvenile justice system: A comprehensive review

The purpose of this review was to detail the human or social service needs and service use patterns (i.e., healthcare, education, social services, child welfare, mental health, and substance abuse) that influence youth's entry and prolonged involvement with the juvenile justice system. What emerged from the literature was a pattern of service needs and prior service usage that placed youth at risk of juvenile justice involvement. Extralegal factors, such as individual characteristics (e.g., race/ethnicity, gender, and mental health and trauma histories) and social/environmental characteristics (e.g., family conflict, unmet service needs, and prior social service use) influenced how youth traveled across the sectors of care. The authors present a social justice systems model that depicts the varied service pathways that youth may concurrently or sequentially travel across the social and justice systems of care. The paper concludes with a discussion of the implications for practice, policy, and research.Youth Service utilization Social services Juvenile justice Literature review

Child Mental Health in Jordanian Orphanages: Effect of Placement Change on Behavior and Caregiving

Background: To assess the mental health and behavioral problems of children in institutional placements in Jordan to inform understanding of current needs, and to explore the effects of placement change on functioning and staff perceptions of goodness-of-fit. Methods: An assessment was completed of 134 children between 1.5–12 years-of-age residing in Jordanian orphanages. The Child Behavior Checklist was used to assess prevalence rates of problems across externalizing and internalizing behavior and DSM-IV oriented subscales. Also included was caregiver perceived goodness-of-fit with each child, caregiving behavior, and two placement change-clock variables; an adjustment clock measuring time since last move, and an anticipation clock measuring time to next move. Results: 28% were in the clinical range for the internalizing domain on the CBCL, and 22% for the externalizing domain. The children also exhibited high levels of clinical range social problems, affective disorder, pervasive developmental disorder, and conduct problems. Internalizing problems were found to decrease with time in placement as children adjust to a prior move, whereas externalizing problems increased as the time to their next age-triggered move drew closer, highlighting the anticipatory effects of change. Both behavioral problems and the change clocks were predictive of staff perceptions of goodness-of-fit with the children under their care. Conclusions: These findings add to the evidence demonstrating the negative effects of orphanage rearing, and highlight the importance of the association between behavioral problems and child-caregiver relationship pathways including the timing of placement disruptions and staff perceptions of goodness-of-fit