Displaying items by tag: Mental health

MAY 23, 2017
BY: JODIE MARTIN, MENTOR: THE NATIONAL MENTORING PARTNERSHIP

Over the past several weeks, many youth development professionals have become aware of the Netflix series, 13 Reasons Why, which revolves around the suicide of a female high school student, Hannah Baker. Due to its fast-spreading popularity, whether or not you have seen it, you may have received questions from parents and youth about the themes that are addressed in the series. These themes, many of which are uncomfortable and controversial, are nonetheless important to talk about, especially with students of a similar age to the characters depicted on the show. Conversations about mental health and suicide can reduce the stigma behind these experiences to allow those who are suffering to know that they are not alone and can get help. However, because of the complexity of these topics and the ways in which they are depicted in the series, parents/guardians, school administrators, and youth development professionals should be aware of the questions and concerns young people may have after watching it, so they can be prepared for the important discussions the series may spark.

For those who are unfamiliar with the series’ premise, the story unfolds through a series of pre-recorded tapes on which the main character, Hannah Baker, describes thirteen reasons that led up to her suicide. Through the episodes the audience finds out that Hannah has had many rumors spread about her, and that eventually she was the target of bullying, social isolation, and sexual abuse. Below, we offer some information about the complex themes addressed in the show, and where you can go for more resources. As we know many parents and youth development professionals have been addressing these topics with youth, we invite you to post other resources and tips you have found useful in the comments section below.

Published in NMRC Blog
Friday, 19 August 2016 12:19

A New Lens for Mentoring: Trauma Informed Care

Webinar Date: March 19, 2015

PANELISTS

  • Laurie Vargas, M.S., PPSC, Mentoring for Success

RESOURCES:

Paper List of Additional Resources
Paper Self Care Assessment
Paper Download the Presentation Slides

Published in Webinars
MARCH 7, 2017
BY: BERNADETTE SÁNCHEZ, PHD, NMRC RESEARCH BOARD MEMBER & PROFESSOR AT DEPAUL UNIVERSITY

Editor's Note: Several members of the NMRC Research Board participated in the 2017 National Mentoring Summit this past February, leading a research track that featured OJJDP-funded research and totaled 13 workshops across the multi-day event. We asked several Research Board members to share their key insights from the event based on a workshop they lead, an innovation they learned about, or a conversation they had with an attendee that made them think about the mentoring field in a new light. We will run several of these stories over the months of March and April in the NMRC blog to bring the Summit to life for those who could not attend.

Recent longitudinal studies show that Black adolescents and adults from low socioeconomic backgrounds who are resilient are also more likely to get physically sick. However, White adolescents and adults from similar backgrounds are immune to this negative outcome. For example, a study of Black, low-income adolescents revealed that those who were resilient (as demonstrated by high aspirations, unwavering persistence, investment in education, and avoidance of activities that sidetrack success) were also more likely to have type 2 diabetes as adults compared to Black adolescents who didn’t have these resilient traits. This trend didn’t emerge for White, low-income adolescents who were resilient. Other studies show similar patterns between White and Black participants. What explains these trends? Researchers speculate that Black, low-income resilient youth may feel enormous pressure to succeed, may feel socially isolated as they transition to new settings (e.g., college), and may encounter racism, which could ultimately leave them exhausted and neglect their physical health.

Published in NMRC Blog
Thursday, 19 May 2016 12:30

Better Futures

*Note: The National Mentoring Resource Center makes these “Insights for Mentoring Practitioners” available for each program or practice reviewed by the National Mentoring Resource Center Research Board. Their purpose is to give mentoring professionals additional information and understanding that can help them apply reviews to their own programs. You can read the full review on the National Mentoring Resource Center website.


In considering the key takeaways from the research on this program that other mentoring programs can apply to their work, it’s useful to reflect on the features and practices that might have influenced its rating as “Effective” (that is, a program that shows definitive evidence of effectiveness)…

Perhaps the first thing that jumps out to readers of the evaluation of Better Futures is the substantial effect sizes that this program has achieved. Effect sizes are, essentially, a measure of just how much change from business-as-usual that an intervention or program has made on participants. In general, mentoring programs as a whole produce an effect size that is considered to be “small” (the 2011 meta-analysis led by NMRC Research Board Chair Dr. David DuBois found an overall effect size of .21). But Better Futures as produced impacts that go far beyond these modest gains, with effect sizes ranging from .74 to 1.75 for just about every outcome the evaluation examined. Only the outcomes of “mental health recovery” and “quality of life” failed to show statistically significant changes for participants compared to a randomly assigned control group of youth. But in every other possible outcome, this program produced impacts that were frequently “large” by the standard definition and downright massive in comparison to most mentoring interventions.

So how did Better Futures achieve all this? Let’s look at a few meaningful factors:

A great application of relevant theory when designing the program

As we’ve noted in considering other program reviews for the NMRC, one of the keys to success for mentoring programs may be making sure that the services are building on relevant theories and prior research that indicates that mentors will produce results within the context of the youth needs being addressed. Better Futures does an excellent job of this in its design by building on the concepts of Self-Determination Theory, which is premised on the idea that an individual’s well-being is influenced by the degree of autonomy and skill he or she has in his or her own self-care. This program clearly is built around the idea of empowering youth in foster care—youth who by nature of their experience in the child welfare system may have felt very, very disempowered in the course their life has taken. The program is built on a foundation of self-determination and that idea that if these youth are put in the driver’s seat of their postsecondary planning, and provided with just enough mentoring, skill development, and instrumental support as scaffolding, that the results will be meaningful. And this evaluation certainly seems to indicate that they were correct. Participants empowered in this manner were found to leave this program in a very different place than many of their non-participant peers and all of that arguably starts with the theory of self-determinism and the cultivation of mentoring services that will enhance that self-determinism in mentees.

Normalizing the experience of aging out of foster care and going into post-secondary life

Another relevant idea that we can see play out in the design of this program is that of “normalizing” what is essentially an abnormal experience. Youth in the child welfare system live, by default, lives that are anything but normal. The uncertainty, shifting environments, and inconsistent care offered by that system can leave youth feeling like they are very much anomalies among their peers. In fact, the NMRC has reviewed another promising mentoring program for serving foster youth that emphasizes making the experience seem more “normal” by having them interact with peers who are in similar circumstances. Better Futures seeks to achieve this “normalization” by bringing participants together for a multi-day “institute” on a college campus where they can interact with dozens of youth who are facing the same challenges and uncertainties as they head into young adulthood and plan for life after high school. The potential power of bringing together cohorts of youth going through the same difficult transition cannot be overstated as this offers the opportunity for connections to multiple mentors and a wealth of peer learning and information sharing, along with the overarching relief of knowing “I’m not in this alone.”

Offering a blend of developmental and instrumental mentoring

The support offered by Better Futures is, in many cases, highly “instrumental” in nature—that is, it emphasizes teaching, information sharing, and helping youth achieve some concrete goal or complete some discrete task. In fact, the mentors in the program have a suite of 17 different “experiences” that they are supposed to provide to youth, as well as 11 targeted self-determination “skills” they are supposed to teach, all in the service of preparing a plan for post-secondary education. So the experience of being a mentee in the program appears largely to be that of getting some concrete help on all this planning and completing the often mundane tasks associated with going to college, such as applying for financial aid or figuring out housing circumstances. But the way that the program does this is also relationship-driven and there is a heavy emphasis on personal growth, reflection, and peer support. This is a program that values relationships and encourages participants to, for the first time in their lives, take control of their future and the trajectory of the years to come. This combination of developmental mentoring and instrumental support is very much in alignment with recent theory about how mentors might work best with youth, helping them grow as people generally while also providing targeted instrumental support to overcome hurdles as needed. (For more on this idea, see this special issue of New Directions for Youth Development; the full text articles may be available through the services of public or university libraries.)

Picking the right mentors to help “normalize” this transition

Another key factor in the success of Better Futures may be who they ask to fill the mentor role. The mentors in this program are all young adults who have been to college and who also themselves have been in the foster care system or dealt with mental health issues. One can imagine that seeing a slightly older person who comes from a similar background and has managed to make this transition is highly motivating and empowering to participants. These mentors are likely to have invaluable first-hand experience with the struggles, the stumbling blocks, and the “tips” that can make this transition go well for mentees. It’s hard to imagine any old volunteer bringing the same level of understanding, skill, and personal lived experience to the table, no matter how good the training provided. This program does a nice job of backing up its self-determination message with living examples of what that transition looks like on the other side.

Tracking fidelity of implementation… flexibly

Another interesting feature of the program is found in those 17 “experiences” and 11 skills that the program tries to give mentees. As suggested earlier in this discussion, when a program is this grounded in meaningful theory and the expected changes, one might assume that fidelity to the model (how rigorously the program does certain tasks) is paramount, even though each mentee is a unique person with unique challenges and needs. But Better Futures finds a very nice middle ground between the rigidity of the model and the flexibility to meet clients where they are at. The mentors in the program are not expected to deliver all 17 of those “experiences” to every mentee, but rather, to select the ones that are most relevant to each of the individual participants. This way, the program can deliver a whole host of relevant skill-building and instrumental supports to every youth in the program, while also maintaining the flexibility needed to customize the experience in accordance with that overarching self-determination principle.

The mentors are encouraged to provide as many of the experiences as possible, but this can, as noted, be customized and tailored to the individual. The mentors are also responsible for tracking the components of the intervention that each mentee receives. Even though the program allows for a lot of flexibility, their fidelity results speak for themselves: 100% participation in the Summer Institute elements, 99.3% in exposure to the 11 self-determination skills, and 90.4% participation in the 17 experiential activities. These results speak to a program that allows mentors to give mentees the right developmental experiences but also ensure that everyone in the program is getting a robust intervention. After many years in the child welfare system, one can only imagine how nice it must feel to mentees to have services customized to their needs and not be shoved into a one-size-fits-all approach.

In spite of these strong outcomes and innovative approaches, there are some caveats that service providers should keep in mind when thinking about this program:

  • The evaluation does not provide a cost-per-match estimate, but one imagines that the multi-day Institute and customized support after are not low-cost. This program is providing a lot of support, but it is unclear how scalable this model is, both for cost and logistical reasons.

  • The evaluation also does not examine whether these youth actually went to college more than control youth. One might assume that they did, given their massive gains in measures of planning and preparation, but it’s unclear whether the program actually led to more of these youth attending, and subsequently graduating, from their chosen higher education institutions. A follow-up study looking at those outcomes would be a nice addition to our understanding here.

For more information on research-informed program practices and tools for implementation, be sure to consult the Elements of Effective Practice for Mentoring™ and the "Resources for Mentoring Programs" section of the National Mentoring Resource Center site.

Tuesday, 23 August 2016 15:02

Better Futures Program

Evidence Rating: Effective - One study

Date: This profile was posted on August 22, 2016


Program Summary

A program designed to help young people in foster care with serious mental health challenges prepare for postsecondary education. The program is rated Effective. Youths who received the intervention had significant improvements on self-determination, mental health empowerment, transition planning, career self-efficacy, hope, barriers to education, postsecondary preparation, and transition planning, but not on quality of life or mental health recovery.

You can read the full review on CrimeSolutions.gov.

Evidence Rating: Promising - One study 

Date: This profile was posted on March 06, 2017


Program Summary

This cognitive–behavioral mentoring intervention was designed to improve child behavior and family functioning among 8- to 12-year olds with mental health disorders, and their primary caregivers. This program is rated Promising. There were significant differences between the intervention and control groups on measures of child behavior, parenting stress, perceived social support, and attachment to parents.

You can read the full review on CrimeSolutions.gov.

*Note: The National Mentoring Resource Center makes these “Insights for Mentoring Practitioners” available for each program or practice reviewed by the National Mentoring Resource Center Research Board. Their purpose is to give mentoring professionals additional information and understanding that can help them apply reviews to their own programs. You can read the full review on the CrimeSolutions.gov website.


In considering the key takeaways from the research on this program that other mentoring programs can apply to their work, it’s useful to reflect on the features and practices that might have influenced its rating as “Promising” (that is, a program that shows some evidence that it achieves justice-related goals when implemented with fidelity).

1. This program represents a very thoughtful approach to integrating a unique, standalone intervention into a youth mentoring context.

Mentoring practitioners often borrow ideas or curricula from related fields and disciplines when developing mentoring interventions designed to address specific youth challenges or behaviors. Certainly the reviews of programs conducted to date by the National Mentoring Resource Center are filled with examples of such programs. There can be tremendous potential in applying successful approaches from one context to the work of a mentor. That certainly appears to be the case for this program, which brought many of the principles of the highly-successful cognitive behavioral approach to therapy to mentoring relationships for youth.

Cognitive behavioral therapy has been shown to produce meaningful results for adults and youth in relatively short periods of time and that short-term focus is seen in this program, which offered youth only 12 weeks of mentoring⎯a far cry from the school- or calendar-year focus of many mentoring programs. And luckily for practitioners, the developers of this intervention even merged this psychological intervention into a mentoring context in two different ways: A traditional one-to-one program and a group program (although, unfortunately, they ran these programs separately at different times and did not compare the results between the two approaches).

Programs looking to integrate principles or ideas from other interventions or disciplines can find inspiration in the table included on page 205 of the 2009 evaluation of the program in Child & Family Behavior Therapy (you can view a full text version of the article here). This table illustrates how the developers compared and contrasted the practices of cognitive behavioral therapy and typical youth mentoring (group, in this case) across several key dimensions (time, activities, length of meeting, parent involvement, relationship focus, level of training, transportation, and employment status of provider). The table also shows how they eventually merged these practices into the hybrid model that they implemented and studied. This illustrates how practitioners can go about thoughtful integration of one intervention with another. Rather than just taking a curriculum or a set of ideas from one context and assuming it can work in another, these developers looked at all of the factors that made one intervention work and thought carefully about how those practices could be brought over or modified for a mentoring context. Any program looking to bring new ideas to a mentoring program environment should plan on making a table like this to show how they think the interventions will mesh and what might need tweaking to make it work in practice.

The same journal article also offers a clear breakdown of the content of the 12 weeks of the program illustrating how key cognitive behavioral concepts, such as relaxation techniques, perspective taking lessons, social problem-solving, and tips for managing challenging or embarrassing situations, were woven into the mentor-mentee interactions. In all, this program, in both of its iterations, really shows how to blend interventions in a thoughtful way.

2. This program shows the value of testing multiple approaches to addressing the same issue for youth.

As noted above, this program was offered in two formats designed to achieve similar goals. In the earlier one-to-one iteration of the program (the results of which were published in 2006) the program focused on not just improving the behavior of mentees but also specifically tested whether the intervention helped parents and caregivers by increasing their feelings of support and reducing their stress around their child’s circumstances and behavior. The idea being that if the mentors could improve the child’s behavioral issues, that that might reduce stress in the home and lead to even greater outcomes. And in fact, that’s exactly what they found. Findings supported their idea that reducing parent stress in the home was a pathway by which the mentoring was able to benefit behavioral outcomes for youth. So this version of the program attempted to address these youths’ needs on two fronts: direct work with the mentor and indirect impact on the home environment by reducing parent stress, increasing their feelings of support, and bringing more harmony to the home environment. More mentoring programs should explore how the direct work with a mentor can translate to or be reinforced in the home environment and whether the impact of the mentoring extends to others in the family, even if indirectly.

The later published evaluation of the program in 2009 put a different spin on this work: a group format, which offered additional adults to teach and model the behaviors taught in the curriculum and more opportunities for practicing newly learned strategies and skills with peers in a variety of situations. The program was designed with the aim of ensuring that mentees still got the individual attention they needed, but with more chances to bring what they were learning to life in real world contexts (most notably actual interactions with peers).

As with the one-to-one version of the program, the evaluation of the group model also found evidence of favorable impacts on the youth’s behavior, including both internalizing and externalizing problems. But unlike the one-to-one model, this version did not show evidence of improving parent feelings of stress. This difference in findings across the two studies emerged in spite of the fact that in both versions of the program, mentors spent some time after each session speaking with parents about their child’s progress and discussing the activities and lessons. It is unclear as to why the group program did not improve parent stress (perhaps the group format resulted in less specific information-sharing about each parent’s particular child). Unfortunately, the 2009 study did not look at one key factor that the 2006 study did: Parent reported perceptions of social support in managing their child’s behavior. In the one-to-one version of the program, parents in the program group reported feeling more supported and less stress (presumably as a result of that social support). But the later published study simply didn’t ask if they felt more supported, so we don’t know if parents felt that way or not.

Perhaps the ideal version of this program is a “best of both worlds” one that combines the group structure to provide more mentoring, more peer support, and more ability to use what’s being taught, combined with additional emphasis on that parent support aspect and reducing the stress in the home. One can imagine that such a combination would perhaps maximize the impact of the program. That’s yet another iteration of the program that would have to be studied in the ways that these were. But there seems to be enough evidence here that mentoring programs explicitly serving youth with emotional and behavioral challenges would be well advised to consider how they can support parents and reduce that in-home stress.

More generally, mentoring programs that are just getting started or want to incorporate a new concept into a mentoring context may want to try different approaches simultaneously and study them to see which works best and the different reasons or unique pathways that explain their success or failure. That approach can help practitioners refine the idea of the program and eventually optimize services and the potential impact the mentoring can have.

3. The use of a “token economy” is an intriguing idea in a mentoring context.

In the evaluation of the group mentoring version of the program it is briefly mentioned that mentors instituted a simple “token economy” to reward mentees for their positive behavior and for instances of applying the recently-taught lessons of the program correctly in real-life situations. These rewards, or “points,” could then possibly be exchanged for other rewards, such as playing a particular game or going on a fun outing. The idea of reinforcing positive behavior in this way is one that mentoring programs that are looking to influence behavior in the real world might consider. There is growing evidence that this kind of “gamification” can improve behavior in the context of other types of interventions, perhaps most notably in Positive Behavioral Interventions and Supports. There are concerns that this gamified approach reduces intrinsic motivation and leaves youth simply seeking the external reward. But for a mentoring intervention designed to get youth adopting and practicing targeted behaviors with some regularity, reinforcing that behavior through some kind of token economy might be a nice additional incentive that can help make using the desired strategies a routine habit over time.

4. When evaluating a program for youth with substantial needs, it’s always a good idea to control for other services.

One of the key things that the evaluators did in both of the studies mentioned here is control statistically for the volume of other services that mentored youth and their families were receiving. These researchers understood that these youth would be getting lots of other support and other interventions on top of what their program was offering (e.g., medication, case management, out-patient therapy, etc.). So in an effort to better isolate the effects of the program, they also took into account the volume of these other services and supports. It seems as though those other services did not influence the findings in either study, but the researchers are quick to note that their method of controlling still leaves room for that possibility.

To try and quantify the volume of other support mentees were getting, the researchers simply totaled up the number of hours of support the youth was receiving and noted whether the youth was getting medication. This composite approach made it easier to control for the potential influence of these other services, but it lacked nuance and specificity. They did not track (or if they did, did not utilize information on) whether the mentee started, stopped, or switched medication during the program, nor did they control separately for the type of treatment approaches they were engaged in. As a result, there is some uncertainty around how the mentoring program may have different impacts for youth getting various other supports or changing their medications. This illustrates just how hard it can be to control for the myriad other factors that may influence a mentoring program’s success. Practitioners and researchers are often left executing a simple-yet-incomplete model of what those other factors might be, weighing how much information they can reasonably collect with the knowledge that they must control for external factors somehow. This program, and the researchers approach to evaluating it, offer a good example of how to split that difference in a way that is doable while also being upfront about the approach not being perfectly complete.


For more information on research-informed program practices and tools for implementation, be sure to consult the Elements of Effective Practice for Mentoring™ and the "Resources for Mentoring Programs" section of the National Mentoring Resource Center site.

Evidence Rating: Promising - One study 

Date: This profile was posted on March 06, 2017


Program Summary

This cognitive–behavioral, group-mentoring intervention was designed to improve child behavior and family functioning among 8- to 12-year olds with mental health disorders, and their primary caregivers. This program is rated Promising. Although there were significant improvements on measures of social problem solving and behavior problems, there were no improvements on measures of attachment to parents and social skills among children in the intervention group, compared with the control group.

You can read the full review on CrimeSolutions.gov.

Friday, 19 August 2016 11:06

Early Risers ‘Skills for Success’ Program

Evidence Rating: Promising - One study

Date: This profile was posted on June 13, 2011


Program Summary

A multi-component, high-intensity, competency-enhancement prevention program that targeted elementary school children (ages 6 to 10) who were at high risk for early development of conduct problems. This program is rated Promising. The program had a significant, positive impact on youths’ academic achievement and the discipline practices of their parents. However, the program did not have a significant effect on children’s aggression.

You can read the full review on CrimeSolutions.gov.

Friday, 19 August 2016 11:08

Family Check-Up (FCU) for Adolescents

Evidence Rating: Promising - More than one study

Date: This profile was posted on March 23, 2015


Program Summary

A family-centered preventive intervention designed to assist families with high-risk adolescents, ages 11–17. The goal is to reduce the growth of adolescents’ problem behaviors and substance abuse; improve parenting skills; and reduce family conflict. The program is rated Promising. Students who received FCU services showed significantly less growth in antisocial behavior and substance use as well as a stable GPA from the start of middle school into high school.

You can read the full review on CrimeSolutions.gov.

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