Building Protection In Interventions For High Risk Adolescents With Serious
Emotional Disturbances And Aggression
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Natasha K. Bowen
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School of Social Work, CB 3550
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University of North Carolina
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Chapel Hill NC 27705
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919 403 2976
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FAX: 919 962 7557
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nbowen@email.unc.edu
Purpose: Adolescents with serious emotional disturbances (SED) and
violent behaviors are costly and difficult to serve in public mental health
settings. Many also become involved with the legal system, increasing the
costs of serving them and decreasing their chances of successful adult
functioning. Using data collected by practitioners in an intensive intervention
program in North Carolina, this study sought to determine if (a) building
protection was associated with decreases in violent behavior, and (b) program
effects differed for adolescents with different levels of initial protection.
Methods: Annual assessment/treatment-planning data collected
by case managers in the program include over 60 established risk and protective
factors, and indicators of violent behavior. Changes over time in
mean behavior ratings, and mean levels of protection (total and 2 subcategories)
were examined for 388 adolescents (ages 13-17) with three waves of data.
The relationship between changes in protection and behavior was then examined
using linear regression and HLM. Analyses were conducted for the full sample
and three subgroups with different entry levels of protection.
Results: Improvements in behavior and three protection composites
were observed for the full sample. Subgroup experiences differed, however,
with the high protection group often showing no improvement. After controlling
for demographics and initial risk levels, increased protection was predictive
of improved behavior. HLM analyses revealed homogeneous rates of change
within subgroups, higher rates of change for the low protection group,
and the importance of home social skills to behavioral improvement.
Implications for Practice: Results validated the intervention
goal of building protection in high risk adolescents with SED and aggression;
suggested that home social skills are a key protective factor to target
in efforts to reduce violent behavior; and indicated that adolescents with
high, medium and low levels of initial protection respond differently to
interventions and therefore require different intervention strategies.