David L. Hussey

Profile Characteristics and Behavioral Change Trajectories of Young Residential Children

We aimed to identify profile characteristics for a recent sample of young residential children, examine the differential impact that profile characteristics have on behavior change, and describe the relationship between behavioral symptomatology and length of stay in residential treatment. A sample of 142 consecutively admitted residential treatment children were studied over a five-year period. Hierarchical Linear Modeling was the primary statistical method used to analyze behavioral rating data for a subset of 57 children assessed by teachers and treatment staff using the Devereux Scales of Mental Disorders. Younger age, female gender, and lower IQ were associated with increased levels of psychopathology. Residential length of stay was strongly linked to levels of behavioral symptomatology. HLM is a valuable analytic strategy that employs client profile characteristics to model behavioral change trajectories and help predict treatment responsiveness. System reform philosophies that promote expectations for rapid symptom improvement and removal of residential treatment from the continuum of care may exceed current treatment capacities.

Psychological Distress, Problem Behaviors, and Family Functioning of Sexually Abused Adolescent Inpatients

OBJECTIVE By studying children and adolescents who have been sexually abused, improvements in identifying and treating emerging pathology can be gleaned before personality structures become more rigidly defined and less amenable to therapeutic interventions. It is through studying and comparing subgroups of victims and controls that clinical researchers can additionally elucidate abuse-related manifestations that contribute to the development of psychopathology. METHOD A group of sexually abused adolescent psychiatric inpatients was compared with a control group of inpatient counterparts on measures of social competence, self-esteem, depression, substance abuse, and perceptions of family characteristics and functioning. Consecutive admissions to an adolescent inpatient psychiatric unit (N = 423) were carefully screened for a history of sexual abuse, then divided into two groups, each with 87 subjects, after matching on key variables including age, race, gender, socioeconomic status, and psychiatric diagnosis. RESULTS Sexually abused and control group inpatient adolescents were similar on standardized measures of psychological distress and family functioning. Statistically significant differences were found between groups on substance abuse measures. CONCLUSION The phenomenology of the relationship between sexual abuse and substance abuse and the implications for inpatient treatment are summarized.

Male victims of sexual abuse: An analysis of adolescent psychiatric inpatients

All too often it has been assumed that male victims of sexual abuse are simply similar to their female counterparts. The present study compares the psychological and substance use statuses of sexually abused adolescent male psychiatric inpatients with nonsexually abused adolescent male psychiatric inpatients. Data were collected from 166 male patients consecutively admitted to a 24-bed adolescent psychiatric unit. Abused adolescent males showed significant differences in several domains: they used drugs more frequently, were more depressed, had lower self-esteem, were more hopeless about the future, had more difficulty controlling sexual feelings, and were more concerned about their appearance than their nonabused counterparts. Implications for investigation, treatment, and training are discussed.

Understanding Clinical Complexity in Delinquent Youth: Comorbidities, Service Utilization, Cost, and Outcomes

Abstract This study describes the extent and severity of multiple comorbidities in a juvenile detention center population, and explores how these numerous problems impact the utilization of treatment services, costs, and outcomes including those for substance abuse, mental illness, and criminal activity. Cluster analyses of the outcome scales at intake yielded two groups: youth high (42%) and youth lower (58%) on all factors. Girls experienced the most significant impairments across emotional problems, behavior complexity, internal mental distress, and victimization domains, utilized significantly more units of residential treatment, individual counseling and case management, and had the highest treatment costs. The total cost of services (

Nonprobability Sampling in Social Work Research: Dilemmas, Consequences, and Strategies

1,171,290, N = 114) was significantly related to substance problems in the past year (r = .219, p < .05), emotional problems (r = .237, p < .05), behavior complexity (r = .318, p < .05), internal mental distress (r = .263, p < .05), environmental risk (r = .205, p < .05), and conflict tactics (r = .240, p < .05). Despite initial differences in measures of baseline severity, high and low cluster youth, and boys and girls in general, achieved similar results on the key outcome variables 12 months later. Study implications include a need for co-occurring, integrated treatment efforts that address family, emotional, and mental health problems of delinquent youth (especially females) in order to improve their ability to successfully attend to substance abuse problems and interpersonal conflicts.

Democracy, Inequality, Modernization, Routine Activities, and International Variations in Personal Crime Victimization

ABSTRACT This study critically reviews sampling procedures commonly found in social work research. Through a Monte Carlo study simulating conditions of probability and nonprobability sampling procedures, the study demonstrates consequences of using nonprobability sampling procedures and identifies conditions under which researchers should examine the issue critically and exercise caution in reporting findings. Five empirical strategies to address dilemmas are recommended. The study calls for greater efforts to fund and coordinate large-scale social work research particularly at the federal level.

Implementing and evaluating school-based primary prevention programs and the importance of differential effects on outcomes

Using the International Crime Victimization Survey (ICVS), this study investigates the relative contribution of macro-level variables (democracy level, modernization, world system status, and inequality) and individual-level variables (marital status, age, gender, education, income) in predicting the occurrence and intensity of personal crime victimization. The analysis utilizes multilevel regression, which controls for the ‘‘nesting’’ of individuals living in the same nation and controls for unmeasured random effects among the 42 nations under study. The results of the zero-inflated negative binomial (ZINB) regression analysis indicate that individual characteristics are better predictors of both the occurrence and intensity of personal crime victimization than are macro-level variables related to political and economic conditions of nations. Findings of the current study diverge from those of previous international studies that used official crime data.

Gender Differences in Young Residential Treatment Children

Abstract In 2004, Second Step (Committee for Children, 2002), a violence prevention program, was implemented in the Cleveland Heights-University Heights school district for 1,416 K through second grade students. Both process and outcome measures were used to evaluate program impact and examine issues related to the implementation and evaluation of evidence-based practices. Process measures indicated a high level of implementation fidelity, while pre/post outcome testing on a 20% random sample of students demonstrated significant reductions in reactive aggression scores, t= 2.221, df= 238, p< 0.05, and evidence of declines in proactive aggression. Authors discuss challenges and opportunities related to implementing and evaluating evidence-based programming in Safe Schools/Health Students sites, particularly regarding strategies for the assessment of differential intervention effects to evaluate program outcomes.

Music Therapy and Complex Trauma: A Protocol for Developing Social Reciprocity

SUMMARY Continued explication of gender differences is an important area of investigation in order to further understanding of the developmental and treatment aspects of severe and early onset problem behavior. An emerging body of residential and juvenile justice treatment literature has identified several key gender differences, including higher rates of psychiatric symptomatology and comorbidity among females versus their male counterparts. This study investigated gender differences in a sample of 306 predominately preadolescent residential treatment youth consecutively admitted to a single treatment agency over an eight-year period of time. Females evidenced higher rates of psychiatric symptomatology, even after controlling for a history of sexual abuse. An in-depth chart review analysis of a subset of 47 sexually abused youngsters revealed remarkably similar individual and family risk factor profiles for males and females. Gender may moderate the impact of maltreatment and social adversity differently for preadolescent females versus males in the expression of psychiatric symptomatology.

Behavioral Change Trajectories of Partial Hospitalization Children

SUMMARY Music therapy is emerging as a practice medium that is applicable for children who have experienced severe and prolonged interpersonal trauma in highly compromised caretaking relationships. Complex trauma is an evolving diagnostic and conceptual schema that attempts to describe fundamental trauma-related disturbances, including the interplay between interpersonal trauma and interpersonal functioning. Children with early and significant trauma histories often manifest ongoing interpersonal and attachment difficulties, including a diminished ability to reciprocate in social relationships. Therapy approaches specifically designed to develop and nurture the reciprocal social capacities are critically important to trauma recovery and healthy child development. The purpose of this article is to discuss the use of music therapy approaches in complex trauma work, and to describe briefly a music therapy protocol designed to stimulate attachment capacity and develop social reciprocity skills. The protocol provides residential therapists a model that is flexible, stage-wise, and adaptable, addressing core relational capacities that children need to negotiate safe interpersonal attachments.