Kristin M. Ferguson

Factors associated with trauma and posttraumatic stress disorder among homeless youth in three U.S. cities: The importance of transience†

Homeless youth experience disproportionately high rates of trauma and posttraumatic stress disorder (PTSD). This study examined correlates of trauma and PTSD among homeless youth with a focus on the impact of homeless culture, substance addiction, and mental health challenges. Homeless youth (N = 146) from Los Angeles, California, Denver, Colorado, and St. Louis, Missouri, were recruited from organizations providing services to homeless youth using comparable methods. Results indicate that 57% of respondents had experienced a traumatic event and 24% met criteria for PTSD. A multinomial logistic regression model revealed greater transience, alcohol addiction, mania, and lower self-efficacy predicted PTSD whereas trauma exposure was associated with alcohol addiction only. Findings have implications for screening and intervening with traumatized homeless youth across service settings.

Feasibility Study of the Social Enterprise Intervention With Homeless Youth

Objective: To reduce mental health symptoms and high-risk behaviors and increase social support and service utilization among street-living youth, the authors conducted a pilot study to assess the feasibility of the social enterprise intervention (SEI) at a homeless youth agency. Method: Convenience sampling was used to recruit 16 street-living youth from the agency. SEI participants received 7 months of vocational and small business training and service referrals. A comparison sample of 12 agency youth was used. Results: Findings from independent sample t tests demonstrate that SEI participants displayed significant improvements at 9 months in life satisfaction, family contact, peer support, and depressive symptoms. Conclusions: Preliminary findings suggest that the SEI was feasible within the agency setting and associated with higher mental health and social outcomes.

Exploring Family Environment Characteristics and Multiple Abuse Experiences Among Homeless Youth

This qualitative study used data from the Social Enterprise Intervention (SEI) pilot study, a comprehensive vocational training program with integrated clinical services for homeless youth. In-depth interviews were conducted with 28 homeless youth participating in the SEI study to explore their perceptions of family environment characteristics and abuse experiences. The constant comparative method was used to analyze transcripts from in-depth interviews with the youth participants. Emergent themes related to family characteristics include home instability, abandonment, and caregiver substance abuse. Abuse-related subthemes include intrafamilial abuse, caregiver abuse, rejection, and deprecation by caregivers. Grounded theory is used to interpret findings and develop working hypotheses to guide future studies of multitype maltreatment among homeless youth.

Correlates of Street-Survival Behaviors in Homeless Young Adults in Four U.S. Cities

This study assessed the prevalence and correlates of behaviors used by homeless young people to survive on the streets. Survival behaviors include prostitution, selling blood or plasma, dealing drugs, stealing, and panhandling. One hundred ninety-six homeless young adults from 4 metropolitan areas-Los Angeles, CA (n = 50); Austin, TX (n = 50); Denver, CO (n = 50); and St. Louis, MO (n = 46)-participated in individual, semistructured, face-to-face interviews. Researchers predicted that youth transience would be related to high rates of survival behaviors. Multivariate logistic regression was used to test a model predicting relationships between survival behaviors and transience, employment, substance use, and social support. Young adults who were transient, unemployed, drug-addicted, and reliant on peers for help were more likely to use these survival behaviors. In addition, among the transient subsample, being White, more reliant on peers for help, more transient, and having been victimized were associated with high use of these survival behaviors. Identification of the environmental and demographic factors associated with survival behaviors suggests that there may be value in combining harm-reduction strategies with efforts to reduce the transience of homeless young adults.

Beyond indigenization and reconceptualization Towards a global, multidirectional model of technology transfer

Throughout the 20th century, global social work education has been transformed by two key processes: indigenization and reconceptualization or authentization. In much of the developing world, such influences have greatly affected the formation of both social work education and practice as systematic responses to local social and economic development problems. Social work in developed countries has also been shaped to some extent by similar phases (Bernard, 1995; Midgley, 1981). This article presents an overview of the indigenization and authentization of social work education in developing countries. Existing frameworks describing the progression of social work education are reviewed, mainly from Asia, the Middle East and Latin America, whence the principal models of social work exchange have emanated. Finally, an alternative model is presented, which conceptualizes the multidirectional exchange of information and technology between and among developed and developing countries. The proposed model builds on frameworks by Cox (1997), Ragab (1995), Resnick (1995), and Mayadas and Elliott (1997), and responds to criticisms that developing countries’ historical

Multiple Victimizations Before and After Leaving Home Associated With PTSD, Depression, and Substance Use Disorder Among Homeless Youth

Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on homeless youth—a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder [PTSD], depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths’ odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths’ odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences.

Employment Status and Income Generation Among Homeless Young Adults Results From a Five-City, Mixed-Methods Study

This mixed-methods study identified correlates of unemployment among homeless young adults in five cities. Two hundred thirty-eight homeless young people from Los Angeles (n = 50), Austin (n = 50), Denver (n = 50), New Orleans (n = 50), and St. Louis (n = 38) were recruited using comparable sampling strategies. Multivariate logistic regression results indicate that homeless young adults were more likely to be unemployed if they had been on the streets longer, currently lived on the streets, earned an income from panhandling, and were addicted to drugs. Quantitative findings are expanded on with focus-group data from a group of homeless young people in Los Angeles regarding their challenges in locating and maintaining employment. Employment-related barriers for this population include prior homelessness, geographic transience, previous felonies, mental illness, and addiction. Findings suggest that homeless young adults’ employment status and use of specific income-generating activities may be influenced by demographic, environmental, and geographic contexts.

Estrangement factors associated with addiction to alcohol and drugs among homeless youth in three U.S. cities

Substance use is highly prevalent among homeless, street-involved young people. Societal estrangement is often associated with substance use, particularly among this population. The current study sought to identify four domains of social estrangement (disaffiliation, human capital, identification with homeless culture, and psychological dysfunction) in relation to alcohol and drug addiction. Homeless young adults were recruited from three disparate urban areas: Los Angeles, CA (n=50), Austin, TX (n=50) and St. Louis, MO (n=46) using comparable research methods and measurement instruments. Findings demonstrated that variables measuring psychological dysfunction and homeless culture predicted alcohol addiction, while institutional disaffiliation and homeless culture predicted drug addiction. Findings affirm distinct patterns of estrangement related to alcohol compared to drug addiction. Understanding these features and the heterogeneity of this population has strong potential for assisting development of programs targeting substance use among this underserved population.

Social Control Correlates of Arrest Behavior among Homeless Youth in Five U.S. Cities

This study identified homelessness, substance use, employment, and mental health correlates of homeless youths’ arrest activity in 5 cities. Two hundred thirty-eight street youth from Los Angeles, Austin, Denver, New Orleans, and St. Louis were recruited using comparable sampling strategies. Ordinary least squares (OLS) regression results reveal that being arrested for criminal activity is associated with length of homelessness, history of juvenile detention and incarceration, receiving income from theft, substance abuse, and mental illness. Arrests are also associated with interactions between lack of formal employment income and receiving income from theft and between drug and alcohol abuse/dependency. Understanding the health and situational factors associated with homeless youths’ delinquent activity has implications for providing more comprehensive health, mental health, and substance abuse services.

Perceptions of Resiliency and Coping: Homeless Young Adults Speak Out.

This study explored the perceptions of resilience and coping among homeless young adults, a focus that differs from previous research by considering the unconventional resilience and coping of this high-risk population. Semistructured qualitative interviews were conducted with 45 homeless young adults. Individual interviews were audio recorded, transcribed, and analyzed by coders using an iterative process of content analysis. Findings revealed four primary themes that highlight perceptions of resiliency and coping, including individual strengths, positive life perspective, external social supports, and individual coping strategies. Implications for professionals working with this population suggest that developing and strengthening programs tailored to utilize homeless young adults’ resiliency may be beneficial. Recognizing the strengths and resilience that homeless young adults are capable of, and incorporating a strength-based perspective to empower these young adults, may encourage positive choices and increase the likelihood of transitioning out of homelessness.