DIfferences in Treatment Trajectories Between Two Profiles of Adolescent Systems Involvement

Area of Science:

• Adolescent behavioral health
• Systems science
• Clinical psychology

Background:

• A significant proportion of adolescents using behavioral health services are involved in multiple systems (mental health, juvenile justice, child welfare, education).
• Lack of integrated care across these systems often results in unmet needs for these youth.
• Adolescent behavior problems require tailored conceptualizations for those involved in multiple systems.

Purpose of the Study:

• To identify distinct classes of systems involvement among adolescents receiving behavioral health treatment.
• To compare these classes based on demographics and diagnoses.
• To examine changes in delinquency and substance use over one year for youth within these identified classes.

Main Methods:

• Latent class analysis was used to identify distinct groups of systems involvement.
• Demographic and DSM-IV diagnostic data were compared across identified classes.
• Latent growth curve modeling analyzed changes in delinquency and substance use over a one-year follow-up period.

Main Results:

• Two distinct classes of adolescent systems involvement were identified: heavy involvement across all systems, and high involvement in only mental health and education systems.
• Adolescents with heavy involvement in all systems demonstrated significantly greater decreases in delinquent activity compared to other youth.
• This same group showed less reduction in substance use over the one-year follow-up period.

Conclusions:

• Classifying adolescents based on their patterns of multiple systems involvement is clinically useful.
• Findings can help treatment providers identify and tailor interventions for youth heavily involved in all systems.
• Further research can explore treatment trajectories and influencing factors for multi-system involved youth.