Connecting Youth with Family: Strategies for Preventing and Ending Youth Homelessness

Helping youth strengthen relationships with their family is key to preventing and ending youth homelessness. Most youth under the age of 18 who experience homelessness return home to family, and many youth over the age of 18 do as well. Family conflict is a key risk factor in youth experiencing homelessness, while strengthening family relationships can help prevent it.

Knowing this, family intervention is a core component of the work many programs undertake with youth experiencing or at risk of homelessness, including Basic Centers funded by the U.S. Department of Health and Human Services that provide youth up to age 18 with emergency shelter and other supports. However, we at HHS know that it can be hard to sort through the different models and determine which have evidence behind them.

So, my office, HHS’ Office of the Assistant Secretary for Planning and Evaluation, funded a project with the Urban Institute to look at available research to better understand how much evidence was behind various family interventions to address youth homelessness.

We found a wide variety of existing family interventions. Some are designed to prevent youth homelessness, some focus on reunifying families, and others aim to reconnect and rebuild family relationships. We also found interventions varied in terms of their effectiveness.

We identified two evidence-based interventions that had been rigorously tested using multiple high-quality trials (at least one of which was with youth experiencing homelessness):

• Ecologically Based Family Therapy: Family systems therapy designed to support positive family connections as well as communication and problem-solving skills.
• Functional Family Therapy: Therapy designed to change maladaptive patterns within and around the family by enhancing family interactions and communication.

And four evidence-informed interventions that had been tested with at least one high-quality trial:

• Multidimensional Family Therapy: A family-based therapy approach that aims to reduce adolescent substance abuse.
• Multisystemic Therapy: An individualized treatment approach for youth demonstrating antisocial behavior that incorporates interventions targeting several areas that may influence problem behaviors.
• Treatment Foster Care Oregon: An intensive system of treatment for children and adolescents delivered by trained therapists, foster parents, biological family members, and case managers.
• Support to Reunite, Involve, and Value Each Other (STRIVE): A family therapy approach for youth who are newly experiencing homelessness and their families.

Importantly, we found that these six interventions had a lot in common. All offered services in the family home, and each included clinical services and parent training. They involved multiple, intensive sessions and were mostly delivered by graduate-level therapists.

There’s still more work to do when it comes to conducting research. Not many interventions have been tested specifically with runaway and homeless youth (RHY) or track homelessness as an outcome. Only a few are designed specifically for racial or ethnic minority youth or those who identify as lesbian, gay, bisexual, or transgender.

Key Lessons for Implementing Family Interventions

In addition to examining interventions, the project also identified key lessons for implementing family interventions:

• Think carefully about how to engage parents. Parents’ involvement can help support youth engagement, so it’s important to identify any barriers, such as stress, to parental engagement early on and work to address them.
• Include both youth and parents in decision-making. Leveraging multiple perspectives can make case management plans more effective. When youth and families help set goals, it can increase their buy-in and commitment to reaching those goals. This decision-making can occur quickly within an RHY or other youth provider setting.
• Offer services in multiple locations, including the family home. Parents may be stretched too thin to participate in services across town. Offering services at home can make it easier for them to engage, and youth may actually prefer that family sessions occur within the family home.
• Offer multiple sessions and follow-up. Some providers offer frequent coaching and lead check-ins or follow-up sessions over the phone. This can help reinforce the conflict resolution and other skills youth and families build through the intervention.

Next Steps

But what does this all mean? In addition to continued rigorous research, we need studies of the components and implementation of newer interventions.

We must also work together — across local, state, and federal levels and in the Runaway and Homeless Youth (RHY), child welfare, juvenile justice, and education sectors — to share what’s working and what’s not.

To learn more, we hope you’ll join us for a webinar on December 6, co-hosted by ASPE and the Urban Institute, along with the National Network for Youth and the National Alliance to End Homelessness, to further explore the report’s findings.

Read the Report, where you can also find links to more information about the interventions described above.

Amanda Benton is a Social Science Analyst in the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services, where she serves as the lead analyst for family and youth homelessness, engaging in inter- and intra-agency policy coordination and helping to manage research contracts.