Strengthening Youth Engagement and Retention Skills

Youth living in impoverished communities experience high incidents of involvement with the juvenile justice system, high rates of school dropout, high levels of suicidal behavior, economic hardships that result in frequent moves and often unstable family support networks and lower levels of successful engagement and retention in behavioral health services (Carson, Cook & Alegria, 2010; Hogue & Dauber, 2011; Huey & Polo, 2008). In their daily lives they face violence, homelessness, incarceration, foster care, disabilities, immigration and sexual orientation and racial intolerance. Engagement and retention in treatment are major problems for mental health prevention and intervention programs. This course will present evidence based interventions designed to enhance the knowledge and skills of engagement and retention in treatment when working with high need youth, young adults and their families. We will review commonly utilized theoretical models that inform engagement and retention strategies: the Health Belief Model; Behavior Modification; Strategic and Structural Family Systems Theory; the Ecological Model and the Therapeutic Alliance. We will present promising approaches to engagement and retention which include the Strategic Structural-Systems Engagement (SSSE) model (Szapocznik’s et al.,1988) in which engagement resistance is part of the process; adjunctive family support interventions (Miller & Prinz, 2003); interventions that utilize Motivational Interviewing to address engagement (Nock & Kazdin, 2005; Grote et al. 2009); and McKay and colleagues (1996) provider engagement training to enhance the therapeutic alliance early on in treatment. Special attention will also be given to issues of diversity as it relates to building therapeutic relationships and intervening with youth and their families.