Addressing the Mental Health Consequences of Being Reared in Poverty for Youth Who Rely On Public Safety Net Service Systems: The 4Rs and 2Ss for Strengthening Families
Methods: The 4Rs and 2Ss intervention was examined via a randomized effectiveness study involving 320 low-income youth (ages 7-11) and their families approaching 13 urban child mental health clinics. Participants were randomly assigned to one of two study conditions: 1) 4Rs/2Ss or; 2) SAU. Outcomes related to youth behavior and social skills functioning, as well as parent/family-level domains were captured via a set of standardized assessments at four time points: baseline, mid-test (8 weeks), post-intervention (16 weeks) and 6 month follow-up (10 months from baseline). Random regression modeling was used to examine multi-level outcomes across time.
Results: Participants in the 4Rs/2Ss multiple family group intervention sessions reported significant improvements in child behavioral difficulties at post-test (16 weeks) and at 6 month follow-up relative to those youth/families assigned to SAU. In addition, 4Rs/2Ss group participants manifested significant improvements over those in SAU at both post-test and 6 month on the following outcomes: youth social skills, perceptions of parental stress related to managing difficult child behaviors, and overall impairment in functioning.
Implications: Each year, billions of dollars are spent on addressing child mental health needs or the consequences of failing to provide high quality, evidence-based services to children and their families when difficulties emerge in childhood. Medicaid Redesign efforts across states necessitate the use of efficient, evidence-informed service models that align with needs of youth, families, and can easily be delivered by the existing workforce. This presentation highlights both a process to develop services to meet the complex needs of youth, families, providers and systems, as well as rigorous research evidence for positive, long-term child and family-level outcomes obtained within “real world” public clinics.