Background

Homeless youth often leave home as a last resort to escape abusive home environments. In collaboration with Drs. Kristin Ferguson (Arizona State University) and Sanna Thompson (University of Texas, Austin – retired), my multi-site study of 601 homeless youth in Denver, Los Angeles, and Austin, found approximately 80% of youth experienced physical abuse and 36% sexual abuse prior to leaving home.

Unfortunately, once on the streets, youth face new victimization risks, such as robbery, assault, and sexual assault. Across the sites in our study, more than 83% experienced direct victimization while 78% witnessed victimization of others or were threatened with violence. Much of the violence experienced while homeless is severe and leads to significant physical and emotional injury. Unfortunately, those youth with the most significant trauma histories are most at risk for new experiences of victimization on the streets.

One explanation for the link between significant childhood trauma and later victimization is that early chronic abuse normalizes violent behavior and makes it difficult to detect new risks when they are encountered. For example, a youth who ran away from a violent home where they witnessed domestic violence may later miss red flags that a new acquaintance is being controlling, jealous, or emotionally abusive.

Our 145 qualitative interviews across the three cities helped us to identify the situations that place youth at risk for victimization and to better understand youths’ methods for detecting risk. Youth described the following risk cues:

  • Internal risk cues, consisting of physiological and physical sensations that indicated something was not right, such as tightness in their stomachs, racing hearts, chills;
  • Interpersonal cues, consisting of reading other people’s body language, mannerisms, and invasive questioning; and
  • Environmental cues, consisting of situations such as dark, isolated, and unfamiliar locations associated with danger.

Many youth stated that, although they used these cues to detect risk, danger could occur anytime and anywhere, suggesting that they often did not identify cues before victimization was unavoidable.

Safety Awareness for Empowerment (SAFE)

Safety Awareness for Empowerment (SAFE) is a mindfulness-based cognitive skill-building intervention aimed at training homeless youth to better detect danger cues and then problem solve and act assertively to avoid such dangers. The intervention uses mindfulness techniques to augment youths’ abilities to attend to internal, interpersonal, and environmental risk cues associated with victimization. The model was adapted from Dr. Anne DePrince’s Healthy Adolescent Relationship Project to reduce intimate partner violence among teen girls in child welfare. We modified the intervention to address risk cues identified through our previous qualitative and quantitative findings. Through a small randomized control trial with a total of 74 youth, SAFE was pilot tested and shown to increase risk detection abilities and improve some aspects of mindfulness.

Next Steps

A key factor associated with victimization is substance use. Youth who use substances are less able to detect danger cues and to defend themselves. At the same time, youth who have experienced trauma and victimization report more often using substances to self-medicate. SAFE, adapted to address these two interrelated problems, is now being tested with a grant from the National Institute on Drug Abuse. This larger 3-year trial will determine whether youth randomly assigned to participate in SAFE are less likely, compared to youth who receive usual shelter services, to experience victimization and use substances over a 6-month period.

Although victimization is quite elevated among homeless youth, it is not inevitable. We hope to empower youth to develop skills to keep themselves safe and healthy.

bender_kimberlyBlog Post Author: Kimberly Bender, PhD, Associate Professor at the Graduate School of Social Work at the University of Denver

Kimberly’s area of expertise is psychosocial intervention for homeless youth. In addition to leading the research projects described in this blog post, she has published extensively in the areas of substance use, trauma, posttraumatic stress disorder, and broader mental health concerns experienced by homeless youth. Additionally, Dr. Bender prioritizes training students as research team members on her community-engaged research projects and has been recognized with several student-nominated awards.

Like this post?
Check out this one on Robin Petering’s experiences teaching yoga to homeless youth.

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