Truancy Programs Richard Dembo, Ph.D. Criminology Department University of South Florida 4202 E. Fowler Avenue Tampa, FL April 2010

The General State of Truancy Programs in the U.S. In many communities, truancy programs remain sanction and procedure oriented. Resources are focused on identifying, locating and transitioning truant youth back into their respective schools with appropriate sanctions and/or citations. Often, these efforts include formal adjudication, police involvement, and suspension or remedial programs, which have not been shown to be effective in resolving the issues fostering truancy.

The General State of Truancy Programs in the U.S. (Continued) Many communities lack screening/assessment and intervention services for truant youth in spite of the psychosocial problems these youth often present. A more effective response to truancy requires identifying and addressing the problems that these youth and their families are experiencing through effective truancy intervention programs. Review of the literature identified a relatively small number of studies of interventions that have been put in place to decrease truancy rates by remediating the problems causing this behavior. ~(Dembo & Gulledge, 2009).

Types of Truancy Programs School Based Programs Community Based Programs School & Community Based Programs Court System Based Programs Law Enforcement Based Programs

Essential Qualities of Effective Truancy Programs In its review of promising truancy reduction programs, the Colorado Foundation for Families and Children noted several critical elements that were necessary for effective programming: 1)parent/guardian involvement; 2)a continuum of services, to include meaningful incentives, consequences and support; 3)collaboration with community resourcesincluding law enforcement, mental health services, mentoring and social services; 4)school administrative support and commitment to keeping youth in the educational mainstream; 5)ongoing evaluation. ~Colorado Foundation for Families and Children(2007)

Essential Qualities of Effective Truancy Programs (Continued) Few of the many programs the Foundation reviewed met these criteria Of particular concern was the general lack of detailed information on program implementation and system issues experienced by truancy reduction programs, as well as a lack of process and outcome evaluations, which could inform the field.

Essential Qualities of Effective Truancy Programs (Continued) Most evaluations of truancy programs are: –Based on aggregate data; –Often lack meaningful comparison groups (Lehr, Sinclair & Christenson, 2004); –Focus on short-term benefits (e.g., reduction in unexcused absences) which do not provide meaningful information on changes in individuals school attendance or academic school performance (OJJDP, 2001 citing Mueller, Giacomazzi, & Stoddard, 2006).

Challenges Presented by Truancy Programs Each of the various types of truancy programs have experienced implementation challenges. As previously noted, a majority of the research published from truancy studies is predominantly descriptive in nature. –Of these, a relatively small proportion of studies describe program evaluation efforts. –Even smaller still is the number of studies that discuss implementation challenges or empirically validated results of project effectiveness and short or long term outcomes.

Challenges Presented by Truancy Programs (Continued) The general lack of methodologically sound, empirical studies conducted to determine truancy program effectiveness continues to impede our understanding of how to best serve the growing numbers of truant youth across the nation. Program evaluations in pilot studies conducted in the field are frequently considered threatening; whereas, unevaluated programs are perceived to be safe.

Challenges Presented by Truancy Programs (Continued) Reluctance for program evaluations may be because: –The facts, when made public, may set back a program and the policy under which it operates, particularly if there are some negative findings in the evaluation. (Palumbo, 1987, p. 22).

Challenges Presented by Truancy Programs (Continued) Additionally: –If project staff members are fearful of negative evaluation results, avoiding political embarrassment rather than accomplishing program goals may become the first priority (Faux, 1971, p. 278). –Descriptive and predictive studies are important to our understanding events and issues preceding student truancy, chronic absenteeism, and school dropout.

Challenges Presented by Truancy Programs (Continued) Studies that evaluate the effectiveness of truancy interventions are needed to determine whether these programs successfully serve their intended populations and meet project goals by improving truant youth psychosocial functioning, including truant and related behavior.

Challenges Presented by Truancy Programs (Continued) A serious need exists to precisely document truancy interventions, as well as to empirically evaluate their effectiveness. Further, it is important to establish a continuum of care for truant youth, inviting collaboration with relevant community agencies.

The Hillsborough County, Truancy Intake Center Intake and Processing Youths at the TIC Involvement in Intervention Services

Issues Relating to Truancy Truancy in American schools Midpoint along a continuum (Nat'l School Safety Center, 1996) Truants represent an at-risk population (Dembo & Turner, 1994) Stressful, troubled family situations Educational difficulties Emotional and other psychosocial difficulties Alcohol and/or other drug use Identification and response

Drug involvement exists among a sizable proportion of truant youth Truant youth are unlikely to receive drug intervention services under current procedures Affordable and transportable interventions for drug-using truant youth are rare, yet greatly needed Truant youth consist of a heterogeneous group of younger, mild-to- moderate drug using youth Very few low-intensive services are available to them A Significant and Innovative Approach

A Significant and Innovative Approach (Continued) Current treatment technologies for juvenile drug abuse are incorporated into the curriculumCurrent treatment technologies for juvenile drug abuse are incorporated into the curriculum –Cognitive-behavioral, problem solving, and family strategies Truancy centers - opportunistic settings for BITruancy centers - opportunistic settings for BI Inclusion criteria are targeted for non-serious justice involved, mild-to- moderate drug using youths in order to test the intervention as a secondary prevention curriculumInclusion criteria are targeted for non-serious justice involved, mild-to- moderate drug using youths in order to test the intervention as a secondary prevention curriculum –A form of service that has been generally understudied and under- utilized in juvenile drug treatment systems

Specific Goals To test the efficacy of Brief Intervention-Youth (BI-Y) and Brief Intervention-Parent (BI-P) on post-program drug use and related behaviors for truant youth To test the efficacy of Brief Intervention-Youth (BI-Y) and Brief Intervention-Parent (BI-P) on post-program drug use and related behaviors for truant youth To test the relative effects of parental involvement in the BI on post-treatment drug use and related behaviorsTo test the relative effects of parental involvement in the BI on post-treatment drug use and related behaviors To identify youth and parent factors that are associated with significant post-program improvementTo identify youth and parent factors that are associated with significant post-program improvement –Reductions in drug use and delinquent behavior and improvement in school behavior and attitudes

Efforts to address truant behavior are all too often sanction and procedure oriented Truant youth: disciplinary and management problems Without a continuum-of-care across service areas (i.e. school, community, court, law enforcement agencies), truancy initiatives are ill-equipped to address issues directly associated with truancy Academic problems, troubled family situations, and other psychosocial difficulties - including drug use Continuity of Care

Continuity of Care (continued) Current intervention services in Hillsborough County are addressing truancy by crossing agency boundaries. The following agencies work together:Current intervention services in Hillsborough County are addressing truancy by crossing agency boundaries. The following agencies work together: The Hillsborough County Juvenile Assessment Center, Hillsborough County Sheriffs Office, the City of Tampa Police Department, Hillsborough County School Board, and the University of South Florida [with NIDA funding]The Hillsborough County Juvenile Assessment Center, Hillsborough County Sheriffs Office, the City of Tampa Police Department, Hillsborough County School Board, and the University of South Florida [with NIDA funding]

Continuity of Care (continued) The benefits of interagency collaboration includes: Common objective of all collaborative agencies in addressing the service needs and risk factors of truant youth in an effort to prevent their school failure and movement into the juvenile justice systemCommon objective of all collaborative agencies in addressing the service needs and risk factors of truant youth in an effort to prevent their school failure and movement into the juvenile justice system Holistic, systems oriented, in-home interventionHolistic, systems oriented, in-home intervention Extended follow-up and community referral servicesExtended follow-up and community referral services

Selection of Study Subjects Study Setting Hillsborough County Truancy Intake Center (TIC) Study Eligibility Youth processed at the TIC are eligible for inclusion if:Youth processed at the TIC are eligible for inclusion if: They are between years of age,They are between years of age, They indicate past year alcohol/drug use on the Personal Experience Screening Questionnaire (PESQ; Winters, 1992) or TIC Social Worker indicates youth has an alcohol/drug use issue,They indicate past year alcohol/drug use on the Personal Experience Screening Questionnaire (PESQ; Winters, 1992) or TIC Social Worker indicates youth has an alcohol/drug use issue, They have no official record of delinquency, or a delinquency record with no more than two misdemeanorsThey have no official record of delinquency, or a delinquency record with no more than two misdemeanors *Social Worker / Guidance Counselor Referral System* *Social Worker / Guidance Counselor Referral System* Students may also be referred to the BI-Project by their on-site school Social Worker or Guidance CounselorStudents may also be referred to the BI-Project by their on-site school Social Worker or Guidance Counselor The social worker/guidance counselor may present the BI project to the youth/family and encourage them to contact the TIC staffThe social worker/guidance counselor may present the BI project to the youth/family and encourage them to contact the TIC staff After a referred family makes contact, project staff will check the youth for eligibility (i.e., arrest history)After a referred family makes contact, project staff will check the youth for eligibility (i.e., arrest history) *Diversion Program Referral System* *Diversion Program Referral System* We also accept referrals of youths meeting study eligibility criteria from a community diversion programWe also accept referrals of youths meeting study eligibility criteria from a community diversion program

Invitation to ParticipateInvitation to Participate Overview of project; Schedule first in-home assessmentOverview of project; Schedule first in-home assessment Research InterviewsResearch Interviews A research staff member meets with youth & parent for the consent/assent process and an initial in-home interviewA research staff member meets with youth & parent for the consent/assent process and an initial in-home interview Follow-up in-home interviews conducted at 3, 6, 12, & 18-months following last participationFollow-up in-home interviews conducted at 3, 6, 12, & 18-months following last participation Youth and parents interviews conducted separatelyYouth and parents interviews conducted separately Family Enrollment

Random Assignment 1/3 of the participants do not meet with an interventionist; receive Standard Truancy Services + project referral assistance 1/3 of the participants have two (youth) in-home sessions with an interventionist 1/3 of the participants have three in-home sessions with an interventionist (two youth sessions + one parent/guardian session) Session ONE (Youth) Substance use and related consequences Willingness to change Causes and benefits of change Goals for change the youth would like to pursue Abstinence or reduce substance use goals Session TWO (Youth) Reviews progress with the agreed upon goals Identifies risk situations associated with the youths difficulty in goal attainment Strategies to address barriers toward goal attainment Negotiates a continuation in goals or advancement to more ambitious goals Session THREE (Parent/Guardian) Integrated behavioral and family therapy approach Topics addressed with parent/guardian: Childs substance use problems Parent attitudes/behaviors regarding their childs substance use Parent monitoring/supervision to promote progress toward their childs intervention goals Parent communication skills to enhance youth-parent connectedness Youth and parent/guardian given $5 for each session they attend. Intervention Groups

Strengths of Brief Intervention BI coordinates therapy components Rational-Emotive Therapy (RET) Promotes adaptive beliefs Problem Solving Therapy (PST) Promotes coping skills BI promotes self-efficacy BI is individually tailored BI is flexible BI focuses on real-life applications BI promotes parent monitoring and support

Gender Breakdown (n=137)

Ethnic Breakdown (n=137)

Age: Mean= 14.71, SD=1.22 Lives With: Biological mom and dad:13.9% Biological mom alone:28.5% Biological mom & stepdad/boyfriend:22.6% Biological mom & other relative/friend:16.8% Biological dad: 2.2% Biological dad & stepmother/girlfriend: 2.9% Biological dad & other relative/friend: 0.7% Other living arrangement:12.3% Age and Living Arrangement

Alcohol/Other Drug Use (n=137) Alcohol Ever drank alcohol to point of feeling buzzed or intoxicated (64%) Ever drank alcohol 5+ times in lifetime to the point of feeling buzzed or intoxicated (36%) Marijuana Ever used marijuana (93%) Ever used marijuana 5+ times in lifetime (66%) Other Drugs Ever Used by 10% of Youths Barbiturates (12%) Ever used other drug 5+ times (9%)

Alcohol/Other Drug Use Urine test results (n=125) Positive for Amphetamines*6% Positive for Cocaine <1% Positive for Opiates-- Positive for Marijuana 47% * Many of these youths were on amphetamine based ADHD medication.

Alcohol/Other Drug Use/Abuse Diagnosis Substance Use/Abuse Diagnosis(%) None Abuse Dependence Alcohol Marijuana Other drugs (e.g., barbs) Combined/Ov. Diagnosis

Unemployment of parent52.6% Divorce of parents42.3% Death of loved one62.8% Serious illness34.3% Victim of violent crime20.4% Eviction from house or apartment18.2% Legal problem resulting in jail time or detention27.0% Accidental injury requiring hospitalization 9.5% Other traumatic event not listed46.7% (e.g., youth being placed in foster care, not having a relationship with father) Mean=3.14, SD=1.73 Parent/Guardian Report of Youth or Their Family Experiencing Stressful/Traumatic Events in Lifetime (n=137)

Self-Reported Sexual Risk Behaviors: Baseline and 3 Mos. Follow-Up Baseline (Ever) (n= )(%) 3 Mos. Follow Up (n=101)(%) 1. Have any of your close friends had sex? Have you had any kind of sexual contact with another person? Have you had sexual intercourse? Have you had sexual intercourse without using a condom? Do you find it difficult to use condoms every time you have sex? Have you thought you or your partner might be pregnant? Have you been or gotten someone pregnant? Have you been tested for HIV? Have you had sex with two or more people? Have you had anal intercourse (sex in the butt)? Have you had a sexually transmitted disease (STD)? 21

Past Year Self-Reported Delinquency (%)(N=137) Offense Type Index Person crimes General Theft <12 Drug Sales <1 Total Delinquency

Psychosocial Description of the Youths Families and the Youths (n=136 or 137) (% Ever) Family Problems Family member ever had an alcohol/other drug abuse problem58 Family member ever received alcohol/other drug use treatment24 Family history of mental health problems36 Youth Problems Ever had an alcohol/other drug abuse problem19 Ever received treatment for alcohol/other drug abuse problem11 Ever received services for emotional/behavioral problems51

The Longitudinal Model Figure 1

Conceptual/Research Foundation for the Model The sexual risky behavior model is based on the literature indicating: –Relationships between youths psychosocial problems and drug use (Dembo & Schmeidler, 2002; Dembo, Wareham et al., 2007); –Relationships between these constructs and youths engaging in sexual risky behavior (Elkington, Teplin et al., 2008; Rowe, Wang et al., 2008; Cook, Comer et al., 2006; Tolou- Shams, Brown et al., 2008; Dembo, Belenko et al., 2009); –Continuity of sexual risky behavior over time (Romero, Teplin et al., 2007; DiClemente, Wingood et al., 2002).

Key Measures 1. Self-Reported Delinquency (Elliott et al., 1976), log transformed 2. Stressful/traumatic events of youth/family member (Parent reports) (from parent/guardian (Adolescent Diagnostic Interview [ADI] [Winters & Henly, 1993]) 3. Reported family alcohol/drug problems & mental health problems(ADI) 4. Youth reported emotional/psychological problems (ADI) 5. Lifetime alcohol, marijuana other drug use (baseline ADI) 6. UA marijuana (baseline) 7. Sexual Risky Behavior (POSIT HIV/STD Risk Behavior Questions baseline and 3 month follow- up). Good psychometric properties (e.g., internal consistency = 0.80, one-week test-retest reliability = 0.90; concurrent validity with the Sexual Risk Questionnaire scores: r = 0.80) Variable Measurement Level: –Continuous: SRD total score, caretaker report of stressful/traumatic events (measures 1 & 2) –Categorical: All other variables in the model were binary or ordinal

Preliminary Analyses Confirmatory factor analysis of the psychosocial and drug use variables found them to be significantly related to separate, but correlated, latent variables (Mplus; Muthen & Muthen [version 5], 2007) (chi-square=14.64[15], p=.48) (CFI=1.000, TLI=1.000, RMSEA=0.000, WRMR=0.591). Exploratory factor analysis (SPSS, Version 17) at each time point, found the sex risk behavior items 2 (sexual contact), 3 (intercourse), 4 (sex w/o condom) & 9 (2+ sex partners) to form a separate factor. Hence, these items were used as our measures of sex risk.

Preliminary Analyses (Continued) At each time point, confirmatory factor analysis found the sex risk behavior items to measure one latent variable reflecting sexual risk (baseline: chi-square=0.14[1], p=0.71) )(CFI=1.000, TLI=1.014, RMSEA=0.000, WRMR=0.142); 3 mos. follow-up: chi-square=1.79[2], p=0.41) (CFI=1.000, TLI=1.002, RMSEA=0.000, WRMR=0.348) For the baseline and 3 month follow-up sexual risk items/factors, measurement invariance (equal factor loadings and thresholds) was supported by additional analyses (Nested chi-square test=7.48[5],p=0.19) (Widaman & Reise, 1997).

Results of Model Test Figure 2

Covariate Effects on Latent Variables in the Sexual Risky Behavioral Model Psychosocial Factors Drug Use Baseline Sex Risk 3 mos. Sex Risk EstimateS.E.EstimateS.E.EstimateS.E.EstimateS.E. Age * * Gender (Female) AAmer * Hispanic

Future Directions Repeat analyses with a larger number of cases Examine for intervention effects Pursue latent growth modeling analyses involving more time points Pursue mediation analyses