SYNC Program for Psychosocial Functioning in Foster Youth

Overseen By Carrie J Furrer, PhD,MS,BA

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Portland State University

Disqualifiers: Non-English speaking, Developmentally disabled, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 8

106 Participants Needed

Trial Summary

What is the purpose of this trial?

This study will deploy a scalable secondary prevention program that leverages existing foster youth transition services to improve mental health functioning and service use before and after exiting foster care. Our short-term objective is to remotely test a group intervention called Stronger Youth Networks and Coping (SYNC) that targets cognitive schemas influencing stress responses, including mental health help-seeking and service engagement, among foster youth with behavioral health risk. SYNC aims to increase youth capacity to appraise stress and regulate emotional responses, to flexibly select adaptive coping strategies, and to promote informal and formal help-seeking as an effective coping strategy. The proposed aims will establish whether the 10-module program engages the targeted proximal mechanisms with a signal of efficacy on clinically-relevant outcomes, and whether a fully-powered randomized control trial (RCT) of SYNC is feasible in the intended service context. Our first aim is to refine our SYNC curriculum and training materials, prior to testing SYNC in a remote single-arm trial with two cohorts of 8-10 Oregon foster youth aged 16-20 (N=26). Our second aim is to conduct a remote two-arm individually-randomized group treatment trial with Oregon foster youth aged 16-20 with indicated behavioral health risk (N=80) to examine: (a) intervention group change on proximal mechanisms of coping self-efficacy and help-seeking attitudes, compared to services-as-usual at post-intervention and 6-month follow-up: and (b) association between the mechanisms and targeted outcomes, including emotional regulation, coping behaviors, mental health service use, and symptoms of depression, anxiety, and PTSD. Our third aim is to refine and standardize the intervention and research protocol for an effectiveness trial, including confirming transferability with national stakeholders.

Will I have to stop taking my current medications?

The trial information does not specify whether participants must stop taking their current medications. It is best to consult with the trial coordinators for specific guidance.

What data supports the effectiveness of the treatment Stronger Youth Networks and Coping (SYNC) for improving psychosocial functioning in foster youth?

The SYNC program aims to improve foster youth's coping skills and help-seeking behaviors, which are important for mental health. Initial testing showed that the program is acceptable and feasible, suggesting it could be a valuable addition to existing services for foster youth. ^{1 2 3 4 5}

How is the SYNC treatment different from other treatments for foster youth?

The SYNC treatment is unique because it focuses on enhancing individual strengths and building quality relationships to improve psychosocial functioning in foster youth, unlike other treatments that may not specifically target these modifiable protective factors. ^{3 6 7 8 9}

Research Team

Jennifer Blakeslee, PhD,MSW,BS

Principal Investigator

Portland State University

Eligibility Criteria

This trial is for foster youth in Oregon, aged 16-20, who have been in care for at least 90 days post-age 14 and show signs of behavioral health risks. It's not open to those who can't actively participate due to language barriers, significant developmental disabilities, or crisis situations.

Inclusion Criteria

Indicated behavioral health risk. Behavioral health risk is indicated by child welfare administrative indicators of lifetime behavioral health need or service involvement (DSM diagnoses, psychotropic medication, emotional-behavioral disability, congregate care/residential placement)

I am 16-20, was in foster care after 14, and can get federal transition help in Oregon.

Exclusion Criteria

I am able to actively participate and understand English.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the SYNC intervention, which includes 8 weekly remote 90-minute sessions delivered by a facilitator and a near-peer young adult.

8 weeks

8 visits (virtual)

Follow-up

Participants are monitored for changes in coping self-efficacy, help-seeking attitudes, and mental health outcomes.

6 months

Treatment Details

Interventions

• Stronger Youth Networks and Coping (SYNC)

Trial Overview The SYNC program is being tested to see if it helps foster youth manage stress better by improving their emotional regulation and coping strategies. The study will also look at whether the program encourages seeking help as a way to cope with mental health issues.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

The Intervention group receives the SYNC intervention in addition to typical child welfare services (i.e., services as usual). The SYNC intervention includes 8 weekly remote (videoconference) 90-minute sessions delivered by a facilitator and a near-peer young adult aged 20-26, both with lived experience in child welfare.

Group II: Services-as-usual Active Control 1 Intervention

The Services-as-usual (SAU) group receives typical child welfare services, which include ILP, or federally funded transition planning (e.g., identifying and supporting youth education and employment goals) and life skills (e.g., budgeting, renting an apartment, insurance) services typically delivered through a mix of classes, group activities, and/or individual skill-building with a paraprofessional service provider.

Stronger Youth Networks and Coping (SYNC) is already approved in United States for the following indications:

Approved in United States as Stronger Youth Networks and Coping (SYNC) for:

• Improving mental health functioning and service use among foster youth with behavioral health risk

Who Is Running the Clinical Trial?

Portland State University

Lead Sponsor

Trials

24

Recruited

26,600+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

The SYNC intervention aims to improve coping self-efficacy and help-seeking behaviors among youth in foster care, addressing their unique mental health challenges and support needs, based on insights from a needs assessment and feedback from a research advisory group.

Initial testing with 30 youth participants and 82 service providers showed that the intervention is acceptable and feasible, emphasizing the importance of group-based formats and peer mentorship to engage young people effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking. Blakeslee, JE., Kothari, BH., Miller, RA.[2023]

In a study involving 384 children in specialized foster care, most participants showed significant improvement in various outcomes, highlighting the effectiveness of this intervention.

Longer stays in specialized foster care (up to two years and five months) were linked to better outcomes, particularly for younger children and those with fewer problems, suggesting that extended support can be beneficial.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes of specialized foster care in a managed child welfare services network. Cross, TP., Leavey, J., Mosley, PR., et al.[2019]

A scoping review of 41 quantitative studies over 20 years identified key individual and interpersonal factors that can improve psychosocial well-being in adolescents aged 13-19 in foster care, emphasizing the importance of individual strengths and quality relationships.

When youth in foster care have their psychosocial needs met and develop strong relationships, it leads to better outcomes, suggesting that interventions should focus on enhancing these protective factors to support their development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual and interpersonal factors associated with psychosocial functioning among adolescents in foster care: A scoping review. Kothari, BH., Blakeslee, J., Miller, R.[2021]

The study of 22 youth aged 16-20 in foster care revealed that their support networks often lack capacity due to interpersonal difficulties, which limits the effectiveness of support from family, peers, and caseworkers.

However, stable and cohesive support networks, characterized by strong relationships with caregivers and service providers, can enhance the multidimensional support available to these young adults as they transition out of foster care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding support network capacity during the transition from foster care: Youth-identified barriers, facilitators, and enhancement strategies. Blakeslee, JE., Best, JI.[2023]

The mentoring and skills group intervention significantly reduced the likelihood of children in foster care being placed in residential treatment by 82%, indicating a strong positive impact on their stability.

Children in nonrelative foster care who participated in the intervention experienced 44% fewer placement changes and were five times more likely to achieve permanency, highlighting the intervention's effectiveness in improving long-term outcomes for these vulnerable children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

RCT of a mentoring and skills group program: placement and permanency outcomes for foster youth. Taussig, HN., Culhane, SE., Garrido, E., et al.[2021]

Mentees in foster care experienced shorter mentoring matches and were more likely to have their matches close prematurely compared to those not in foster care, indicating a need for targeted support in these relationships.

The study found that the implementation of benchmark program practices was associated with longer match lengths for mentees in foster care, suggesting that structured mentoring practices can enhance the stability of these relationships.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting Mentoring Relationships of Youth in Foster Care: Do Program Practices Predict Match Length? Stelter, RL., Kupersmidt, JB., Stump, KN.[2019]

A study involving 732 foster youth found that individual characteristics like attachment insecurity and delinquency significantly impact their perceived social support during the transition to adulthood.

Social connections with caregivers, relatives, and especially romantic partners or natural mentors greatly enhance perceived social support, suggesting that fostering these relationships can be crucial for improving outcomes for foster youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The predictors of perceived social support among former foster youth. Zinn, A., Palmer, AN., Nam, E.[2018]

The Fostering Healthy Futures program, a 9-month mentoring and skills intervention for maltreated children, was effective in reducing posttraumatic stress and dissociation symptoms in children with low to moderate baseline risk exposure, based on a study of 156 children aged 9-11.

However, children with high levels of adverse childhood experiences did not show significant improvement compared to the control group, indicating that the program may be less effective for those facing greater trauma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Moderating Effect of Risk Exposure on an Efficacious Intervention for Maltreated Children. Weiler, LM., Taussig, HN.[2020]

A resilience enhancement program for 32 female runaway youths in shelters showed significant improvements in resilience, anxiety, and problem drinking at a one-month follow-up, indicating its potential effectiveness.

The program focused on five protective factors—self-esteem, self-regulation, relational skills, problem-solving skills, and goal-setting skills—demonstrating that targeted skill development can positively impact mental health outcomes in this vulnerable population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of a Resilience Enhancement Programme for Female Runaway Youths: A Quasi-Experimental Study. Noh, D.[2019]

References

1. England pubmed.ncbi.nlm.nih.gov

Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Outcomes of specialized foster care in a managed child welfare services network. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Individual and interpersonal factors associated with psychosocial functioning among adolescents in foster care: A scoping review. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Understanding support network capacity during the transition from foster care: Youth-identified barriers, facilitators, and enhancement strategies. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

RCT of a mentoring and skills group program: placement and permanency outcomes for foster youth. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Supporting Mentoring Relationships of Youth in Foster Care: Do Program Practices Predict Match Length? [2019]

7. England pubmed.ncbi.nlm.nih.gov

The predictors of perceived social support among former foster youth. [2018]

8. England pubmed.ncbi.nlm.nih.gov

The Moderating Effect of Risk Exposure on an Efficacious Intervention for Maltreated Children. [2020]

9. England pubmed.ncbi.nlm.nih.gov

The Effect of a Resilience Enhancement Programme for Female Runaway Youths: A Quasi-Experimental Study. [2019]