Stephen Gaetz
I am committed to a research agenda that foregrounds social justice and attempts to make research relevant to policy and program development. What began as an interest in working with marginalized youth in Ireland has evolved into a professionally informed fascination with processes of social exclusion as experienced by people who are homeless. As such, my research on homeless youth has focussed on their economic strategies, health, education and legal and justice issues.

Prior to joining the Faculty of Education at York University, I worked at Shout Clinic, a health service for street youth in Toronto. There, I was not only involved in health promotion and program planning, but was also given the opportunity to conduct research which had practical outcomes. For instance, my research on street youth and oral health _ unique in the field of dentistry _ was used to advocate for better dental services for marginalized populations, and played a role in establishing the first free dental service for street youth in Canada. My research with Bill O'Grady focuses on street youth and their economic strategies, and has resulted in a number of publications. This research was used to advocate against the passing of the "Safe Streets Act" in Ontario, and contributed to the establishment of an innovative employment program for street youth.

My commitment to making knowledge count underlies his involvement in the coordination of the Canadian Conference of Homelessness in May, 2005. More recently, I have been working on the development of The Homeless Hub, which is a web-based clearinghouse of homelessness research in Canada.

Selected Publications:

Gaetz, Stephen (1997) Looking Out for the Lads: Community Action and Youth Provision in an Urban Irish Parish. St. John's: Institute of Social and Economic Research 235 pg. (html)

Gaetz, Stephen (2006) "Editorial Making Research Matter: The Canadian Conference on Homelessness" Canadian Review of Social Policy

Gaetz, Stephen, Tarasuk, Valerie, Dachner, Naomi (2006) "'Managing' Homeless Youth in Toronto: Mismanaging Food Access and Nutritional Well-being" Canadian Review of Social Policy

Gaetz, Stephen (2005). "Another Girl: An Atypical Story about a Typical Adolescent". In L. Biggs & P. Downes (Eds.), Gendered Intersections: A Collection of Readings for Women's and Gender Studies. Toronto: Fernwood Books.

Gaetz, Stephen & O'Grady, Bill (2004). "Work on the streets". In Encyclopaedia of Homelessness. Great Barrington, MA: Berkshire Publishing.

Gaetz, Stephen (2004) "Safe Streets for Whom? Street Youth, Social Exclusion and Criminal Victimization". Canadian Journal of Criminology and Criminal Justice. 46 (4), 423-455.

O'Grady, Bill & Gaetz, Stephen (2004). "Homelessness, Gender and Income Generation: the case of Toronto Street Youth". Journal of Youth Studies. 7(4), 397-416.

Gaetz, Stephen & O'Grady, Bill (2002). "Making Money - Exploring the Economy of Homeless Workers" Work, Employment and Society. 16 (3), 433-456.

Gaetz, Stephen & Lee, Jack (1995). "Developing Dental Services for Street Youth" Ontario Dentist. November, 72 (9), 34-37.

Lee, Jack, Gaetz, Stephen & Goettler, Fred (1994). "The Oral Health of Toronto's Street Youth" in Canadian Dental Association Journal. 60 (6), 545-548.

Professional Reports

Gaetz, Stephen & O'Grady, Bill (2006). The Missing Link: Discharge planning, Incarceration and Homelessness. The John Howard Society of Ontario.

Gaetz, Stephen (2004) Understanding Research on Homelessness in Toronto: A Literature Review. Toronto: York University and Wellesley Central Health Foundation.

Gaetz, Stephen (2002). Street Justice - The Legal and Justice Issues of Homeless Youth in Toronto. Toronto: Justice for Children and Youth.

Contact Info:

Stephen Gaetz
Associate Professor
Faculty of Education
York University
N837D Ross Building
4700 Keele St.
Toronto, ON M3J 1P3
Tel: (416) 736-2100 x20050
Fax: (416) 736-5913

Dr. Jeff Karabanow
Dr. Jeff Karabanow is an associate professor at the School of Social Work and Cross-Appointed with International Development Studies and Health and Human Performance at Dalhousie University. His teaching interests involve community development, social policy, research methodology, organizational theory and international social work. Jeff has worked with street youth in Toronto, Montreal, Halifax, India and Guatemala. He has published numerous academic articles about street youth culture and has completed a film documentary looking at the plight of street youth in Guatemala City. His most recent works include: a book titled Being Young and Homeless: How youth enter and exit street life (2004, Peter Lang USA) which chronicles the stages of street engagement and disengagement for homeless and runaway youth; and a National Homelessness Initiative funded study (2005) looking at how young people across Canada navigate their way out of street life.

Contact Info:

Dr. Jeff Karabanow
Associate Professor
School of Social Work,
International Development Studies
Dalhousie University
6414 Coburg Rd., Halifax, Nova Scotia, B3H 2A7
Tel: 902 494 1193
Fax: 902 494 6709
Email: jkaraban@dal.ca

Sean Kidd
Sean Kidd's primary area of research interest lies in the examination of risk and resilience among marginalized persons. Much of his work to date has focused on suicidality, resilience, and intervention development among homeless youth. He has also done work in areas including the development of community-based programs of recovery for persons with serious mental illness, adolescent suicidality, cultural psychology, and the integration of qualitative methods within psychology.

He is an Assistant Professor with the McMaster University Department of Psychiatry and Behavioural Neurosciences, an Assistant Clinical Professor with the Yale Department of Psychiatry, and is the staff Psychologist with St. Joseph's Healthcare, Hamilton, Mental Health Rehabilitation Services.

Igor van Laere, MD
Municipal Public Health Service (GGD)
PO BOX 2200,
1000 CE Amsterdam,
The Netherlands
ivlaere@ggd.amsterdam.nl

Introduction
Multiple social and medical problems leading to homeless people accessing multiple services hardly prevents homeless people escape from excessive morbidity and early mortality. Despite investments, research and a multitude of projects to address the most underserved, the epidemic of homelessness does not seem to decrease.1-3
With my own father as my medical teacher and with my own experience, providing full-time outreach social medical care to homeless people in Amsterdam during the last ten years, I will demonstrate that homeless people are in need of Hippocrates. I will describe my family biography and lessons learned.

Family biography
My father Roger van Laere was brought up by his caring parents in a rural Dutch village close to the Belgian border. As a child he was inspired by the professionalism of the local family doctor. My father knew he ought to become a family doctor himself. He was a curious and smart child who understood the need for books. At school he enjoyed history and biology. Outside school he enjoyed sports and dancing.
In the 1950s my father met my mother on the dance floor. From that day a caring and hospitable couple were formed. My father went to medical school at the University of Nijmegen and mom followed him as a nurse. They made good friends. Friends with whom they still are in close contact, friends who all have reached an influential position in the community. Most have been admirably successful.
After University my father went to the army, as a young family doctor. A captain, (from the rural village Liempde in a caring and hospitable province called Noord-Brabant and the place where my parents still live today), introduced him to the local family doctor who asked for my fathers substitution during his leave. Infected by the appearance and performance of the rural people, my parents found their destiny and took over the pharmacy holding family practice.
Three boys and a daughter were born. New friends were made. Patients were cared for without a single complaint or judgment, even after several assisted births during several nights and new patients waiting early in the morning. In the meantime, my father wrote fifteen books on rural people and their peculiarities coping with life and health. He lectured on birth, marriage and death. His material came from local people who were born around the 1900s. Forty years passed by. My brother Olof van Laere took over the family practice. My parents retired to enjoy their grandchildren.

After my father graduated from medical school my two brothers and me were born in the city of Nijmegen. My good sister was born in a hospital in a neighboring village of Liempde. Parents who showed care and hospitality brought us up. They stimulated school, curiosity and adventure. At school I enjoyed history and biology. Outside school I enjoyed sports and dancing. I was better at curiosity and adventure than at doing books.
Without pushing from my parents, and without guilt of choosing my own direction, initially I thought of following sports and dancing. However I made the decision to go to medical school at the University of Amsterdam. During lectures I observed teachers and my own notes. I hardly opened books. I outlived my curiosity and urge for adventure by traveling and meeting people and health services in six continents.
After my medical graduation, I decided to go into internal medicine inspired by the professional role-model of internists. A lack of senior teachers in internal medicine in Amsterdam brought me to a teaching hospital in the city of Eindhoven in my province Noord-Brabant. As a resident I observed the practice of caring and hospitable senior doctors who did not complain nor judge others but worked patiently during long-hour weeks.
Driven by my curiosity and adventure I decided to go back to Amsterdam, to become a family doctor. Due to a time consuming procedure for a biannual entrance ticket into the school for family doctors, I became a resident in internal medicine in a teaching hospital instead. I had left my caring and hospitable province life and re-entered an individual and hostile city life. Again I observed the practice of my senior doctors. This time it was different.

In the 1990s in Amsterdam I observed doctors complaining and judging others above providing care to patients. I felt less care and less hospitality. I became restless and rebellious. It took a little over a year to leave the hospital and a friend of mine guided me into community care. I felt welcomed as I entered the world of public health.
During the years that followed I missed my patients and hospital rounds. To keep in touch with hospital care as such, I freelanced as an accident and emergency doctor at the Academic Medical Centre. I love the academic smell. On the work floor I was confronted by the infectious presence of a nurse. Since than we have been trying to be a caring and hospitable couple. We made good friends with whom we are still in close contact. Friends who have reached an influential position in the community, most of whom are admirably successful.

Lessons learned
During my outreach care activities in the community I observe the appearance and behavior of homeless patients. With growing curiosity, (this time with books), I started to write on subjects reflecting highly prevalent health problems of my patients: tramps’ feet, pulmonary infections and dental problems. I wrote about my wrestling with extremely serious morbidity and providing assertive treatment: I presented a biography of life, health and amount of care invested in the homeless alcoholic. I started to collect demographics and data on health problems to look at the homeless population. 4
Due to lack of experience in epidemiology, research and building community care networks, I went to the Netherlands School of Public Health. I enjoyed my group of fellow doctors, they came from all over the country and had a wide variety of stories to tell. I enjoyed working with my teachers, immersing myself in books, visiting organizations, studying subjects on management and policy making, and writing my thesis on homelessness and health. On the last school day I graduated. In the meantime I had four papers published in Dutch medical journals.

After learning the key social and medical problems of my homeless patients, the functioning of organizations to address the underserved has become my main interest. I was able to study the process and problems of people at risk to become evicted from their homes and of those already evicted. With the help of an intelligent epidemiologist, we studied the process of eviction, the annual reports of organizations involved and local policy. Additionally, we collected data of individual cases who were close to losing their home which was rented from social housing agencies. We studied the process of eviction, demographics, social and health problems and help offered by organizations. To meet the already evicted we interviewed persons who had recently become homeless and had been living on the streets for less than two years.
The results of the study homeless after eviction 5 depressed me, though they do not surprise me. Those in highest need, housed or rough, do find little social and even less medical assistance. The longer the homeless are on the streets the less help (but the more substances) they find. And if homeless people find a desk for help then often they are confronted with a problem. Organizations, their procedures, complaints and judgments prevent delivery of adequate help for those who were never able to express or address problems of their own adequately.
As a result of an increasing epidemic of homeless people and their public appearance and performance, new policy and projects, (mostly based on emotion and budget rather than on knowledge and experience), are introduced to alleviate symptoms rather than etiologic agents. While studies on effectiveness of interventions are hardly available 1-3, we are predominantly faced with ongoing symptomatic policy and fragmented research. Interventions that take place further down the road of homelessness, to bring the homeless back to society, hardly succeed without chronic intensive, expensive and coercive care.

Without a social diagnosis no medical therapy. Confronted with homeless patients I consciously make the diagnosis “homelessness” for the consequences of treatment of problems in six areas simultaneously: housing, income, activities, substance use, mental and physical disorders. If such multiple morbidity is not addressed simultaneously all efforts to support a single disease (e.g. opiate dependence, psychosis or pneumonia) will be negated as soon as the homeless person is back on the street. A valuable tool in the chain of care for the homeless, to prevent recurrent or further social and or medical damage after admission in clinics or prisons, is a shelter infirmary facility with care provided by an integrated outreach team of social and medical workers addressing the six problem areas. 4-6
Since I love to explore the borders of public health, I am currently working on a social medical care model to meet the underserved, those in social and medical exclusion. The model will be based on specific problems in the six areas (individual demands) and specific skills, tasks and individual responsibilities of social ánd medical workers simultaneously to effectively meeting up with the needs of homeless people (population supply). With ongoing curiosity and adventure I enjoy to write and lecture on homelessness, health and care.

To me, the art of social medicine is to observe man, health and community in order to discover patterns in their interactions. One has to describe carefully what one observes rather than doing expensive tests to look for what one did not observe. A diagnosis of a population’s social and medical needs can be made after curious and adventurous observation, with neither complaining nor judging the population observed. This is the essence of Hippocrates. 7
As it is harder to treat a patient than a disease, doctors can have a tendency to focus on disease and the organizational flow that follows the disease. As a consequence doctors are in danger of treating forms and procedures more than they do patients. Human beings with ill-health need social and medical care simultaneously, especially those in highest need. No matter what the diagnosis of a single disease is.

Lessons learned
During my outreach care activities in the community I observe the appearance and behavior of homeless patients. With growing curiosity, (this time with books), I started to write on subjects reflecting highly prevalent health problems of my patients: tramps’ feet, pulmonary infections and dental problems. I wrote about my wrestling with extremely serious morbidity and providing assertive treatment: I presented a biography of life, health and amount of care invested in the homeless alcoholic. I started to collect demographics and data on health problems to look at the homeless population. 4 Due to lack of experience in epidemiology, research and building community care networks, I went to the Netherlands School of Public Health. I enjoyed my group of fellow doctors, they came from all over the country and had a wide variety of stories to tell. I enjoyed working with my teachers, immersing myself in books, visiting organizations, studying subjects on management and policy making, and writing my thesis on homelessness and health. On the last school day I graduated. In the meantime I had four papers published in Dutch medical journals.

After learning the key social and medical problems of my homeless patients, the functioning of organizations to address the underserved has become my main interest. I was able to study the process and problems of people at risk to become evicted from their homes and of those already evicted. With the help of an intelligent epidemiologist, we studied the process of eviction, the annual reports of organizations involved and local policy. Additionally, we collected data of individual cases who were close to losing their home which was rented from social housing agencies. We studied the process of eviction, demographics, social and health problems and help offered by organizations. To meet the already evicted we interviewed persons who had recently become homeless and had been living on the streets for less than two years. The results of the study homeless after eviction 5 depressed me, though they do not surprise me. Those in highest need, housed or rough, do find little social and even less medical assistance. The longer the homeless are on the streets the less help (but the more substances) they find. And if homeless people find a desk for help then often they are confronted with a problem. Organizations, their procedures, complaints and judgments prevent delivery of adequate help for those who were never able to express or address problems of their own adequately.
As a result of an increasing epidemic of homeless people and their public appearance and performance, new policy and projects, (mostly based on emotion and budget rather than on knowledge and experience), are introduced to alleviate symptoms rather than etiologic agents. While studies on effectiveness of interventions are hardly available 1-3, we are predominantly faced with ongoing symptomatic policy and fragmented research. Interventions that take place further down the road of homelessness, to bring the homeless back to society, hardly succeed without chronic intensive, expensive and coercive care.

Without a social diagnosis no medical therapy. Confronted with homeless patients I consciously make the diagnosis “homelessness” for the consequences of treatment of problems in six areas simultaneously: housing, income, activities, substance use, mental and physical disorders. If such multiple morbidity is not addressed simultaneously all efforts to support a single disease (e.g. opiate dependence, psychosis or pneumonia) will be negated as soon as the homeless person is back on the street. A valuable tool in the chain of care for the homeless, to prevent recurrent or further social and or medical damage after admission in clinics or prisons, is a shelter infirmary facility with care provided by an integrated outreach team of social and medical workers addressing the six problem areas. 4-6
Since I love to explore the borders of public health, I am currently working on a social medical care model to meet the underserved, those in social and medical exclusion. The model will be based on specific problems in the six areas (individual demands) and specific skills, tasks and individual responsibilities of social ánd medical workers simultaneously to effectively meeting up with the needs of homeless people (population supply). With ongoing curiosity and adventure I enjoy to write and lecture on homelessness, health and care.

To me, the art of social medicine is to observe man, health and community in order to discover patterns in their interactions. One has to describe carefully what one observes rather than doing expensive tests to look for what one did not observe. A diagnosis of a population’s social and medical needs can be made after curious and adventurous observation, with neither complaining nor judging the population observed. This is the essence of Hippocrates. 7
As it is harder to treat a patient than a disease, doctors can have a tendency to focus on disease and the organizational flow that follows the disease. As a consequence doctors are in danger of treating forms and procedures more than they do patients. Human beings with ill-health need social and medical care simultaneously, especially those in highest need. No matter what the diagnosis of a single disease is.

Conclusion
Healthy conclusions can be drawn if based on knowledge and experience taught by caring and hospitable doctors. I try to bring my art to homeless patients by presenting the diagnosis of homelessness and the therapeutic consequences. The six problem areas, potentially present among all underserved populations, have to be addressed simultaneously. Social and medical care have to be united in a model of outreaching 1-6, (as life in a rural village), to narrow the gap between the poor and rich, the ill and healthy.
Focus on early signs of behavior causing social and medical damage to both the individual and the community (monitor) enables us to build care networks for social ánd medical interventions to prevent unnecessary and costly disease and hazardous roads towards premature death.
Following my family biography and lessons learned, homeless people are in need of Hippocrates. According to the Greek Asclepiad tradition Hippocrates thought his sons the art of medicine. 7

So did my good father.

References

• Morrison D. Extent, Nature, and Causes of Homelessness in Glasgow. A needs assessment. Homelessness and Partnership, NHS Greater Glasgow, March 2003.


• MacKinnon D et al. Delivering Health Care to Homeless People: an effectiveness review. NHS Health Scotland, 2004. www.healthscotland.com


• Ng AT, McQuistion HL. Outreach to the homeless: craft, science and future implications. J Psychiatr Pract 2004; 10(2):95-105.


• Laere IRAL van, Buster MCA. [Health problems of homeless people attending outreach primary care surgeries in Amsterdam]. Ned Tijdschr Geneeskd 2001; 145:1156-60. [Dutch]


• Laere IRAL van, Wit MAS de. [Homeless after eviction]. Amsterdam: GG&GD Municipal Public Health Service, February 2005. [Dutch]


• Laere IRAL van. [Homeless and a chain of care: diagnostics and care in four problem areas simultaneously]. Medisch Contact 2004; 59(20): 830-1. [Dutch]


• Jouanna J. Hippocrates. London: The John Hopkins Press Ltd, 1999.

John Langley, MD
Mental Health Service
St. Michael’s Hospital
30 Bond St., Rm 17-006
Toronto, Ontario, M5B 1W8
(416-864-3084)
john.langley@utoronto.ca

Dr. Langley is an assistant professor in the Department of Psychiatry, University of Toronto, and he is a staff psychiatrist in the Mental Health Service of St. Michael’s Hospital. He holds a cross appointment to the Division of Child Psychiatry and he is the director of postgraduate education for the division. Dr. Langley has a strong interest in community and adolescent psychiatry and he has worked with street-involved youth for many years. He provides psychiatric consultation to several inner city agencies including Covenant House, the Youth Hostel Outreach Program, Central Toronto Youth Services, and the New Outlook Youth Justice Program. He is also the medical director of the STEPS for Youth program at St. Michael's Hospital, a program for early intervention in psychosis. In the area of research, currently he holds two peer-reviewed grants titled: “A Model for Recovery for Individuals with Recurrent Suicide Attempts” and “Mental Health Needs of Transitional Youth on the Street, A Collaborative Project”.

Marcela Raffaelli Marcela Raffaelli received her B.A. from Williams College and her Ph.D. from the University of Chicago in 1990. She spent several years as a post-doctoral researcher at Johns Hopkins University, where she was involved in an HIV/AIDS prevention project for Brazilian street youth. She joined the faculty at the University of Nebraska-Lincoln in 1995 and has a joint appointment between the Department of Psychology (Developmental Psychology) and the Institute for Ethnic Studies (Latino and Latin American Studies). Her research and teaching focus on child and adolescent development, adolescent risk-taking, development under conditions of poverty, sexual socialization, and immigrant youth. Professor Raffaelli, who is a U.S./Brazilian dual citizen, is involved in collaborative research with scholars at the Center for the Psychological Study of Street Youth at the Federal University of Rio Grande do Sul, Porto Alegre, Brazil. She travels regularly to Brazil to participate in the Center's training and outreach activities, has conducted several studies with Center researchers, and published on a variety of topics related to street youth. Professor Raffaelli's U.S.-based research has focused primarily on social and cultural influences on sexuality during adolescence and early adulthood. She is also a member of the Latino Research Initiative, a community-university partnership that is aimed at addressing the needs of Nebraska's Latino population.

Relevant Publications (Selected)

Koller, S. H., & Raffaelli, M. (In press). Improving the lives of street youth in Latin America: Towards the construction of a new agenda for developmental research, practice, and policy. To appear in Y. Ronin & S. H. Erlich (Eds.), The case for the child: Towards the construction of a new agenda. Intersentia.

Raffaelli, M., Koller, S. H., & de Morais, N. A. (In press). Assessing the development of Brazilian Street youth. Vulnerable Children & Youth Studies.

Raffaelli, M., & Koller, S. H. (2005). Future expectations of Brasilian street youth. Journal of Adolescence, 28, 249-262.

Raffaelli, M., Koller, S.H., Bandeira, D.R., Reppold, C., Kuschick, M. & Dani, D. (2000). Gender differences in Brazilian street youth's family circumstances and experiences on the street. Child Abuse and Neglect, 24, 1431-1441.

Raffaelli, M. (1999). Street youth in Latin America: A developmental review. Interamerican Journal of Psychology, 33, 7-28.

Raffaelli, M., & Larson, R. W. (Eds.). (1999). Homeless and working youth around the world: Exploring developmental issues. New Directions in Child Development, 85 (W. Damon, Series Ed). San Francisco, CA: Jossey-Bass.

Raffaelli, M. (1997). Family situation of street youth in Latin America: A cross-national review. International Social Work, 40, 89-100.

Raffaelli, M., Siqueira, E., Payne Merritt, A., Greco, M., Campos, R., et al. (1995). HIV-related knowledge, attitudes, and risk behaviors of Brazilian street youth. AIDS Education and Prevention, 7, 287-297.

Campos, R., Raffaelli, M., Ude, W., Greco, M., Ruff, A., et al. (1994). Social networks and daily activities of street youth in Belo Horizonte, Brazil. Child Development, 65, 319-330.

Contact Info:

email: mraffaelli1@unl.edu

Lynn Rew,
Lynn Rew EdD, RN, FAAN, is the Denton & Louise Cooley and Family Centennial Professor in Nursing at The University of Texas at Austin, Austin, Texas, U.S.A. Her research focuses primarily on sexual health and self-care behaviors in homeless youth aged 16-23 years. She may be contacted at ellerew@mail.utexas.edu. She recently completed a 4-year sexual health intervention study with 572 youth. Findings will be forthcoming in a special issue of the Journal of Health Psychology devoted to homelessness. Recent publications include:
Rew, L., Fouladi, R., Land, L, & Wong, Y.J. (In press). Outcomes of a brief sexual health intervention for homeless youth. Journal of Health Psychology.

Warf, C., Rew, L., Saewyc, E., Ammerman, S.,, & Ensign, J. (In press). Society of Adolescent Medicine position paper on homeless adolescents. Journal of Adolescent Health.

Taylor, M., Johnson, R.J., Rew, L., Land, L., Fouladi, R., & Abel, E. (2007). Attachment and sexual health behaviors in homeless youth. Journal for Specialists in Pediatric Nursing, 12(1), 37-48.

Rew, L., McDougall, G., Riesch, L., & Parker, C. (2005). Development of the Self-Efficacy for Testicular Self Examination Scale. Journal of Men's Health & Gender, 2(1),59-63.

Rew, L., Whittaker, T. A., Smith, L. R,, & Taylor,-Seehafer, M. (2005). Sexual health-risks and protective resources in gay, lesbian, bisexual, and heterosexual homeless youth. Journal of Specialists in Pediatric Nursing, 10(1), 11-19.

Rew, L. (2003). A theory of taking care of oneself grounded in experiences of homeless youth. Nursing Research, 52,234-241.

Rew, L., & Horner, S. (2003). Personal strengths of homeless adolescents living in a high-risk environment. Advances in Nursing Science, 26(2), 90-101.

Rew, L. (2002). Relationships of sexual abuse, connectedness, and loneliness to perceived well-being in homeless youth. Journal for Specialists in Pediatric Nursing, 7, 51-63.

Mary Jane Rotheram-Borus, Ph.D.

Dr. Rotheram-Borus is Bat-Yaacov Professor in Child Psychiatry and Biobehavioral Sciences, Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles (UCLA). She directs the UCLA Global Center for Children and Families. Dr. Rotheram-Borus received her Ph.D. in 1977 in clinical psychology, with an emphasis in child and community psychology, from the University of Southern California. She has spent the past 30 years developing, evaluating, and disseminating evidence-based interventions for children and families. She has worked extensively with adolescents, especially those at risk for substance abuse, HIV, homelessness, depression, suicide, and long-term unemployment. Dr. Rotheram Borus has directed and implemented more than 15 intervention studies that have demonstrated the benefits of providing behavior change programs and support to families in difficult life circumstances. Several of these programs have received national and international recognition, including designation as model programs by the Centers for Disease Control and Prevention, the American Psychological Association, and the American Medical Association. Dr. Rotheram Borus has authored or co-authored more than 200 journal articles. She has received both foundation and NIH grants to design prevention programs for children and families at high risk for HIV, mental health problems, suicide, and substance abuse.

Contact Info:

Mary Jane Rotheram-Borus, Ph.D. Professor, Department of Psychiatry UCLA Center for Community Health 10920 Wilshire Boulevard, Suite 350 Los Angeles, CA 90024-6521 (310) 794-8280; Fax (310) 794-8297 E-mail: Rotheram@ucla.edu

Natasha Slesnick

Natasha Slesnick is an Associate Professor at the Department of Human Development and Family Science at the Ohio State University and is a licensed clinical psychologist. Since 1998, she has focused her attention on family therapy development for runaway youth and their families. Through this work, she found that a large group of youth did not have contact with their parents, did not access the local shelters, and were in fact, not accessing services at all. She and her colleagues then focused effort on treatment development with street living youth. Prior to moving to Columbus, OH, she opened and oversaw a drop-in center for homeless youth in Albuquerque, NM. She has received funding from NIDA, NIAAA and SAMHSA to support her efforts in improving service delivery to this underserved group.

Relevant Publications:

Slesnick, N., Meyers, R. J., Meade, M., & Segelken, D. H. (2000). Bleak and hopeless no more: Treatment engagement of substance abusing runaway youth and their families. Journal of Substance Abuse Treatment, 19, 215-222.

Slesnick, N. (2001). Variables associated with family therapy attendance in runaway youth: Preliminary findings. American Journal of Family Therapy, 29, 411-420.

Slesnick, N., & Meade, M. (2001). System youth: A subgroup of substance-abusing homeless adolescents. Journal of Substance Abuse, 13, 367-384.

Slesnick, N., Meade, M., & Tonigan, J. S. (2001). Relationship between service utilization and runaway youths' alcohol and other drug use. Alcoholism Treatment Quarterly, 19, 19-29.

Meade, M., & Slesnick, N. (2002). Ethical considerations for research and treatment with runaway and homeless adolescents. Journal of Psychology, 136, 449-463.

Slesnick, N., Vasquez, C., & Bittinger, J. (2002). Family functioning, substance use and related problem behaviors: Hispanic vs. Anglo runaway youth. Journal of Ethnicity and Substance Use, 1, 83-101.

Slesnick, N. (2004). Our runaway and homeless youth: A guide to understanding. Westport, CT: Praeger Publishing.

Slesnick, N. & Prestopnik, J. L. (2004). Office versus home-based family therapy for runaway, alcohol abusing adolescents: Examination of factors associated with treatment attendance. Alcoholism Treatment Quarterly, 22(2), 3-19.

Slesnick, N., & Prestopnik, J. L. (2004). Perceptions of the family environment and youth behaviors: Alcohol abusing runaway adolescents and their primary caretakers. The Family Journal, 12, 243-253.

Slesnick, N. & Tonigan, J. S. (2004). Assessment of alcohol and other drugs used by runaway youths: A test-retest study of the Form 90. Alcoholism Treatment Quarterly, 22(2), 21-34

Slesnick, N. & Prestopnik, J. L. (2005). Dual and multiple diagnosis among substance abusing runaway and homeless youth. American Journal of Drug and Alcohol Abuse, 31(1), 179-201.

Slesnick, N., & Prestopnik, J. L. (2005). Ecologically-based family therapy outcome with substance abusing runaway adolescents. The Journal of Adolescence, 28, 277-298.

Slesnick, N., Bartle-Haring, S., & Gangamma, R. (2006). Predictors of substance use and family therapy outcome among physically and sexually abused runaway adolescents. Journal of Marriage and Family Therapy, 32, 261-281.

Slesnick, N., Bartle-Haring, S., Glebova, T., & Glade, A. (2006). Primary alcohol versus primary drug use among adolescents: An examination of differences. Addictive Behaviors, 31, 280-293.

Gangamma, R., Slesnick, N., Toviessi, P., & Serovich, J. (2006). Comparison of HIV Risks among Gay, Lesbian, Bisexual and Heterosexual Homeless Youth. Journal of Youth and Adolescence.

Slesnick, N., Prestopnik, J. L., Meyers, R. J., & Glassman, M. (2007). Treatment outcome for homeless, street-living youth. Addictive Behaviors, 32,1237-1251.

Slesnick, N., Bartle-Haring, S., Glebova, T., & Glade, A. (2007). Homeless adolescent parents: HIV risk, family structure and individual problem behaviors. Journal of Adolescent Health, 39(5), 774-777.

Slesnick, N., Kang, M., & Aukward, E. (In press). Treatment attendance among homeless youth: The impact of childhood abuse and suicide attempts. Substance Abuse Journal.

Slesnick, N., Bartle-Haring, S., Dashora, P., Kang, M. & Aukward, E. (In press). Predictors of homelessness among street living youth. Journal of Youth and Adolescence.

Contact Info:

Department of Human Development and Family Science, The Ohio State University.
135 Campbell Hall, 1787 Neil Ave.
Columbus, OH 43210.
Email: Slesnick.5@osu.edu.

Elaine Suk-Ching LIU

Elaine Suk-Ching LIU, PhD, MSW, is Associate Professor of Department of Applied Social Studies, City University of Hong Kong. She had almost ten years experiences serving as a School Social Worker, Youth Counselor and School Social Work Supervisor in The Hong Kong Federation of Youth Groups before joining the Department of Applied Social Studies, City University of Hong Kong as a faculty member. For the last 17 years as a faculty member in City University of Hong Kong, she has taught courses in Social work and Counseling. She also had been supervising social work practicum to many social work students in the areas of youth and family. She has published in the areas of school social work, help-seeking behavior, values and morals of young people, parent-child relationship and young adolescents running away from home. Her recent and upcoming publications on youth include:

1. "Perceived Parent-child Adjustment in the Family Reunification among a Group of Runaway Adolescent". Journal of Adolescence. 2005. Vol. 28, Issue 6. p.687-707., (Single-author)

2. "Parents, Teachers and Peers and Early Adolescent Runaway in Hong Kong". Vol. 40, No. 158, Summer, 2005, P. 403-424. Adolescence. (Co-author)

3. "Factors Underlying Junior High School Students' Seeking Help from Social Services." Childhood. 2, 2005, Vol. 12, pp.55-69. (Co-author)

4. "Youth Empowerment and Volunteerism: Principles, Policies and Practices" (Chief Editor and co-author of the concluding chapter), in print by City University Press by end of 2007.

She also had been a consultant and a trainer to many projects in the areas of youth development and youth policy in Hong Kong, Macau and Singapore. Recent years, she has been advocating and promoting youth development and empowerment, youth volunteerism and youth cross-cultural learning both locally and internationally. She had convened the 1st International Conference on Youth Empowerment: A Cross Cultural Exchange (1st ICOYE) in May 2004 and 2nd International Conference on Youth Empowerment: Empowering Youth through Volunteerism (2nd ICOYE) in June 2006. She is one of the founding members of the Youth Studies Net of City University of Hong Kong and was its Director from 2004-2006. She is a member of the Commission on Youth of Hong Kong Government since 2004. She is the winner of the Faculty of Humanities and Social Science Contribution to Learning Award in 2001 in City University of Hong Kong.

Sanna J. Thompson

Sanna J. Thompson, Ph.D. is an Associate Professor at The University of Texas at Austin, School of Social Work. Her research has focused primarily on high-risk youth and their families, with special emphasis on runaway/homeless youth populations. Dr. Thompson's publications reflect her focus on issues of runaway/homeless/unaccompanied adolescents and their families.

Dr. Thompson has conducted studies of homeless/runaway youth utilizing shelter services across several Midwestern states, New York, and Texas. Studies have included interviews with youths' parents as well. A comparison group of youth with a history of running away who were admitted to a county detention center in New York has also provided further understanding concerning the association between running away and juvenile justice system involvement. Dr. Thompson has also conducted a series of secondary analyses and published results from the Runaway Homeless Youth Management Information System [RHY MIS - 1997]. These data are compiled from all federally-funded youth shelters across the United States and are the only nation-wide data available on runaway and homeless youth. Dr. Thompson has also conducted a series of studies with homeless, street youth in Austin, TX with the aim of understanding their use of drugs/alcohol, perceptions concerning substance use, and how using drugs/alcohol relates to remaining on the street. In addition, a comparison study of homeless youth in Austin, TX and St. Louis, MO suggests the varied transience and pathways young people take during their traveling careers. Dr. Thompson received a five-year Career Development Award from the National Institute on Drug Abuse to test a home-based family therapy intervention aimed at improving engagement and retention of youth and their families in treatment following a runaway episode.

Relevant Publications (listed chronologically):

**In press**
Thompson, S.J., Maccio, E., Desselle, S., Zittel-Palamara, K. (in press). Predictors of traumatic distress among runway youth utilizing two service sectors. Journal of Traumatic Stress.

Thompson, S.J. Kim, J., McManus, H., Flynn, P., Kim, H. (in press). Peer relationships: Comparison of homeless youth in the U.S. and South Korea. International Social Work.

Thompson, S.J., Bender, K., Kim, J. (in press). Family factors as predictors of depression among runaway youth: Do males and females differ? Child and Adolescent Social Work Journal.

McManus, H.H. & Thompson, S.J. (in press). Trauma among unaccompanied homeless youth: The integration of street culture into a model of intervention. Journal of Aggression, Maltreatment and Trauma.

Nebbitt, V.E., House, L.E., Thompson, S.J., Pollio, D.E. (in press). Successful transitions of runaway/homeless youth from shelter care. Journal of Child and Family Studies.

Thompson, S.J., Bender, K., Windsor, L., Cooke, M., Williams, T. (in press). Homeless youth: characteristics, contributing factors, and service options. Human Behavior and the Social Environment.

Pollio, D.E., Thompson, S.J., Tobias, L., Reid, D., Constantine, J., Spitznagel, E. (in press). Longitudinal outcomes for youth receiving runaway/homeless shelter services. Journal of Youth and Adolescence.

**2007**
Thompson, S.J. (2007). Homeless Youth and Trauma. In E. Carll (Ed.) Trauma Psychology, Vol. 1. Greenwood Publishing. Bender, K., Thompson, S.J., McManus, H., Lantry, J., Flynn, P.M. (2007). Capacity for survival: Exploring strengths of homeless street youth. Child and Youth Care Forum, 36, 25-42.

**2006**
Thompson, S.J. & Kim, J. (2006). Intervening with students and families who frequently relocate or are homeless. In C. Franklin, M.B. Harris, & P. Allen-Meares (Eds.) School Social Work and Mental Health Workers Training and Resource Manual. Oxford University Press.

Thompson, S.J., McManus, H., Lantry, J., Windsor, L., & Flynn, P. (2006). Insights from the street: Perceptions of services and providers by homeless young adults. Evaluation and Program Planning, 29(1), 34-43.

Thompson, S.J., McManus, H., Voss, T. (2006). PTSD and substance abuse among youth who are homeless: Treatment issues and implications. Brief Treatment and Crisis Intervention, July, 1-12.

Thompson, S.J., & Pillai, V.K. (2006). Determinants of runaway episodes among adolescents using crisis shelter services. International Journal of Social Welfare, 15, 142- 149.

Thompson, S.J. & Pollio, D.E. (2006). Identifying the role of disaffiliation, psychological dysfunction, identification of runaway culture, and human capital in the runaway history of adolescents.. Social Work Research, 30(4), 245-251.

Thompson, S.J. & Windsor, L. (2006). Runaway youth admitted to juvenile detention: Factors for cigarette, alcohol, and marijuana use. Free Inquiry in Creative Sociology, 34(1), 69-76.

Thompson, S.J., Windsor, L., Lantry, J., Bender, K., Maddox, G. (2006). The quagmires of conducting clinical research: One team's quest for creative solutions. Reflections, 12(2), 36-45.

**2005**
Windsor, L.C. & Thompson, S.J. (2006). Predictors of violent juvenile behavior: Examining the impact of victimization and exposure to violence. Social Perspectives/Perspectivas Sociales, 8(1), 103-129.

Thompson, S.J. (2005). Factors associated with trauma symptoms among runaway/homeless adolescents. Stress, Trauma, and Crisis: An international Journal, 8(2/3), 143-156.

Thompson, S.J., Pomeroy, E.C. & Gober, K. (2005). Family-based treatment models targeting substance use and high-risk behaviors among adolescents: A review. In C. Hilarksi (Ed.) Addiction, assessment, and treatment with adolescents, adults, and families. Haworth Press.

Thompson, S.J., Zittel-Palamara, K., & Forehand, G. (2005). Difference in risk factors for cigarette, alcohol, And marijuana use among runaway youth utilizing two service sectors. Journal of Child & Adolescent Substance Abuse, 15(1), 17-36.

Thompson, S.J., Windsor, L.C., & Zittel-Palamara, K. (2005). Family reunification among two groups of runaway adolescents utilizing emergency shelters. Family Preservation Journal, 8, 95-109.

Thompson, S.J. & Windsor, L. (2005). Runaway youth admitted to juvenile detention: Risk factors for cigarette, alcohol, and marijuana use. In A. Mata (Ed.) High Risk Youth, High Risk Families and High Risk Communities: Implications for Prevention, Intervention and Treatment. Mellen Press.

**2004**
Thompson, S. J. (2004). Risk/protective factors associated with substance use among runaway/homeless youth utilizing emergency shelter services nationwide. Substance Abuse, 25(3), 13-26.

Thompson, S.J., Zittel-Palamara, K.M., & Maccio, E. (2004). Runaway youth utilizing crisis shelter services: Predictors of presenting problems. Child and Youth Care Forum. 33(6), 387-404.

Thompson, S.J. & Johnston, L. (2004). Risk factors of Gay, Lesbian, and Bisexual Adolescents: Review of empirical literature and practice implications. Journal of Human Behavior and the Social Environment, 8(2/3), 111-128.

Thompson, S.J., Pollio, D.E., Eyrich, K., Bradbury, E., North, C.S. (2004) Successfully exiting homelessness: Experiences of formerly homeless mentally ill individuals. Evaluation and Program Planning, 27(4), 423-431.

Safyer, A.E., Thompson, S.J., Maccio, E., Zittel-Palamara, K., Forehand, G. (2004). Adolescent and parent perceptions of runaway behavior: Problems and Solutions. Child and Adolescent Social Work Journal, 21(5), 493-510.

**2003-2000**
Thompson, S.J., Maguin, E., Pollio, D.E. (2003). National and regional differences among runaway youth using federally funded crisis shelters. Journal of Social Service Research, 30(1), 1-17.

Thompson, S.J., Kost, K.A., Pollio, D.E. (2003). Examining risk factors to predict family reunification for runaway youth: Does ethnicity matter? Family Relations, 52(3), 296-305.

Thompson, S.J., Pollio, D.E., Constantine, J., Reid, D., Nebbitt, V. (2002). Short-term outcomes for youths receiving runaway homeless shelter services. Research on Social Work Practice, 12(5), 589-603.

Thompson, S.J., Safyer, A.W., Pollio, D.E. (2001). Examining differences and predictors of family reunification among subgroups of runaway youth using shelter services. Social Work Research, 25(3), 163-172.

Thompson, S.J., Pollio, D.E., Bitner, L. (2000). Outcomes for adolescents using runaway and homeless youth services. Journal of Human Behavior and the Social Environment, 3(1), 79-97.

Dr. Kimberly A. Tyler

Dr. Kimberly A. Tyler is Associate Professor of Sociology at the University of Nebraska-Lincoln. Her research interests include child abuse and neglect, sexual victimization, mental health outcomes, social networks, and high-risk behaviors among homeless and high-risk youth and adolescents. Dr. Tyler currently has a National Institute of Health Mentored Research Scientist Career Development Award (KO1), funded by the National Institute of Mental Health entitled "Neglect and Abuse Histories among Young Adults." The purpose of this research is to discover the effects of neglect and abuse on pathways to homelessness and the consequences that such trajectories have on mental health outcomes.

Contact Info:

Dr. Kimberly A. Tyler
University of Nebraska-Lincoln
Department of Sociology
711 Oldfather Hall
Lincoln, NE 68588-0324
U.S.A.
Phone: (402) 472-3631
Email: kim@ktresearch.net

Select Publications:

2009 Tyler, Kimberly A., Lisa A. Melander, and Elbert P. Almazan. "Self Injurious Behavior among Homeless Young Adults: A Social Stress Analysis." Social Science and Medicine, 70:269-276.

2009 Tyler, Kimberly A. and Lisa A. Melander. "Discrepancies in Reporting of Physical and Sexual Abuse Among Homeless Youth." Journal of Child Sexual Abuse, 18(5):513-531.

2009 Tyler, Kimberly A., Lisa A. Melander, and HarmoniJoie Noel. "Bidirectional Partner Violence Among Homeless Young Adults: Risk Factors and Outcomes." Journal of Interpersonal Violence, 24(6):1014-1035.

2009 Tyler, Kimberly A. "Risk Factors for Trading Sex Among Homeless Young Adults." Archives of Sexual Behavior, 38(2):290-297.

2008 Tyler, Kimberly A. "A Comparison of Risk Factors for Sexual Victimization Among Gay, Lesbian, Bisexual, and Heterosexual Homeless Young Adults." Violence and Victims, 23(5):586-602.

2008 Tyler, Kimberly A. "Social Network Characteristics and Risky Sexual and Drug Related Behaviors Among Homeless Young Adults." Social Science Research, 37(2): 673-685.

2008 Tyler, Kimberly A., and Bianca E. Bersani. "A Longitudinal Study of Early Adolescent Precursors to Running Away." Journal of Early Adolescence, 28(2): 230-251.

2007 Tyler, Kimberly A., Les B. Whitbeck, Xiaojin Chen, and Kurt Johnson. "Sexual Health of Homeless Youth: Prevalence and Correlates of Sexually Transmissible Infections." Sexual Health Journal, 4(1): 57-61.

2006 Tyler, Kimberly A. and Katherine A. Johnson. "Trading Sex: Voluntary or Coerced? The Experiences of Homeless Youth." Journal of Sex Research, 43(3): 208-216.

2006 Tyler, Kimberly A. "A Qualitative Study of Early Family Histories and Transitions of Homeless Youth." Journal of Interpersonal Violence, 21(10): 1385-1393.

2006 Tyler, Kimberly A. and Katherine A. Johnson. "Pathways In and Out of Substance Use among Homeless Emerging Adults." Journal of Adolescent Research, 21(3):133-157.

2004 Tyler, Kimberly A. and Katherine A. Johnson. "Victims and Offenders: Accounts of Paybacks, Invulnerability, and Financial Gain among Homeless Youth." Deviant Behavior, 25:427-449.

2004 Tyler, Kimberly A., Les B. Whitbeck, Dan R. Hoyt, and Ana Mari Cauce. "Risk Factors for Sexual Victimization among Male and Female Homeless and Runaway Youth." Journal of Interpersonal Violence, 19(5):503-520.

2003 Tyler, Kimberly A., Les B. Whitbeck, Dan R. Hoyt, and Kurt D. Johnson. "Self-Mutilation and Homeless Youth: The Role of Family Abuse, Street Experiences, and Mental Disorders." Journal of Research on Adolescence, 13(4):457-474.

2002 Tyler, Kimberly A. and Ana Mari Cauce. "Perpetrators of Early Physical and Sexual Abuse among Homeless and Runaway Adolescents." Child Abuse & Neglect, 26:1261-1274.

2001 Tyler, Kimberly A., Dan R. Hoyt, Les B. Whitbeck, and Ana Mari Cauce. "The Effects of a High-Risk Environment on the Sexual Victimization of Homeless and Runaway Youth." Violence and Victims, 16:441-455.

2001 Tyler, Kimberly A., Dan R. Hoyt, Les B. Whitbeck, and Ana Mari Cauce. "The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth." The Journal of Research on Adolescence, 11:151-176.

2000 Tyler, Kimberly A., Les B. Whitbeck, Dan R. Hoyt, and Kevin A. Yoder. "Predictors of Self-Reported Sexually Transmitted Diseases among Homeless and Runaway Adolescents." The Journal of Sex Research, 37:369-377.

Report on Findings from the Homeless Young Adult Project (HYAP).