Abstract
Recent evidence attests to the shortcomings of typical services for improving outcomes among emerging adults with serious mental health conditions (SMHCs). Researchers and providers have responded by developing new programs and interventions for meeting the unique needs of these young people. A significant number of these programs and interventions can be described as taking a positive developmental approach, which is informed by a combination of theoretical sources, including theories of positive development, self-determination, ecological systems, and social capital. To date, however, there has been no comprehensive theoretical statement describing how or why positive change should occur as a result of using a positive developmental approach when intervening with this population. The goal of this article is to propose a general model that “backfills” a theory behind what appears to be an effective and increasingly popular approach to improving outcomes among emerging adults with SMHCs.
Similar content being viewed by others
References
Arnett J. Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist 2000; 55(5): 469–480.
Davis M, Banks S, Fisher W, et al. Longitudinal patterns of offending during the transition to adulthood in youth from the mental health system. Journal of Behavioral Health Services & Research 2004; 31(4): 351-366.
Davis M, Vander Stoep A. The transition to adulthood for youth who have serious emotional disturbance: Developmental transition and young adult outcomes. Journal of Mental Health Administration 1997; 24(4): 400-426.
Vander Stoep A, Beresford S, Weiss N, et al. Community-based study of the transition to adulthood for adolescents with psychiatric disorders. American Journal of Epidemiology 2000; 152: 352-362.
US Government Accountability Office. Young adults with serious mental illness: Some states and federal agencies are taking steps to address their transition challenges. GAO Publication No. 08-678, Washington DC: Author, 2008.
Courtney ME, Dworsky A. Midwest Evaluation of the Adult Functioning of Former Foster Youth. Chicago: The University of Chicago, Chapin Hall Center for Children, 2005.
Garland AF, Hough RL, McCabe KM, et al. Prevalence of psychiatric disorders in youths across five sectors of care. Journal of the American Academy of Child & Adolescent Psychiatry 2001; 40(4): 409.
National Collaborative on Workforce and Disability. Guideposts for Success, Second Edition. Washington DC: Institute for Educational Leadership, National Collaborative on Workforce and Disability; 2013.
James DJ, Glaze LE. Mental Health Problems of Prison and Jail Inmates. Washington DC: Bureau of Justice Statistics, 2006.
Shufelt JL, Cocozza JJ. Youth with Mental Health Disorders in the Juvenile Justice System: Results from a Multi-State Prevalence Study. Delmar, NY: National Center for Mental Health and Juvenile Justice, 2006.
Unger JB, Kipkke MD. Homeless youths and young adults in Los Angeles: Prevalence of mental health problems and the relationship between mental health and substance abuse disorders. American Journal of Community Psychology 1997; 25(3): 371.
Vander Stoep A, Beresford S, Weiss N, et al. Community based study of the transition to adulthood for adolescents with psychiatric disorders. American Journal of Epidemiology 2000; 152: 352-362.
Kessler RC, Demler O, Frank RG, et al. Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine 2005; 352(24): 2515-2523.
Pottick KJ, Bilder S, Vander Stoep A, et al. US patterns of mental health service utilization for transition-age youth and young adults. Journal of Behavioral Health Services & Research 2008; 35(4): 373-389.
U.S. Department of Human Services Substance Abuse and Mental Health Services Administration. What a Difference a Friend Makes: Social Acceptance is Key to Mental Health Recovery. SMA 07-4257, Washington DC: National Mental Health Anti-Stigma Campaign, 2007.
Davis M. Pioneering Transition Programs; The Establishment of Programs that Span the Ages Served by Child and Adult Mental Health. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, 2007.
Jivanjee P, Kruzich J, Gordon L. Community integration of transition-age individuals: Views of young adults with mental health disorders. Journal of Behavioral Health Services & Research 2007; 35(4): 402-418.
Sieler D, Orso S, Unruh, DK. Creating options for youth and their families. In: HB Clark, DK Unruh (Eds). Transition of Youth and Young Adults with Emotional or Behavioral Difficulties: An Evidence-Based Handbook. Baltimore: Brookes Publishing, 2010, pp. 117-140.
Marsenich, L. A Roadmap to Mental Health Services for Transition Age Young Women: A Research Review. Sacramento, CA: California Institute for Mental Health, 2005.
Lane KL, Carter EW. Supporting transition-age youth with and at risk for emotional and behavioral disorders at the secondary level: A need for further inquiry. Journal of Emotional and Behavioral Disorders 2006; 14: 66-70.
Gilmer TP, Ojeda VD, Fawley-King K, et al. Change in mental health service use after offering youth-specific versus adult programs to transition-aged youths. Psychiatric Services 2012; 63(6): 592-596.
Walker JS, Gowen LK. Community-Based Approaches for Supporting Positive Development in Youth and Young Adults with Serious Mental Health Conditions. Portland, OR: Portland State University, Research and Training Center for Pathways to Positive Futures, 2011.
Hagner D, Malloy JM, Mazzone MW, et al. Youth with disabilities in the criminal justice system: Considerations for transition and rehabilitation planning. Journal of Emotional and Behavioral Disorders 2008; 16(4): 240-247.
Powers LE, Geenen S, Powers J, et al. My Life: Effects of a longitudinal, randomized study of self-determination enhancement on the transition outcomes of youth in foster care and special education. Children and Youth Services Review 2012; 34(11): 2179–2187.
Haber, MG, Karpur A, Deschenes N, et al. Predicting improvement of transitioning young people in the partnerships for youth transition initiative: Findings from a multisite demonstration. Journal of Behavioral Health Sciences and Research 2008; 35(4): 488-513.
Melton RP, Roush, SN, Sale, TG, et al. Early intervention and prevention of long-term disability in youth and adults: The EASA model. In K Yeager, D Cutler, D Svendsen et al. (Eds). Modern Community Mental Health: An Interdisciplinary Approach. New York: Oxford University Press, 2013, pp. 256-275.
Gowen LK, Bandurraga A, Jivanjee P, et al. Development, testing, and use of a valid and reliable assessment tool for urban American Indian/Alaska Native youth programming using culturally appropriate methodologies. Journal of Ethnic & Cultural Diversity in Social Work 2012; 21(2): 7-94.
Cobb RB, Lipscomb S, Wolgemuth J, et al. Improving Post-High School Outcomes for Transition-Age Students with Disabilities: An Evidence Review. NCEE 2013-4011, Washington, DC: National Center for Education Evaluation and Regional Assistance, Institute of Education Sciences, US Department of Education, 2013.
Fraker T, Rangarajan A. The Social Security Administration’s Youth Transition Demonstration Projects. Journal of Vocational Rehabilitation 2009; 30: 223–240.
Blau GM, Caldwell B, Fisher SK, et al. The Building Bridges Initiative: Residential and community-based providers, families, and youth coming together to improve outcomes. Child Welfare 2010; 89(2): 21–38.
Podmostko, M. Tunnels and Cliffs: A Guide for Workforce Development Practitioners and Policymakers Serving Youth with Mental Health Needs. Washington, DC: National Collaborative on Workforce and Disability for Youth, Institute for Educational Leadership, 2007.
Herz D, Lee P, Lutz L. Addressing the Needs of Multi-System Youth: Strengthening the Connection Between Child Welfare and Juvenile Justice. Center for Juvenile Justice Reform, Robert F. Kennedy Children’s Action Corps, 2013.
Luecking DM, Luecking RG. Translating research into a seamless transition model. Career Development and Transition for Exceptional Individuals 2013. doi:10.1177/2165143413508978.
Koball H, et al. Synthesis of Research and Resources to Support At-Risk Youth, OPRE Report # OPRE 2011-22. Washington DC; Office of Planning, Research and Evaluation, Administration for Children and Families, US Department of Health and Human Services, 2011.
Marsenich, L. A Roadmap to Mental Health Services for Transition Age Young Women: A Research Review. Sacramento, CA: California Institute for Mental Health, 2005.
Test DW, Fowler CH, Richter SM, et al. Evidence-based practices in secondary transition. Career Development for Exceptional Individuals 2009; 32: 115-128.
Test DW, Mazzotti VL, Mustian AL, et al. Evidence-based secondary transition predictors for improving postschool outcomes for students with disabilities. Career Development for Exceptional Individuals 2009, 32: 160-181.
Schwartz, AA, Jacobson JW, Holburn SC. Defining person-centeredness: Result of two consensus methods. Education and Training in Mental Retardation and Developmental Disabilities 2000; 35: 235–249.
Taylor JE, Taylor JA. Person-centered planning: evidence-based practice, challenges, and potential for the 21st century. Journal of Social Work in Disability & Rehabilitation 2013; 12(3): 213–35.
Dresser K, Clark HB, Deschênes N. Implementation of a positive development, evidence-supported practice for emerging adults with serious mental health conditions: The Transition to Independence Process (TIP) Model. Journal of Behavioral Health Services & Research 2015; 42(2).
Woolsey L, Katz-Leavy J. Transitioning Youth with Mental Health Needs to Meaningful Employment and Independent Living. Washington, DC: National Collaborative on Workforce and Disability for Youth, Institute for Educational Leadership; 2008.
Walker JS, Flower KM. Provider perspectives on principle-adherent practice in empirically-supported interventions for emerging adults with serious mental health conditions. Journal of Behavioral Health Services & Research 2015; 42(2).
Fraker T, Rangarajan A. The social security administration’s youth transition demonstration projects. Journal of Vocational Rehabilitation 2009; 30: 223–240.
US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. Cooperative Agreements for State/Community Partnerships to Integrate Services and Supports for Youth and Young Adults 16-25 with Serious Mental Health Conditions and Their Families: Request for Applications. Available online at http://www.reginfo.gov/public/do/DownloadDocument?documentID=340451&version=0. Accessed January 10, 2015.
Walters D, Zanghi M, Ansell D, et al. Transition Planning with Adolescents: A Review of Principles and Practices Across Systems. Tulsa, OK: National Resource Center for Youth Development, 2010.
Gullan RL, Power TJ, Leff SS. The role of empowerment in a school-based community service program with inner-city, minority youth. Journal of Adolescent Research 2013; 28(6): 664–689.
Brink AJW, Wissing MP. Review article: A model for a positive youth development intervention. Journal of Child and Adolescent Mental Health 2012; 24(1): 1–13.
Morton MH, Montgomery P. Youth empowerment programs for improving adolescents’ self-efficacy and self-esteem: A systematic review. Research on Social Work Practice 2012; 23(1): 22–33.
Fixsen D, Naoom SF, Blase KA, et al. Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network, 2005.
Steckler A, Linnan LE (Eds). Process Evaluation for Public Health Interventions and Research. San Francisco: Jossey‐Bass, 2002.
Frechtling JA. Logic Modeling Methods in Program Evaluation. San Francisco: Jossey-Bass, 2007.
Rogers PJ, Petrosino A, Huebner TA, et al. Program theory evaluation: Practice, promise, and problems. New Directions for Evaluation 2000; 87: 5-13.
Savaya R, Waysman M. The logic model: A tool for incorporating theory in development and evaluation of programs. Administration in Social Work 2005; 29(2): 85-104.
Hamilton JD, Kendall PC, Gosch E, et al. Flexibility Within Fidelity. Journal of the American Academy of Child & Adolescent Psychiatry 2008; 47(9): 987–993.
Barth RP, Lee BR, Lindsey MA, et al. Evidence-based practice at a crossroads: The timely emergence of common elements and common factors. Research on Social Work Practice 2011; 22(1): 108–119.
Duncan BL, Miller SD, Wampold BE, et al. (Eds). The Heart and Soul of Change: Delivering What Works, Second Edition. Washington, DC: American Psychological Association, 2010.
Chorpita BF, Daleidan EL. Mapping evidence-based treatments for children and adolescents: Application of the distillation and matching model to 615 treatments from 322 randomized trials. Journal of Consulting and Clinical Psychology 2009; 77(3): 566-579. doi: 10.1037/a0014565.
Garland AF, Bickman L, Chorpita BF. Change what? Identifying quality improvement targets by investigating usual mental health care. Administration and Policy in Mental Health 2010; 37(1): 15-26.
Bruns EJ, Walker JS, Bernstein AD, et al. Family voice with informed choice: Coordinating wraparound with research-based treatment for children and adolescents. Journal of Clinical Child and Adolescent Psychology 2014; 43(2): 256-269.
Walker JS, Gowen K, Jivanjee P, et al. Pathways to Positive Futures: State-of-the-Science Conference Proceedings (Part 1). Portland, OR: Portland State University, Research and Training Center for Pathways to Positive Futures, 2013.
Masten AS, Coatsworth JD, Neemann J, et al. The structure and coherence of competence from childhood through adolescence. Child Development 1995; 66: 1635–1659.
Masten AS, Burt KB, Roisman GI, et al. Resources and resilience in the transition to adulthood: Continuity and change. Development and Psychopathology 2004; 16: 1071–1094.
Lerner RM, Freund AM, De Stefanis I, et al. Understanding developmental regulation in adolescence: The use of the selection, optimization, and compensation model. Human Development 2001; 44: 29–50.
Skaletz C, Seiffge-Krenke I. Models of developmental regulation in emerging adulthood and links to symptomatology. New Directions for Child and Adolescent Development 2010; 130: 71–82.
Eisenberg N, Cumberland A, Guthrie IK, et al. Age changes in prosocial responding and moral reasoning in adolescence and early adulthood. Journal of Research on Adolescence 2005; 15: 235–260.
Hawkins MT, Letcher P, Sanson A, et al. Positive development in emerging adulthood. Australian Journal of Psychology 2009; 61(2): 89–99.
Salmela-Aro K. Personal goals and well-being: How do young people navigate their lives? New Directions for Child and Adolescent Development 2010; 130: 13-26.
Schmid KL, Phelps E, Lerner RM. Constructing positive futures: Modeling the relationship between adolescents’ hopeful future expectations and intentional self regulation in predicting positive youth development. Journal of adolescence 2011; 34(6): 1127–1135.
Li J, Julian MM. Developmental relationships as the active ingredient: A unifying working hypothesis of “what works” across intervention settings. The American Journal of Orthopsychiatry 2012; 82(2): 157–166.
Kia-Keating M, Dowdy E, Morgan ML, et al. Protecting and promoting: An integrative conceptual model for healthy development of adolescents. The Journal of Adolescent Health 2011; 48(3): 220–228.
Lerner RM. Theories of human development: Contemporary perspectives. In: W Damon, RM Lerner (Eds). Handbook of Child Psychology, Volume 1: Theoretical Models of Human Development, Fifth Edition. New York: Wiley, 1998, pp. 1–24.
Amerikaner MJ. Continuing theoretical convergence: A general systems theory perspective on personal growth and development. Journal of Individual Psychology 1981; 37: 31–53.
Bronfenbrenner U. The Ecology of Human Development: Experiments by Nature and Design. Cambridge: Harvard University Press, 1980.
Bronfenbrenner U, Morris PA. The ecology of developmental processes. In: W Damon, RM Lerner (Eds). Handbook of Child Psychology, Volume 1: Theoretical Models of Human Development, Fifth Edition. New York: Wiley, 1998, pp. 993–1027.
Shapiro SL, Schwartz GE. The role of intention in self-regulation: Toward intentional systemic mindfulness. In: M Boekaerts, PR Pintrich, M Zeidner (Eds). Handbook of Self-Regulation. San Diego: Academic Press, 2005, pp. 253–273
Lerner RM, Brentano C, Dowling EM, et al. Positive youth development: Thriving as the basis of personhood and civil society. In: RM Lerner, CS Taylor, A Von Eye (Eds). New Directions for Youth Development: Pathways to Development among Diverse Youth, Issue 95. San Francisco: Jossey-Bass, 2002, pp. 11–33.
Gestsdóttir S, Lerner RM. Positive development in adolescence: The development and role of intentional self-regulation. Human Development 2008; 51: 202–224.
Baltes PB, Baltes MM. Psychological perspectives on successful aging: The model of selective optimization with compensation. In: PB Baltes, MM Baltes (Eds). Successful Aging: Perspectives from the Behavioral Sciences. New York: Cambridge University Press, 1990, pp. 1–34.
Brandtstädter J. Personal self-regulation of development: Cross-sequential analyses of development-related control beliefs and emotions. Developmental Psychology 1989; 25: 96–108.
Snyder CR, Rand KL, Sigmon DR. Hope theory: A member of the positive psychology family. In: CR Snyder, SJ Lopez (Eds). Handbook of Positive Psychology. New York: Oxford University Press, 2002, pp. 231–243.
Deci E, Ryan R (Eds). Handbook of Self-Determination Research. Rochester, NY: University of Rochester Press, 2002.
Bandura, A. Perceived self-efficacy in cognitive development and functioning. Educational Psychologist 1993; 28(2): 117-148.
Baltes PB. On the incomplete architecture of human ontogeny: Selection, optimization and compensation as the foundation of developmental theory. American Psychologist 1997; 52: 366–380.
Brandstädter J. Action perspectives on human development. In: W Damon, RM Lerner (Eds). Handbook of Child Psychology, Volume 1: Theoretical Models of Human Development, Sixth Edition. New York: Wiley, 2006, pp. 516–568.
Miller WR, Rollnick S. Motivational Interviewing, Third Edition: Helping People Change (Applications of Motivational Interviewing). New York: Guilford Press, 2012.
Vygotsky LS. Mind in Society. Cambridge, MA: Harvard University Press, 1978.
Csikszentmihalyi M. Flow: The Psychology of Optimal Experience. New York: Harper & Row, 1990.
Piskur B, Daniels R, Jongmans M, et al. Participation and social participation: Are they distinct concepts? Clinical Rehabilitation 2014; 28: 211–220.
McCarthy J, Sullivan P, Wright P. Culture, personal experience and agency. British Journal of Psychology 2006; 45: 421-439.
Miller JG, Rehka D, Chakravarthy S. Culture and the role of choice in agency. Journal of Personality and Social Psychology 2011; 101(1): 46-61.
Scharf M, Mayseless O. Finding the authentic self in a communal culture: Developmental goals in emerging adulthood. In: S Schuman, J.-E Nurmi (Eds). The Role of Goals in Navigating Individual Lives During Emerging Adulthood. New Directions for Child and Adolescent Development. No. 130. San Francisco: Jossey-Bass, 2010, pp. 83-95.
Shogren, KA. Culture and self-determination: A review of the literature and directions for future research and practice. Career Development for Exceptional Individuals 2011; 34: 115-127.
Castro FG, Barrera Jr. M, Holleran Steiker LK. Issues and challenges in the design of culturally adapted evidence-based interventions. Annual Review of Clinical Psychology 2010; 6: 213–239.
Walker JS, Koroloff N. Mehess SJ. Community and state systems change associated with the Healthy Transitions Initiative. Journal of Behavioral Health Services and Research 2015; 42(2).
Acknowledgments
This work was supported by funding from the National Institute of Disability and Rehabilitation Research, United States Department of Education, and the Center for Mental Health Services Substance Abuse and Mental Health Services Administration, United States Department of Health and Human Services (NIDRR grant H133B090019). The content does not necessarily represent the views or policies of the funding agencies. The author would like to thank all of the stakeholders who provided their insights and feedback for this work.
Conflict of Interest
The authors report no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Walker, J.S. A Theory of Change for Positive Developmental Approaches to Improving Outcomes Among Emerging Adults with Serious Mental Health Conditions. J Behav Health Serv Res 42, 131–149 (2015). https://doi.org/10.1007/s11414-015-9455-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11414-015-9455-x