Homelessness

Analyses of Social Issues and Public Policy, Vol. 2, No. 1, 2002, pp. 223--238

Home Street Home: The Interpersonal Dimensions of Adolescent Homelessness

Matthew Paradise∗ University of North Carolina Greensboro

Ana Mari Cauce University of Washington

This paper draws on the available literature, as well as unpublished data, to reconstruct the often chaotic early childhood experiences of homeless adoles- cents and to describe the problematic ways of relating that may result from these troubled life histories. We also examine the processes by which homeless youth become separated from their families, and we make connections between socio- emotional problems on the street and early neglect and abuse at home. The risk- amplification model is offered as a theoretically compelling explanation of the adolescent homeless experience, high rates of victimization on the streets, and mental health problems that arise out of these circumstances. Finally, we present a promising approach for intervening with homeless youth, one that explicitly targets this cycle of ineffective interpersonal relationships.

It is one of life’s true injustices that the children who are most at risk for social, emotional, and behavioral problems so often come from equally vulnerable parents. Young people with the greatest needs frequently grow up in those families least able to meet them, and this scenario has been played out in the early years of many, if not most, youth who end up on the street. It makes sense, then, that Bowlby’s (1944) earliest formulations about how family members relate to one another, and the problems that might result when these relationships were unsuccessful, arose out of observations and interviews with young people in trouble with the law, a population that shares many qualities with homeless and runaway youth.

∗Correspondence concerning this article should be addressed to: Matthew Paradise, Department of Psychology, Box 26164, UNCG, Greensboro, NC 27402-6164. [e-mail: matthew [email protected]].

This work was supported by grant R01AA10253 to Professor Cauce from the National Institute on Alcohol Abuse and Alcoholism.

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C© 2002 The Society for the Psychological Study of Social Issues

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There have been surprisingly few studies focusing specifically on the so- cial lives of homeless young people, but the high prevalence of mental health problems in this population has been well documented (see Cauce, Paradise, Embry, Ryan, Lohr, Theofilis, Sy, Morgan, & Wagner, 1998; Robertson & Toro, 1999, for more complete reviews). Put simply, the research suggests that emo- tional disorders, conduct problems, and suicidal ideation are widespread among homeless adolescents (Feitel, Margetson, Chamas, & Lipman, 1992; Yoder, 1999; Yoder, Hoyt & Whitbeck 1998). For example, Cauce and her colleagues (1994) looked at street-involved youth using structured diagnostic interviews and found that approximately two-thirds met criteria for at least one DSM III-R diagno- sis. Among these, conduct disorder was most prevalent, present in close to half the sample. Attention deficit/hyperactivity disorder and depression were also common and about a fifth of all youth met criteria for at least one of these disorders. In this same project, participants’ responses to items from the Child Behavior Checklist (Achenbach, 1991) supported these trends. About half of the homeless youth scored above “borderline” or “clinical concern” cutoffs (the 95th and 98th percentiles in normative samples) for externalizing or internalizing disorders.

In the present effort, we argue that the emotional and behavioral problems that characterize so many homeless youth result from an interaction between individual vulnerability and environmental risk. We also believe that family is central here, and that a young person’s leaving home is frequently part of a process of familial disintegration that begins in early childhood. The link between vulnerability and risk becomes concretized early on in a pattern of negative interactions between parent and child. The resulting difficulties in family relationships persist into ado- lescence and eventually manifest in the young person’s leaving or being expelled from home. As Rothman notes, “runaway behavior is a complex, multifaceted phenomenon, that at its heart, implicates a failure in the family relational system” (1989). Consequently, the phenomenon of teen homelessness sheds light on what can happen when this central relationship, the bond between the individual and his or her family, breaks down.

To this end, we have drawn upon the available research to reconstruct the often chaotic early childhood experiences of these youth, and we follow with a description of some of the problematic ways of relating that may result from these life experiences. We then examine the processes by which youth become sepa- rated from their families, an event that typically leaves them vulnerable to further exploitation and abuse. Finally, we present a model that connects an individual youth’s troubled familial relationship with problematic relationships on the street and with mental health problems more generally. We conclude with a discus- sion of a promising approach for breaking this cycle of ineffective interpersonal relationships.

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Prevalence and Types of Homeless/Runaway Youth

In the last decade, there has been an increased appreciation among researchers, policy makers, and the general public that teenagers are leaving home with alarming frequency. Reliable estimates of the prevalence of adolescent homelessness have been difficult to obtain, but the most recent and rigorous attempt, drawn from a nationally representative sample of nearly 6,500 youth aged 12 to 17, indicated that about 5%—or more than a million youth nationwide—were, at some point, home- less during a 12-month period (Ringwalt, Greene, Robertson, and McPheeters, 1998). This included adolescents who had stayed in shelters, but not those who had stayed in other places commonly associated with homelessness, such as public parks, bus stations, or a friend’s or acquaintance’s residence. Consequently, this number likely underestimates the true magnitude of the problem. Less conservative estimates put the number at 1.5 million or more (National Network of Runaway and Youth Services, Inc., 1985; U.S. Department of Health and Human Services, 1986).

Nonetheless, the research base on homeless and runaway youth is quite lim- ited, and street youth are the least understood group within a broader homeless population that is itself understudied (Rotheram-Borus, Koopman & Ehrhardt, 1991). The bulk of this literature describes the various problems associated with the homeless experience itself, and studies that examine the quality of homeless- youth relationships, on or off the streets, are scarce. Efforts aimed at tying these factors into a theoretical perspective are even more rare. Thus, in addition to drawing upon published research, in this article we frequently draw upon unpublished data in two studies we have conducted in recent years.

The first, the Seattle Homeless Adolescent Research Project (SHARP), was conducted at the University of Washington in conjunction with the Washington State Department of Mental Health and with YouthCare, Inc., a provider of ser- vices to homeless youth (Cauce et al., 1994, 1998). SHARP sought to provide a better understanding of the background characteristics and mental health sta- tus of homeless teens and to evaluate the effectiveness of two strategies for case management with these youth. Some 354 homeless youth drawn from local social service agencies were included in this effort. The second study, the Seattle Home- less Adolescent Research and Education Study (SHARE), a follow-up to the first study, looked more closely at youth victimization, substance use, and the relation- ship between family history and life on the streets. Three hundred seventy-two young people participated in the second study, many of them recruited directly off the streets or from areas frequented by street youth. Both studies were short-term longitudinal, with youths interviewed every 3 or 4 months for between 12 and 18 months.

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Early Childhood: Vulnerability Meets Insufficiency

Whether caused by genetic predisposition, poor prenatal care, or complica- tions during birth, there is a growing body of evidence that many homeless youth enter childhood “hard-wired” for behavior and attention problems. A yearlong ef- fort, arising out of the SHARP study, provided psychological testing for homeless adolescents in YouthCare’s school program. While the total number of youths as- sessed was small, a few shy of 30, nearly every participant demonstrated some sort of learning disability, as evidenced by unusual performance patterns on standard IQ tests. The results implicated difficulties sustaining attention and controlling impulses, as well as gaps in previous learning, as primary deficits, but other more subtle difficulties were present as well. Youths themselves often reported having trouble at school for as long as they could remember. Parents of homeless teens concur, noting that their children had problems paying attention, sitting still, or regulating their emotions from earliest childhood.

Given the many factors that might contribute to such deficits, the evidence that these problems, or their underlying causes, were present at birth or in early childhood is far from conclusive. Still, homeless adolescents’ developmental histo- ries typically reveal emotional instability and substance use problems remarkably similar to those described in the literature on families where mothers and infants did not receive adequate levels of pre-natal care or were medically compromised in some other way. Infants from these kinds of families are characterized by irritable temperaments and go on to have more difficulty eliciting the type of nurturance necessary for optimal bonding and attachment (Moffitt, 1993). Because parents’ own emotional responding is, at least in part, contingent on their child’s ability to reciprocate affection, it can be hard for a parent to develop warm and loving feelings towards a difficult infant. Cuddly babies, by definition, elicit cuddling. Fussy babies make for frustrated parents. When caretakers are already stressed, frustration can readily turn to anger or detachment, feeding the cycle of negativity and conflict that characterizes the path to adolescent homelessness.

For children who enter the world without such innate vulnerabilities, sim- ilar deficits may be engendered by an early family life characterized by vari- ous combinations of conflict and violence, parental instability and substance use, and overly harsh parenting or neglect. The bulk of early literature on homeless youth, based on surveys of social service providers and youth in shelters (e.g., Greenblatt & Robertson, 1993), suggested that many homeless teens come from exactly these types of homes (Janus, McCormack, Burgess, & Hartman, 1987; National Network, 1985; Rothman & Davis, 1985; Shaffer & Caton, 1984). More recent studies—including the SHARP and SHARE projects, which have recruited young people directly off the streets as well as from social service agencies— reinforce these early findings and demonstrate that chaotic family histories char- acterize homeless youth on the street as well.

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Over half of SHARP participants report that their parents had substance abuse problems, and about three-quarters report that either their mother or father had experienced problems with the law. The reported rates of both substance abuse and legal problems were higher for mothers than for fathers, although this is likely the product of homeless youth having more contact with mothers, since fewer than half of these young people report living with fathers past the first six years of life (Cauce et al., 1998). From a relational standpoint, however, the difficulties experienced by mothers is especially meaningful because of the central role that mother-infant bonding plays in the formation of secure attachment.

In the follow-up to the SHARP study, a similar pattern of impaired parent- child relationships was apparent. About a third of participants from the SHARE project indicated that their home was unstable during the first six years of their life. A comparable number of respondents indicated that their primary caregiver— the person who took care of them most often while growing up—had abused alcohol or drugs, or had been arrested at least once. Many also reported that this primary caregiver had spent time in jail or prison. Such parental problems frequently translate into poor parenting, emotional distance, and a lack of support. More than a third of SHARE youth indicated that their primary caregiver rarely talked with them about what was going on in their lives and was too busy to do things with them. Not surprisingly, then, a large number of youth reported that their primary caregiver often didn’t even know when they were away from home. Just over half of SHARE youth indicated that their caregiver was unhappy with the things that he or she did. And, perhaps most tellingly, half of the respondents indicated that their parent or caregiver didn’t understand them or where they were coming from. It is clear that instead of feeling supported or cared for, youth headed for homelessness report alienation, apathy, and neglect from the very adults who were supposed to be responsible for them.

The corrosive nature of parent-child relationships in the homes of many home- less teens is best described by two recent studies that are notable for their method- ological rigor. The first compared the family environments of homeless youth recruited through shelters in Detroit with a comparison group of housed youth. Despite the close match on a variety of background and demographic variables, homeless youth were found to differ from the housed group on virtually every measure of family functioning examined. The nature of the difference was, as expected, always in the direction that suggested more dysfunction and instability and less warmth and support. More specifically, reports from homeless adoles- cents indicated that, compared to controls, their parents were less affectionate toward them, they were more often victims of parental maltreatment, and their parents were more violent toward each other (Wolfe, Toro, & McCaskill, 1999; McCaskill, Toro, & Wolfe, 1998).

An even more detailed look at family dysfunction is outlined in the work of Whitbeck and colleagues (Whitbeck, Hoyt, & Ackley, 1997a, 1997b; Whitbeck &

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Hoyt, 1999). In a series of studies including more than 500 runaway and homeless youth from small, medium, and large cities in the country’s heartland, Whitbeck and his associates found that most youth felt their caretakers had neglected them. More disturbingly, many youth also reported that these caregivers threw things at them, pushed or grabbed them, slapped them, or even hit them with an object. Youth and caretaker responses to standardized questionnaires assessing rejection, warmth, support, and parenting underscore the dysfunction that so often characterizes these homes. Homeless youth and their caretakers scored higher on measures of rejection than matched samples of youth and parents. Parents and caretakers of homeless youth in this study also scored lower on measures of monitoring, suggesting that they did not keep track of where their children were or set clear limits on their behavior. Finally, homeless and runaway youth noted lower levels of warmth and support than housed youth, and reports from caretakers were in line with these trends as well (Whitbeck & Hoyt, 1999).

Perhaps most compelling is the fact that the powerful relationship between adolescent homelessness and family dysfunction in Whitbeck’s research was evi- dent in both youth and caretaker reports. This cross-informant agreement indicates that deficits in parenting and home life do not exist simply in the eyes of the young people. Rather, the convergence between reports from homeless young people and their parents speaks to the extent and pervasiveness of the problems experienced by many of these families (Whitbeck et al. 1997b; Whitbeck & Hoyt, 1999). The absence of parental accounts of family environment had been a potential source of bias and a significant methodological weakness in previous studies of homeless youth, and this work represents an important step forward in understanding the role of family environment in a young person’s leaving home.

Whitbeck’s research also provides the best insight so far on the dynamics that characterize these families, and it establishes a clear link between substance use, conflict, and violence. Approximately half the youth in one study stated that a parent’s alcohol or drug use led directly to arguments between themselves and the caretaker, which then resulted in violence directed toward them. A similar per- centage of caretakers reported that their substance use resulted in more arguments with their children and in their children witnessing more violent confrontations. Almost a quarter of the caretakers admitted that their substance use led to violence directed specifically toward the youth (Whitbeck & Hoyt, 1999).

Leaving Home: The Family Disintegrates

Adolescent homelessness is frequently depicted in books, movies, and tele- vision as having resulted from a single explosive confrontation, a conflict about house rules, drugs, or sexual behavior. And, in some cases, a young person’s leaving home is sparked by a specific fight. Nonetheless, the typical path into homeless- ness, while often punctuated by violence and conflict, is far more often marked

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by a heterogeneous dissolution process, one that involves a variety of factors and that typically occurs over an extended period of time.

Several authors have attempted to create a typology of youth based on the reasons they left home and, most recently, Rothman (1989, 1991) outlined five dynamics that fuel adolescent homelessness. These include: (1) a desire to “find oneself ” (Adams & Munro, 1979); (2) conflict with parents (Adams & Munro, 1979; Blood & D’Angelo, 1974; Gullotta, 1978); (3) a response to detrimental home conditions and a need for control over their lives (Brennan, Huizinga, & Elliott, 1978); (4) the search for a more compatible value system and a search for meaning (Adams & Munro, 1979; Reilly, 1978); and (5) psychopathology (Reilly, 1978; Kratcoski, 1974).

Although typologies such as these have proven clinically useful over the years, the actual number of homeless young people who fall into each of these categories has been in dispute. For instance, current research offers scant evidence that any substantial number of youth leave home out of the kind of search for meaning suggested by Rothman (1989). To the contrary, there is a great deal of evidence that the bulk of today’s homeless youth have left home due to familial conflict, crisis, or inadequate support in the home.

Across a number of recent studies, the most frequent reasons youth give for leaving home are family disagreement and conflict. More specifically, parental drug and alcohol use, family violence, neglect, and abuse are frequently cited by homeless young people as reasons for their departure (Robertson & Toro, 1999). One of the most methodologically rigorous examinations of this topic analyzed the actual antecedents to running away. Results indicated that an unstable family environment, specifically one characterized by abrupt changes in family structure, neglect, or sexual abuse, was especially predictive of a young person’s running away from home (Yoder, Whitbeck, & Hoyt, 1999).

It is important to note, however, that because researchers most often ask youths why they left home, this does not mean the decision to do so was in fact their own. Data gathered from homeless adolescent populations in cities as diverse as Detroit, San Francisco, Des Moines, Lincoln, Neb., and Seattle—with samples that included youth in shelters as well as on the street—demonstrate that between a quarter and two-thirds of homeless youth do not make the decision alone (Kennedy, 1991; Robertson & Toro, 1999). In the SHARP study, for instance, only one-third of all youths indicated that the decision to leave home was their own. Another third said they had been kicked out of the home by their parents or caretakers, and about one-fifth reported that authorities had removed them. The remainder were either abandoned or had left as a result of a mutual decision between themselves and their parents (MacLean, Embry, & Cauce, 1999).

Moreover, a young person’s running away rarely marks the final disintegration of the family, functional or otherwise. To the contrary, the bulk of youth who run away from home return within a week and do not become homeless or spend

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significant amounts of time on their own. Even hardened street youth, those who have spent months or even years on their own, often attempt to reunite, sometimes successfully, with the families they left. In the SHARE study, for instance, a small (about 5%) but meaningful group of young people was clearly identified as homeless (i.e., no stable residence), but had spent some part of the week prior to their research interview living with their parents. Over three-quarters of the sample had previously left home and returned at least once, and close to one- third had cycled between home and the streets six or more separate times. Young people on their own appear to maintain a surprising amount of contact with their adult caregivers, and for many of them, hitting the streets is a way to manage or moderate, rather than terminate, a troubled relationship with their family.

Life on the Streets: From the Frying Pan into the Fire

Most accounts of life on the streets for young people quickly overwhelm ro- mantic notions about freedom, independence, and the runaway experience. Instead of broadening their horizons and exploring the country by hitchhiking or jumping trains, runaway and homeless youth typically remain close to home, quite often living in the same city as their parents or guardians. When they do roam, it is more often in search of a safe place to stay than out of a sense of adventure. Data from the SHARP study revealed that, on average, youth changed their permanent “residence” every 45 days (Cauce et al., 1998), but that most homeless youth cycle more rapidly among a few recurring living situations. Although reports vary from study to study, the most common places for homeless youth to stay include shelters or hostels, friends’ or relatives’ homes, squats in abandoned buildings, or on the street itself (Cauce et al., 1998; McCarthy & Hagan, 1992).

There has yet to be a close examination of specific patterns of shelter-seeking among street youth, but observations from SHARP and SHARE suggest that in many cases, youth attempt to stay with relatives or friends first, but eventually exhaust already tenuous support networks and overstay their welcome. For the most troubled adolescents, this may happen quite quickly. Young males seem to deplete these resources most rapidly because the kinds of externalizing behaviors in which they are likely to engage appear to take the greatest toll on fragile relationships. As these support networks break down, life on the streets becomes increasingly likely for these troubled youth.

For many young people, the pattern of troubled relationships, abuse, and exploitation that precipitated their homelessness is only made worse by leaving home. Homeless adolescents are ready targets for exploitation from both adults and peers, and the literature makes clear that street youth are frequently victims of physical and sexual assault (Cauce et al., 1998; Greenblatt & Robertson, 1993; Whitbeck et al., 1997a; Yates et al. 1998). Approximately half of the street youth interviewed in a Los Angeles study said they feared being sexually or physically

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assaulted, shot, or stabbed (Kipke, Montgomery, Simon, & Unger, 1997). In a sam- ple of New York street youth, about a fifth had been robbed, physically assaulted, or sexually assaulted within their first 100 days on the street (Rotheram-Borus, Rosario, & Koopman, 1991). In another survey of homeless youth in the Midwest, between one-fifth and one-third said they had been beaten up, robbed, or propo- sitioned for sexual favors since living on their own, and more than 10% of the girls reported that they had been raped (Whitbeck & Hoyt, 1999). The dangers associated with adolescent street life are both substantial and widespread.

There is some evidence that early victimization at home may actually play an important role in priming a youth for abuse and exploitation on the streets. Whitbeck and Hoyt (1999) found, for example, that young women who had been sexually abused by a caretaker at home were twice as likely to be sexually revic- timized on the streets than homeless young women who had not been abused. Still, Whitbeck maintains that a young person’s current living situation plays a key role in translating this risk into reality and that such situational factors are, in fact, the more proximal cause of abuse and exploitation.

In a multisite study of almost 1,000 street youth and including SHARE par- ticipants (Whitbeck, Hoyt, Yoder, Cauce & Paradise, 1999), participation in non- sexual-deviant subsistence strategies, such as dealing drugs, was found to more than double the likelihood of physical victimization even after controlling for fac- tors like sexual or physical maltreatment at home. On the other hand, participating in subsistence strategies of a sexual nature, like trading sex for money or food, in- creased the likelihood of sexual victimization almost fourfold. Again, behavior on the streets appears to be the conduit through which the risks associated with early maltreatment are conveyed. This is especially problematic given that homeless youth have few options for self-support using conventional means.

In today’s society, where youth and sexuality have become virtual commodi- ties, many homeless teens find that their bodies are their most serviceable assets. Whether they are looking for food, money, drugs, or simply a place to stay for the night, an unfortunate number of street youths trade sexual favors in order to sustain themselves (Silbert & Pines, 1981). In studies of street youth in New York City and Los Angeles, for example, between a third and a half reported trading sex to meet at least one of their basic needs (Rotheram-Borus, Meyer-Bahlburg, Koopman, Rosario, Exner, Henderson, Matthieu, & Gruen, 1992; Kipke et al, 1997). Be- tween a quarter and a third of the clients at a Hollywood health clinic that served street youth reported engaging in this kind of subsistence sex (Yates et al, 1988) and a third of a Toronto street youth sample admitted to prostitution (McCarthy & Hagan, 1992). Sex, it seems, is often simply a way for a homeless youth to get by.

Even larger numbers of homeless teens engage in deviant subsistence strate- gies that don’t involve sex. In one sample of street youth from the Midwest, about a third of the young men admitted to stealing, with a quarter reporting they had broken into a house or store to do so. Almost half of these homeless young men sold

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drugs, as did almost a third of the young women (Whitbeck & Hoyt, 1999). Close to three-quarters of street youth in a Toronto study reported that they had com- mitted at least one serious theft since leaving home (McCarthy & Hagan, 1992). Again, this kind of delinquency appears to be disturbingly widespread among young people who leave home.

Subsistence, simply finding a place to stay or food to eat, does appear to be a key motivating factor in theft and similar activities. Whitbeck (1999) reports that homeless youth are more likely to steal food when they are hungry or to engage in other kinds of theft when they don’t have a place to stay, and youth who can not find other jobs are more likely to engage in prostitution. Nonetheless, adolescents who have experienced problems at home or were part of delinquent peer groups before leaving home, are substantially more likely to be involved in theft while on the streets than those who come from less troubled backgrounds.

In the end, the nature of homeless youths’ involvement in illegal activities is best explained when past experience and current life circumstances are brought together. McCarthy and Hagan note, “A key to this integration is a focus on aver- sive conditions at home and in school because taking to the street and subsequent criminal activity are often responses to successive and causally linked aversive conditions, for example, when parental abuse and neglect at home lead to youths’ taking to the streets” (1992, p. 624). Indeed, many of the factors that best predict ending up on the streets, such as harsh parental discipline, are also highly predictive of falling into the kind of situations that put a youth at risk for criminal activity after leaving home.

Putting the Pieces Together: A Risk Amplification Model

As we have noted repeatedly, the last two decades have given rise to increas- ingly sophisticated descriptions of the homeless youth experience. We suspect that these young people often enter the world with innate vulnerabilities, and we know that they frequently grow up in troubled families, where parental substance abuse, family conflict, and violence are common. Regardless of whether they chose to leave, were kicked out by parents, or were removed by the state, many of these young people were abused at home, either physically, sexually, or both. Once on the streets, homeless youth make ends meet by a variety of means that, for many, include illegal activities. We also know that they experience a myriad of mental health problems both prior to leaving and while on their own. Still, theory that pieces together these disparate parts has, to this point, remained elusive.

Whitbeck and colleagues (Whitbeck et al., 1997a; Whitbeck, Hoyt, & Yoder, 1999) offer one especially noteworthy exception in recent work. Drawing from research in developmental psychology and sociology, as well as from their exten- sive observations of runaway and homeless youth in the Midwest and Northwest, they have developed a theoretically rich model that ties together early family

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environment, subsequent participation in deviant behavior, victimization on the streets, and psychopathology. Their risk-amplification model is, at its heart, a narrative effort that traces the path between family problems, homelessness, psy- chopathology and risky behavior. The various problems that characterize the early family lives of so many homeless youth, namely high levels of family conflict and parental substance use, result in violence and abuse. These, in turn, result in a youth making his or her way, whether by choice or expulsion, to the street and, more importantly, result in his or her remaining there. In the same way, the scarce interpersonal resources that often characterize young people who end up on the street make them likely to fall in with a deviant peer group once there.

In an early version the model, Whitbeck and Simons (1990) argued that physi- cal and sexual abuse at home predisposes an individual youth to both homelessness and subsequent victimization. Here, the link between childhood abuse and later exploitation is magnified by homelessness. Abuse, leaving home, and other neg- ative life events propel an individual further along a trajectory of increasing risk. Each step along this trajectory makes subsequent victimization more likely. More recently, Whitbeck and Hoyt (1999) traced developmental trajectories in the lives of homeless youth more directly, describing a cycle that begins with parental prob- lems and ends with elevated rates of internalizing, including symptoms associated with depression and post traumatic stress disorder.

This model has received empirical support both cross-sectionally (Whitbeck, Hoyt, & Yoder, 1999; Whitbeck & Hoyt, 1999) and prospectively on samples of youth from the Midwest and from the SHARP effort described above (Whitbeck, Hoyt, Yoder, Cauce & Paradise, 1999). The path to adolescent homelessness out- lined in this model makes clear that leaving home is rarely an individual pursuit. Rather, the developmental histories of many homeless youth make it evident that family problems (e.g., poor parenting or familial abuse), difficulties forming re- lationships, and involvement with deviant peers are central, if not essential, to a young person’s ending up on his or her own.

The End Product: Social Networks

Surprisingly little empirical work has been done on the social lives of street youth, but it is evident that once on the street, youth congregate in groups that are differentiated by degrees of involvement in deviant activities (Kipke, Montgomery, Simon, & Unger, 1997). Although affiliation with deviant peer groups on the street is often a simple continuation of the types of association that a young person had before leaving home (Hagan & McCarthy, 1997), these groups often exert tremendous pressure on a youth to engage in unsafe activities, including substance use and unprotected sex, that may be especially dangerous on the streets (Ennett, Bailey, & Federman, 1999; Kipke et al., 1997). Unchecked by parental control or

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adult supervision, this pressure is particularly intense for a young person living on his or her own.

It is important, however, to acknowledge that peers on the street often play a dual role in the life of a homeless adolescent. They are undoubtedly sources of risk, but can also supply nurturance and support. Individuals who provide services to homeless youth describe close networks or “street families” that provide physical and emotional assistance as well as protection from the many dangers that accom- pany street life. In describing these networks, youth often refer to street-siblings or street-parents as the people they are most likely to count on during times of need (Hagan & McCarthy, 1997; Whitbeck & Hoyt, 1999). In the course of inter- views with street youth in the SHARP and SHARE projects, research staff heard countless stories about the ways in which homeless youth shared food, money, and whatever else they had with members of these street families. The importance of sharing seems to be one of the most fundamental values of people who live on the street.

The paradoxical effect of peer involvement on the street was well illustrated in a recent study that looked at the role of social support networks in the development of depressive symptoms among homeless and runaway youth. In this effort, overall availability of peer social networks was associated with instrumental and emotional support and, in turn, with decreased depressive affect. Nonetheless, youth who were involved specifically with a deviant peer group, perhaps the same one that provided material support, evidenced increased depressive symptoms (Bao, Whitbeck, & Hoyt, 1999). Friendship on the streets can be a double-edged sword; the very same peers a homeless young person might rely on in times of need are also those most apt to expose the youth to risk and victimization.

A Look Toward the Future: What We Can Do to Help

The magnitude and variety of the problems associated with adolescent home- lessness are undeniable, yet relatively little is known about the long-term prospects for a person who ends up living on his or her own as a teenager. Robertson and Toro (1999) offer a brief overview of the research on this topic, but acknowledge that the literature on this topic is especially thin. While methodological rigor is the exception rather than the rule here, the available evidence indicates that there is a strong association between adolescent homelessness and problems in adulthood. These include increased involvement in the justice system, employment problems, and social isolation (Hagan & McCarthy, 1997).

It makes sense, given that these youths’ histories are so often marked by failed relationships in the family, that the only empirically validated intervention to address mental health problems in homeless youth hinges on the development of another relationship. More specifically, case-management services, provided by a supportive and interested adult, appear to make a real difference in the

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day-to-day functioning of these young people. Moreover, those homeless adoles- cents who received intensive and targeted case management in the SHARP study, in contrast to youth who received case-management services already offered in the community, evidenced better rates of improvement over a three-month period (Cauce et al., 1994).

The specific components of this approach are described elsewhere (Cauce et al., 1994; Cauce, Paradise, Ginzler, Embry, Morgan, Lohr, & Theofolis, 2000), but the program emphasizes a close, guardian-like relationship between the case manager and the homeless youth. A year after becoming involved in the study, participants in the intensive case-management condition showed improvements over baseline on measures of both mental health and behavioral functioning. Girls receiving intensive case management did particularly well and showed lower rates of re-victimization on the streets than those receiving case management as usual (Ryan, Kilmer, Cauce & Hoyt, in press). The effectiveness of this approach speaks to the protective nature of a concerned and committed adult for these young people, and when such relationships occur in the context of a sensitive intervention, they appear to serve a protective function and afford the potential to break the cycle of victimization that is so prevalent among kids on the street.

Despite the promise of case management as an effective tool for helping these young people, it would be insincere to end on an optimistic note. The lives of many street youth are so impoverished, so unhappy, and so dangerous that those who study or work with them are almost inevitably affected emotionally. Although SHARP and SHARE interviewers reported that they enjoyed their work and appreciated the many strengths in these youths, the work was, at times, difficult and distressing (Cauce & Lohr, 1997). With few exceptions, these are youth who have had little respite from the trouble and chaos outlined in this article. For many, homelessness is simply the most recent stop on a tremendously difficult ride through life.

A great deal of attention has been paid to the impact of extra-familial influences on adolescent development in recent years. It has been argued that cultural factors like movies, music, or video games may play a greater role than family life or parenting in the initiation of adolescent problem behaviors. Our experience with homeless teens suggests that those who dispute the critical role of parents in the lives of adolescents (e.g., Harris, 1995) have likely not spent much time with young people who have become physically and emotionally disconnected from their parents. A legacy of family violence, conflict, and neglect is not readily escaped, even by leaving home.

It is imperative to recognize, then, that adolescent homelessness represents a failure of our society on multiple levels—social, political, and economic. Young people who end up living on their own also represent a profound moral breakdown: a collective inability to understand that we are unconditionally responsible for our youth and, through them, for our families. The failure may, in most cases, begin

236 Paradise and Cauce

with parents, but it ends with all of us. The growing trend in America toward making young people more accountable for their actions (e.g., the rapid erosion of a separate and rehabilitative system of juvenile justice) has not been matched by a similar push to make society accountable for its disenfranchised youth. It is time to acknowledge, then, that adults are key players in the genesis of adolescent homelessness, and it will be adults who must learn to effectively intervene.

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MATTHEW PARADISE is an Assistant Professor in the Department of Psychol- ogy at the University of North Carolina Greensboro and also serves on the faculty of the Center for Developmental Science at UNC Chapel Hill. Dr. Paradise fo- cuses his research on adolescents and young adults at-risk for psychopathology, as well as on the connection between mental health and substance use across time. He is also concerned with the roles of family and community in the genesis of maladaptive behavior and with community-based strategies for intervention.

ANA MARI CAUCE is presently the Earl R. Carlson Professor in the Department of Psychology at the University of Washington. She has a joint appointment in the Department of American Ethnic Studies and is also director of the University of Washington Honors Program. Dr. Cauce is particularly interested in normative and non-normative development in ethnic minority youth and in at-risk youth in general.

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