Young people involved in the sex trade have existed throughout history. Following passage of the 2000 Trafficking Victims Protection Act (TVPA) by the U.S. Congress, 22 U.S.C. 7102(8), U.S. citizens and lawful permanent residents who are under the age of 18 and trading sex in any capacity are now considered domestic minor victims of human trafficking. With the TVPA's passage, public awareness and services for victims of human trafficking increased. However, strategies to meet the needs of these young people are in the early stages of development. Knowledge gaps exist about the characteristics of young people who trade sex, what services these young people would like to receive, and the challenges of service provision. This study focused on three agencies that received funding to work with domestic minor victims of sex trafficking: the SAGE Project, Inc. in San Francisco, the Streetwork Project at Safe Horizon in New York, and the STOP-IT Program at Salvation Army in Chicago. This study addressed the following questions through a secondary analysis of quantitative and qualitative data: (1) What are the characteristics of young people who trade sex?; (2) What services do the young people request and what do they receive?; and (3) What are the challenges case managers experience in their work with this population?

Gay fathers are creating family forms and parenting practices that reach beyond the nuclear family model. Analysis suggests that fathers in this study are developing unique and queer versions of kinship. Fathers' desire for emotional connection leads to the creative assemblage of paid caregivers, friends, children's non-legal biological kin, and gay men's families of origin into kinship networks. These creative mixtures may be perceived as unusual family formations, but they assist gay fathers in creating social support and connected lives for themselves and their children. These findings are based on a qualitative research project that consisted of interviews with 15 gay fathers who resided in 8 households and who were raising 13 children. The participants were all self-identified gay men who had formed planned families outside of heterosexual relationships. Research aims included: To explore the lived experience of gay men raising children; To explore how gay fathers adapt concepts of kinship; To describe the role of social support in the lives of gay fathers; To present emergent and unanticipated topics.

Data-collection methods included development of a genogram that described each family and their social support networks. In-depth interviews based on a semi-structured interview guide were then conducted with participants. Data analysis techniques were based within a grounded theory framework. Analysis resulted in development of 47 repeating ideas, which were then organized into nine themes: 1) Methods of family formation and Desire to parent; 2) Challenges of parenting; 3) Rewards of parenting; 4) Kinship is about connection; 5) Biology is less and more important than I thought; 6) Importance of non-kin social supports; 7) Changes in sense of connection to the gay community; 8) I always knew I would be a dad; and 9) Experiences with social welfare institutions. Implications and recommendations for future research and practice are included.

The aim of this dissertation was to examine the extent of association, if any, between strengths (including those of the client, the client's family, and the client's environment) and psychiatric symptom severity for "youth" (children and adolescents aged 5-22) in contact with a mental health and/or substance abuse agency in a public System of Care. This dissertation examined a public systems dataset that included administrative assessment data for every client aged 5-22 (n=2049) who entered into a public System of Care from June 2010-August 2013. The assessment data was collected by clinicians at entry to the system (initial assessment), six months after initial assessment, and twelve months after initial assessment. Behavioral/social learning theory and related research in applied and experimental settings (e.g. Goldiamond, 1974; Madden, 2013; Staats, 2012) would suggest that growth in strengths would be associated with reduction in symptoms. However, time order cannot be determined with the current data and thus only associational relationships are discussed.

This dissertation is a "three paper" dissertation including a dissertation introduction, three inter-related papers, and a dissertation conclusion. The dissertation introduction provides a background to the entire dissertation and is intended to orient to the reader to terminological and conceptual issues relevant to all three papers (each paper might also cover some of the literature included in the dissertation introduction, as relevant to the specific paper).

Paper one reviews the literature on prevalence of emotional and behavioral problems among youth in the United States, orients the reader to the history and current policies of Systems of Care (SOC), and reviews the literature on strength-based assessment. Then, paper one reports the prevalence of clinician-reported strengths in the public System of Care, explores the psychometric properties of the assessment's Strengths section, and describes three alternative modeling options to explore group differences (by gender, age, and ethnicity) of youth strengths. Youth assessed at entry to the System of Care were reported to enter with considerable strengths, similar to other studies reporting on prevalence of strengths in a System of Care (e.g. CMHI, 2011; Dunleavey et al., 2011). The confirmatory factor analysis found that the hypothesized two factor model was a better fit for the data than a single factor model, though the fit of the two factor model was only adequate and the interpretation of the factors were questionable. Individual strength items were assessed as the most informative for future analyses, compared to the factors or the composite score.

Paper two examines whether, at initial assessment, client strengths are associated with psychiatric symptoms. Higher levels of family relationships, peer relationships, and educational strengths were significantly associated with lower levels of psychiatric symptoms, after accounting for variation due to clinician, program, reported trauma exposure and youth demographics.

Paper three reviews some studies that report on the relationship between strengths and mental health outcomes in Systems of Care samples. This paper then examines 1) the average change in psychiatric symptom severity twelve months after entry (initial assessment) to the System of Care, 2) whether initial strengths are associated with rate of change in psychiatric symptoms, 3) whether rate of change in strengths at six month and twelve month assessment are associated with rate of change in psychiatric symptoms, and 4) explores the contribution of variations related to clinician, youth, and time. Results suggest that self-reported growth in peer relationships, relationship permanence, and education strengths twelve months after entry to the System of Care was associated with larger reported reductions in symptoms at twelve months, adjusting for clustering, time, and youth demographics. Only associational relationships are reported; causal direction cannot be established in the current data. The percentage of youth referred for services, where they were referred from and to, the percentage who went to services, type, quantity, and quality of interventions offered and used (if any), and drop-out rates and reasons are not reliably tracked in the System of Care.

This dissertation focuses on one aspect of service delivery in public mental health systems, namely the role of strengths, if any, in Systems of Care for youth with emotional and behavioral problems. The dissertation conclusion discusses overall themes that emerged, notes limitations relevant to the entire dissertation, and discusses implications for social workers and others.

The purpose of this study was to explore the identity development process and health care experiences of individuals who identify their gender somewhere along the transmasculine spectrum. Using a qualitative grounded theory approach, data were collected through semi-structured interviews with 28 transmasculine identified individuals. Additionally, results from a pilot study with 15 genderqueer identified individuals supplemented these interview data. The interviews focused on the process of transmasculine identity development and experiences in seeking and receiving health care services across a variety of practice settings. Participants also shared how their interactions with individual health and mental health care providers, organizations, and the larger managed care system impacted (both positively and negatively) their experiences of gender identity development.

The results of this research also indicate that various components of health care provision may impact transmasculine identity development. Access to trans-friendly health care organizations and providers, an informed consent model of health care provision, trans-friendly organizational policies, insurance coverage for transgender health needs, and relationship-centered communication with health providers all lend themselves to a positive, affirming experience of identity.

Estimates state that 250,000 to 500,000 Rwandan women were raped in the 1994 genocide. International tribunals made subsequent progress in finding organizers guilty of rape as a war crime and act of genocide for the first time in the history of international law. However, very little is known about the court-related decision-making process of women survivors of these rapes who decided to testify in the local transitional courts, called "gacaca".

The results of this exploratory mixed methods study begin to fill that void by asking several key questions. First, what factors in Rwandan women's lives related to their decision to take their cases of sexual violence to the gacaca courts? More specifically, is there an association between involvement in women's programs and deciding to take one's case of sexual violence to gacaca? How did survivors of sexual violence define "justice" and did this align with the type of justice provided by the gacaca courts? What suggestions do rape survivors have to improve these courts for survivors of sexual violence?

Income, education level, social support, involvement with women's organizations, sharing one's story of rape in an all-women's group, and opinions about the courts were explored as factors. It was hypothesized that all of these factors might have some relationship to the decision to take or not to take the cases to the courts, and that the women might wish to have the courts provide greater access to reparations and to services for individuals who testify and their children.

This study surveyed 106 women in three providences who experienced rape during the 1994 genocide. Logistic regression was used to explore relationship between the individual factors and the decision to take or not to take a case of rape to the transitional courts using the quantitative data (n=106). Follow-up interviews were conducted with 19 women, in which they were specifically asked to provide suggestions to improve the transitional court system for those who have suffered sexual violence. Suggestions for improving the courts from the qualitative data (n=19) were coded and analyzed using DeDoose mixed methods and qualitative software.

Several factors do appear to have strong relationships to decisions to take cases to court: sharing one's story of rape in an all-women's group, having a number of positive feelings about going to the courts, and having more positive feelings than fears of reprisal and ostracism. The women suggested greater attention to reparations, and greater access to economic development opportunities. The results of this exploratory study indicate meaningful possibilities for how NGOs might interact with survivors of sexual violence by encouraging more women's groups, and training group leaders in how to facilitate discussions that intentionally discuss sexual violence. The data also support court policies that can reach out to women survivors with information on the courts, greater insurances that reparations are given to the women who come forward with their cases of sexual violence.

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