Aging out or continuing on? Exploring strategies to prepare marginalized youth for a transition to recovery in adulthood

Objective: This study aimed to improve our understanding of how to best assist marginalized youth during their transition to adulthood, and how to provide them services that help them achieve independence within existing public systems of care. Method: Using purposive sampling methods, 17 direct service providers and supervisors of a large behavioral health organization participated in individual interviews and focus groups. Results: A team of analysts identified eight primary themes: (a) the primacy of consistent and caring relationships with adults; (b) working with youth and family concurrently; (c) the complicated dance of autonomy and independence; (d) engagement of alumni and peers in service delivery; (e) transition navigator: an active not passive approach to becoming an adult; (f) youth as the drivers of treatment and recovery; (g) provider training and resources to address the unique needs of transition-age youth; and (h) broadening the definition of treatment. Conclusions and Implications for Practice: Our findings have important implications for practice, including (a) adapting clinical practice to meet the unique needs of transition-age youth and young adults; (b) engaging and expanding positive support systems; and (c) shifting the mindset of transition-age youth and young adults, their caregivers, and providers from a perspective of "aging out" of the mental health system to a perspective of "continuing on" in the management of their mental health through treatment and rehabilitation as needed as young adults.