Program Goals/Target Population
Great Life Mentoring (formerly called 4Results Mentoring) is a mentoring intervention in which volunteer adults from the community are matched with youth receiving outpatient mental health care for a period of 1 year of more. The primary goal of the program is to provide one-on-one support and companionship as a supplement to outpatient mental health services. The program is provided to youth, ages 7 to 18, who are referred from mental and behavioral health providers in the county in which the program is situated. Youth referred to the program are from low-income families, and all have a mental health diagnosis.
Mentors are meant to provide an enhancement to treatment; youth are expected to continue receiving mental health services. Eligible youth are matched with volunteer mentors who are expected to meet with them for 2 to 3 hours weekly over a period of at least 1 year. During these contacts, mentors engage in positive community activities and provide one-on-one support and companionship to youth.
Mentors are adults recruited from the community at large. After passing an initial screening, they complete a 20-hour, curriculum-based training prior to being matched with a mentee. The training serves as a further screening process for establishing volunteer suitability. Mentors document their contacts with mentees in a database that is reviewed by program staff (who follow up as needed on a situational basis). Mentors have monthly in-person meetings with staff of the program throughout their first year, with additional one-on-one meetings and email contact as needed. Mentors also receive guidance as appropriate from the youth’s mental health providers.
Program staff conduct face-to-face orientation and intake meetings with eligible participants and their caregivers, provide families with monthly newsletters and updates on program events, collect satisfaction survey information from families every 6 months, and follow up with families on an as-needed basis. They also maintain contact with referring mental health therapists.
The program’s training and supervision model draws on multiple theoretical elements designed to support youth (Higley et al. 2016), including attachment theory (Bowlby 1988), in which mentors are encouraged to build unconditionally supportive relationships with their mentees. Other relevant theoretical elements include the importance of attunement in mentor responses and therapeutic techniques such as active listening.
Children’s Global Assessment Scale (GCAS) Scores
At 2 years after initiation of mentoring, DuBois and colleagues (2018) found that model-predicted CGAS scores of the Great Life Mentoring (GLM) youth were more than one standard deviation higher than those of non-GLM youth. This statistically significant difference indicated a large estimated program effect.
Reasons for Ending Mental Health Treatment
There was a statistically significant difference between the GLM and matched non-GLM groups in reasons of ending mental health treatment. The GLM group was less likely to have an unplanned and client-initiated ending of mental health treatment, compared with the matched comparison group (33.9 percent versus 56.3 percent, respectively). The GLM group was also more likely to have a planned ending of mental health treatment, compared with the matched comparison group (32.3 percent versus 18.8 percent, respectively).
DuBois and colleagues (2018) used a quasi-experimental design to evaluate the Great Life Mentoring (GLM) program. The study sample consisted of 66 youths in the GLM program and 66 youths in the comparison group. This sample was drawn from a larger pool of 91 youths who participated in the GLM program (and who also received traditional mental health services) at any point over a period of approximately 15 years and a randomly selected comparison group of 400 youths who received mental health care (but did not participate in the GLM program) over the same period. All participants in the study received outpatient mental health services from Columbia River Mental Health Services, in Washington State. The groups were matched on a range of variables, including demographic characteristics (e.g., race/ethnicity, age, gender, family income); risk factors (e.g., involvement in the juvenile justice system, issues with substance abuse); and history of diagnosis, psychiatric hospitalization, and overall assessment of functioning on the Children’s Global Assessment of Functioning Scale.
In both groups, the average age was about 10 years, and 50 percent of the group was female. GLM group participants were white (81.5 percent), African American (9.3 percent), Hispanic (1.9 percent), and other (7.4 percent). Comparison group participants were white (76 percent), African American (8 percent), Hispanic (4 percent), and other (12 percent). Slightly less than half of both groups were of very low-income status, and the most common DSM-IV Axis I diagnosis was depressive disorder. Approximately two thirds of mentors of youth in the GLM program were female. All female youths were matched with female mentors, and some male youths were also matched with female mentors. The majority of mentors (85.8 percent) had an associate’s degree or higher, and approximately one third had a background in a helping profession or role (e.g., teaching, child care).
Participants’ general functioning was assessed using the Children’s Global Assessment Scale (CGAS), in which a clinician rates the youth’s most impaired level of general functioning for a 1-month period on a continuum of health/illness, with scores ranging from 100 to 1 (Shaffer et al.1983). Scores were categorized into deciles, with summary descriptions ranging from “Doing Very Well” (100–91) to “Extremely Impaired – so impaired that constant supervision is required for safety” (10–1). CGAS scores were obtained at intake and at varying intervals (not determined by the researchers) thereafter. Reasons for ending mental health treatment were obtained from discharge status codes in agency records. Reasons included planned ending, unplanned and client-initiated ending, or other (e.g., youth moved away from area, was transferred to another facility).
To evaluate effects of the GLM program on CGAS scores, a linear mixed model analysis was conducted. In this analysis, CGAS scores were a repeated measure predicted by group (i.e., GLM or non-GLM), time in days since intake, time in days since start of the mentoring relationship, interactions between group and each of the time variables, and selected covariates (gender, family income status, age, primary Axis I diagnosis, presence/absence of secondary Axis I diagnosis). The intercept, time-since-intake, and time-since-start of the mentoring relationship were modeled as random within-subject factors. For non-GLM youth, time-since-start of the mentoring relationship was coded relative to the start date of the mentoring relationship for the GLM youth. On average, each youth had approximately five CGAS scores. The interaction of time-since-start of mentoring relationship with group was of primary interest as it represented the extent to which the linear rate of change in CGAS changed differentially for GLM and non-GLM youths at the point in time when GLM youths were paired with their mentors. Differences between GLM and non-GLM youths on model-predicted CGAS scores were examined for up to 2 years following the initiation of mentoring. Effects of the program on reasons for ending mental health treatment were evaluated using a chi-square test of association. No subgroup analysis was conducted.
DuBois and colleagues (2018) reported that for the 91 youths in the full Great Life Mentoring (GLM) sample, the average length of their mentoring relationships was about 3 years. In addition,14 of these mentoring relationships remained active at the time of the study. Higley and colleagues (2016) reported that the program had a high retention rate for volunteer matches, with successful retention of 98 percent of mentors for at least 1 year and an average relationship length of 3.7 years.
DuBois and colleagues (2018) found that longer-term mentoring relationships for the Great Life Mentoring (GLM) youth were predicted if they 1) were from a low-income family (versus a very low-income family), 2) had a mentor with a higher level of education, and 3) did not have a primary diagnosis of ADHD.
These sources were used in the development of the program profile:
Bowlby, John. 1988. A Secure Base: Clinical Applications of Attachment Theory
. London: Routledge.
Higley, Elizabeth, Sarah C. Walker, Asia S. Bishop, and Cindy Fritz. 2016. “Achieving High Quality and Long-Lasting Matches in Youth Mentoring Programmes: A Case Study of 4Results Mentoring.” Child & Family Social Work
Shaffer, David, Madelyn S. Gould, James Brasic, Paul Ambrosini, Prudence Fisher, Hector Bird, and Satwant Aluwahlia. 1983. “A Children’s Global Assessment Scale (CGAS).” Archives of General Psychiatry
Walker, Sarah C. 2013. 4Results Mentoring Evaluation
. Seattle, Wash.: University of Washington, Department of Psychiatry and Behavioral Sciences, Division of Public Behavioral Health & Justice Policy.