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Trauma-informed juvenile justice systems and approaches.
... An additional question asks about current risk and safety concerns. The PSI also includes specific PTSD symptoms that are often edited out of other brief screeners, such as risky behavior, given that research has shown they implicated in the association between trauma and adolescent justice-involvement ( (Ford et al., 2015) is a 12item scale with behaviorally-anchored ratings for the frequency and severity of PTSD and CPTSD (emotional, somatic, interpersonal, behavioral, self, and sexual dysregulation) symptoms which can be scored to screen for the severity of DSM-IV or DSM-5 PTSD (including the dissociative subtype) or ICD-11 CPTSD. ...
... Even when screenings or assessments are not mandated by the court or facility, and youth are given the right to refuse to provide information, youth may choose to make disclosures about traumatic experiences. Such disclosures may bring in to play mandated reporting laws, with which staff administering these measures should be knowledgeable and prepared to comply (Feierman & Ford, 2015). In addition, youth may disclose information during screening or assessment that has relevance to their charges or probation status (e.g., when traumatic events have occurred during youth's participation in illegal activities, probation violations, involvement with illicit substances, etc.). ...
... Research and studies on crime and delinquency among youth documented as far back as the 1960s have shown that childhood trauma is a significant risk factor in juvenile delinquency and criminal behavior [1,2,3,4,5,6,7,8,9]. Symptoms of trauma have also been associated with delinquent or criminogenic behavior [10,11,12,8]. Persons with traumatic experiences relive disturbing memories, are chronically anxious, feel guilty, emotionally numb, and selfmedicate with drugs and alcohol [13,14]. Untreated trauma negatively affects help-seeking and treatment engagement resulting in premature withdrawal from therapy and increasing the likelihood of committing another offense [15,16,17,18,19,20,21]. ...
... Fourth, with clear guidance, skillful and experienced therapists should be able to offer TF-CBT and make it easy for youth under probation to avail of the therapy -given that the youth's overall low disclosure as a response to the stigma attached to mental illness and involvement with the legal justice system is well known [54] and the extensive literature and research studies that have associated delinquent behaviors and justice involvement with significant youth trauma events which could manifest as violent or aggressive behavior [55,56,10,57]. Recognizing that it is critical for youth under probation to be assessed for trauma, and their suitable caregiver be engaged by therapists, eligibility requirements could be waived (with clear justifications and supporting documentation) so the youth do not miss the opportunity for TF-CBT. ...
OBJECTIVE: The implementation of Trauma Focused Cognitive Behavioral Therapy (TF-CBT) for youth under probation is underresearched. Since a TF-CBT project implementation goal was not met, the author aimed to address the following questions: What were the unaddressed barriers to TF-CBT participation and completion? What factors could have significantly impacted TF-CBT completion? Were the positive outcomes of TF-CBT on the project's proposed measures confirmed? The author likewise aimed to capture the lessons from this project’s implementation.METHOD: Review of administrative documents focused on project set-up, flow of participation and TF-CBT completion to identify the barriers. Chart reviews included data for 54 out of 60 TF-CBT participants. Three TF-CBT youth groups were identified. TF-CBT with: no in vivo (C7, n = 12); four to six TF-CBT components, including trauma narration (C4-6, n = 13); and one to four components in phase I of TF-CBT (C1-4, n = 29). All statistical tests were set at p < .05. Groups were compared on demographics, pre-TF-CBT trauma and functioning, assessment and treatment services, justice involvement, and services satisfaction. Outcome measures were change scores on the UCLA Post Traumatic Stress Disorder Reaction Index, Youth Outcome Questionnaire and youth arrests.RESULTS: The unaddressed barriers could very well be due to youth’s low disclosure and development of trust and therapist’s skills. Significant between-groups difference in parental involvement (χ2 = 6.08, p < .05) and number of trauma events experienced (F = 3.58, p < .05); and significant decrease in overall trauma symptom scores before and after TF-CBT participation with a very large effect size in group C7 (t = 3.73, p < .001, d = 1.08) were found.LESSONS LEARNED: The therapists were possibly viewed by the youth as part of the police system (which justice involved youth likely do not trust). Future implementations must seriously consider: the need for sufficient training of therapists; waiving program eligibility requirements; the value of a coherent communications protocol, clinical quality review and management, early assessment of services satisfaction, and information on families of justice involved youth; and, tracking behaviors that are incompatible with those that warrant arrests.
... They also are more likely to come from economically disadvantaged families, consistent with the adverse effects of socioeconomic disadvantage (Yoshikawa, Abor, & Bearsless, 2012). Some-particularly, but not exclusively, males-have become involved with juvenile justice, which may be a source of therapeutic and social services but which also can subject the youth and their families to additional adversities and potentially places them on a lifetime trajectory of problematic legal involvement (Feierman & Ford, 2016). Others may receive highly intensive-and often restrictive-mental health and schoolbased services (i.e., Class 1), which appears to be associated with especially high levels of externalizing behavior problems. ...
Childhood maltreatment is an important public health problem because it can impair child development and result in chronic physical and mental health disorders and increased social risk. The purpose of this study is to describe the prevalence of posttraumatic stress disorder (PTSD), dissociation, and the dissociative subtype of PTSD (PTSD-D) among adolescents with exposure to trauma, to describe typologies of service usage by trauma-exposed adolescents, and to examine the co-occurrence of PTSD and dissociation. This study used baseline data from the National Child Traumatic Stress Network (NCTSN) Core Data Set (CDS) collected from 2004 to 2010. The sample included 3,081 trauma-exposed adolescents ages 12 to 16 who were seeking clinical services at an NCTSN site. Psychopathology variables were PTSD, dissociation, and behavioral symptoms, measured with the UCLA PTSD Reaction Index, the Trauma Symptom Checklist for Children, and the Child Behavior Checklist. Latent class analysis was used to derive a model of service use typologies and PTSD/dissociation groups. This study illuminated the complex relationships between trauma, dissociation, posttraumatic stress, and service utilization in an adolescent population. The PTSD-D group, characterized by depersonalization and derealization, did not substantially differ from the PTSD-only group on trauma history or mental health measures. In a latent class model that accounted for a broader range of dissociation symptoms, distinct PTSD/dissociation groups emerged, including a dissociative subtype group, and PTSD-only group, and a unique dissociation group characterized by dissociative amnesia and detached arousal. There were five distinct service usage typologies with varying levels of pattern complexity and intensity of level of care. Trauma itself, rather than PTSD or dissociation, was associated with service usage complexity. This study suggests that there is a need to broadly assess dissociation symptoms among adolescents in clinical settings and provide trauma-informed care in service sectors where they might be seeking treatment.
... They also are more likely to come from economically disadvantaged families, consistent with the adverse effects of socioeconomic disadvantage (Yoshikawa, Aber, & Beardslee, 2012). Some-particularly, but not exclusively, males-have become involved with juvenile justice, which may be a source of therapeutic and social services but which also can subject the youth and their families to additional adversities and potentially places them on a lifetime trajectory of problematic legal involvement (Feierman & Ford, 2016). Others may receive highly intensive-and often restrictive-mental health and schoolbased services (i.e., high-intensity/multisystem group), which appears to be associated with especially high levels of externalizing behavior problems. ...
Objective:
The purpose of this study is to describe typologies of service utilization among trauma-exposed, treatment-seeking adolescents and to examine associations between trauma history, trauma-related symptoms, demographics, and service utilization.
Method:
Latent class analysis was used to derive a service utilization typologies based on 10 service variables using a sample of 3,081 trauma-exposed adolescents ages 12 to 16 from the National Child Traumatic Stress Network Core Dataset. Services used 30 days prior to the initial assessment from 5 sectors were examined (health care, mental health, school, social services, and juvenile justice).
Results:
A 5-class model was selected based on statistical fit indices and substantive evaluation of classes: (a) High intensity/multisystem, 9.5%; (b) Justice-involved, 7.2%; (c) Low intensity/multisystem, 19.9%; (d) Social service and mental health, 19.9%; and (e) Low service usage/reference, 43.5%. The classes could be differentiated based on cumulative trauma, maltreatment history, PTSD, externalizing and internalizing symptoms, and age, gender, race/ethnicity and place of residence.
Conclusions:
This study provides new evidence about patterns of service utilization by trauma exposed, treatment seeking adolescents. Most of these adolescents appear to be involved with at least 2 service systems prior to seeking trauma treatment. Higher cumulative exposure to multiple types of trauma was associated with greater service utilization intensity and complexity, but trauma symptomatology was not. (PsycINFO Database Record
... In doing this, juvenile justice services must be delivered that are appropriate and responsive to each child's ethno cultural background and based on an assessment of each violence-exposed child's individual needs. In particular, the special circumstances and needs of girls and LGBTQ (lesbian/gay/ bisexual/transsexual/questioning) youth needed to be addressed (Ford 2016). Young people who exhibit 'at risk' behaviors should be treated in a rehabilitative setting such as a hospital or mental health facility. ...
In 2016, the Australia Federal Government called a formal public inquiry under the arrangement of a Royal Commission to investigate the care and custody arrangements of children under detention orders in the Northern Territory. The NT youth detention system has been shown to be over-reliant on segregation as a behavior management tool which has likely resulted in the abuse of children in their care. This paper examines literature on the use of segregation to explain the progressively degenerating behavior of the children in custody and the likely negative physical and psychological impacts to the children involved. The paper calls for the prohibition of segregation of children arguing that a paradigm shift in the youth detention system to a model employing non-institutional care with trauma informed practice needs to be made.
... Even when screenings or assessments are not mandated by the court or facility, and youth are given the right to refuse to provide information, youth may choose to make disclosures about traumatic experiences. Such disclosures may bring in to play mandated reporting laws, with which staff administering these measures should be knowledgeable and prepared to comply (Feierman & Ford, 2015). In addition, youth may disclose information during screening or assessment that has relevance to their charges or probation status (e.g., when traumatic events have occurred during the course of youths' participation in illegal activities, probation violations, involvement with illicit substances, etc.). ...
... As in any psychotherapy, youth may choose to make disclosures in the course of trauma treatment that bring mandated reporting laws into play (e.g., if youth discloses having been sexually or physically abused). It is essential that clinicians are knowledgeable about and prepared to comply with the mandated reporting laws in their locality (Feierman & Ford, 2015). However, justice-involved youth also may disclose information during therapy that does not rise to the level of mandated reporting but is relevant to legal charges or probation status (e.g., when traumatic events occurred during the course of delinquent activities or probation violations). ...
More than 80% of youth in juvenile justice or forensic settings report a lifetime history of exposure to at least one traumatic stressor, and the majority report multiple types of victimization, which places them at risk for severe and persistent emotional, developmental, behavioral, and legal (e.g., recidivism) problems. Trauma Affect Regulation: Guide for Education and Therapy (TARGET), a trauma-focused self-regulation psychotherapy, has been adapted and evaluated as a one-to-one and group intervention for justice-involved youth and their parents. TARGET provides psychoeducation explaining how traumatic stress reactions shift the brain into a survival mode, and practical skills that reset trauma-related alarm reactions such as anger, anxiety, avoidance, emotional numbing, and hopelessness. TARGET then engages recipients in learning and actively practicing a seven-step skill sequence for self-regulation and an abbreviated four-step version, and applying these to process traumatic stress reactions (including intrusive trauma memories) in therapy and in daily life. Anonymized case examples of TARGET groups with each gender are provided, and the research evidence base, including randomized and field studies, and infrastructure for sustained implementation of TARGET in justice and related programs are summarized.
Youth in juvenile justice facilities are at high risk of self-directed violence (SDV; suicide attempts and self-harm). Research shows that positive youth perceptions of adults are preventive against SDV among community youth, yet it is unknown whether this extends to detained youth. Using a large national dataset, the present study examines whether, at the facility level, youth perceptions of staff are associated with rates of youth SDV over time. Results from a multilevel mixed-effects negative binomial model suggest that after accounting for various juvenile facility characteristics and practices, youth perceptions of staff are marginally associated with decreased rates of SDV over time. The results from the present study hold implications for research, policy, and practice. Importantly, the results imply a need for facility-wide and evidence-based staff training on SDV among detained youth that emphasizes building positive interpersonal relationships between staff and youth.
Research has demonstrated that exposure to traumatic experiences in childhood and adolescence can result in adverse outcomes, including mental health concerns, school troubles, delinquency, and juvenile justice system involvement. The current study draws on a framework informed by feminist pathways and trauma theories to revisit the effect of traumatic experiences on recidivism two years following initial system contact. Data from a Midwestern juvenile court illustrated traumatic experiences are common pathways into the system but are not predictive of experiences through the system using general recidivism outcome measures. However, several other variables predicted youth receiving new petitions. The effects of race/ethnicity and age are more pronounced when the sample was disaggregated by referral unit (truancy vs. delinquency unit). We discuss different methodological and measurement factors to consider when examining the trauma-recidivism relationship.
Objective:
Despite increasing depression and suicide rates in justice-system-involved youth, little is known about depressogenic risk factors in this population. Therefore, we explored how levels of and changes in hopelessness and perceptions of procedural justice predicted depressive and suicidal outcomes in justice-system-involved youth.
Hypotheses:
We hypothesized that higher levels and increasing trajectories of hopelessness, as well as of perceived injustice, would predict depressive symptoms and suicidal ideation across adolescence and emerging adulthood. We also expected that procedural injustice would explain the relation between hopelessness and these outcomes. Finally, we hypothesized that gender and race/ethnicity would moderate the influence of hopelessness and perceived injustice.
Method:
Data for the present study were collected as part of the Pathways to Desistance study. In total, 1,354 adolescents (Mage = 16.04 years; 86.4% male; 41.4% non-Hispanic Black, 33.5% Hispanic, 20.2% non-Hispanic White) convicted of serious offenses participated. For the present study, participants answered questions on measures of procedural justice, hopelessness, depression, and suicidal ideation across 11 time points over 7 years.
Results:
Using latent growth curve modeling, we found partial support for our hypotheses. Specifically, baseline levels of hopelessness predicted depression levels and increases in depression during adolescence (ps < .01). Further, changes in hopelessness predicted corresponding changes in depression throughout adolescence and emerging adulthood (ps < .001). Similarly, procedural justice levels predicted levels of depression (p < .001), and changes in procedural justice corresponded to changes in depression during emerging adulthood (p = .01). With regard to suicidal ideation, levels of and changes in hopelessness in emerging adulthood predicted corresponding suicidal ideation outcomes (ps ≤ .01). Meanwhile, we found only marginal support for our mediation model (p = .05). Collectively, results did not vary across gender or race/ethnicity.
Conclusions:
Hopelessness and perceived injustice are unique predictors of depression for juvenile-justice-system-involved youth. Preventive interventions targeting both hopelessness and procedural justice could help attenuate elevated depression rates in this population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
More than 80 % of youth in juvenile justice or forensic settings report a lifetime history of exposure to at least one traumatic stressor, and the majority report multiple types of victimization, which places them at risk for severe and persistent behavioral and legal (e.g., recidivism) as well as emotional and developmental problems (Ford et al. 2013b). Youth also may be exposed to traumatic stressors while in juvenile justice supervision or facilities, compounding their traumatic stress symptoms and potentially leading them to engage in behavior (e.g., reactive aggression) that can endanger other youths and adults (Ford et al. 2012). Traumatized youth involved in juvenile justice also may appear to be sociopathic due to acquiring “callous and unemotional traits” as a result of emotional numbing (Kerig et al. 2012), leading them to be labeled as irredeemable and putting them at risk for lifelong incarceration or violent death (Teplin et al. 2005).
Exposure to traumatic stressors can happen at any time in a person’s life. Although some age groups are more susceptible to exposure to certain types of traumatic stressors (e.g., young adults are more likely to encounter war-related traumatic stressors than younger or older people because that is the developmental period in which military service most often occurs), all traumatic stressors can occur at any point in the life span. Therefore, with each passing year of life, the probability of having been exposed to a traumatic stressor increases, until in midlife or older adulthood it is rare to find a person who has not ever been exposed to a traumatic stressor. Epidemiology studies demonstrate that the likelihood of experiencing psychological trauma and of developing PTSD differs depending upon a variety of factors including age, gender, ethnocultural background, socioeconomic resources, and the extent of violence and poverty in the community or nation. However, anyone from any background in any part of the world can experience psychological trauma.
Psychosocial interventions for posttraumatic stress reactions increasingly are recognized as a key component in the provision of juvenile justice services. This article provides an overview of the research; clinical and legal successes; and challenges emerging from the development, evaluation, and implementation of trauma-focused psychosocial therapeutic interventions (TF-PTI) in juvenile justice systems. Four TF-PTI models that have empirically demonstrated effectiveness with justice-involved youth are described. Clinical and legal precautions are discussed to inform practitioners, policymakers, administrators, and the judiciary when utilizing or adopting these and other TF-PTIs as one component of trauma-informed juvenile justice programming. The review highlights potential benefits that may accrue to public safety, as well as to the health and positive development of youth and families when juvenile justice programs provide access to evidence-based TF-PTIs in a systematic, equitable, and culturally competent manner.
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