Volume 5, Issue 1 • Spring 2016

Table of Contents

Editor's Note

Trauma-Informed Collaborations Among Juvenile Justice and Other Child-Serving Systems: An Update

Looking Forward: A Research and Policy Agenda for Creating Trauma-Informed Juvenile Justice Systems

Psychosocial Interventions for Traumatized Youth in the Juvenile Justice System: Research, Evidence Base, and Clinical/Legal Challenges

Acute and Chronic Effects of Substance Use as Predictors of Criminal Offense Types Among Juvenile Offenders

Examining the Influence of Ethnic/Racial Socialization on Aggressive Behaviors Among Juvenile Offenders

Assessing Probation Officers' Knowledge of Offenders with Intellectual Disabilities: A Pilot Study

Gender and Adolescents’ Risk for Recidivism in Truancy Court

Trauma-Informed Collaborations Among Juvenile Justice and Other Child-Serving Systems: An Update

Erna Olafson, Clinical Psychiatry and Pediatrics, Cincinnati Children’s Hospital Medical Center, and the University of Cincinnati Medical School; Jane Halladay Goldman, Service Systems Program, UCLA–Duke University National Center for Child Traumatic Stress; Carlene Gonzalez, National Council of Juvenile and Family Court Judges.

Correspondence concerning this article should be addressed to Erna Olafson, University of Cincinnati College of Medicine, 311 Albert Sabin Way ML0539, Cincinnati, OH 45229. E-mail: erna.olafson@uc.edu

This paper was supported in part by a grant to the Center for Trauma Recovery and Juvenile Justice from DHHS/SAMHSA, Award Number: U79SM061273 (Grant Period: 9/30/12–9/29/16).

Keywords: trauma-informed, cross-system collaboration, juvenile justice

Abstract

In order to address trauma among youth in the juvenile justice system, as well as those at risk for justice involvement, systems must engage in quality, meaningful collaboration to restore youths’ faith in societal institutions as sources of protection and support. This paper describes a selection of trauma-informed collaborations that occur across the nation among stakeholders in juvenile justice, child welfare, schools, and mental health to assist youth in the juvenile justice system or those at risk for justice involvement. These collaborations include the Georgetown University Crossover Youth Practice Model (CYPM), Trauma Systems Therapy (TST), the Positive Student Engagement Model for School Policing, the Child Development Community Policing (CDCP) Program, and the Stark County Traumatized Child Task Force. This paper describes tools that have been developed to support these cross-system collaborations and are central to developing a common understanding of trauma and how to address it across systems and disciplines. Themes that are identified as key ingredients in successful cross-system collaboration include effective leadership, engagement of stakeholders, development of shared goals, and evaluation of collaborative projects. The paper concludes with a summary of lessons learned from these programs, including the challenges inherent in taking locally successful trauma-informed interventions to scale nationally.

Introduction

The high rates of youth in the juvenile justice system who have experienced trauma have led to a call for earlier identification and treatment of these youth across child- and family-service systems, preferably before justice involvement is necessary (Stewart, 2013). Traumatic experiences have profound effects on children’s adjustment and development that may be exacerbated by adverse encounters with the social, educational, and legal institutions responsible for their safety and care. One of the core concepts of the National Child Traumatic Stress Network (NCTSN) for understanding traumatic stress responses in children and families is that “challenges to the social contract, including legal and ethical issues, affect trauma response and recovery” (NCTSN Core Curriculum on Childhood Trauma Task Force, 2012, p. 5). When there is an actual or perceived failure of child-serving institutions to provide justice and safety, a breach in the child’s trust in the social contract can occur. Such a breach “may exert a profound influence on the course of children’s post-trauma adjustment, and on their evolving beliefs, attitudes, and values regarding family, work and civic life” (NCTSN Core Curriculum on Childhood Trauma Task Force, 2012, p. 5). In order to uphold the social contract and prevent children from experiencing secondary posttraumatic complications, coordinated cross-system collaboration is needed to ensure safety and protection, address traumatic stress symptoms, and minimize re-traumatization (Stewart, 2013).

Common Themes

In exploring practices and interventions that encourage cross-system collaboration in systems of care for children, four common themes essential to fostering trauma-informed cross system collaboration emerged: effective leadership, stakeholder engagement, identification of shared outcomes, and evaluation. Effective leadership is essential throughout the project, from the initial vision and the identification and engagement of key stakeholders, to the creation of institutional structures to sustain trauma-informed practices once the initial team has done its work. Although one champion often emerges as the primary leader in such endeavors, having a group of leaders from all institutional levels is most effective in sustaining such efforts (Center for Technology in Government, 2003). Key stakeholders vary by system, but collaborating through Memoranda of Understanding (MOU) and Multi-Disciplinary Teams (MDTs) is essential so that the transition to trauma-informed care is experienced as a joint effort, rather than as a top-down, organizational change. Central to this planning phase is the collaborative identification by key stakeholders of shared goals and outcomes (e.g., improving attendance within school systems or increasing safety in juvenile justice facilities). These collaborative efforts also allow for multiple groups (including community members) to impact policy reform (Herz & Ryan, 2008). Evaluation of the impact of cross-system collaboration informs future planning and increases the possibility of sustaining such efforts. Organizational change cannot depend on individual champions who first implement a practice but must be assured by convening the community to support these changes through public education and by institutionalizing these practices so that they become part of the daily routine within the target organizations.

Child-serving systems that should be brought into this collaborative project as early as possible include juvenile justice (law enforcement, the judiciary, attorneys, juvenile probation, diversion, and residential facilities), child welfare (child protection, foster and adoptive families), mental health, schools (teachers, administrators, and school resource officers), and advocates. This paper describes how stakeholders from these key systems have worked together with community partners to develop an approach to identify, assess, and provide therapeutic services to children and families who are experiencing trauma-related behavioral and psychological impairments by describing a selection of promising practices in cross-system collaboration.

Georgetown University Crossover Youth Practice Model

In collaboration with Casey Family Programs, the Center for Juvenile Justice Reform (CJJR) developed a practice model focused on issues related to crossover youth, who are known to be in both the dependency and delinquency systems. The goals of the Crossover Youth Practice Model (CYPM) are to reduce: (a) the number of youth placed in out-of-home care, (b) the use of congregate care, (c) the disproportionate representation of children of color, and (d) the number of youth becoming dually adjudicated (Center for Juvenile Justice Reform, 2015). To date, nearly 90 jurisdictions in 20 states across the nation have participated in CYPM (Center for Juvenile Justice Reform).

Research suggests that cross-agency collaborative efforts that include reconciling agency missions and sharing information are needed to best serve the crossover youth population (Herz, Ryan, & Bilchik, 2010) and to use resources effectively across agencies (Petro, 2006). CYPM’s three phases parallel the themes of this paper. These three phases focus on: (a) identification and decision-making; (b) joint assessment; and (c) coordinated care management, ongoing assessment, and permanency planning (Center for Juvenile Justice Reform, 2015). In Phase I of CYPM, commitment and leadership of participating agencies (e.g., judiciary, juvenile justice, child welfare, etc.) are crucial to successfully implementing CYPM. During this phase, stakeholders decide collaboratively on shared goals, such as defining the target population, establishing a protocol for identifying crossover youth as early as possible, developing trust between collaborative stakeholders, creating strategies for sharing information between agencies (e.g., developing a MOU), and identifying possible funding services available to crossover youth.

Because crossover youth are at heightened risk of entering the juvenile justice system from the child welfare system, many aspects of CYPM exemplify trauma-informed practices. The principles of CYPM focus on identifying at-risk youth as early as possible and diverting them from the juvenile justice system by offering evidence-based therapeutic services. In collaboration with the NCTSN, CJJR developed a trauma-informed training module as part of CYPM to address behavioral health and trauma. In this training module, participants who represent multiple systems of care within a community walk through the case of a crossover youth and work together to identify points where earlier identification, intervention, and communication among systems could have created a more positive outcome for the youth (Marrow, Pynoos, Decker, & Halladay Goldman, 2012). The work of the CJJR has been highlighted in a three-part webinar series hosted by the NCTSN on trauma-informed practices (The National Child Traumatic Stress Network, n.d.). The series discusses decision-making points in cases of crossover youth, trauma-informed interventions for youth, and the impact of the federal programs at the local level. The CYPM structure (including behavioral health and trauma modules) helps to decrease the likelihood of youth being re-traumatized in the system(s) by making key stakeholders cognizant of aspects of youth’s personal history such as exposure to traumatic stressors, as well as societal factors that may place youth of color, in particular, at a greater risk of both traumatic events and being funneled into the juvenile justice system.

In Phase II of the CYPM, collaborative efforts of multidisciplinary stakeholders come to the forefront. During this phase, processes and policies are developed to outline inter-agency contact, decide which assessment tools to utilize, conduct joint screening/assessments, and coordinate case planning (including identifying and funding evidence-based services) for youth and their families. In Phase III of CYPM, child welfare and juvenile justice agencies continue to participate in coordinated case management by MDTs, including ongoing assessment and concurrent planning. Much of the CYPM framework parallels Siegel and Lord’s (2004) suggestions for improving court practices and programs, which focused on five core areas: (a) screening/assessment, (b) case assignment, (c) case flow management, (d) case planning/supervision, and (e) interagency collaboration. A few examples of ways to improve case flow management for crossover youth include joint pre-hearing conferences, combining dependency and delinquency hearings, and adopting time-certain hearing schedules (Siegel & Lord, 2004). In many jurisdictions, permanency roundtables or benchmark conferences (which include judges) are held to discuss permanency of a youth. In some instances, permanency pacts are developed to identify individuals who will provide the youth with ongoing support when transitioning from care.

Casey Family Programs, in collaboration with the CJJR, recently published an evaluation of the CYPM. Haight, Bidwell, Marshall, and Khatiwoda (2014) discuss findings from participants of a 2-year long ethnographic study on the CYPM and reported structural changes that improved services for youth and families, as well as procedural changes that allowed for information sharing across departments and organizations. Participants also noted improvements in professional support and relationships among cross-system stakeholders. Allowing stakeholders and families to have a voice in the process as well as offering adequate support and training to frontline workers were identified as crucial elements for implementing CYPM changes. In addition to evaluating CYPM efforts, many jurisdictions have documented their system reform efforts, which include forming joint protocol manuals (New York City Administration for Children’s Services, Department of Probation and Family Court, 2014). Documenting steps in the process helps to ensure that a jurisdiction will sustain reform efforts as it becomes daily practice.

Trauma Systems Therapy

Trauma Systems Therapy (TST) is a promising, cross-systems comprehensive approach to enhance recovery for youth who have experienced trauma. TST recognizes and addresses the interaction between a child and his/her traumatic stress response, the physical environment that may serve to shift a child into a state of emotional dysregulation, and the social environment (i.e., system of care) that may be inadequate in helping the child navigate his/her stress response. TST has been utilized with various youth populations, including those associated with the child welfare and juvenile justice systems (e.g., those residing in congregate care settings; New York University School of Medicine Child Study Center, n.d.).

Implementing TST within an organization or community starts with an Organizational Planning Process. This planning begins by engaging leadership in a process that parallels engaging children and families into treatment, followed by an exploration of the primary issue or source of pain to determine whether TST is a good fit to address that “organizational pain.” TST engages key stakeholders by relying on the development of a core MDT to implement TST in the community. This process includes not only the usual MDT participants (i.e., psychiatrist, psychologist, and social worker) but also a home-based team and a child advocacy attorney. The attorney’s role might include education advocacy for a child failing out of a school system due to the intrusion of traumatic stress symptoms, immigration advocacy for a child who is undocumented and about to be deported, or school-discipline advocacy for a youth who is about to be referred by the school to law enforcement. The attorney can work with multiple systems involved in a family’s life and help the providers understand the impact of the traumatic experiences and symptoms, as well as how the system’s involvement could support that child’s recovery. The Organizational Planning Process includes an assessment of which of these team components can be fulfilled within the organization and which must include cross-system community stakeholders. The implementation team then engages with those community partners by identifying shared goals and outcomes and developing specific collaborative agreements that outline how they will work together to meet those goals for the children and families they jointly serve.

TST utilizes a youth-centered approach that recognizes and addresses the role of system involvement in a child’s recovery from posttraumatic stress and the essential need for cross-system collaboration (Saxe, Ellis, & Brown, 2015). This focus on the youth and system allows for opportunities to rebuild the social contract that is so essential to trauma recovery, particularly with youth involved in the child welfare and juvenile justice systems. Like other models, TST offers wraparound services for children and youth, but the multidisciplinary case plan revolves around the youth’s traumatic history when making recommendations for the most appropriate services. TST is currently being implemented in 14 states and the District of Columbia. In a district-wide project in Washington, DC, team members reported that the model provided a pathway for collaboration that they had not previously experienced, possibly due to TST’s explicit emphasis and guidance on collaboration. TST suggests that no single provider can possibly meet all of a child’s needs. In order to break down the learned helplessness of the participating agencies’ staff, which developed following multiple previously failed partnership attempts, TST lays the groundwork for successful cross-system collaboration by allotting time to carefully build partnerships with key players. TST is also sustained through flexibility and ongoing consultation. Participants have developed an innovative, collaborative community of stakeholders that meets monthly via phone to receive peer and faculty consultations on balancing fidelity with adaptability. This has led to sustained adaptations of the model into areas including child welfare, substance abuse, school, and refugee settings. The developers are currently piloting a web-based data collection system that will allow for more systematic evaluation of the model across sites (A. Brown, personal communication, March 26, 2015).

Positive Student Engagement Model for School Policing

In recent years, schools have become a major “feeder” system for youth (especially youth of color) into the juvenile justice system (Fabelo et al., 2011). Research has shown that the zero tolerance, or “Broken Windows” approaches used in the 1990s to handle minor school infractions (e.g., smoking, fighting, etc.), have violated the social contract by playing a role in the increased number of out-of-school (OOS) suspensions and expulsions (Poe-Yamagata & Jones, 2000). The severity of the punishments associated with zero tolerance policies and subsequent practices have resulted in a significant number of students being arrested and referred to the juvenile justice system (Wald & Losen, 2003; Fabelo et al., 2011). To the extent that this pipeline reflects a failure of child-serving systems to provide justice and safety, it represents a challenge to the social contract that could not only traumatize affected youth but also breach their trust in the social contract.

In response to the school-to-prison pipeline, the Multi-Integrated Systems Approach (now referred to as the Positive Student Engagement Model for School Policing) was developed by Judge Steven Teske, the Chief Judge of the Juvenile Court of Clayton County, GA. These efforts encourage the use of restorative rather than punitive practice (Holtham, 2009). As a collaborative leader, Judge Teske brought key stakeholders together to engage in a dialogue about the importance of collaborative reform efforts related to the consequences of zero tolerance policies. One of the accomplishments of the group was to draft a MOU between stakeholders on the School Reduction Referral Protocol (Strategies for Youth, 2012a) that implemented a three-tier process for handling specific misdemeanor offenses (Strategies for Youth, 2012b). A second MOU focused on (a) the development of a multidisciplinary panel of stakeholders that would make referrals to the court and (b) services that would be offered to youth and their families. Teske and Huff (2010) stress the importance of judicial officers facilitating discussions between stakeholders to support shared collaborative goals and outcomes, which include diverting low-risk youth to alternative programs and developing written protocols to ensure compliance and sustainability of such efforts.

Evaluation of the multidisciplinary protocol indicates significant community impact. Data suggests that since implementing the protocol, OOS suspensions, school referrals, and delinquent felony rates have decreased, while graduation rates have increased by about 20% (Teske, 2011; Teske, Huff, & Graves, 2013). A report from the Annie E. Casey Foundation associates a 70% reduction in local detention populations and a more than 40% decrease in the number of youth in out-of-home placements in Clayton County, GA, with the implementation of these reform efforts (Annie E. Casey Foundation, 2013). In an effort to apply trauma-informed knowledge, Judge Teske and Clayton County have more recently implemented a System of Care (SOC) organization that supports the objectives of the Juvenile Detention Alternative Initiative (Clayton County System of Care, 2015). The logic model for the SOC organization takes a trauma-informed approach by including needs assessments and developing personalized SOC plans for system-involved youth. These plans include mental health services, mentoring, tutoring, cultural empowerment, job skills, and parent education.

The Child Development Community Policing Program

Partnerships between law enforcement and mental health systems provide unique opportunities to reach children and families as soon as a crisis or traumatic event occurs, and to potentially foster children’s perception that societal institutions, such as the police, have the capacity to improve their situation and make them safer. In order to build such a partnership, the Child Development Community Policing (CDCP) Program was developed by the Yale Child Study Center in New Haven, CT, in collaboration with the New Haven Police Department. The elements of the model were developed from the work that mental health practitioners and police officers did while riding together in police cars, particularly attending to needs of children and youth who were present when the police were responding to, for example, domestic violence calls. As the police officers and mental health practitioners figured out how to best help youth who had experienced traumatic stressors, they took note of their most effective practices and developed the CDCP model (Marans, Murphy, Casey, Berkowitz, & Berkman, 2006). CDCP has been successfully implemented and sustained in New Haven, CT; Providence, RI; and Charlotte-Mecklenburg County, NC (H. Hahn, personal communication, April 24, 2015).

The elements of CDCP include: an immediate, on-scene response to violent and catastrophic events, as well as a follow-up response to such events; seminars for officers on child development, human behavior, trauma, and collaborative responses; seminars for clinicians on basic police practices; clinician/police ride-alongs that build working relationships and a shared knowledge base; and weekly case conferences to address the specific needs of referred families. Specific response protocols have been developed for the acute on-scene response, provision of brief treatment with coordinated case management (i.e., Child and Family Traumatic Stress Intervention), follow-up with victims of domestic violence, provision of ongoing mental health treatment, canvassing of neighborhoods following community violence, and death notifications to families. These interventions are aimed at all children and families who come in contact with the police, including those experiencing domestic violence, as well as youth who exhibit delinquent or at-risk behaviors.

Through the CDCP model, youth may be identified relatively early as having experienced traumatic stressors and being in need of services. This approach, upon provision of physical and psychological safety, may allow youth to develop a different conceptualization of the police and mental health team. The promotion of a youth’s more positive perception of the police and system involvement, therefore, may maintain or repair a youth’s social contract. This may occur when a family feels safer and receives treatment for domestic violence issues, or when the police and mental health partners canvass a neighborhood after a violent incident and thus promote feelings of safety, protection, and engagement. Rather than excusing a youth’s behavior, the model encourages law enforcement and mental health systems to work together to examine a range of interventions to assist the youth.

The successful implementation of CDCP relies on the development of shared goals, such as improving the safety and well-being of a community, and the active engagement of key stakeholders through their intense interaction and frequent participation in team meetings and co-trainings. In Providence, RI, the collaboration began with strong, effective, and committed leadership from mental health and police participants. Such partnerships have been successfully sustained through major leadership shifts. Participants believe that this has occurred because all partners at all levels have witnessed the benefits to their community; have felt more effective in their own professional roles; and have integrated their collaborative practices into each partner organizations’ policies, procedures, and cultures (S. Erstling, personal communication, March 26, 2015).

Court and Mental Health Collaborations

Proactive collaboration between the court system and the local mental health system has also shown promise for prevention, as well as for treatment. “A juvenile court judge enjoys a unique ability to act as a community convener,” noted Judge Michael L. Howard and psychologist Dr. Robin Tener, as they described their work in a large Ohio county (Howard & Tener, 2008, p. 29). The Stark County Traumatized Child Task Force, founded by Judge Howard and community partners in 2001 when Howard was still a magistrate, fostered not only a trauma-informed juvenile court system but also a trauma-informed surrounding community. From 2001 onward, Judge Howard and his team worked to convene the community by inviting national speakers, such as Dr. Bruce Perry, to present community seminars about trauma, followed by breakout discussion groups. They also pulled together leadership from almost every local child-serving agency to take part in this community convening, followed by invitations to join the planning task force. By 2004, Howard campaigned for judge and won election on a platform that included taking better care of local youth through a teen court program that included a focus on trauma treatment. As a result of the continuing, mostly unfunded work, many of the community organizations that joined the task force now routinely screen children and youth. When a history of trauma exposure is identified, youth and their caregivers are referred for a thorough traumatic stress evaluation (M. L. Howard, personal communication, July 7, 2015). This process provides a variety of opportunities to educate children and their families about the effects of traumatic stress and the need for trauma-focused treatment and prompts communication among the systems involved in treating such youth. For those youth who are involved with the juvenile court system, the court intervenes to support trauma-focused treatment not only with potential delinquency cases but also with protection cases in dependency court. Because this work began before trauma treatment had become mainstream in U.S. mental health agencies, Howard and Tener noted, “Yet, in our community, the juvenile court, rather than the mental health providers, has been the driving force in raising trauma awareness” (Howard & Tener, 2008, p. 31). As the work of the task force has continued, these initial efforts have expanded to system-wide awareness and action, including increasing leadership by mental health systems.

Judge Howard argued that in order to be sustained, trauma-informed approaches cannot depend on the vision of a single individual, a “champion,” but must be institutionalized. Since 2008, Judge Howard and fellow stakeholders on the Stark County Traumatized Child Task Force have partnered with the NCTSN to institutionalize trauma awareness in all the regional systems that serve children and youth who may be traumatized, including schools; the local Red Cross; court personnel and court volunteers; the county mental health board; and members of probation, child welfare, and local mental health agencies (M. Howard, personal communication, April 17, 2015). Judge Howard reports that more could still be done to bring law enforcement fully on board. He reports success in the schools by integrating trauma-responsive approaches into an ongoing state-mandated program, the Ohio Department of Education’s Positive Behavior Intervention. Howard reports that to “sell” this to school administrators and teachers, the key stakeholders in the task force argued that integrating trauma work into their behavior interventions might well improve test scores. In collaboration with the NCTSN, trauma screening and treatment have also been institutionalized and evaluated in the local juvenile justice residential treatment program for clinicians and staff (Olafson et al., 2016).

The work in Stark County has served as a model for using the community convening power of the judiciary to foster trauma-informed dependency and delinquency court systems nationwide. It remains to be seen how such local efforts, dependent as they are on personal relationships in a small area, might be brought to scale in larger regional, or even national, trauma-informed projects.

Tools to Sustain Trauma-Informed, Cross-System Practices

In addition to the interventions described above, there are a number of tools that are useful for sustaining trauma-informed practices within organizations. The key is to provide specialized trauma training, as well as to enhance the abilities of the various systems to effectively communicate with each other.

Specialized Trauma Training

Interventions are most effective when all family members, court staff, case workers, residential treatment staff, probation officers, teachers, and community volunteers who are engaged with traumatized youth (a) understand how trauma might impact a child or youth and (b) are able to provide support, understanding, and recommendations for helping the youth re-regulate. Research showed that a trauma-focused treatment combined with trauma training for staff resulted in positive outcomes for youth residing in moderate-high security correctional facilities (Marrow, Knudsen, Olafson, & Bucher, 2012; Olafson et al., 2016). These outcomes included reduced levels of depression in youth participating in such interventions, less threatening behavior by youth toward staff, decreased use of physical restraint and seclusion, and increased levels of hope and optimism among youth (Marrow, Knudsen, Olafson, & Bucher, 2012; Olafson et al., 2016). In an environment where all parties recognize and respond to traumatic stress symptoms in a supportive manner, a youth can more easily begin to understand his or her trauma reminders and feel safe to engage in actions that lead to emotional and behavioral regulation. The NCTSN has created a number of curricula designed to foster trauma-responsive systems.

The Child Welfare Trauma Training Toolkit (Child Welfare Collaborative Group, National Child Traumatic Stress Network, & the California Social Work Education Center, 2013) is a curriculum aimed at child welfare caseworkers to increase their understanding of trauma, suggest concrete actions to address traumatic stress, and provide them with information to guide families to appropriate interventions. Think Trauma, a four-module trauma-informed milieu training for residential treatment staff, probation officers, and court personnel, addresses trauma psycho-education, posttraumatic coping strategies to use with reactive traumatized youth, and secondary trauma in staff members (Marrow, Benamati, Decker, Griffin, & Lott, 2012).

Many youth who are in diversion programs, are on probation, or are at risk for juvenile justice involvement are cared for in homes by foster parents or family members who could benefit from guidelines about the impact of trauma on youth and effective ways to respond. Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents (National Child Traumatic Stress Network, 2010), was co-created by NCTSN trauma experts and experienced foster parents and is used by child welfare agencies across the country. It combines trauma knowledge and peer support with opportunities to apply that knowledge to a child in the caregivers’ home.

A partial list of other promising trauma-informed tools that provide trauma training/knowledge to specific groups of professionals with a goal of sustaining trauma-informed practices includes: Cops, Kids & Domestic Violence (National Child Traumatic Stress Network, 2006); trauma-informed guidelines for residential treatment facility staff to accompany dissemination of Trauma-Focused Cognitive Behavioral Therapy (Cohen, Mannarino, & Navarro, 2012); the Child Trauma Toolkit for Educators (National Child Traumatic Stress Network Schools Committee, 2008); Ten Things Every Juvenile Court Judge Should Know About Trauma and Delinquency (Buffington, Dierkhising & Marsh, 2010); and the NCTSN Bench Card for the Trauma-Informed Judge (National Child Traumatic Stress Network, Justice Consortium & National Council of Juvenile and Family Court Judges, 2013).

Lessons Learned

There are several lessons to be learned from this sampling of local and national attempts at cross-system collaboration. These collaborations grow naturally out of situations where professionals and staff from one system spend time with professionals and staff from another in cross-trainings, co-location of services, and regular cross-discipline meetings. Practices that promote cross-system collaborations might be started by an individual “champion,” but they must be proven effective and institutionalized within each system’s policies, procedures, funding, and practices in order to be sustained. The development, implementation, and sustainment of these practices must meaningfully involve families and community partners. They must also involve staff at all levels, as frontline staff, in particular, have the most interaction with youth and families and are therefore likely to have the most impact on youth and families’ perceptions of the agency. A key part of these approaches involves collaboration among service systems to improve the continuity of care; address trauma at the earliest point possible; prevent further trauma to the child and family; and develop a more robust, community-oriented response to caring for families that have experienced trauma. It remains to be seen whether successful local and regional efforts can be taken to scale nationally.

In addition, successful collaborations across systems require not only resources that translate methods and goals across disciplines, but resources that also provide clear and explicit role definitions, so that each player stays within her or his training and competence while working with interdisciplinary partners. Lessons learned should be shared across disciplines and are most effective when they are communicated by respected professionals within the targeted audience’s own profession; thus, police officers learn well from other police officers (in trainings jointly presented by trauma experts), and judges learn well from other judges (also joined by trauma experts). The national collaboration among NCTSN, the National Council of Juvenile and Family Court Judges, the American Bar Association, and the Office of Juvenile Justice and Delinquency Prevention have led to a host of collaborative papers, fact sheets, webinars, and trainings in addition to the selection of resources listed above.

One theme across these collaborations is the assumption that staff members from all service systems use a trauma-informed approach when interacting with a youth and his or her family. As they attempt to identify whether trauma might be one underlying source of a youth’s misbehavior, delinquency, or other presenting symptoms and then take steps to address that trauma, the youth in question will be more likely to engage with societal systems and view herself or himself as part of the larger society. The isolation and withdrawal that occurs with untreated traumatic stress, together with the disengagement from systems that have not proven helpful within a youth’s life, might possibly be prevented if a community takes a trauma-informed approach. If communities can model collaboration, engagement, and understanding across their systems, then youth and families might be more likely to engage with their communities rather than give up and disengage. This assumption is, however, currently untested; further research should explore a potential link between trauma-informed approaches, the degree of community connectedness, and the impact on rates of juvenile delinquency. If these connections are validated, there are methods such as the Breakthrough Series Collaboratives (Ebert, Amaya-Jackson, Markiewicz, Kisiel, & Fairbank, 2012) that bring communities together across systems by (a) providing support to help them implement training, policies, and procedures that support trauma-informed practices; and (b) facilitating evaluation of new practices via pilot testing and data collection on the short- and long-term impact of the new approaches that are instituted (Ebert et al., 2012). Such approaches would allow communities to look for a measurable impact on levels of delinquency in order to determine whether trauma-informed approaches across systems are indeed effective in reducing the number of youth with trauma histories who enter the juvenile justice system. Further, such measures could help determine whether these new approaches can sustain effectiveness over time.

The new prevalence of the interventions, practices, tools, and methodologies described above point to a shift in society’s perceptions about the root causes of delinquency. More than that, this new perception reflects an optimism that has emerged from seeing the results of treating traumatic stress in youth. Coupled with that optimism is the knowledge that youth can recover from their exposure to multiple and ongoing traumatic experiences.

About the Authors

Erna Olafson, PhD, PsyD, has doctorates in history and clinical psychology and is associate professor of clinical psychiatry and pediatrics at the University of Cincinnati College of Medicine and Cincinnati Children’s Hospital Medical Center. She is co-director of the Center for Trauma Recovery and Juvenile Justice—a National Child Traumatic Stress Network Level II Center funded by SAMHSA—and has co-chaired the Network’s Justice Consortium since 2004.

Jane Halladay Goldman, PhD, is the director of the Service Systems program at the National Center for Child Traumatic Stress, the coordinating site of the National Child Traumatic Stress Network. In this role, she coordinates projects related to creating trauma-informed child and family service systems within juvenile justice, child welfare, education, medical, and mental health settings, as well as coordinating services and care across systems. 

Carlene Gonzalez, PhD, is a senior policy analyst in the Family Violence and Domestic Relations Division at the National Council of Juvenile and Family Court Judges (NCJFCJ). During her time at NCJFCJ, she has assisted on projects related to the CCC (Courts Catalyzing Change) Initiative, Trauma-Informed Courts, School Pathways to the Juvenile Justice System, the Military Summit, and Vision 21: Linking Systems of Care for Children and Youth.

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