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

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

Carly B. Dierkhising, School of Criminal Justice and Criminalistics, California State University, Los Angeles;
Christopher E. Branson, Department of Child and Adolescent Psychiatry, New York University School of Medicine.

Correspondence concerning this article should be addressed to Carly B. Dierkhising, School of Criminal Justice and Criminalistics, California State University, Los Angeles, 5151 State University Drive, Los Angeles, CA 90032. Email: cdierkh@calstatela.edu

Acknowledgments: We would like to thank Drs. Patricia Kerig and Julian Ford for their thoughtful contributions to previous drafts of this manuscript.

Keywords: trauma, traumatic stress, trauma-informed systems, juvenile justice

Abstract

The movement to create trauma-informed juvenile justice systems has made great strides in recent years. An integral part of this process is collaboration between traumatic stress experts and juvenile justice professionals in developing trauma-informed approaches to serve diverse populations across a range of jurisdictions and settings. In this article, we outline a research and policy agenda by highlighting four core domains of a trauma-informed juvenile justice system: (a) screening, assessment, and intervention; (b) workforce development; (c) vulnerable populations; and (d) system reform. The movement to create trauma-informed juvenile justice systems has progressed due to emerging research on the impact of exposure to traumatic stressors and subsequent posttraumatic stress reactions on youths’ risk of involvement in the juvenile justice system, as well as studies on promising and evidence-based screening, assessment, and therapeutic interventions for traumatized adolescents. Most importantly, traumatic stress researchers and practitioners are moving beyond the phase of educating juvenile justice stakeholders to actually disseminating and implementing trauma-informed practices; many jurisdictions are ready and willing to create and put into place such a system.

Introduction

Creating a trauma-informed juvenile justice system is not a rapid transformation and often requires a paradigm shift at multiple levels (e.g., law enforcement, courts, probation, diversion, detention, mental health services; Substance Abuse and Mental Health Services Administration [SAMSHA], 2014). To do it successfully, juvenile justice professionals and traumatic stress researchers need to collaborate in establishing shared goals and developing and evaluating trauma-informed approaches to serve diverse populations across a range of jurisdictions and settings. Stakeholders in both realms agree that improved adolescent well-being is an overarching goal, but they don’t always agree on how to define well-being or the strategies for achieving this goal. The underlying premise of the trauma-informed approach is that negative youth outcomes, including delinquency (i.e., behaviors that place youth at risk for juvenile justice involvement) and recidivism, are reduced primarily through strengthening youth resilience and reducing symptoms of posttraumatic stress and co-occurring mental health problems (Ford, Kerig, & Olafson, 2014). The overall aims of the juvenile justice system are to enhance public safety, reduce recidivism, and hold youth accountable for their actions. Moving forward, researchers need to illustrate how trauma-informed practices and policies can support the juvenile justice system’s aims in a cost-effective manner in order to strengthen the case for implementing and sustaining a trauma-informed approach in juvenile justice systems.

There is evidence that goals are becoming increasingly aligned from both sides of the fence. Traumatic stress researchers are formulating research agendas that have direct relevance, at a practical level, to juvenile justice practices and policies. For instance, traumatic stress research and advocacy efforts have made a case for abandoning traumatizing practices in justice settings (Burrell, 2013; Dierkhising, Lane, & Natsuaki, 2014), implementing trauma screening and assessment (Kerig, 2013), and using trauma-informed treatment models in secure settings (Marrow, Knudsen, Olafson, & Bucher, 2012b; Ford & Hawke, 2012) in order to improve working conditions for staff and reduce youth recidivism and mental health problems. In addition, recent policies and recommendations from a growing number of juvenile justice stakeholders call for the adoption of trauma-informed practices (American Bar Association, 2014; International Association of Chiefs of Police, 2014; National Council of Juvenile and Family Court Judges, 2015). For example, the U.S. Attorney General’s Defending Childhood Initiative calls for routine screening and assessment for trauma-related impairment in justice settings, reducing the use of harsh or coercive practices that may “trigger” or re-traumatize youth with prior trauma histories, protecting victims of commercial sexual exploitation, improving the system’s response to girls, and other recommendations for a trauma-informed approach to juvenile justice (Attorney General’s National Task Force on Children Exposed to Violence, 2012).

A key challenge to establishing clear and shared goals in creating trauma-informed juvenile justice systems is the lack of consensus on the essential elements that constitute a trauma-informed juvenile justice system. Several recommendations have been proposed, with significant overlap among them (e.g., Attorney General’s National Task Force on Children Exposed to Violence, 2012; Dierkhising, Ko, & Goldman, 2013a). Taking these recommendations into account, we have identified four common domains of a trauma-informed juvenile justice system that encompass a range of pragmatic policies and practices: screening, assessment, and intervention; workforce development; vulnerable populations; and system reform. This article delineates these domains and related practices and policies, identifies essential elements for future research and evaluation, and suggests ways that stakeholders and researchers can adopt a common language and common goals.

Screening, Assessment, and Interventions

A key element of trauma-informed systems is the provision of effective services to support youth recovery from trauma and traumatic stress (National Child Traumatic Stress Network [NCTSN], 2007). Clearly, juvenile justice systems must offer screening and assessment for trauma-related mental health issues in order to identify youth in need of trauma-informed services. Yet, many unanswered questions remain regarding how best to utilize the information gleaned from trauma-informed screening instruments and the most efficient and effective way to deliver or adapt services when youth are identified as having traumatic stress-related impairments (Kerig, 2013).

To create trauma-informed justice systems, it is typically recommended that juvenile justice professionals implement routine, if not universal, screening of youth for trauma exposure and PTSD or related behavioral health needs (American Bar Association, 2014; NCTSN, 2007). However, state juvenile justice practitioners need research-based and logistically feasible guidance around how to implement this recommendation. This includes when to screen youth (i.e., pre- or post-adjudication); who should conduct the screenings (e.g., probation officers, court staff, intake unit); which screening tools work best at particular set points of contact (e.g., some take time to administer/score, which can burden busy front-line staff); and how youth are referred for services based on the results.

Screening must only take place if the information from it leads to specific actions. It has also been noted that jurisdictions must determine what type of information is needed as youth move through the system, particularly those on the front end of the system (Kerig, 2013). It may not be necessary, or trauma-informed, to have youth screened for exposure to a broad range of traumatic events at intake or pre-adjudication, given that a safe environment and rapport with staff is not likely to have been established at this point. What may be more important early on is screening for traumatic stress reactions and related functional impairments so that the psychosocial problems that brought the youth into contact with the system in the first place can be addressed. Research on the timing of screening, the subsequent services youth receive based on them, and whether the services improve outcomes, can help identify the cost-benefit ratio to justify screening efforts and service provision.

Youth who screen positive for trauma-related impairment should be referred for a comprehensive trauma-informed assessment to determine if a referral to trauma-informed treatment is warranted. In the juvenile justice system, assessment of youth offenders typically focuses on both criminogenic risk factors (i.e., factors significantly associated with risk of recidivism) and service needs (i.e., mental health issues or psychosocial difficulties). Although justice system researchers and professionals have typically conceptualized criminogenic risk factors as distinct from mental health needs (Cauffman, Steinberg, & Piquero, 2005), accumulating evidence reveals an overlap between the former and the symptoms of post- traumatic stress. Structured risk assessment tools used in juvenile justice settings typically include items measuring individual factors, such as anger and impulsivity (Skeem, Scott, & Mulvey, 2014), and these difficulties in regulating behavior and emotions are highly similar to core symptoms of posttraumatic stress (e.g., hyperarousal, irritable behavior and angry outbursts, reckless behavior). Trauma exposure and posttraumatic stress are also significantly associated with other commonly assessed criminogenic risk factors, including substance use, callous-unemotional traits, peer problems, negative family relationships, and academic problems (Evans-Chase, 2014; Kerig & Becker, 2010). Additionally, some studies have shown that commonly used juvenile risk assessment tools are significantly less accurate at predicting recidivism among youth offenders with histories of trauma exposure than for offenders without prior exposure (Li, Chu, Goh, Ng, & Zeng, 2015; Onifade et al., 2014). This is particularly important, given that scores indicating higher criminogenic risk are used to justify placement of youth offenders in detention facilities to protect the public (Andrews & Dowden, 2006). Research is needed in two areas: (a) to examine whether incorporating assessment of trauma exposure and related impairment into criminogenic risk assessment tools increases their predictive validity, and (b) to further clarify the relationship between trauma/traumatic stress and established criminogenic risk factors. If assessment tools can show that some youth have deficiencies in self-regulation as a result of posttraumatic stress reactions rather than criminogenic risk factors, courts may be encouraged to divert these youth to community-based trauma-informed services, which promote development of self-regulation skills. This would require additional work in the pre-adjudication phase of court processing, so research is needed to determine if those costs can be justified by outcomes such as reduced incarceration and recidivism. As it stands, incarceration is more costly than diverting youth to evidence-based treatment and fails to reduce recidivism (Justice Policy Institute, 2010).

Trauma-informed interventions (i.e., services designed to promote recovery from posttraumatic stress) have been shown to reduce PTSD symptoms and other behaviors (e.g., externalizing/aggression) that contribute to adolescents becoming involved in the juvenile justice system (Black, Woodworth, Tremblay, & Carpenter, 2012; Ford et al., 2014; Marrow et al., 2012b; Smith, Chamberlain, & Deblinger, 2012). However, few studies have examined these interventions’ long-term impact on delinquency or recidivism. Additional studies with larger, multisite samples and longer follow-up periods are needed to clearly establish which trauma-informed interventions reduce delinquent behaviors and recidivism as well as co-occurring posttraumatic stress problems.

Youth with the most serious criminal offenses and/or highest levels of criminogenic risk tend to receive the most services in cash-strapped juvenile justice systems; meta-analytic research findings show the greatest reductions in recidivism, from a cost-benefit perspective, result from interventions targeting this group (Lipsey, 2009). Traumatic stress experts, however, emphasize providing intervention to youth based on severity of PTSD and associated symptoms and call for early intervention to prevent trauma-exposed youth from developing serious and wide-ranging deficits (Gerrity & Folcarelli, 2008). To reconcile these different priorities, studies are needed that evaluate the effectiveness and cost benefit of trauma-informed treatment for youth with varying levels of criminogenic risk and posttraumatic stress symptomatology.

Given the significant cost of implementing new interventions (i.e., trauma-informed treatment), research is needed to compare the effectiveness of trauma-informed services with other evidence-based interventions for justice-involved youth in reducing both criminogenic risk and posttraumatic stress impairments. Such research will help clarify which youth stand to benefit most from what type of specific interventions (e.g., traditional or trauma-informed) and whether existing treatments for delinquent youth can effectively reduce traumatic stress. For example, research has shown that Multidimensional Treatment Foster Care, a widely used and evidence-based intervention for youth offenders requiring out-of-home placement, has been adapted effectively for youth with delinquency and co-occurring posttraumatic stress reactions, improving both outcomes (Smith et al., 2012).

Because youth can be involved in a variety of juvenile justice settings of different durations, researchers will need to develop and evaluate trauma-informed interventions of varying intensity and determine which ones are cost effective to deliver and which ones are most appropriate for various settings. Determining the ideal dose or length of trauma-informed interventions also requires consideration of legal and ethical issues. For example, manualized trauma-informed interventions for adolescents typically call for 10 to 24 weekly sessions (and additional sessions as needed), but this would not suit short-term programs, such as detention or pre-adjudication diversion programs. Youth charged with lesser offenses who demonstrate needs related to posttraumatic stress should not be kept in the justice system just so they can receive trauma-informed interventions (i.e., a net widening effect). For these youth, an appropriate intervention might be a single session of psychoeducation on trauma and a referral for voluntary trauma-informed interventions.

Another question for future research is where youth offenders should receive treatment. Many communities face a shortage of mental health providers, particularly those trained in evidence-based treatments for posttraumatic stress (Courtois & Gold, 2009; Shields, Delany, & Smith, 2015; U.S. Department of Health and Human Services, 2015). One study found that probation officers working in counties with a shortage of mental health providers were significantly less likely to refer youth on their caseload for treatment (Wasserman et al., 2008). Training existing front-line staff (i.e., non-clinicians) to deliver interventions offers a cost-effective strategy for increasing the availability of trauma-informed services in juvenile justice settings. Quasi-experimental studies report positive results for paraprofessional-delivered interventions for youth in the justice system, including trauma-informed intervention groups in juvenile detention centers (Ford & Hawke, 2012). Additional research is needed to establish whether front-line justice staff (case managers, probation or correctional officers) can be trained to deliver skills-based, trauma-informed interventions safely and effectively. Such groups could serve youth with mild to moderate trauma-related impairment, while youth with more serious or complex trauma issues would still receive referral to community-based trauma-informed interventions or onsite contracted providers in the case of detention/corrections.

Workforce Development

Infusing trauma-informed practices throughout the juvenile justice system requires that staff members of all levels and disciplines are knowledgeable about childhood traumatic stress (SAMSHA, 2014). Youth involved in juvenile justice interact with several professionals who hold decision-making authority over their lives, the majority of whom are not trained in mental health or informed about the nature and impact of traumatic stress (Andersen, Papazoglou, Koskelainen, & Nyman, 2015; Levin & Greisberg, 2003; NCTSN, 2008). Judges, attorneys, probation officers, and case managers serve as “gatekeepers” to mental health services, so it is essential that they understand the potential benefit of trauma-informed interventions and recognize warning signs that a youth in front of them may be suffering from traumatic stress. Additionally, the justice system has historically used coercive practices to ensure youth compliance with the law and court mandates, including the threat of incarceration for probation violations among youth in the community and the use of seclusion or restraint in secure facilities. Such practices may trigger or reactivate PTSD symptoms for youth with prior exposure to traumatic stressors, and this can contribute to what appears to be an unwillingness of the youth to engage responsibly in legally mandated rehabilitation (e.g., missing court to avoid possible incarceration, reacting aggressively to threats of probation violations; Ford, Chapman, Connor, & Cruise, 2012). Thus, staff should receive training on trauma-informed approaches for interacting with youth that are designed to help them prevent or respond effectively to youth violations of court mandates or program rules.

Several trauma-informed training curricula and intervention models have been developed for juvenile justice staff. These models focus on education on the impact of traumatic stress exposure and posttraumatic stress reactions on adolescent development and behavior, and provide specific skills for working with traumatized youth. Available resources range from best practice handouts for specific groups (e.g., National Child Traumatic Stress Network Justice Consortium, 2013) to multiday workshops designed to increase front-line juvenile justice professionals’ knowledge and teach specific skills to engage, de-escalate, and assist traumatized youth (Ford, 2014; Marrow, Benamati, Decker, Griffin, & Lott, 2012a).

The key research challenge is to determine which of these models are effective in different juvenile justice settings and with different populations, as none have been rigorously evaluated to see if they increase front-line professionals’ knowledge and skills around working with traumatized youth.

Future studies should evaluate the impact of various training models across different positions (judges, probation/correctional officers, case managers) and settings (courts, secure facilities, community-based programs). Such research should evaluate whether training increases staff knowledge and buy-in for adopting trauma-informed practices and whether this, in turn, leads to changes in practice and youth outcomes. The primary outcomes of interest will and should differ across positions and settings. For example, a key goal of the trauma-informed approach is to reduce the use of harsh disciplinary practices in correctional settings (i.e., restraint) that may trigger a traumatic response or further traumatize youth; therefore, research must demonstrate that replacing such practices with trauma-informed approaches can improve youth outcomes without sacrificing staff and youth safety.

Workforce development is also needed to educate and shield front-line staff from the negative effects of working with youth who suffer from posttraumatic stress reactions. Secondary traumatic stress describes the psychological duress that results from learning about another person’s traumatic experiences or experiencing that person’s posttraumatic stress reactions in firsthand interactions (National Child Traumatic Stress Network Secondary Traumatic Stress Committee, 2011). Research reveals high rates of secondary traumatic stress reactions among juvenile justice professionals, including court and correctional staff (Denhoff & Spinaris, 2013; Levin et al., 2011). Secondary traumatic stress reactions increase the risk for burnout and turnover among justice staff (Denhoff & Spinaris, 2013; Lewis, Lewis, & Garby, 2013). High rates of turnover are a barrier to implementing and sustaining effective juvenile justice programs generally as well as trauma-informed practices specifically, because agencies cannot afford to continually provide intensive training to waves of new staff. Research studies, therefore, are needed to evaluate juvenile justice practices and policies designed to prevent, or enable staff to cope effectively with, secondary traumatic stress reactions. Although there are no well-established interventions for preventing or treating work-related traumatic stress reactions (Bercier & Maynard, 2014), promising practices that merit further investigation include staff training on secondary trauma and working with trauma survivors, supervision and peer support groups on work-related trauma/stressors, and critical incident debriefing.

Vulnerable Populations

Disproportionate minority contact (DMC1) and racial and ethnic disparities (RED2) are pervasive throughout juvenile justice systems and have contributed to a legacy of unjust treatment and historical trauma among minority youth and their families (Lacey, 2013). Reducing DMC was mandated under the Juvenile Justice and Delinquency Prevention Act (JJDPA) in 1992 (Cabaniss, Frabutt, Kendrick, & Arbuckle, 2007), and while some jurisdictions have been successful in implementing strategies to reduce DMC/RED—of note is the work by the Models for Change DMC Action Network and the W. Haywood Burns Institute—progress has generally been slow.

1 This refers to the fact that minority youth are justice-involved in disproportionate amounts compared to their numbers in the general population.

2 This refers to the fact that minority youth receive disparate treatment at all points of contact throughout the juvenile justice system, such as harsher sanctions for the same crimes, compared to White youth (Bell & Ridolfi, 2008).

Future research on DMC/RED would benefit from taking a trauma-informed approach to how DMC/RED impacts youth outcomes. For instance, minority youth who come in contact with the justice system are not blind to inequalities and are likely to view the system as unjust or discriminatory. Research shows that fairness is central to improving youth outcomes (National Research Council, 2014), and this must include minority youth perceptions of discrimination and fairness within the system. Traumatic stress researchers should investigate the impact of discrimination and fairness on outcomes among trauma-exposed youth in the juvenile justice system. Betrayal trauma theory, and the idea of institutional betrayal in particular, suggests that when institutions (and people) that are charged with protecting individuals fail to do so, it can elicit or exacerbate traumatic stress reactions (Smith & Freyd, 2014).

Research also shows that youth who feel legal cynicism, which refers to the perception that judges, police, and other legal authorities are unfair or untrustworthy (Sampson & Bartusch,1998), are more prone to criminal behavior and negative experiences with law enforcement (Fagan & Tyler, 2005). Future research should evaluate how DMC/RED in the juvenile justice system and the resultant stigma and discrimination experienced by youth of color relate to both criminogenic (e.g., recidivism, legal socialization, procedural justice) and psychological outcomes (e.g., posttraumatic stress impairment and related behavioral health problems). For example, debate has been intense in recent years about the use of “Terry” stops, in which police officers temporarily detain and search people they suspect are engaged in criminal activity (also known as “stop and frisk”; Geller, Fagan, Tyler, & Link, 2014). Critics point to statistics indicating that this tactic is disproportionately applied to young men of color in impoverished neighborhoods (New York Civil Liberties Union, 2011). A recent study of 18-to-26 year old males in New York City evaluated the impact of being subjected to stop-and-frisk encounters by police officers and found that young males stopped more frequently reported higher rates of PTSD symptoms (Geller et al., 2014). Notably, study participants who perceived fair treatment by police officers during stop-and-frisk encounters reported significantly fewer PTSD symptoms (Geller et al., 2014). This highlights the link between a person’s perceptions of treatment with significant psychological outcomes and shows how important interactions with those in authority are to psychological health.

Girls are another vulnerable population requiring individualized attention from a trauma-informed framework. Retrospective accounts of trauma histories of juvenile justice–involved girls reveal significantly higher rates of exposure to sexual abuse and assault compared to the trauma histories of juvenile justice–involved boys (Dierkhising et al., 2013b; Kerig & Ford, 2014). Because of the high rates of sexual trauma among girls, advocates have suggested that the sexual violence to prison pipeline (Saar, Epstein, Rosenthal, & Vafa, 2015) is the more common trajectory into the system for girls compared to the way boys become involved in the juvenile justice system. These striking rates of sexual trauma, coupled with the additional unique needs girls bring with them into the system (e.g., pregnancy, high rates of family and intimate partner violence, anxiety/mood disorders), have resulted in a growing movement to provide gender-responsive programming for girls (Watson & Edelman, 2012). However, more research is needed to better understand the need for gender-responsive programming as well as to identify what programs specifically work for girls (Kerig & Schindler, 2013).

Commercial sexual exploitation of children (CSEC) is a special problem for juvenile justice systems, as these youth have traditionally been treated as criminals rather than victims of trauma (Institute of Medicine, 2013). Unfortunately, the prevalence of CSEC and the need for prevention and intervention has far outpaced our understanding and implementation of appropriate responses (Rafferty, 2013). In relation to the juvenile justice system, the practice and policy priority is to ensure that CSEC survivors are referred to trauma-informed services and diverted out of the system whenever possible (Institute of Medicine, 2013). To achieve this, professionals working with children must use validated risk assessments that can identify CSEC victims so that they can consider alternate sanctions and implement intervention services. For instance, the Vera Institute of Justice (2014) developed a screening and assessment tool to identify CSEC victims, but it has yet to be validated in a juvenile justice setting.

A growing number of jurisdictions have developed systemic responses to serving CSEC youth, yet there is significant variation in the criteria used to identify youth at risk for or involved in sexual exploitation as well as the system response to such youth (Shared Hope International, 2014). For instance, in Los Angeles County, a specialized court addresses youth at risk for sexual exploitation, which is primarily determined by prior or current charges for prostitution or admissions following arrest for prostitution (California Courts: The Judicial Branch of California, n.d.). Youth who voluntarily enter the program receive victim-centered services and may have their criminal charge dropped once they complete probation.

Future research must evaluate whether approaches to screening and service provision for sexually exploited youth within juvenile justice systems improve youth safety and reduce psychological and legal problems. Engaging these youth in sustained services is a very difficult challenge due to their tendency to return to exploitive relationships and settings (Walker, 2013). Research is needed to determine whether trauma-informed interventions can enhance engagement with CSEC youth in rehabilitative services and reduce their entrapment in revictimization.

System Reform

Physical and psychological safety during stays in residential juvenile justice facilities is essential to a trauma-informed approach and the basis for recovery from traumatic stress impairment. Physical safety (i.e., being free from victimization and abuse) during institutional stays is also a constitutional right for all youth (Dierkhising et al., 2014). Unfortunately, there is consistent evidence that many youth are not, and do not feel, safe during residential placement (Burrell, 2013; Dierkhising et al., 2014; Mendel, 2011). Youth with traumatic stress histories are also found to be more vulnerable to victimization in facilities, and victimization during residential placement (by staff or peers) has been associated with increased posttraumatic stress symptoms and continued criminal involvement following release (Dierkhising et al., 2014).

The Prison Rape Elimination Act (PREA) established a set of required practices and standards that institutions must follow and meet to prevent sexual victimization during residential stays (Burrell, 2013). However, youth report a broad range of victimization, beyond sexual assault and exploitation, during residential stays (Beck, Harrison, & Guerino, 2010). Future research should evaluate strategies and practices aimed at reducing all types of victimization in juvenile justice facilities so that broader guidelines and oversight can be established. For instance, research could examine whether trauma training and/or nonpunitive disciplinary responses (e.g., de-escalation, rapport-building) improve youth safety. Implementing a trauma-informed care initiative has been shown to reduce the use of seclusion/restraint and youth disciplinary infractions in three out of four studies in secure juvenile justice facilities (Elwyn, Esaki, & Smith, 2015; Ford & Hawke, 2012; Marrow et al., 2012b; Olafson et al., 2016). Similarly, studies in inpatient mental health settings have shown that trauma training leads to reductions in seclusion and improvements in patients’ self-reported sense of safety in the unit (Muskett, 2014).

Youth perceptions of psychological safety are also relevant to a trauma-informed approach (NCTSN, 2007). Longitudinal research indicates that youths’ positive perceptions of their residential stays (safety, fairness, and order) are related to better youth outcomes (Schubert, Mulvey, Loughran, & Losoya, 2012). Future research should focus on the youth voice and their perceptions of safety during their institutional and justice-related experiences. Research findings such as these could inform (a) the feasibility of implementing specific trauma-informed interventions in justice settings to ensure that youth feel safe enough to participate in treatment; (b) staff training on trauma, safety, and rapport-building; and (c) legal and legislative opportunities to continue to support and uphold youths’ constitutional rights to be free from cruel and unusual punishment.

Cross-system collaboration is another core element of a trauma-informed approach, given that trauma-exposed youth tend to be involved in multiple service systems, including child welfare, special education, and mental health/substance abuse treatment (Dierkhising et al., 2013a). Unfortunately, cross-system collaboration is especially difficult within justice systems, because of legal protections regarding information sharing between agencies; this often means that pertinent information about a youth’s mental health, service needs, and well-being are not available to other providers working with the youth (Stewart, 2010). For example, dually involved youth3 have some level of contact with the child welfare system because of a case of abuse or neglect, and some level of contact with the juvenile justice system (Abbott & Barnett, 2015). They are, by definition, a trauma-exposed population (Herz, Ryan, & Bilchik, 2010) and are in need of a trauma-informed approach. As trauma-informed practice with dually involved youth is rare, given the complexities of information sharing across systems and other systemic challenges (e.g., consistent use of multidisciplinary case management), these youth often become a hidden population (Herz et al., 2010). In addition, compared to the general juvenile justice population, the dually involved youth population has a higher prevalence of girls (Herz & Ryan, 2008; Saar et al., 2015), even greater racial disparities (Herz & Ryan, 2008; Ryan, 2011), and a higher risk for CSEC (Dierkhising, Geiger, Hurst, Panlilio & Schelbe, 2015). Future research that explores strategies to successfully identify this hidden population is needed to be able to direct them to appropriate trauma-informed services.

Some jurisdictions have found success in streamlining information sharing through coordinated case planning and systems integration initiatives. For instance, the Center for Juvenile Justice Reform’s Crossover Youth Practice Model (Abbott & Barnett, 2015) helps jurisdictions improve information sharing for youth involved in both the dependency and delinquency systems so that multiple providers (e.g., child welfare workers, probation officers, education specialists, and mental health service providers) can communicate and establish a common and agreed-upon case plan. This process has the potential to decrease the workload for justice practitioners as well as reduce retraumatization for youth. Future research should evaluate the role of multidisciplinary teams and information sharing in enhancing traumatized youths’ recovery and stable transition out of the system. In addition, researchers could consider the utility of including a trauma expert or, at the very least, consider how information about the youth’s trauma history and traumatic stress symptoms guides service and disposition recommendations for dually involved youth. Policy analyses will also be useful in evaluating whether easing restrictions on information sharing or building coordinated data systems can reduce service system involvement and improve child well-being for those involved in multiple systems.

3 Crossover youth is the umbrella term for youth who have been exposed to maltreatment and are later or concurrently involved in delinquent activities. Dually involved youth are a subset of the crossover population and are youth who have some level of formal system involvement with both child welfare and juvenile justice systems (Abbott & Barnett, 2015).

Family engagement and partnership is a struggle for most juvenile justice jurisdictions. This struggle can be traced back to one of the guiding doctrines of the juvenile court, parens patriae, which determines that the state can take guardianship of youth, establish them as wards of the court, and make decisions on their behalf (American Bar Association, n.d.). This doctrine essentially makes the court the child’s parent with or without the consent of the child’s actual guardian or parents. This process can be quite demeaning and shameful for families and is often counterproductive to family participation in the child’s rehabilitation or recovery. Indeed, families report feeling stigmatized, blamed, and mistreated by the system (Rozzell, 2013) on top of often experiencing their own trauma histories and traumatic stress, which can be exacerbated through their child’s system-involvement.

Future research should explore strategies for promoting family engagement while focusing on reducing stigmatization of families and eliminating barriers to family engagement. For instance, one survey found that three out of four family members reported barriers to visiting their children during residential stays, such as not having the time, money, or access to transportation (Justice for Families, 2012). Family visitation during residential stays has been shown to reduce behavioral incidents among youth and improve academic performance (Agudelo, 2013). Further, the Justice for Families study (2012) found that many families want to be included in treatment and decision making for their children. Practices and policies that reduce stigmatization and include families in their children’s case planning and treatment may reduce the potential for retraumatization from system involvement. Restrictive definitions of families also create a barrier to family engagement. Policies that broaden the definition of family are needed so that important caregivers and people in the children’s support system can visit and be engaged with them during their system involvement.

Recommendations for Implementation Research

Initiatives to implement trauma-informed practices within juvenile justice will need to include strategies to address the many potential barriers to systemic change. Systems or organizations looking to implement these practices should begin by conducting a needs assessment to determine their readiness for change, identify trauma-informed practices already in place, and prioritizing areas of focus (Marsh, Dierkhising, Decker, & Rozniak, 2015). A handful of assessment tools and procedures have been developed to measure and evaluate agencies’ or systems’ use of trauma-informed practices, although only two were created specifically for juvenile justice (Branson, 2015; Marsh et al., 2015). Research reveals that the success of such initiatives is strongly influenced by the context and characteristics of targeted service settings, including staff-level factors (e.g., whether staff supports trauma-informed practice or whether staff experiences burnout or lots of turnover) and agency factors (e.g., leadership, organizational culture; Aarons, Hurlburt, & Horwitz, 2011). Accordingly, several researchers have noted the need to develop implementation strategies that either fit with the unique characteristics and constraints of targeted service settings or can be modified to increase system readiness to adopt new practices (Aarons et al., 2011). For example, Taxman, Henderson, Young, and Farrell (2014) found that consultation focused on creating an organizational climate conducive to change led juvenile justice case managers to adopt mental health services and practices at higher levels than consultation focused solely on increasing staff skill with these practices. Moving forward, researchers and juvenile justice professionals should collaborate to develop and evaluate strategies for increasing organizational readiness for change and promoting the sustained adoption of trauma-informed practices. Implementation strategies will probably need to be tailored for different justice settings (e.g., courts, probation, law enforcement, diversion, and detention/correctional facilities). The contextual factors that most influence implementation success are also likely to vary across settings (e.g., geographical size, access to resources, administrative buy-in or support, intervention fidelity, local policies).

Conclusion

Most central to the sustainability of trauma-informed juvenile justice systems is building a solid empirical foundation on the utility of these strategies through program evaluation, needs assessments, and process evaluations that include both trauma-related and justice-related outcomes. Because jurisdictions vary greatly in their legal requirements, resources (financial, staff size, type of staff), geographical limitations, or advantages, it is all the more important for researchers to investigate how to tailor trauma-informed care initiatives to fit the unique needs and characteristics of different settings. As we continue to evaluate trauma-informed practices in juvenile justice settings, we must also consider the utility of employing multiple practices compared to a few. In other words, is there a tipping point for becoming a trauma-informed system? It is probable that practices build on one another. Understanding the cumulative effect of these practices and policies will further support the widespread adoption and sustainability of a trauma-informed approach within juvenile justice systems.

About the Authors

Carly B. Dierkhising, PhD, is an assistant professor in the School of Criminal Justice and Criminalistics at California State University, Los Angeles. Her primary areas of research include trauma, juvenile justice, adolescent development, and delinquency, as well as developing trauma-informed systems.

Christopher E. Branson, PhD, is an assistant professor of child and adolescent psychiatry at the New York University School of Medicine. His research focuses on implementing and evaluating trauma-informed systems change in juvenile justice, the link between traumatic stress and delinquent behavior, and treatment of co-occurring disorders among youth offenders.

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