The Importance of Treating for Trauma in Juvenile Justice-Involved Youth

risk assessment: Fredrick Butcher (headshot), research assistant professor at Case Western Reserve University, smiling man with dark beard, mustache, glasses wearing blue sweater over shirt.

Fredrick Butcher

Fred Butcher 2 (1)Research over the past several decades has established that youth exposure to violence is a widespread and significant problem. This is particularly true for youth involved in the juvenile justice system, as research has shown that up to 90 percent of these youth have histories of violence exposure, with many reporting multiple serious incidents.

Violence exposure as either victims or witnesses often lead to developing symptoms of trauma as a result. Given that the vast majority of juvenile justice-involved youth are likely to have extensive histories of violence exposure, it is safe to say that trauma is a critical issue facing this population.

Researchers and practitioners alike have long advocated for a trauma-informed approach to juvenile justice. While all juvenile justice youth are not necessarily exposed to violence, those who are exposed are at risk for further problems with delinquency and criminal behavior into adulthood. The treatment of trauma in these youth may prevent further involvement with the juvenile justice system and help to stop their progression into the adult criminal justice system.

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Ohio’s Behavioral Health Juvenile Justice (BHJJ) initiative provides community-based treatment to juvenile justice-involved youth with behavioral health issues in lieu of incarceration. Community-based treatment has been shown to produce better behavioral health and justice-related outcomes.

An important aspect of the BHJJ initiative is a comprehensive and standardized data collection effort that focuses on both these areas of interest. These data are used to track individual needs and outcomes to better inform treatment planning as well as providing opportunities for program evaluation and needs assessment for each participating county. For us, this effort has helped develop a wealth of data over the last decade that has provided much-needed insight into the behavioral health of youth involved in the juvenile justice system.

Along with my co-authors Joseph Galanek, Jeff Kretschmar and Daniel Flannery, we used data from the BHJJ initiative to illustrate how the treatment of trauma can have a positive effect on this population in a recently published article in Social Science & Medicine. We first examined the importance of neighborhoods on both violence exposure and trauma.

As we had expected, youth living in a neighborhood that has concentrated poverty and disadvantage are more susceptible to violence exposure. While poverty in and of itself does not necessarily lead to increased trauma symptoms, the increased risk for violence exposure puts youth living in disadvantaged neighborhoods at risk for trauma.

[Related: Traumatized, Locked Up, LA Girls Starting to Get More Help]

We then examined the impact of trauma on social relationships. While previous research has emphasized the protective nature of social relationships on trauma, little attention is paid to the role of trauma in forming and maintaining those relationships. For youth who are exposed to violence as either witnesses or victims, positive social relationships with family, peers and other adults can have an insulating effect from the violence around them.

However, trauma can often be an impediment to building and maintaining relationships. From this perspective, the problem becomes cyclical. To mitigate the impact of exposure to violence on trauma, social relationships are important, however trauma is what is preventing youth from accessing this protective resource.

It is important to remember that many youth involved in the juvenile justice system are exposed to violence and trauma on an ongoing basis. Many of these youth live in disadvantaged neighborhoods where they are more likely to witness and be victims of violence. These youth are particularly at risk for trauma symptoms, therefore, it is important to provide these youth with treatment to address the trauma and the skills to develop the resources to mitigate the effects of violence exposure.

While macro-level interventions to stabilize neighborhoods are necessary and should be part of the bigger picture, helping youth to build and maintain social relationships that help them become more resilient to violence exposure and trauma is an immediate area of need for the juvenile justice and other social service systems. Our data show that in order to build resiliency, it is necessary to first address trauma symptoms.

Effective screening and assessment are important initial steps in addressing the behavioral health needs of juvenile justice youth. Proper assessment can help identify the treatment needs of youth as they enter the system so that treatment can be better targeted to their needs.

Many juvenile justice systems, however, fail to adequately assess youth for trauma and other behavioral health needs. Many tools exist that measure violence exposure and trauma but not all have been tested and validated to be appropriate for a juvenile justice population. Ultimately, early and effective assessment is vital to understanding the depth of the problem, identifying the needs of each individual as they enter the system and providing treatment to those in need. And, as our data illustrate, the effective assessment and treatment of trauma helps to provide youth with the resources necessary to minimize the effects of violence exposure and ultimately can help reduce the likelihood of continued involvement with the justice system.

Fredrick Butcher, Ph.D., is a research associate with the Begun Center for Violence Prevention and Research in the Jack, Joseph and Morton Mandel School of Applied Social Sciences at Case Western Reserve University in Cleveland. His research on violence exposure and trauma in juvenile justice-involved youth has appeared in a number of journals in a number of social science fields including criminal justice and social work.

More related articles: 

To Help Youth with Trauma Brain, Treat Entire Family

OP-ED: ‘Trauma-Informed Care’ is More Than a Mantra

Sexual Trauma Marks Girls’ Path to Juvenile Justice System

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