Trauma

Section 1.4

Judicial, Legal, Law Enforcement, Justice, Social Service and School Professionals Should Ensure that Past Trauma and Other Experiences, Which May Underlie or Lead to Status-offending Behaviors, Are Identified and Responded to with Appropriate Screening, Assessment, Treatment, Services and Supports

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Many youth alleged to have committed status offenses have been victims of child abuse or neglect and/or have witnessed family or community violence.  These experiences may be traumatic and in some cases will lead to short- or long-term traumatic stress symptoms.  A recent survey of children and adolescents in the general population found that half had experienced two of more types of victimization (being the target of or witnessing violence) and eight percent had experienced seven or more types of victimization.1 Studies estimate that past traumatic experiences and Post Traumatic Stress Disorder are twice as common among juvenile justice-involved youth.2  Children who are abused or who experience other types of violence are more likely to commit crimes (as minors or adults), have mental health and substance abuse issues, and commit suicide.  Youth who witness family or community violence are also more likely to have social and academic problems, and experience anxiety, depression and/or aggression.3  Traumatic stress can manifest as anxiety, depression, concentration issues (post-traumatic stress is frequently misdiagnosed as ADHD), impulsivity, emotional numbing, lack of affect, and conduct problems, among other issues.4

Juvenile justice and social service agencies and courts can take steps to recognize and respond to the impact of trauma on the children they serve:5

  • Implement universal screening using trauma-specific instruments with proven reliability and validity, such as the UCLA PTSD index,6 the Traumatic Events Screening Inventory7 or the MAYSI-2.8
  • Provide youth with evidence-based or empirically-supported interventions to address the effects of trauma.  Information about different evidence based practices including Trauma-Focused Cognitive Behavioral Therapy and Trauma Affect Regulation: Guide for Education and Therapy, is available from the Substance Abuse and Mental Health Services Administration.9
  • Raise awareness among court staff, agency personnel and the community about the impact of trauma, including multi-disciplinary training for judges, social workers and others about how trauma impacts brain development, symptoms of traumatic stress, and other trauma-related topics.
  • Provide intensive training for detention facility staff so that certain youth behaviors are recognized as symptoms of traumatic stress, rather than simple disobedience or acting out, and responded to appropriately.
  • Front-load and expedite dispositions and provide court orientations to youth in order to connect them to services faster and reduce the likelihood of system-induced trauma.
  • Educate attorneys on how to interview clients using trauma-informed strategies.

 

Everyone reacts to exposure to violence differently, so how traumatic experiences will manifest in emotions and behavior varies from one youth to another.  For this reason, professionals should consider past victimization and other types of experiences that may have led to a status offense charge, even in youth who do not seem to be suffering from traumatic stress symptoms.  

Youth in the court system may require screening for past trauma and should receive necessary services.  Professionals working with these youth must understand how past trauma affects their system involvement and futures.  Youth should also be protected from self-incrimination while being screened for trauma or other behavioral health conditions. Screening forms or assessments used at various stages may ask about potentially illegal acts, such as substance abuse or violent reactions to feelings of anxiety or stress, and disclosures may not be protected by confidentiality rules when asked in a court, rather than a clinical, context.10  Youth should be told how information in these tools will be used and shared, and that they can skip any questions they do not wish to answer. 

System-induced trauma should be minimized by avoiding court involvement and secure confinement, minimizing out-of-home placement and placement changes, and choosing therapeutic, rather than punitive, settings if out-of-home placement is necessary.  Involving and educating parents and other family members about the impact of trauma is also essential, both because this information will help them be a resource for their children and because many parents of youth in the court system have also experienced (and are still impacted by) traumatic events.11

Everyone reacts to exposure to violence differently, so how traumatic experiences will manifest in emotions and behavior varies from one youth to another.  For this reason, professionals should consider past victimization and other types of experiences that may have led to a status offense charge, even in youth who do not seem to be suffering from traumatic stress symptoms.  For example, lack of accommodation for a student who is not fluent in English, or who has a learning disability may or may not appear to be traumatic, but should certainly be addressed if a youth is involved in a truancy case.  Professionals should also be aware that gender differences exist both in the types of trauma youth commonly experience (e.g., girls are more likely to be sexually abused, and/or abused in relationships, while boys are more likely to be physically assaulted and to witness death or injuries) and effects of trauma (girls are more likely to meet PTSD diagnostic criteria, and experience depression and anxiety).12  Understanding a young person’s past (possibly traumatic) experiences can help professionals better serve them in many ways, from an attorney advocating that traumatic experiences should be considered as a mitigating factor at disposition to a caseworker, probation officer or detention staff member ensuring that an adolescent is screened and receives necessary treatment for PTSD.


1 Finkelhor, D., Turner, H., Hamby, S., & Richard Ormrod. (2011). “Polyvictimization: Children’s Exposure to Multiple Types of Violence, Crime, and Abuse.” Juvenile Justice Bulletin – NCJ 235504. Washington, DC: U.S. Government Printing Office. Available at: http://www.unh.edu/ccrc/pdf/jvq/Polyvictimization%20OJJDP%20bulletin.pdf.

2 Ford, J. D., Steinberg, K., Hawke, J., Levine, J., & Zhang, W. (2012). "Randomized Trial Comparison of Emotion Regulation and Relational Psychotherapies for PTSD with Girls Involved in Delinquency.” Journal of Clinical Child and Adolescent Psychology, 41, 27-37; Ford, J D., J Hartman, K.,  Hawke, J., and John F. Chapman.  (2008). “Traumatic Victimization, Posttraumatic Stress Disorder, Suicidal Ideation, and Substance Abuse Risk Among Juvenile Justice-Involved Youth” Journal of Child & Adolescent Trauma. 1(1).

3 Siegfried, C.B., Ko, S.J., & Kelly, A. (2004). “Victimization and Juvenile Offending.” Pg. 5, Los Angeles, CA and Durham, NC: National Child Traumatic Stress Network: Juvenile Justice Working Group.

4 National Child Traumatic Stress Network Child Welfare Committee. Child Welfare Trauma Training Toolkit (2008). Available at: http://www.nctsn.org/products/child-welfare-trauma-training-toolkit-2008.

5 These tips are based on efforts currently underway in jurisdictions across the country, as described in: Pilnik, L., & Kendall, J. R. (2012). “Victimization and Trauma Experienced by Children and Youth: Implications for Legal Advocates.” Moving From Evidence to Action: The Safe Start Series on Children Exposed to Violence, Issue Brief #7. North Bethesda, MD: Safe Start Center, Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Available at: http://www.safestartcenter.org/publications/issue-brief-7-victimization-and-trauma-experienced-children-and-youth-implications

6 A self-report questionnaire to screen for exposure to traumatic events and assess PTSD symptoms in school-age children and adolescents. More information available at: http://www.nctsn.org/content/ucla-posttraumatic-stress-disorder-reaction-index-dsm-iv.

7 A 15 to 24-item clinician-administered interview that assesses a child's experience of a variety of potential traumatic events including current and previous injuries, hospitalizations, domestic violence, community violence, disasters, accidents, physical abuse, and sexual abuse. More information available at: http://www.ptsd.va.gov/professional/pages/assessments/tesi.asp.

8 A paper-and-pencil self-report inventory of 52 questions designed to assist juvenile justice facilities in identifying youths 12 to 17 years old who may have special mental health needs.  More information available at: http://nysap.us/MAYSI2.html.

9 The Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-based Programs and Practices (NREPP), a “searchable online database of mental health and substance abuse interventions,” is available at http://nrepp.samhsa.gov.

10 Rosado, L.M. & Riya Shah  (2007) Protecting Youth from Self-Incrimination when Undergoing Screening, Assessment and Treatment within the Juvenile Justice System. Available at: http://www.jlc.org/sites/default/files/publication_pdfs/protectingyouth.pdf.

11 National Child Traumatic Stress Network, Child Welfare Committee. (2011). “Birth Parents with Trauma Histories and the Child Welfare System: A Guide for Judges and Attorneys.” Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress. Available at: http://nctsn.org/sites/default/files/assets/pdfs/birth_parents_trauma_guide_judges_final.pdf.

12 NCCD Center for Girls and Young Women. (nd) Understanding Trauma through a Gender Lens. Available at: http://www.nccdglobal.org/sites/default/files/publication_pdf/understanding-trauma.pdf.