Youth involved in the juvenile justice system face a multitude of challenges and have many psychosocial needs that span across different contexts and service systems. Practitioners working within the juvenile justice population may thus struggle to determine how to navigate such needs and provide effective care. This article describes how the application of Bronfenbrenner’s ecological systems theory may be particularly useful to elucidate therapeutic considerations to working with juvenile justice involved youth. We provide descriptions of each subsystem within Bronfenbrenner’s model and how they relate to the unique needs of justice-involved youth, provide a case example to illustrate relevant interventions within each subsystem that focuses on existing setting strengths, and end with practitioner recommendations to address psychological well-being with the juvenile justice population.
Juvenile-justice-involved youth are known to have higher rates of traumatic exposure and traumatic stress symptoms, which increases the necessity for appropriate treatment and targeted case planning for these youth. Traumatic stress symptoms have been shown as a risk factor for delinquent behaviors, though practices for treating juvenile-justice-involved youth who have traumatic stress symptoms is limited. Evidence-based practice dissemination has focused on the use of trauma-focused treatment in residential and community settings. Juvenile-justice-involved youth can be most vulnerable in the secure detention setting. Youth in detention face ongoing stressors in the secure setting, having to witness interpersonal violence by peers, being subject to physical restraints, and attempting to cope in a setting with limited choices. Best practices for the juvenile detention setting are even more limited, despite knowledge of the efficacy of evidence-based trauma interventions in reducing trauma symptoms and restoring healthy family dynamics and relationships that trauma disrupts. This practice note discusses the implementation of trauma-focused cognitive-behavioral therapy in the detention setting, and the interventions flexibility, appropriateness, and impact for youth in detention.
Clinical Impact StatementLittle is known regarding implementation of evidence-based psychosocial intervention for trauma in youth detention, with more emphasis being placed on assessment and referral for this setting. This practice note demonstrates implementation of trauma-focused cognitive-behavioral therapy and how the model can be adapted for the unique needs of these youth.
Suicide is the second leading cause of death among 10- to 25-year-olds, and suicidal behavior is four times more likely among youth who enter juvenile justice settings. The current quality improvement work aimed to improve the use of suicide prevention practices in a behavioral health unit within a juvenile detention center and was informed by the Plan-Do-Study-Act method and the Exploration, Preparation, Implementation, and Sustainment model of evidence-based practice implementation. Aligned with guidelines for suicide prevention in juvenile detention, the quality improvement work resulted in the implementation of universal screening and assessment of behavioral health concerns and the Stanley and Brown Safety Planning Intervention. We review the quality improvement process, provide an overview of the final clinical model, including methods for tailoring and sustainably implementing the Safety Planning Intervention within juvenile detention, and end with a case example and future directions to expand the impact of this work.
Child homelessness is highly correlated with complex traumatic exposure, which may include experiences of intimate partner violence (IPV), community violence, and chronic illness. Individuals exposed to complex trauma in childhood are at increased risk for poor health and psychosocial outcomes in adulthood. Despite this, trauma-focused behavioral health services are not a core service offered to families in shelter, and families often face barriers to accessing such services. In recognition of these barriers, a small family shelter (Jane Addams Place) secured a grant to offer trauma-focused cognitive behavioral therapy (TF-CBT) to its resident children. TF-CBT, an evidence-based practice, has proven successful in treating symptoms of posttraumatic stress disorder (PTSD) in this setting. This article describes the challenges and successes of this program, and proposes several practice implications.
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