Faculty Bibliography

The purpose of this study was to examine the impact of childhood trauma exposure, posttraumatic stress disorder, and trauma-related comorbid diagnoses on the risk for readmission to juvenile detention among youth in a large metropolitan area (N = 1282). The following research questions were addressed: 1) Does a greater number of childhood traumas increase the risk for readmission to detention following release? 2) Does the risk for readmission differ by type of trauma? 3) Do PTSD and other co-morbid diagnoses increase the risk for readmission? and 4) What role do demographic factors play in the relationship between trauma-related variables and risk for readmission? This study utilized the screening results of 1282 youth who were voluntarily screened for PTSD, depressive symptoms and substance use during their initial intake to detention. More than half of the sample was readmitted during the three-year study period, with readmissions most likely to occur within one year of release. Returning to detention within one year was also associated with increased risk for multiple readmissions. Youth readmitted to detention were more likely to have a history of sexual abuse and problematic substance use. No other significant relationships were found between risk for readmission and trauma-related variables. Although trauma-related symptoms may be crucial targets for treatment, focusing solely on trauma exposure and traumatic stress symptoms without considering the impact of other risk factors may not be enough to decrease the likelihood of readmission for youth of color in a large urban environment.

Despite an increased focus on trauma-informed care within the juvenile justice system, we still know very little about the impact of trauma on juvenile justice professionals or their perceptions of trauma-informed interventions. To fill this gap, this study used an organizational assessment to examine perceptions of trauma-informed care among juvenile professionals in a juvenile detention setting. Participants included 204 staff members in two secure juvenile detention facilities. Staff who reported greater availability of trauma-informed practices were more likely to perceive that youth and families felt safe and those who reported that the facility was taking steps to address secondary trauma were more likely to report a sense of staff safety. Regarding individual factors, only age and gender were related to perceptions of youth and family safety. Frontline staff were more likely than supervisory staff to feel they had received adequate training in trauma and had the skills necessary to deescalate youth. These findings suggest that staff are open to trauma-informed practices in juvenile detention, but a greater focus on supervisory staff is needed. Shifting from individual-level strategies to facility-level improvements could have a greater impact on enhancing staff members"™ perceptions of safety, which improves their ability to care for youth.

The majority of youth in the juvenile justice system have experienced multiple traumatic events in their lives, including community violence, physical abuse, neglect, and traumatic loss. These high prevalence rates, coupled with the known negative consequences of trauma in childhood and adolescence, have led to a greater emphasis on implementing trauma-informed services and practices within juvenile justice settings. However, although many stakeholders and government entities have expressed support for creating more trauma-informed juvenile justice systems, there is still limited empirical knowledge about which interventions are most effective at improving outcomes, particularly at the organizational or facility level. In an effort to fill this gap, the current study evaluated the impact of a trauma-informed milieu intervention, including skills training for youth and training for staff, on rates of violence at two secure juvenile detention facilities (N = 14,856) located in a large Northeastern city. The analyses revealed that the intervention was significantly related to a reduction of violent incidents in Facility A, with no impact on incidents in Facility B. Follow-up analyses revealed that a larger proportion of eligible youth in Facility A completed the skills group program as compared with eligible youth in Facility B (16% vs. 9%). This finding has important implications for the implementation of trauma-informed interventions for youth in juvenile detention settings, as it suggests that to impact outcomes at the facility level, a minimum threshold of youth may need to be exposed to the intervention. In addition, reductions in violence at Facility A were only realized after both staff training and youth skills components were implemented, suggesting that both components are necessary to create change at the facility level. Future research is needed to further explore the impact of organizational and implementation-level factors on trauma-informed care outcomes in juvenile justice settings.

BACKGROUND:Juvenile justice-involved youth have high rates of trauma exposure, physical and sexual abuse and PTSD. Several factors have been found to be related to PTSD symptoms in youth including number and chronicity of traumatic events. OBJECTIVE:To simultaneously examine the relationships between allostatic load (defined here as number of traumatic experiences), poly-victimization (exposure to two or more forms of victimization based on 5 of the 6 categories in Ford et al.'s 2010 study), physical/sexual abuse and PTSD in justice-involved youth. PARTICIPANTS AND SETTING/METHODS:The sample consisted of 1984 youth in juvenile detention in a Northeastern city. The sample was 73.4% male and the majority of youth were either African American or Hispanic. METHODS:Clinicians collected demographic and psychosocial information, and measured symptoms of PTSD, depression, and problematic substance use. RESULTS:Results showed that youth with more traumas, those who experienced poly-victimization and those who experienced physical/sexual assault/abuse were not only more likely to have PTSD, but also more likely to have depression, thoughts of suicide/self-harm, and problematic substance use (as indicated by the presence of 2 or more of 6 possible indicators). Poly-victimization was a stronger correlate of PTSD than number of traumas or physical/sexual assault/abuse. However, among youth with PTSD, number of traumas was associated with co-occurring problems while poly-victimization and physical/sexual assault/abuse were not. CONCLUSIONS:Findings can be used to help direct resources to juvenile justice-involved youth who are most in need of treatment.

The majority of individuals working with justice-involved youth receive limited training addressing the impact of childhood trauma. There is a need for trauma-related training for staff, as well as valid measures to evaluate the effectiveness of training. The National Child Traumatic Stress Network designed a training curriculum, Think Trauma, which educates staff about the impact of trauma on justice-involved youth. A 45-item Think Trauma Evaluation Questionnaire (TTEQ) was developed to assess participants' changes in knowledge and attitudes. This article examines the factor structure and internal consistency of this questionnaire. Two-hundred and ninety-six employees at two secure juvenile detention centers completed the TTEQ. The results suggest that the questionnaire is feasible to administer to a large group and has a factor structure corresponding to areas covered in the curriculum. A reliable and valid measure of trauma knowledge and attitudes is important to identifying the training needs for a particular facility

Although positive youth development (PYD) is increasingly influential in the field of youth programming, core knowledge and competencies for youth workers continue to be defined. Youth serving agencies throughout the United States face serious obstacles in the creation of a stable and well-trained workforce, despite the presence of many talented and resourceful individuals who work with youth in the community. One strategy for organizational and staff development is through PYD-oriented, community-based partnerships designed to enhance youth worker knowledge and competence. Two different partnerships are described in this report. The first brought together experts in youth work, health, and trauma, and focused on improving youth worker response to psychologic trauma commonly experienced by urban youth. This partnership used an iterative reflective practice approach to describe best practices in youth work. The second partnership strategically taught evaluation skills to youth program consumers, AmeriCorps service members, and adult youth workers to advance youth-adult partnerships. These exemplars demonstrate that partnerships can drive systems for improving competencies in youth workers and the capacities of youth services

This article presents the process used to develop a set of statewide positive youth development (YD) outcome indicators to complement existing adolescent well-being indicators in New York State (NYS). Intended uses included program and community-, county-, and state-level planning; grant writing; evaluation; and outcome monitoring in coordination with national YD-oriented initiatives. A common set of metrics, if adopted, would promote consistency and information sharing across levels and purposes. A workgroup of the NYS Youth Development Team reviewed existing indicators and accepted nominations from NYS stakeholders. Input from Youth Development Team members and national YD experts was used to narrow the list to 91. Forty-one NYS policy makers performed card sorts and ratings of the indicators, and a concept-mapping process, employing hierarchical cluster analysis, identified nine clusters of items. The policy makers, along with 121 NYS program providers and 91 young adults (aged 18-21) rated the indicators from 1 ('not important') to 5 ('very important'). All intergroup correlations of ratings were 0.93 or greater, and therefore responses were analyzed together. The concept map and mean indicator ratings were used to select a short list of 15 indicators. Although respondents were intentionally given a mix of problem-focused, risk-focused, and strength-based items, the highest rated items were almost exclusively strength based

Community-based partnerships (CBPs) focused on youth development (YD) have the potential to improve public health outcomes. These partnerships also present opportunities for the design and implementation of innovative, community-level change strategies, which ultimately may result in new capacities for positive YD. Evaluation-driven learning and improvement frameworks facilitate the achievement of these partnership-related benefits. Partnerships are complex because they embody multiple levels of intervention (eg, youth-serving programs, youth participation as partners or evaluators, network development for collaborative projects and resource sharing, YD-oriented organizational or community policy change). This inherent complexity transfers to evaluations of CBPs. This article provides resources for meeting evaluation-related challenges. It includes a framework for articulating relevant evaluation questions for YD-oriented CBPs, a summary of relevant types of evaluation studies, and practical solutions to common evaluation problems using targeted evaluation studies. Concrete examples of relevant, small-scale evaluation studies are provided throughout

This article describes an intake questionnaire (Adquest) that was designed, tested, and implemented, and later employed in clinical data-mining studies, by practitioners in an adolescent mental health program. The instrument is primarily a practice-based, clinical information-gathering and client engagement device. Consequently, it differs in significant ways from more research-driven Rapid Assessment Instruments (RAIs). Despite these differences, when aggregated and analyzed, Adquest data provides valuable psychosocial information about hundreds of vulnerable urban youth seeking mental health services