Addressing Trauma via Juvenile Probation Officer’s Treatment Planning

Addressing Trauma via Juvenile Probation Officer’s Treatment Planning

Juvenile Probation Officers recognize trauma exposure and posttraumatic stress symptom information, but do not prioritize such information as a rehabilitation target during the case planning process. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.

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Featured Article | Law and Human Behavior | 2018, Vol. 42, No. 4, 369-384

Juvenile Probation Officers’ Evaluation of Traumatic Event Exposures and Traumatic Stress Symptoms as Responsivity Factors in Risk Assessment and Case Planning

Authors

Evan D. Holloway Fordham University
Keith R. Cruise Fordham University
Samantha L. Morin Fordham University
Holly Kaufman Fordham University
Richard D. Steele Pennsylvania Juvenile Court Judges’ Commission (JCJC), Harrisburg, Pennsylvania

Abstract

Juvenile probation officers (JPOs) are increasingly using risk/needs assessments to evaluate delinquency risk, identify criminogenic needs and specific responsivity factors, and use this information in case planning. Justice-involved youth are exposed to traumatic events and experience traumatic stress symptoms at a high rate; such information warrants attention during the case planning process. The extent to which JPOs identify specific responsivity factors, in general, and trauma history, specifically, when scoring risk/need assessments is understudied. In the current study, 147 JPOs reviewed case vignettes that varied by the adolescents’ gender (male vs. female), traumatic event exposure (present vs. absent), and traumatic stress symptoms (present vs. absent), and then scored the YLS/CMI and developed case plans based on that information. JPOs who received a vignette that included trauma information identified a higher number of trauma-specific responsivity factors on the YLS/CMI. Despite an overall high needs match ratio (57.2%), few JPOs prioritized trauma as a target on case plans. The findings underscore the importance of incorporating trauma screening into risk/needs assessment and case planning.

Keywords

juvenile justice, responsivity, risk assessment, RNR, trauma

Summary of the Research

“Approximately 1.5 million youth under the age of 18 are arrested each year. Regardless of whether they are detained or released, the most common disposition in the juvenile justice system is supervised probation in the community. Whether immediately
following disposition or post release from an out-of-home placement, many justice-involved youth are supervised by juvenile probation officers (JPOs) in the community. JPOs develop individualized case plans that guide specific case management and supervision strategies as well as service referrals. Increasingly, case plans are developed based on the results of structured risk assessment tools that facilitate identification of criminogenic needs (e.g., educational difficulties, unstructured leisure time) or impaired functioning (e.g., adverse living conditions, mental health problems)” (p. 369).

“Case planning should also account for current mental health symptoms given converging evidence of the elevated prevalence of mental health disorders among justice-involved youth. Often, justice-involved youth are screened for mental health concerns at probation intake and screening results inform referrals for subsequent mental health services. Researchers have begun to examine how JPOs analyze and translate results of risk assessment and mental health screening information into case plans and pre-dispositional reports. The focus of this research has been to identify how JPOs consider criminogenic needs when making case planning decisions; however, less attention has been paid to how JPO case plan decision making is affected by responsivity factors (e.g., learning styles, mental health symptoms). Thus, the aims of the current study were to examine how justice-involved youths’ histories of traumatic event exposure (TEE) and current traumatic stress symptoms (TSS) impacted JPO scoring of a risk assessment tool and whether such information was incorporated into case plans” (p. 369).

The specific intentions of the current study were to “(a) examine whether information about TEE and TSS impacted JPO scoring of the YLS/CMI, (b) identify whether the presence of TEE and TSS affected summary risk ratings on the YLS/CMI, (c) identify whether the presence of TEE and TSS affected the number of criminogenic needs and trauma-based specific responsivity ratings on the YLS/CMI, and (d) examine how often JPOs considered TEE and TSS as a relevant target on case plans. These aims were addressed through a field-based study utilizing a large sample of JPOs who have received extensive training in scoring the YLS/CMI and using risk/needs assessment results to develop case plans. Mirroring the process employed in the participants’ annual booster training, a vignette was developed that manipulated the presence of TEE and TSS to examine the impact of this information on YLS/CMI scoring and case plan development” (p. 379).

“Results were mixed regarding the impact of TEE and TSS on YLS/CMI scoring and case plans. First, there were no differences in overall risk rating between participants who received a vignette describing TEE or TSS and those who received a vignette with no
mention of trauma. Similarly, the number of high-risk needs identified on the YLS/CMI did not differ by vignette type. Second, JPOs who received a vignette describing a youth with TEE or TSS scored more trauma-relevant YLS/CMI responsivity factors. Therefore, JPOs correctly scored trauma-related information from the vignette on the corresponding section of the YLS/CMI. Although JPOs identified trauma-specific responsivity factors on the YLS/CMI, only three JPOs specifically targeted this information on the case plan. Likewise, JPOs who received a vignette with trauma information were not more likely to make a recommendation for further mental health evaluation or treatment” (p. 379).

Translating Research into Practice

“The presence of TEE and TSS did not result in elevated YLS/CMI risk scores. Although contrary to the hypothesis, this null result is in fact a positive indicator that information about history of traumatic events and specific trauma reactions do not bias ratings of criminogenic needs or inflate the overall risk level” (p. 380).

“TEE and TSS did not affect the number of high-risk needs documented on the YLS/CMI, the number of those needs targeted on the case plan, or the needs-match ratio. This finding is consistent with research demonstrating that TEE and TSS are associated with factors that interact or are related to criminogenic needs, but are not viewed as criminogenic needs on their own. The presence of TEE or TSS could have impacted the scoring of individual items comprising YLS/CMI domains…This finding has both positive and negative implications for case planning. On a positive note, the presence of TEE or TSS did not bias scoring of needs or inflate overall decisions about risk. However, when these same needs were elevated in the presence of TEE or TSS, the overall case plan results suggested that JPOs may be less likely to consider trauma as a
driver of such behaviors and not consider to what extent these needs could be addressed through trauma-specific or trauma informed interventions” (p. 380).

“The RNR model clearly delineates the relevance of specific responsivity factors when developing overall rehabilitation plans. Despite extensive training on the YLS/CMI and case planning, the fact that 30% of participants scored no specific responsivity factors suggests the need for additional training on the responsivity principle” (p. 380).

“JPOs very rarely targeted TEE or TSS for intervention on case plans; only three case plans specifically targeted trauma…This is a particularly troubling finding given the high rate of TEE and PTSD diagnoses among justice-involved youth” (p. 381).

“Just under half of the case plans included a recommendation for mental health services (counseling, therapy, or an evaluation), indicating that a number of JPOs recognized the importance of mental health services for the youth described in the vignette. However, JPOs in the TEE+ and TSS+ conditions were no more likely to recommend a general mental health evaluation or services, which indicates that the presence of trauma information did not result in a greater likelihood of mental health referrals” (p. 381).

“These findings suggest that youth under probation supervision who have a history of TEE, or are currently experiencing TSS, are unlikely to be referred or connected to trauma-specific services by their JPO. Given that youth rarely seek care on their own, such youth are unlikely to receive the potential benefits of trauma-specific assessment or treatment unless JPOs are able to identify trauma and develop case plans that support such referrals. These findings are generally consistent with previous research findings that JPOs are better able to identify externalizing symptoms (e.g., aggressive or delinquent behavior) than internalizing symptoms (e.g., sleep difficulties, negative mood, or PTSD). About 50% of JPOs included general mental health referrals in their case plans. This is a generally positive finding if it can be assumed that clinicians receiving that referral will accurately identify the specific mental health problems contributing to delinquent behavior. However, a generic mental health recommendation, in the presence of specific information about trauma-related symptoms, provides little guarantee that these symptoms will either be further evaluated or effectively treated. The purpose of rating responsivity factors on the YLS/CMI is to ensure that case planning and service referrals are properly informed and targeted. Thus, the fact that almost 30% of the current sample did not utilize the responsivity section of the YLS/CMI indicates that JPOs prioritize criminogenic needs over responsivity factors in case planning” (p. 381).

“Taken together, these findings suggest that JPOs may feel more comfortable deferring to clinicians to confirm a diagnosis and provide guidance as to how mental health information in general, and trauma information in particular, should guide case management practices. However, the relative lack of case plan strategies specifically targeting trauma in the presence of TEE and TSS is problematic; youth with this history will not be identified for further trauma screening and assessment, which represents a missed opportunity to link trauma-exposed youth to appropriate treatment services. This finding also has implications for JPOs’ role as gateway providers to mental health care among justice-involved youth with mental health concerns. For example, a recent study found that when justice-involved youth who screened positive for mental health concerns in juvenile detention were connected to mental health care, clients and their caregivers perceived their JPO as playing a gatekeeper role in their connection to care. Additionally,
recent findings suggest that receipt of mental health treatment is associated with addressing more criminogenic needs, and when case plans addressed both areas, recidivism rates were lower compared with youth with only one or neither area addressed. These findings underscore the importance of identifying and targeting mental health-based specific responsivity factors on case plans and connecting youth to appropriately matched services” (p. 381).

Other Interesting Tidbits for Researchers and Clinicians

“Future research should examine how JPOs consider the relevance of mental health-related specific responsivity factors. It is possible that JPO orientation, whether JPOs see their role as being more aligned with law enforcement or rehabilitation efforts, impacts identification of mental health difficulties and prioritizing this information on case plans. Regardless of orientation, evidence suggests that JPOs who do not feel competent to address mental health concerns with youth on their caseload may be less likely to use strategies associated with treatment” (p. 381).

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