Risks, Outcomes, and Evidence-Based Interventions for Girls in the US Juvenile Justice System

Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system

INTRODUCTION

Youth in the legal system are at high risk for opioid and other substance use problems and exhibit high rates of trauma exposure. Trauma-focused therapeutic approaches to prevent substance use show promise, but few evidence-based interventions are designed with justice-involved youth in mind. Consequently, implementing trauma-informed, evidence-based interventions within juvenile justice systems is challenging. The current paper describes the systematic adaptation of Trust-Based Relational Intervention (TBRI) as a family-centered substance use prevention program for youth transitioning from secure residential facilities.

METHODS

The study utilized the ADAPT-ITT methodological framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention designed to help caregivers support children and youth with histories of trauma. Phases of adaptation included (1) Assessment, (2) Decision, (3) Prototype Development, and (4) Testing and Integration. The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., youth in the legal system and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) with input from participants from the target population, key stakeholders, and content experts.

RESULTS

The systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum, TBRI Youth & Young Adult Curriculum, and TBRI Nurture Groups. The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum.

CONCLUSIONS

Utilizing a systematic methodological framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually appropriate interventions. Accounting for contextual factors and population needs can improve the fit of evidence-based interventions for youth in the legal system, facilitating uptake and ultimately improving outcomes for youth at risk for substance use problems.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04678960.

Adolescent child custody loss and substance use treatment as predictors of young adult substance use trajectories among females with foster care and juvenile justice involvement

This study aimed to identify trajectories of substance use from adolescence to young adulthood among 166 females with dual child welfare and juvenile justice system involvement, and to explore the influence of adolescent child custody status and substance use treatment on substance use trajectories. Results identified four substance use trajectory groups (stable moderate substance use, decreasing substance use, increasing substance use, stable high substance use). Custody loss during adolescence predicted membership in the stable high substance use trajectory group (log odds estimate = 2.99, p = < 0.01). No significant associations were found with adolescent substance use treatment. The findings can inform policymakers, foster care professionals, and law enforcement officers to promote the delivery of timely and appropriate substance use services that respond to the unique needs of females across the child welfare and juvenile justice system populations.

Systematic Review of Gender-Specific Child and Adolescent Mental Health Care

Gender differences in mental health emerge as early as in childhood and adolescence, highlighting the potential need for gender-specific child and adolescent mental health care. However, it is unclear how gender-specific child and adolescent mental health care is implemented and whether its' approaches are useful. Therefore, this study reviews gender-specific interventions and their effectiveness for child and adolescent mental health. Five databases were searched for articles published between 2000 and 2021. In total, 43 studies were included. Most interventions were conducted in school (n = 15) or community settings (n = 8). Substance-related disorders (n = 13) and eating disorders (n = 12) were addressed most frequently. Most interventions targeted girls (n = 31). Various gender-specific aspects were considered, including gender-specific risk and protective factors (n = 35) and needs (n = 35). Although most interventions yielded significant improvements in mental health outcomes (n = 32), only few studies reported medium or large effect sizes (n = 13). Additionally, there was a lack of strong causal evidence derived from randomized controlled trials, calling for more rigorous trials in the research field. Nevertheless, our findings indicate that gender-specific mental health care can be a promising approach to meet gender-specific mental health needs.

Criminal offense charges in women: A 10-year follow-up of an RCT of treatment foster care Oregon

OBJECTIVE

The prevention of delinquency can have long-term benefits for both the individual and society. Previous work has demonstrated positive effects of Treatment Foster Care Oregon (TFCO) on reducing delinquency across a 2-year period for adolescent females involved in the juvenile justice system. The present study examined whether the effects of TFCO are present across a 10-year period, and whether criminal offenses accrued in the juvenile justice system mediate the association between intervention condition and cumulative criminal offenses through emerging adulthood.

METHOD

The sample included 166 women (68% non-Hispanic White) who had been court mandated to out-of-home care as adolescents, randomly assigned to one of two interventions, and followed for an average of 10 years. Juvenile (< 18 years of age) and adult criminal records data were collected and coded for offense severity.

RESULTS

Analyses revealed a significant effect of the TFCO intervention on cumulative criminal offense charge severity across the 10-year follow-up period (β = -.15, p < .05). This effect was mediated by offense charges that occurred after the baseline assessment and prior to Age 18, as shown through a significant indirect effect, β = -.09, p < .05, suggesting the importance of reductions in juvenile delinquency on later criminal offending.

CONCLUSIONS

Intensive out-of-home interventions that reduce juvenile offenses for youth with chronic delinquency may have sustained effects on adult criminality. Implications for prevention programs for female adolescents are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Qualitative Study on Young Women's Lives Prior to and Four Years after Youth Detention: Examining the Good Lives Model's Aetiological Assumptions

Detained female adolescents constitute a vulnerable, challenging, and understudied minority. Interventions for DFA are still dominated by risk management approaches with less focus on strength-based approaches such as the Good Lives Model (GLM). This study explored the functionality of DFA’s behaviour prior to and four years after release from detention, using the GLM as the guiding theoretical framework. A theory-driven thematic analysis was conducted of 30 in-depth interviews with former DFA (M_age = 20.80), exploring the fulfilment of their basic human needs (e.g., relatedness, independence) before and after detention. Before detention, the young women experienced multiple problems trying to fulfil multiple human needs, often contributing to poor balance in their lives and their antisocial behaviour. Although external and internal obstacles to fulfilling human needs were still present at follow-up, important improvements were noted, e.g., in the scope of their human needs and the resources available to fulfil their needs. The findings provide additional insights into the issues experienced by young women in detention and indicate there are opportunities to assist these young women, through the development of appropriate resources and capacities which provide them with appropriate means for fulfilling their needs and moving towards a personally meaningful and prosocial life.

Gender-Based Psychosocial Differences in a Sample of Young Offenders

This study analyzes the differential psychosocial characteristics of male and female young offenders with a judicial measure from a juvenile court in Spain. Data on origin, recidivism, criminal and psychosocial characteristics of a sample of 838 juvenile offenders were collected using the Youth Level of Service/Case Management Inventory (YLS/CMI). Most of the minors were males (n = 650; 77.6%). Regarding the type of offences committed most males committed some type of crime, while females mainly committed misdemeanours. The rates of infractions committed by large groups and belonging to a gang were higher in males than in females. Concerning psychosocial variables, females presented with higher scores than males in three areas (parenting/educational guidelines, leisure and recreation, attitudes and orientation), in the total score and in several specific variables of the YLS/CMI. Moreover, having a poor relationship with one's mother and limited participation in organized activities were related to being a female minor offender, whereas having a short attention span was related to being a male offender. These three variables correctly classified 77.6% of cases. Female minor offenders present with a more severe psychosocial profile than males. Therefore, gender-based variables should be considered and addressed in prevention and intervention programmes for minors.

Moderators of Psychosocial Intervention Response for Children and Adolescents with Conduct Problems

Objective: The purpose of this Brief Report is to synthesize the current evidence base examining moderators of psychosocial intervention response for children and adolescents with conduct problems (CP). We also provide directions for future research.Method: We focused on four categories of psychosocial interventions for the prevention and/or treatment of CP: (1) parent management training (PMT) for children, (2) other family-based interventions for adolescents, (3) youth skills training, and (4) multicomponent interventions (i.e., family-based intervention plus skills training). Emphasis is placed on findings from meta-analyses.Results: Moderation analyses have occurred more frequently for PMT than for other types of interventions. Variables for which there was consistent evidence for positive moderation included higher initial severity of CP, father engagement, higher maternal depressive symptoms, individual administration (vs. group), and treatment/targeted prevention approaches (vs. universal prevention). Variables where there was evidence for no moderation (demonstrating generalizability) included child diagnostic status and family risk in PMT, and diagnostic status and intervention setting for skills training. However, for some variables, evidence of moderation was dependent on intervention type.Conclusions: Future research should examine multiple moderators in combination; incorporate innovative techniques such as integrative data analyses, individual participant data, and class-based modeling, which may identify moderator effects that are undetected by more traditional variable-oriented moderation analyses; and conduct moderated mediation models for informing developmental theory on the interplay of risk and protective factors.

Family-based Intervention for Legal System-involved Girls: A Mixed Methods Evaluation

The increased proportion of juvenile court-involved girls has spurred interest to implement and evaluate services to reduce girls' system involvement. The purpose of this study was to examine the effectiveness of a family-based intervention by using a dominant sequential mixed methods evaluation approach. First, we examined quantitative data using a quasi-experimental design to determine whether the family-based intervention reduced recidivism among court-involved girls. Propensity score matching (PSM) was used to construct statistically equivalent groups to compare one-year recidivism outcomes for girls who received the court-run family-based intervention (n = 181) to a group of girls on probation who did not receive the intervention (n = 803). Qualitative interviews (n = 39) were conducted to contextualize the quantitative findings and highlighted the circumstances that family-focused interventions for court-involved girls. Girls who received the program had slightly lower recidivism rates following the intervention. The qualitative findings contextualized the quasi-experimental results by providing an explanation as to the girls' family circumstances and insights into the mechanisms of the intervention. Results highlighted the importance of family-focused interventions for juvenile justice-involved girls. These findings have practical and policy implications for the use interventions-beyond the individual level-with adjudicated girls and offer suggestions for ways to improve their effectiveness using a community psychology lens. In addition, this paper includes a discussion of evaluating of juvenile court programming from a community psychology perspective including strengths, challenges, and considerations for future work in this area.

Adolescent Gender and Age Differences in Responsiveness to Functional Family Therapy

The current study contributes to a sparse literature on moderators of Functional Family Therapy (FFT) by examining whether responsiveness to FFT, measured by a broad range of outcomes, varies by adolescent gender, age, and their interaction. This study was informed by 687 families (n, adolescents = 581; n, caregivers = 933) and utilized a pre-post comparison design. Fixed-effects regressions with gender, age, and their interaction included as explanatory variables were conducted to calculate the average change in youth mental health, callous-unemotional traits, academic outcomes, substance use, and family functioning. Moderation analyses revealed that according to parent report, girls had significantly greater improvements in peer problems and family functioning, and boys benefited more in increased liking of school. There were differential effects by age, such that older youth had less beneficial mental health outcomes and a smaller decrease in frequency of hash use. The gender by age interaction was significant for adolescents' report of mental health and family functioning outcomes, which suggests that girls benefit from FFT less than boys during early adolescence, but benefit more than boys in late adolescence. This finding adds to literature which has evidenced that family functioning is particularly important for girls by suggesting that FFT is important for improving older girls' mental health and family functioning in particular. The study's results expand the examination of outcomes of FFT to include academic outcomes, and provide insight into key factors that should be considered in addressing adolescent behavioral problems and family functioning.

Intervention Response to the Trauma-Exposed, Justice-Involved Female Youth: A Narrative Review of Effectiveness in Reducing Recidivism

This study aims to examine current research about trauma-exposed, justice-involved (TEJI) female youth, and evaluate the current literature regarding the effectiveness of gender-specific interventions aimed at reducing their recidivism. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology was utilized to examine quantitative and qualitative literature, published from 2000 through March 2020, about interventions for female justice-involved youth with trauma exposure. Analysis of selected studies utilized an integrated framework based on Andrew’s Risk-Need-Responsivity (RNR) model and Lipsey’s factors of effectiveness, which reviewed studies showing the relationship between female justice-involved youth with mental health symptomologies and trauma. The findings show that effective intervention for this population targets the youth’s negative internal mechanisms related to trauma-subsequent psychosocial problems. These studies suggest that trauma-sensitive modalities have the potential to mitigate the further risk of problematic external behaviors. All studies had limited sample sizes, low follow-up rates, and unknown long-term outcomes. Future research should explore dimensions of sustainability and achieving stability in relation to intervention setting. Selecting the proper venue and facilitator for quality implementation and stability of setting is critical in delivering effective therapies. Modifications in public expectations of juvenile justice policy and practice, from disciplinary to therapeutic approaches, is needed.

Early Adversity and Sexual Risk in Adolescence: Externalizing Behaviors as a Mediator

Sexual risk behavior in adolescence can result in serious health consequences that persist across the lifespan, particularly for female youth. While adverse childhood experiences (ACEs) are linked to engagement in sexual risk behavior later in life, little research has examined pathways that may help explain this association. To address this gap, the present study examined whether internalizing and externalizing behaviors mediated the link between (ACEs) and sexual risk behavior in female youth. We examined data from 122 adolescent girls, ages 13-18, who were involved in the juvenile justice system or receiving social supports from local agencies and schools. Girls were asked to report their exposure to ACEs and engagement in sexual risk behavior and caregivers were asked to report on girls' internalizing and externalizing behaviors. Regression analyses indicated that girls who experienced more ACEs and exhibited more externalizing behaviors demonstrated higher rates of sexual risk. Further, externalizing behaviors partially mediated the association between ACEs and sexual risk behavior. Findings suggest that increased exposure to ACEs and higher incidence of externalizing behaviors may place girls at heightened risk for sexual risk behavior. Interventions aimed at decreasing externalizing behaviors may be particularly important in reducing sexual risk behavior among at-risk female youth.

Achieving Justice for Girls in the Juvenile Justice System

Female involvement in the juvenile justice system has steadily increased in the United States over the past three decades. During this time, as male arrests have declined, female arrests have increased. Although many social workers have responded to these trends with a national call to identify and address the unique needs of these girls, we lack much high-quality research, including empirically supported interventions or programming to serve the needs of female youths involved in the justice system. This article provides a summary of the extant research that helps document the unique needs of these female youths and national policy efforts and practice considerations for social work practitioners. These needs and policy initiatives offer important opportunities for social workers to conduct research to improve the understanding of this population and also ways in which to provide services that address these youths' complex needs. The article concludes that these female youths-most of whom are not a danger to society-need services instead of involvement in the justice system.

A Meta-Analysis of Program Characteristics for Youth with Disruptive Behavior Problems: The Moderating Role of Program Format and Youth Gender

There is high variability in efficacy for interventions for youth with disruptive behavior problems (DBP). Despite evidence of the unique correlates and critical consequences of girls' DBP, there is a dearth of research examining treatment efficacy for girls. This meta-analysis of 167 unique effect sizes from 29 studies (28,483 youth, 50% female; median age: 14) suggests that existing treatments have a medium positive effect on DBP (g = .33). For both boys and girls, the most effective interventions included (a) multimodal or group format, (b) cognitive skills or family systems interventions, and (c) length-intensive programs for (d) younger children. Boys demonstrated significantly greater treatment gains from group format interventions compared to girls, which is particularly important given that the group program format was the most prevalent format for boys and girls, with 14 studies involving 10,433 youth encompassing this category. This is the first meta-analysis to examine the effect of program characteristics in a sample of programs selected to be specifically inclusive of girls. Given that girls are underrepresented in intervention research on DBP, findings are discussed in terms of gender-responsive considerations and elucidating how key aspects of program structure can support more effective intervention outcomes for youth.

Sex differences in youth with mental health problems in inpatient, outpatient and youth justice settings

BACKGROUND

Approximately 40-70% of justice-involved youth have untreated mental health problems. There is no current research that directly compares the mental health profiles of youth involved in the justice system to that of inpatients and outpatients. The research reported is significant because it directly compares the needs of these population by use of the same suite of standardized assessment tools.

METHODS

The sample consisted of 755 youth aged 16-19 years recruited from youth justice and mental health facilities in Ontario, Canada. Participants completed semi-structured assessment interviews using the interRAI child and youth suite of instruments to assess for internalizing and externalizing concerns as well as exposure to traumatic life events.

RESULTS

Findings indicated that justice-involved youth experienced higher levels of certain types of trauma. Analyses examining sex differences indicated that, controlling for age, males in the youth justice group reported higher cumulative trauma compared to male outpatients but not inpatients. Females in the youth justice group reported experiencing higher cumulative trauma compared to female outpatients and inpatients. In addition, controlling for sex and age, the youth justice group reported lower internalizing symptoms scores than inpatients and outpatients. Finally, males in the youth justice group scored lower than inpatients in externalizing symptoms, whereas females within the youth justice group scored higher in externalizing symptoms compared to inpatients and outpatients.

CONCLUSIONS

Results indicated that youth who are involved with the justice system exhibit significant psychosocial issues that represent complex service needs which require unique interventions in order to be addressed appropriately.

Health determinants of adolescent criminalisation

Several conditions related to health and development in adolescence can increase the risk that a young person will be exposed to the criminal justice system. Such determinants include neurodevelopmental disability, poor mental health, trauma, and experiences of maltreatment. Furthermore, the risk of exposure to the criminal justice system seems to be amplified by social marginalisation and inequality, such that young people are made susceptible to criminal behaviour and criminalisation by a combination of health difficulties and social disadvantages. This Review presents evidence on the health determinants of criminalisation among adolescents, providing a persuasive case for policy and practice reform, including for investment in approaches to prevent criminalisation on the basis of health and developmental difficulties, and to better address related needs once within a criminal justice system.

A preliminary examination of substance use risk among metropolitan and non-metropolitan girls involved in the juvenile justice system

Research is limited on geographic differences in substance use risk factors among juvenile justice-involved girls. This secondary data analysis from one state juvenile justice system, collected as part of the NIH/NIDA funded JJTRIALS cooperative agreement, assessed criminogenic needs at intake for 160 girls from metropolitan and non-metropolitan counties. Although girls from different geographic areas did not differ significantly on key variables of interest, including substance use risk and related criminality variables, findings suggest that substance use risk is related to criminal history, substance-related offenses, and relationship problems among justice-involved girls. Implications include gender-specific juvenile justice programming and research.

Risk factors for antisocial behavior in children: comparison between boys and girls

Abstract Recognizing the importance of assessing the risk of antisocial behavior, this study aimed to characterize the risk factors for the occurrence of antisocial behavior, seeking to understand if there are differences between boys and girls. Eighty-five cases of children referred by the promotion and protection system due to the display of antisocial behaviors were reviewed. A total of 65 were boys and 20 were girls, aged between six and eleven years. Data collection was performed using the Portuguese version of the risk assessment instruments Early Assessment Risk List for boys and for girls. Gender differences were assessed, with boys exhibiting a higher risk level for antisocial behavior, adopting more serious behaviors (e.g., impulsive behaviors). Girls engaged in less serious behavior (e.g., disrespect). By characterizing the most prevalent risk factors, the results of this study may contribute to the identification of intervention priorities.

A tailored cognitive behavioral program for juvenile justice-referred females at risk of substance use and delinquency: A pilot quasi-experimental trial

This pilot quasi-experimental trial tested a gender-responsive cognitive behavioral group intervention with 87 court-involved female adolescents (5 juvenile courts) who were at indicated risk for substance use disorder. Participants in the intervention (n = 57) received twice weekly group sessions for 10 weeks (20 sessions) focused on building emotional, thought and behavior regulation skills and generalizing these skills to relationally-based scenarios (GOAL: Girls Only Active Learning). Youth in the control condition (n = 30) received services as usual, which included non-gender-specific aggression management training, individual counseling and no services. The GOAL program was found to be acceptable to youth and parents and feasible to implement within a juvenile court setting using skilled facilitators. Compared to services as usual, the program significantly and meaningfully reduced self-reported delinquent behavior (β = 0.84, p < 0.05) over 6 months, and exhibited trend level effects for reduced substance use (β = 0.40, p = 0.07). The program had mixed or no effects on family conflict and emotion regulation skills. These findings are discussed in light of treatment mechanisms and gender-responsive services.

Adolescent Females with Limited Delinquency: A Follow-Up on Educational Attainment and Recidivism

Background

Research has established a strong relationship between education and later life outcomes, where the connection between different school problems and delinquency have been widely acknowledged. These studies have often sampled male juvenile offenders exhibiting extensive and/or persistent delinquency. Less is known about the educational attainment of female juvenile offenders, especially those who display limited delinquency. In a previous study (Azad and Ginner Hau in Child Youth Serv Rev 95:384–396, 2018), the characteristics of this particular group of offenders were explored where the results showed limited self-reported delinquency but elevated school problems.

Objective

The present aim was to conduct a follow-up study of the same sample of female adolescents, in order to study their educational attainment during adolescence and the rate of recidivism within 24 months after being sentenced through registry data.

Method

The sample consisted of adolescent females (N = 144) who were convicted of a crime and sentenced to youth service between 2007 and 2012 in Stockholm, Sweden.

Results

The results showed that the majority of the females did not reoffend within 2 years after being sentenced. They did, however, display high educational deficits. Their grade point average at the end of both compulsory education and upper secondary school was much lower than that of young females in general, and the majority had either dropped out, never begun or received zero in all subjects at the end of upper secondary school.

Conclusions

The low school results indicate a need to support young delinquent females’ educational attainment in order to improve their overall life chances.

#freemind: Young Women Using Mindfulness Meditation to Cope with Life in a Juvenile Justice Institution

The purpose of this study was to introduce mindfulness meditation, a recommended adjunctive treatment for trauma in juvenile justice-involved youth, to incarcerated young women and collect narrative commentary about their experiences to answer the following research questions: What is the experience of incarcerated young women who participate in Internet-based mindfulness meditation classes? How do incarcerated young women apply mindfulness meditation to life in a juvenile justice facility? Participants attended bi-weekly guided meditation sessions and wrote about their experiences after each session in a journal. Three coders used open-coding content analysis to identify topics and themes across 38 journal entries. The primary theme, found in 61% of entries, described the difficulties of living in a juvenile justice facility, providing context for the descriptions found in 58% of entries regarding the usefulness of mindfulness meditation to cope with those difficulties. This study highlights the challenges of living in a correctional institution as a young woman and the barriers such settings pose to the wellbeing and healthy development of their residents. It also points to mindfulness meditation as an operative method of supporting these highly traumatized young women until that time when alternatives to incarceration can be identified.

A Step Toward a Better Understanding of the Relationship Between Victimization and Emotional Distress: Indirect Effect of Adult Attachment and Interaction With Household Dysfunction

A history of victimization has been linked to the latter development of emotional distress. However, not all victims develop emotional distress in response to victimization, emphasizing the need to identify mediators that can guide intervention, as well as moderators to more targeted preventive actions. Within a developmental psychology framework, we aimed to test two models: (a) the role of adult attachment as a mediator in the relationship between victimization and emotional distress, and (b) the role of household dysfunctions as moderators in the relationship between victimization and emotional distress, in psychiatric patients. Participants were 120 adult psychiatric patients, between ages 20 and 79 years (M = -47.22, SD = 13.102) that responded to questions assessing household dysfunction in the family of origin, victimization, and adult attachment. Results revealed that adult attachment was a significant mediator in the association between victimization and emotional distress. Parental mental disorder and total household adversity were significant moderators for that same association. These results provide important clues for intervention. The focus on promoting secure adult relationships may contribute not only to the psychosocial adjustment of psychiatric patients but also to a healthier family functioning. Reducing the household dysfunction may provide a protective environment for the development of children, promoting a positive psychosocial adjustment, also preventing the intergenerational transmission of violence, insecure attachment, and emotional distress.

A Longitudinal Examination of Service Utilization and Trauma Symptoms among Young Women with Prior Foster Care and Juvenile Justice System Involvement

We investigated the prediction of young adult service utilization and trauma symptoms from adverse childhood experiences (ACEs) and adolescent mental health symptoms in young women with dual child welfare and juvenile justice system involvement. A sample of 166 females (ages 13 to 17) was followed to examine the transition to young adulthood. Path models indicated that more ACEs were associated with poorer adolescent mental health. Adolescent mental health symptoms were associated with more young adult trauma symptoms and service utilization. Implications for service providers and policy-makers are discussed.

Risk-Need Profiles of Serious and Chronic Female Juvenile Offenders: Implications for Female Juvenile Correctional Programming

Understanding differences and similarities between male and female juvenile offenders is critically important for determining the treatment needs of each group. Less is known, however, about the similarities and differences among female juvenile offenders and the variation in their needs, risks, and psychosocial profiles. Understanding the variation among female juvenile offenders could lead to improvements in gender-responsive interventions and treatment. Latent profile analysis was conducted to construct risk-need profiles in a state-based sample of incarcerated girls ( N = 203) based on a range of psychosocial subscales covering family, peer, school and cognitive and emotional processes, psychopathology, and antisocial outcomes. Findings revealed four distinct groups/profiles with varying levels of risk-needs- Aggression Only (51%), Alcohol and Drug Use (19%), Socioemotional and Family Relationship Problems (24%), and Severe Alcohol and Drug Use (6%)-warranting the need for varying levels of treatment intensity and different treatment components across subgroups, ranging from less to more extensive.

Multidimensional Family Therapy Reduces Self-Reported Criminality Among Adolescents With a Cannabis Use Disorder

Multidimensional family therapy (MDFT) is an established treatment program for youth displaying multiproblem behavior. We examined whether MDFT decreased criminal offending among cannabis abusing adolescents, as compared with individual psychotherapy (IP). In a Western European randomized controlled trial comparing MDFT with IP, a sample of 169 adolescents with a cannabis disorder completed self-reports on criminal offending. Half indicated they had committed one or more criminal offenses in the 90 days before the baseline assessment. Follow-up assessments were at 6 and 12 months after randomization. The proportion of adolescents reporting nondelinquency increased during the study period, most so in the MDFT condition. In addition, MDFT lowered the number of violent offenses more than IP. This difference was not seen for property crimes. In cannabis abusing adolescents, MDFT is an effective treatment to prevent and reduce criminal offending. MDFT outperforms IP for violent crimes.

Polyvictimization in childhood and its adverse impacts across the lifespan: Introduction to the special issue

Although much empirical work has focused on the adverse impact of specific types of childhood victimization (e.g., sexual, physical, or emotional abuse), researchers and clinicians increasingly are recognizing the prevalence of polyvictimization, or exposure to multiple types of victimization. Polyvictimization during formative developmental periods may have detrimental and potentially lifelong biopsychosocial impacts over and above the effects of exposure to specific types of adversity. In this guest editorial, we summarize the key questions and findings for six empirical studies on polyvictimization included in this Special Issue of the Journal of Trauma & Dissociation. These empirical studies further our understanding of the nature, consequences, and assessment of polyvictimization. We conclude with recommendations for continued scientific research and clinical inquiry on polyvictimization.

Pathways to Preventing Substance Use Among Youth in Foster Care

Substance use problems are highly prevalent among youth in foster care. Such problems in adolescence have long-lasting implications for subsequent adjustment throughout adulthood and even across generations. Although several programs have demonstrated positive results in reducing substance use in at-risk youth, few studies have systemically examined how such programs work for foster youth and whether they are effective for both genders. This study examined the efficacy of KEEP SAFE, a family-based and skill-focused program designed to prevent substance use and other related health risking behaviors among youth in foster care. We hypothesized that improving the caregiver-youth relationship would lead to later reductions in youths' involvement with deviant peers, which subsequently would lead to less substance use, and that this mechanism would work comparably for both genders. A sample of 259 youth (154 girls, ages 11-17 years) in foster care and their caregivers participated in a randomized controlled trial and was followed for 18 months post-baseline. Results indicated that the intervention significantly reduced substance use in foster youth at 18 months post-baseline and that the intervention influenced substance use through two processes: youths' improved quality of relationships with caregivers at 6 months post-baseline and fewer associations with deviant peers at 12 months post-baseline. This suggests that these two processes may be fruitful immediate targets in substance use prevention programs for foster youth. We also found little gender differences in direct and mediating effects of the intervention, suggesting KEEP SAFE may be effective for both genders in foster care.

Incorporating positive youth development into the therapeutic model for incarcerated young woman

Young women in the juvenile justice system have high rates of prior physical and sexual abuse, substance use and psychiatric disorders. Understandably services usually are based on a therapeutic model to address those needs. Positive Youth Development (PYD) is a complementary alternative format that aims to provide resilience, life competencies, and self efficacy for pro-social actions. We provide a narrative review of PYD programs with a focus on how those relate to youth in closed custody. Sleep and physical activity are two behaviors where incarcerated young women still have personal agency, and we present the additional relevance of those program aspects. We describe methods and findings from a feasibility trial of an existing evidence-based, peer-led program for young women high school athletes used with incarcerated young women. Findings are placed in the context of established models of behavior change. The program was feasible and acceptable, and in this small trial, results demonstrate the format's potential efficacy. PYD may provide a trajectory of success and assets that could durably assist these young women following incarceration.

Polyvictimization and Girls' Involvement in the Juvenile Justice System: Investigating Gender-Differentiated Patterns of Risk, Recidivism, and Resilience

A recent dramatic rise in girls' arrests has increased our need to examine whether our models of youth justice system involvement need to be differentiated by gender. Polyvictimization, in particular, has been implicated as a powerful predictor of youth problem behavior. However, recent research suggests that polyvictimization is associated with youth involvement in the justice system in ways that differ for girls at the levels of the independent variables (i.e., the sources of risk), the dependent variables (i.e., youth outcomes), and the mediators of these associations (i.e., the purported mechanisms that account for these relations). The present critique describes growth points in the current research with the goal of suggesting promising directions for future investigations. In particular, gaps are noted regarding our understanding of the specific forms of polyvictimization that affect traumatized girls' development, especially given the highly disproportionate prevalence of sexual abuse among justice-involved girls. In addition, increased attention is needed to gender differences in the timing of victimization and the onset of risky behavior, as well as the nature of trauma-linked youth offenses and recidivism, which research also suggests may differ for boys and girls. Furthermore, a new body of research on psychophysiological reactivity promises to shed light on gender differences in trauma response, resilience, and risk. Finally, the importance acknowledging the intersection of polyvictimization, gender, and race is noted. The article ends with a discussion of the ways in which understanding gender differences and similarities can inform gender-responsive approaches to prevention and intervention efforts.

Treating Youths in the Juvenile Justice System

Adolescents involved with the juvenile justice system have higher rates of risky sexual behaviors, resulting in high rates of sexually transmitted infections and increased risk of human immunodeficiency virus, early or complicated pregnancy, and parenting issues. Comorbid substance abuse, gang association, mental health issues, and history of having been abused as children result in further elevated rates. Girls and lesbian, gay, bisexual, and transgender youths represent growing subpopulations with special risks. Increasingly diverted to community-based alternatives, juvenile justice-involved teens obtain most of their medical care from community providers, who need to understand their risks to provide appropriate, optimal care.

Understanding the Influence of Mental Health Diagnosis and Gender on Placement Decisions for Justice-Involved Youth

Justice-involved youth have high rates of psychiatric diagnoses, and these youth are often placed out-of-home, although evidence identifies several negative implications of juvenile confinement, especially for youth with psychopathology. Furthermore, youth in the justice system may be processed differently based on gender. As males and females tend to manifest symptoms differently, the psychopathology of youth may act to moderate the relationship between gender and placement in the juvenile justice system. The present study used a large, diverse sample (n = 9 851, 19.8 % female) to examine whether youth placed in various types of out-of-home facilities differed in terms of externalizing, internalizing, substance use, or comorbid disorders, and to determine the predictive value of mental health diagnoses in placement decisions. The moderation effect of psychopathology and substance use on the relationship between gender and placement also was explored. The results indicated that each type of disorder differed across placements, with internalizing being most prevalent in non-secure, and externalizing, comorbid, and substance use being most prevalent in secure settings. Mental health diagnoses improved the prediction of placement in each out-of-home placement beyond legal and demographic factors such that externalizing and substance use disorders decreased the likelihood of placement in non-secure settings, and internalizing, externalizing, and substance use disorders increased the likelihood of placement in secure and state-secure facilities. The relationship between internalizing pathology and placement in more secure facilities was moderated by externalizing pathology. The relationship between gender and placement was significantly moderated by mental health such that females with mental health diagnoses receive less secure placements. Implications for policymakers and practitioners are discussed, as well as implications for reforming juvenile justice within a developmental approach.