Evaluating RNR-Based Targeted Treatment and Intervention Dosage in the Context of Traumatic Exposure

AuthorMichael T. Baglivio,Haley Zettler,Jessica M. Craig,Kevin T. Wolff
DOI10.1177/1541204020988575
Published date01 July 2021
Date01 July 2021
Subject MatterArticles
Article
Evaluating RNR-Based
Targeted Treatment and
Intervention Dosage in the
Context of Traumatic Exposure
Michael T. Baglivio
1,2
, Haley Zettler
3
, Jessica M. Craig
3
,
and Kevin T. Wolff
4
Abstract
Best practices in juvenile justice call for the individualized matching of services to assessed dynamic
risk factors, with services delivered at sufficient dosage. However, prior work has largely ignored
whether this recipe for recidivism reduction is as effective for adolescents with extensive traumatic
exposure as it is for those without. The current study leverages a statewide sample of 1,666 juveniles
released from residential placement (84.6% male, 59.8% Black, 11.9% Hispanic). We examine the
associations of individual-level service matching and achieving dosage targets established by Lipsey’s
Standardized Program Evaluation Protocol (SPEP) during residential placement with changes in
dynamic risk during placement and recidivism post-release among juveniles with extensive adverse
childhood experiences (ACE) exposure and those without. Results demonstrate heightened trau-
matic exposure is related to smaller reductions in dynamic risk and to an increased probability of
reoffending, but that youth receiving matched services coupled with adequate dosage leads to
greater treatment progress (dynamic risk reduction) and lower recidivism post-release for both
low-ACE and high-ACE youth. Implications for juvenile justice practice and policy are discussed.
Keywords
juvenile offending, risk-need-responsivity model, treatment dosage, adverse childhood experiences,
dynamic risk changes
Current best practice for juvenile justice systems relies on leveraging structured decision-making
tools such as locally-validated risk assessment, a disposition matrix to guide placement decisions,
and standardized methods to evaluate services (Howell et al., 2014). Such data-driven systems posit
1
Youth Opportunity Investments, LLC, St. Petersburg, FL, USA
2
Department of Criminology, University of South Florida, Tampa, FL, USA
3
University of North Texas, Denton, TX, USA
4
John Jay College of Criminal Justice, New York, NY, USA
Corresponding Author:
Michael T. Baglivio, Youth Opportunity Investments, LLC, 701 94th Ave N., Suite 100, St. Petersburg, FL 33702, USA;
Department of Criminology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL 33620, USA.
Email: baglivio@youthopportunity.com
Youth Violence and JuvenileJustice
2021, Vol. 19(3) 251-276
ªThe Author(s) 2021
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DOI: 10.1177/1541204020988575
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success is to be achieved by ensuring graduated sanctions, from preventi on through residential
placement and aftercare, which are properly resourced where only the highest risk youth are placed
in residential programs, and only after community-based alternatives have been exhausted (Bagli-
vio, Greenwald, & Russell, 2014; Howell, 2003; Wilson & Howell, 1993). An additional predomi-
nant feature includes adherence to the Risk-Need-Responsivity (RNR) paradigm where intervention
services should target individualized (based on assessment) dynamic, changeable risk factors
(Andrews & Bonta, 2003, 2010), and that such targeted treatment should be provided with fidelity
and at optimal dosages (Lipsey, 2009).
Yet, what remains unaddressed is whether this recipe for recidivism reduction works as well for
those adolescents with extensive traumatic exposure histories. The current study examines whether
receiving matched services and optimal treatment dosages during juvenile justice residential place-
ments is as advan tageous for red uctions in dynamic risk during place ment, as well as r eductions in
subsequent reoffending post-release for juveniles with heightened traumatic exposure as it is for those
without such traumahistories. These research questionsare premised on the heightened prevalenceof
traumaticexposure among juvenile offenders relativeto the general population (e.g.,Dierkhising et al.,
2013), and that most, if not all of the RNR espoused major risk factors for offending have been
empirically linked to traumatic exposure (Fritzon et al., 2020). The prevalence of trauma and experi-
encing multipletraumatic exposures and the associations of traumaticexposure with those risk factors
targeted through intervention and treatment through the RNR framework necessitate examination of
whether these current best practice standards aimed specifically to reduce offending serve youth
exposed to significant trauma as well as they serve those with no or little childhood adversity.
Adverse Childhood Experiences (ACE) and Offending
The maltreatment-offending relationship has long been documented (e.g., Widom, 1989), as is the
notion of increased traumatic exposure among youth involved in the juvenile justice system, who are
13 times less likely to report no traumatic exposures and four times more likely to report exposure to
four or more types of trauma (Baglivio, Epps et al., 2014; see also Abram et al., 2004; Dierkhising
et al., 2013). Even more policy-relevant is the increased exposure among youth penetrating deeper
into the justice system, such as those placed in residential facilities (Cannon et al., 2016; Trulson
et al., 2016; Vitopoulos et al., 2018). While some scholars focus on exposure to specific traumatic
events such as child physical abuse or neglect, an approach that has recently grown in popularity is
the focus on an accumulation of traumatic events. The most commonly used paradigm is the Adverse
Childhood Experiences (ACEs), a set of early childhood events that were initially identified by
Felitti and his colleagues (1998). While the first ACE conceptualization included seven traumatic
experiences, a later iteration expanded it to 10, namely emotional abuse, physical abuse, sexual
abuse, emotional neglect, physical neglect, violent treatment toward mother, household substance
abuse, household mental illness, parental separation/divorce, and having a household member with a
history of incarceration (Anda et al., 2010). Initial public health studies utilized retrospective data
and found those with a higher ACE exposure were more likely to experience negative health out-
comes later in life, such as cancer, lung disease, and early morbidity relative to those with fewer
traumatic exposures (Anda et al., 2010; Felitti et al., 1998). Research from other disciplines have
expanded the known consequences of ACEs to include risky sexual behavior, higher rates of
unemployment, serious juvenile offending and life-course offending among others (Bellis et al.,
2013; Craig et al., 2017; Fox et al., 2015; Hillis et al., 2004).
An individual’s ACE score is calculated based upon summing the occurrence of any given ACE
which occurred at least once. No matter how frequently an individual may have experienced a
particular early traumat ic event (e.g. witnessing vio lence against their mother ), they will only
receive a “1” for that particular ACE if they were exposed to it at least once from birth to age
252 Youth Violence and Juvenile Justice 19(3)

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