Trauma-Informed Interventions for At-Risk and Justice-Involved Youth: A Meta-Analysis

• Author: Ajima Olaghere,Catherine S. Kimbrell,David B. Wilson
• Date: 01 September 2021
• DOI: 10.1177/00938548211003117
• Published date: 01 September 2021
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2021, Vol. 48, No. 9, September 2021, 1261 –1277.

DOI: https://doi.org/10.1177/00938548211003117

Article reuse guidelines: sagepub.com/journals-permissions

© 2021 International Association for Correctional and Forensic Psychology

1261

TRAUMA-INFORMED INTERVENTIONS FOR

AT-RISK AND JUSTICE-INVOLVED YOUTH

A Meta-Analysis

AJIMA OLAGHERE

Temple University

DAVID B. WILSON

CATHERINE S. KIMBRELL

George Mason University

The impact of trauma on children and youth has potentially serious and long-lasting negative consequences, including

increased involvement in the juvenile and criminal justice systems. The objective of this study was to meta-analyze research

on the effectiveness of trauma-informed treatment programs for justice-involved youth and youth at risk of justice system

involvement who have experienced some form of trauma. Our systematic search identified 29 publications that met our eli-

gibility criteria and represent 30 treatment–comparison contrasts. Six of these evaluated the effectiveness of trauma-informed

programs for justice-involved youth, and the remaining 24 evaluated programs for at-risk children and youth. The findings

suggest that cognitive-behavioral therapy (CBT), including trauma-focused CBT, is effective. In addition, there was weak

evidence suggesting that programs that used a cognitive restructuring component or had the participant create a trauma nar-

rative were slightly more effective than programs without these features. Additional high-quality randomized controlled trials

are needed.

Keywords: delinquency; youth; juvenile justice; antisocial behavior; trauma; treatment

INTRODUCTION

Research literature has established trauma and later delinquency is linked (Dodge et al.,

1990; Ford et al., 2014, 2016; Ford & Hawke, 2012; Hubbard & Pratt, 2002). Untreated

trauma exposure may result in poor decision-making and persist into young adulthood,

thwarting positive youth development (Coates & Gaensbauer, 2009; Cohen et al., 2000;

Conradi & Wilson, 2010). Untreated trauma can also result in maladaptive coping mecha-

nisms, such as substance misuse (Cohen et al., 2003; Cohen & Mannarino, 2008) and other

delinquency-related outcomes, increasing the odds of formal justice system contact (Ford &

AUTHORS’ NOTE: We have no known conflict of interest to disclose. We received funding from Grant 2016-

MU-MU-0065 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice

Programs, U.S. Department of Justice. Correspondence concerning this article should be addressed to Ajima

Olaghere, Temple University, 1115 Polett Walk, 5th Floor Gladfelter Hall, Philadelphia, PA 19122, USA;

e-mail: aolaghere@temple.edu.

1003117CJBXXX10.1177/00938548211003117Criminal Justice and BehaviorOlaghere et al. / TRAUMA-INFORMED INTERVENTIONS FOR YOUTH

research-article2021

1262 CRIMINAL JUSTICE AND BEHAVIOR

Hawke, 2012; Ford et al., 2014, 2016). It follows that justice-involved youth with untreated

trauma may be at risk of recidivism. In addition, children and youth with untreated trauma

may be at risk of eventual justice system involvement. The current study assesses which

trauma-informed treatments and techniques are likely to best serve the continuum of at-risk

and justice-involved youth.

PRIOR REVIEWS ON TREATMENT EFFICACY

Numerous systematic reviews and meta-analyses have examined the effectiveness of

treatments for children, adolescents, and adults who have trauma histories. Most of these

reviews focus on post-traumatic stress disorder (PTSD) symptomatology, depression, and

anxiety. Few reviews focused on justice-involved youth and were neither systematic nor

meta-analyses (see Chesney-Lind et al., 2008; Cohen et al., 2000; Conradi & Wilson,

2010; Ford et al., 2016; Heckman et al., 2007). While Ford et al. (2016) focused on jus-

tice-involved youth, they did not arrive at any conclusion regarding the effectiveness of

trauma-focused treatments, simply noting the importance of assessing the various compo-

nents of trauma interventions and of reaching youth before their involvement with the

justice system. Similarly, Chesney-Lind et al. (2008) reviewed a modest sample of evalu-

ations for at-risk and justice-involved female populations, highlighting the limited iden-

tification of effective treatments that address the variety of needs for young girls at risk

of contact and currently involved with the juvenile justice system. Heckman et al. (2007)

reviewed eight studies of trauma treatments for PTSD in correctional settings, three of

which involved male youth only. The authors did not draw any firm conclusions about the

benefits of these treatments. Another corpus of prior reviews focused on nonjustice-

involved populations and trauma-related symptomatology outcomes, such as PTSD

symptoms, depression, and anxiety. These reviews found cognitive-behavioral therapy

(CBT) and trauma-focused CBT (TF-CBT) are effective at reducing various outcomes

(Dorsey et al., 2017; Leenarts et al., 2013; Macdonald et al., 2006; Roberts et al., 2010;

Silverman et al., 2008). Other reviews examined eye movement desensitization and

reprocessing (EMDR). The findings were equivocal and mixed with some indication of

efficacy, but ultimately inconsistent across studies (Dorsey et al., 2017; Kar, 2011;

Rodenburg et al., 2009). Closer to the current study, Cary and McMillen’s (2012) review

included behavioral problems as an outcome. The results indicated a small to medium

effect of TF-CBT and components of TF-CBT on behavior problems. This result was also

statistically significant. A review by Fraser et al. (2013) also concluded that CBT-type

programs were effective.

Across the variety of prior reviews identified, none involved a pooled analysis of treat-

ment effects for at-risk and justice-involved youth along a spectrum of risky behavior or

probable justice system-related outcomes. The purpose of this review was to identify

trauma-informed treatments and components to help address the needs of at-risk youth and

justice-involved youth with trauma histories. We focused on the effectiveness of programs

for at-risk youth and youth already involved in the juvenile justice system. We were inter-

ested in the following outcomes: (a) reduced engagement in the juvenile justice system, (b)

PTSD symptoms, (c) impulsivity, and (d) aggressiveness.