Interventions for Trauma-Affected Youth in the Juvenile Justice System: An Overview of Diagnostic, Ethical, and Clinical Challenges and Evidence-Based Treatments

Recognition of the high prevalence of trauma exposure and posttraumatic stress reactions among young offenders has led to calls for a shift toward the implementation of trauma-informed approaches in juvenile justice systems. However, meeting the clinical needs of youth in this population not only requires comprehending the profound effects of polyvictimization, developmental trauma, and complex PTSD but also an appreciation of the ways in which traumatic experiences and posttraumatic sequela intersect with diverse youth identities, including ethnicity and race, gender, sexual minority status, developmental stage, and gang involvement, which in turn may affect engagement in treatment. Ethical, legal, and clinical challenges specific to providing services in the context of the juvenile justice system also must be considered, including complications related to confidentiality, protection from self-incrimination, threats to psychological safety, and the potential for secondary traumatic stress among service providers delivering trauma-focused interventions in forensic contexts. This paper reviews those issues and goes on to describe the existing evidence base for interventions for posttraumatic reactions among justice-involved youth, as well as its limitations, and points toward future directions for research and clinical developments that could to expand the precision and reach of mental health services for youth at risk or already involved in the legal system.