The Effectiveness of PTSD Treatment for Adolescents in the Juvenile Justice System: A Systematic Review

Objective: The objective of this study was to systematically review existing empirical evidence on the effectiveness of trauma-specific treatment for justice-involved adolescents and evaluate the impact of the interventions on the reduction of posttraumatic stress disorder (PTSD) symptoms, co-occurring mental health symptoms, and juvenile justice-related outcomes. Method: A systematic literature search was conducted using a four-step process. Studies were included if they used a manualized, trauma-specific treatment with at least one control or comparison group and a sample comprised exclusively of justice-involved adolescents. Results: In total, 1,699 unique records were identified, and 56 full-text articles were reviewed, of which 7 met the criteria for inclusion. Trauma-specific interventions led to a decrease in PTSD symptoms compared with a control group in four of seven studies, and two studies also demonstrated a reduction in trauma-related depressive symptoms. Finally, juvenile justice-related outcomes were measured in only four studies, with one study finding moderately reduced rates of delinquent behavior and recidivism following trauma-specific treatment. Conclusions: The results from this systematic review suggest that trauma-specific treatment interventions have promising effects for justice-involved adolescents. However, the results reveal a dearth of quality intervention research for treating youths with histories of trauma in the justice system. Significant gaps in the literature are highlighted, and suggestions for future directions are discussed. Clinical Impact Statement This is one of the first known systematic reviews to focus exclusively on the effectiveness of trauma-specific treatments for youths in the juvenile justice system. Trauma-specific treatments are critical to trauma-informed justice practices, yet minimal evidence exists about their effectiveness with this population. Among the seven included studies, trauma-specific treatments significantly reduced PTSD symptoms, co-occurring mental health symptoms, and justice-related outcomes. These findings suggest that trauma-specific interventions can be effectively adapted for use with adolescents in the justice system and improve outcomes beyond PTSD. More research is needed to establish an evidence base across the justice continuum and develop guidelines for the implementation of effective treatments.