Treatment Works For Youth In The Juvenile Justice System

Treatment Works To Prevent Offenses
Treatment works to change the life course of young people and deter them from juvenile justice involvement. Numerous research studies point to the effectiveness of certain types of treatment and services for youth involved in the juvenile justice system. Generally speaking, regardless of type of program or youth, recidivism rates among those who received treatment are as much as 25% lower than those among untreated, control groups.1 The best, research-based treatment programs can reduce recidivism from 25 to 80%.2

Since juvenile offenders are not a single, homogenous group, no one form of treatment is the most effective for every youth. It is possible, however, to make some general statements about effective treatment approaches-and what does and does not seem to work.

Characteristics Of Effective Treatment Programs
Effective treatment programs are structured, intensive, and focus on changing specific behaviors. The most effective programs typically involve intensive training or behavior modification techniques aimed at reducing risk factors for juvenile justice involvement.3 For example, programs which focus on improving interpersonal skills, self-control, anger management, and substance abuse resistance have been found to reduce recidivism by as much as 50%.4 Treatments that are longer in duration and involve more contact hours are associated with better outcomes; for programs based in institutional settings, better outcomes are associated with the use of mental health professionals rather than corrections staff as the treatment providers.5 In general, the most effective programs are highly structured, emphasize the development of basic social skills, and provide individual counseling that directly addresses behavior, attitudes, and perceptions.6

Community-based treatment programs are superior to institution-based programs. A number of researchers support the view that programs in community settings are more effective than those in institutional settings,7 with intensive, community-based, and family centered interventions the most promising.8 Although some youth may need treatment in institutions, many more can be appropriately served in the community, where youth behavior can be addressed in its social context.

It is extremely important for justice authorities to involve family members in the treatment and rehabilitation of their children. Family-focused interventions have shown positive impacts on child and family functioning, delinquent behavior, and recidivism.9 As one parent points out, "Families socialize children...Parents teach children their ways to control their behavior and respect others rights."10 Juvenile justice programs should work to strengthen the capacity of the family to live and work together and to care for the child at home. Families have a wealth of information about a youth's strengths and needs and should be involved in developing treatment plans, individualized education plans, and aftercare plans for their children. Families should also be provided with regular progress reports on all medical, mental health, and educational services their youth receives.

Integrated, multi-modal treatment approaches are essential. Many children in juvenile justice systems are involved in other systems as well, such as mental health, child welfare, or special education. These children are best served when agencies coordinate care and wrap services, supports, and supervision around a child and family in an individualized way. Evaluations show reductions of up to 61% in the number of crimes committed by youth on probation who are involved in "systems of care" programs.11 Multi-modal or multi-component interventions are more effective for youth involved in the justice system than narrowly focused programs.12 Integrated substance abuse and mental health treatment is also considered state-of-the-art for youth with co-occurring disorders.13

An Effective Model: Cognitive-behavioral therapy Cognitive-behavioral approaches have been shown to be particularly effective with youth in the juvenile justice system, as well as for children with anger or conduct problems more generally. The cognitive-behavioral approach is based on the theory that thoughts, beliefs, and attitudes determine emotion and behavior. That is, the way we perceive or evaluate a situation, influences our emotional and behavioral response. Cognitive-behavioral therapy is a didactic approach that involves teaching youth about the thought-emotion-behavior link and working with them to modify their thinking patterns in a way that will lead to better, more adaptive behavior in challenging situations. The cognitive-behavioral approach is effective for youth in the juvenile justice system because it is highly structured and focuses on the triggers for their disruptive or aggressive behavior.
An Effective Model: Multi-Systemic Therapy (MST)
In MST, the therapist collaborates with the family to determine the factors in the youth's "social ecology"-including peers, school, and community-that are contributing to the identified problems and to design interventions to address these factors. The therapist is responsible for removing barriers to service access and for drawing upon youth and family strengths to achieve sustainable outcomes in every case. The ultimate goals of MST are to empower families to cope with the challenges of raising children with behavioral and emotional problems and to empower youth to cope with family, peer, school, and neighborhood difficulties. MST has been demonstrated to be effective in reducing recidivism by up to 70% and out-of-home placements by up to 64% in comparison with control groups in a number of randomized clinical trials. Moreover, MST is cost effective; one study estimated that implementing MST would result in a net gain for a community of over $21,000 per participant (based on criminal justice system and crime victim savings).
An Effective Model: Integrated Systems of Care
Integrated systems of care typically involve collaboration across a number of public agencies, such as juvenile justice and mental health, with the goal of developing coordinated plans for family-centered, community-based services, building upon youth and family strengths. Often youth with emotional or behavioral problems are involved in more than one system, but a "wrap-around" model ensures that a family formulates a single, individualized treatment plan. The model also makes it possible for families to receive a wide array of services and supports, as part of that coordinated plan. Examples of wrap-around programs are the DAWN Project in Indianapolis and Wraparound Milwaukee. In addition to significant improvements in children's behavior and functioning, Wraparound Milwaukee has demonstrated a 42% drop in the number of residential placements over the first two years of the program, which represents a savings of $5.2 million.
Ineffective Programs

Research and evaluation have provided us with considerable knowledge about what works, as well as what doesn't work, in the treatment of juvenile offenders. A number of studies, for example, have found that punishment is not effective as a deterrent and does not reduce recidivism in the long run. One review of the literature concluded that various types of punishment-including regular incarceration and "scared straight" programs-actually produced higher recidivism rates than no punishment.14 Other programs found to be ineffective by themselves at reducing recidivism are increased surveillance, psychodynamic or unstructured counseling, home confinement, regular probation services, frequent drug testing, wilderness / survival programs, electronic monitoring, and boot camps.15

Conclusions

Children with emotional and behavioral disorders present a unique set of challenges to the juvenile justice system. Unfortunately, many communities and states are failing to meet these challenges in effective ways. Good model programs exist around the country to identify, treat, and rehabilitate emotionally disturbed children who commit offenses. By learning more about the needs of emotionally disturbed children and the treatments that work, communities can bring about better outcomes for these youth and their families.

Additional Resources

1Gendreau, P., & Goggin, C. (1996). Principles of effective correctional programming. Forum on Correctional Research, 3, 1-6.

2Gendreau, P. (1996). The principles of effective intervention with offenders. In A. Harland (Ed.), Choosing Correctional Options That Work. Thousand Oaks, CA: Sage Publications.

3Lipsey, M. (1992). Juvenile delinquency treatment: A meta-analytic inquiry into the variability of effects. In Thomas Cook et al. (Eds.), Meta-analysis for explanation: A casebook. Russell Sage Foundation: New York.

4Greenwood, P. (1994). What works with juvenile offenders: A synthesis of the literature and experience. Federal Probation, 58(4), 63-67.

5Lipsey, M., & Wilson, D. (1998). Effective intervention for serious juvenile offenders: A synthesis of research. In R. Loeber & D. Farrington (Eds.), Serious and Violent Juvenile Offenders. Sage Publications: Thousand Oaks, CA.

6Altschuler, D. (1998). Intermediate sanctions and community treatment for serious and violent juvenile offenders. In R. Loeber & D. Farrington (Eds.), Serious and Violent Juvenile Offenders. Sage Publications: Thousand Oaks, CA.

7Palmer, T. (1996). Programmatic and non-programmatic aspects of successful intervention. In A. Harland (Ed.), Choosing Correctional Options That Work. Thousand Oaks, CA: Sage Publications.

8Mulvey, E., Arthur, M., & Repucci, D. (1993). The prevention and treatment of juvenile delinquents: A review of the research. Clinical Psychology Review, 13, 133-167.

9Sherman, L., et al. (1997). Preventing Crime: What Works, What Doesn't, What's Promising? Office of Justice Programs: Washington, DC.

10Adams, J. (June, 1996). Juvenile justice from the inside out. Claiming Children.

11Center for Mental Health Services. (Summer, 1998). Ten key findings. Family Matters.

12Lipsey, M. (1992).

13Riggs, P. (1998). Clinical approach to treatment of ADHD in adolescents with substance use disorders and conduct disorder. Journal of American Academy of Child and Adolescent Psychiatry, 37(3), 331-333.

14Gendreau, P., & Goggin, C. (1996)

15Sherman, L. (1997).