The effectiveness of PTSD treatment for adolescents in the juvenile justice system: A systematic review.

Abstract

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 justiceinvolved 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 justiceinvolved 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 StatementThis 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.

The Outcomes of Trauma-Informed Practice in Youth Justice: An Umbrella Review

“…All but one of the reviews had undertaken some form of quality assessment. Five (Gagnon et al, 2022;Givens et al, 2021;Hodgkinson et al, 2021;Kumm et al, 2019;Rhoden et al, 2019) evaluated primary studies against existing assessment tools, while two (Baetz et al, 2022;Rhoden et al, 2019) assessed sources of bias using the Cochrane Risk of Bias tool. One meta-analysis assessed the reliability and validity of included outcome measures (Eadeh et al, 2021), while another formally assessed the risk of publication bias (Olaghere et al, 2021).…”

“…Narrative Description of Main Findings (in alphabetical order of review) Baetz et al (2022) systematically reviewed seven controlled studies published between 2002 and 2017 to examine the impact of manualized, trauma-specific treatments on the reduction of post-traumatic stress disorder (PTSD) symptoms, co-occurring mental health symptoms, and justicerelated outcomes in justice-involved young people. Treatment effect sizes were calculated for PTSD.…”

“…In addition, the finding of comparatively large treatment effects in primary studies with small samples may indicate a publication bias through which, it is suggested, small studies are (even) more likely than studies with larger samples to be published because of significant findings (Hong et al, 2020). The need for more complete reporting of study information to overcome the possibility of selective reporting of results is noted (Baetz et al, 2022;Olaghere et al, 2021).…”

Relations between PTSD symptoms and reckless behaviors among military veteran students: Moderating roles of negative and positive life experiences.

“…Studies have also shown that individuals experiencing multiple childhood traumatic events are at an increased risk for mental health conditions in adulthood, such as hazardous substance use (Weber & Lynch, 2021) and PTSD (Anda et al, 2010). Notably, exposure to sustained, repeated, or multiple traumas, especially in the childhood years, and especially interpersonal traumas, can result in a complex symptom presentation (Dunn et al, 2017), including PTSD symptoms (Contractor, Brown, & Weiss, 2018; Contractor, Caldas, et al, 2018) and symptoms reflecting a breakdown of self-regulatory capacities (e.g., dissociative symptoms; Baetz et al, 2021).…”

The Impact of Court Decisions on the Recidivism of Juvenile Offenders

“…According to Baetz et al (2021) the importance of court decisions in cases of juvenile offenders becomes particularly significant within the framework of their impact on the possibility of recidivism. The fairness and adequacy of such decisions can determine the future of these young people and their ability to adapt to social life.…”