Written by: Christine Gwin, LCSW-S; Director of Clinical Operations- Juvenile Justice
In the intricate landscape of juvenile justice, a silent crisis brews behind locked doors and institutional walls. The youth in our juvenile justice facilities are not merely offenders they are survivors of trauma, victims of systemic inequities, and individuals with unaddressed mental health challenges. As professionals in behavioral health and professionals in the juvenile justice industry, we must recognize that we are not managing “bad behavior,” but rather complex cases of psychological distress, emotional dysregulation, and trauma-induced coping mechanisms. The acuity of youth in these settings demands a recalibration of our approach—one that leans into evidence-based, individualized, and trauma-informed care.
Unpacking the Complexity
A growing amount of research has revealed an overwhelming percentage of youth involved in the justice system have experienced significant and sustained trauma. These experiences—ranging from physical abuse and neglect to community violence and domestic instability—shape the way youth respond to stress and conflict. In many cases, their maladaptive behaviors are not rooted in malice, but in survival.
Amplifying this is the digital age, where social media increases anxiety, disrupts sleep, and cultivates unrealistic social comparisons. Adolescents already struggling with trauma and emotional regulation now find themselves bombarded with additional psychological stressors. In the absence of healthy coping mechanisms, many resort to aggression, substance use, and risky behaviors—pathways that often culminate in justice system involvement.
The “tough on crime” era brought with it harsh disciplinary methods that often re-traumatized youth, perpetuated defiance, and increased the likelihood of reoffending, oftentimes leading to a lifetime in the system.
In response to poor outcomes and researched backed alternatives, state regulations are now shifting toward a rehabilitative framework—but the question remains: is this change too late for many of the youth already affected?
The Scope of the Problem
The statistics are staggering. Between 60% and 70% of adolescents in juvenile detention meet the criteria for at least one diagnosable mental health disorder, compared to just 20% in the general adolescent population. Common conditions include post-traumatic stress disorder (PTSD), depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), and substance use disorders. The prevalence of co-occurring disorders—especially among girls—is particularly concerning, and yet many facilities remain unequipped to meet this level of clinical complexity.
These disorders often present behaviorally, not verbally. Youth don’t always say, “I’m anxious” or “I feel unsafe.” Instead, they may fight, flee, shut down, or escalate. Without trained clinical staff and trauma-informed practices in place, these behaviors are misread as defiance rather than symptoms, and youth are punished rather than supported.
A Clinical Call to Action: Early Identification and Individualized Care
Recognizing and addressing these issues early is paramount. Most state regulations now mandate mental health screenings upon intake, with tools like the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) offering a validated, efficient means of identifying risk factors. However, identification is only the first step—intervention must follow swiftly and appropriately.
The notion of a “one-size-fits-all” treatment model is outdated and harmful. Facilities that provide the same dosage of therapy, the same curriculum, and the same programming to every youth overlook the unique experiences, diagnoses, and strengths that each individual brings. Effective treatment must be individualized, dynamic, and integrated across systems of care—from therapists and educators to caregivers and community support workers.
Promising Evidence-Based Interventions
Several evidence-based practices (EBPs) have emerged as effective tools in reducing symptoms, improving functioning, and lowering recidivism among justice-involved youth:
- Aggression Replacement Training (ART): ART is a structured cognitive-behavioral program that addresses three core components: anger control, pro-social skills, and moral reasoning. It provides youth with the tools to de-escalate emotionally charged situations and navigate conflict with increased self-awareness and empathy. Research shows that ART leads to reductions in aggressive outbursts and improved interpersonal functioning.
- Multi-Systemic Therapy (MST): MST is an intensive intervention that focuses on the family unit, leveraging parental involvement and community resources to address the systemic causes of delinquent behavior. Rather than isolating youth from their environment, MST strengthens the support structures around them. This model has demonstrated success in reducing repeat offenses and the need for long-term residential placement.
- Trauma-Informed Care Models: Models like the Sanctuary Model, TARGET, and Think Trauma emphasize the importance of psychological and emotional safety. These frameworks train staff to recognize trauma responses, de-escalate crises compassionately, and foster environments of trust and empowerment. Facilities that have adopted trauma-informed care report decreased incidents of violence, improved staff-youth relationships, and higher treatment engagement.
- Life Skills Training (LST): Originally developed for school environments, LST teaches critical skills such as decision-making, self-regulation, and communication. When adapted for justice- involved youth, LST serves as a protective factor against substance use, risky behavior, and peer pressure, offering youth a new behavioral script.
Beyond Programs: Creating a Culture of Healing
Even the most well-researched interventions will fall short in environments that are chaotic, punitive, or dismissive of youth voice. Healing does not occur in isolation—it is shaped by culture, relationships, and consistency. Staff must be trained not only in technical skills, but also in empathy, cultural responsiveness, and reflective practice.
A facility cannot expect transformation from youth without undergoing its own transformation. This includes rethinking intake processes, group structures, and even architectural design to promote a sense of dignity and safety. It also means engaging youth as partners in their care—soliciting feedback, involving them in treatment planning, and reinforcing their agency.
The Road Ahead
Addressing the high acuity needs in juvenile justice facilities is imperative for solutions that improve the lives of youth. Every day we delay implementing evidence-based, individualized, and trauma-informed interventions, we risk deepening the wounds of an already vulnerable population.
But with the right tools, the right mindset, and a commitment to rehabilitation over punishment, transformation is possible. These youth are not broken—they are brilliant, resilient, and worthy of the kind of care that leads not just to survival, but to success.
Let this be a call to all juvenile justice professionals, clinicians, and policymakers: The time for change is not tomorrow. It is now.
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