Trauma Informed Care: What Lawyers Representing Children and Teens Need to Know

DAconley

by Kirstie MacEwen, MSW, LCSW

Practice Tips

Introduction

Modern social work principles present trauma informed care (TIC) as the most effective and safe way to work with clients of any age. TIC is approaching every person you meet as though he or she has experienced some kind of trauma, and doing your best to be sensitive to whatever those traumatic experiences may have been. It is working with intentionality, being grounded in empathy and empathic responses. TIC is vital when working, in any capacity, with children and adolescents, because their brains are still growing and developing. An adolescent brain is malleable. This plasticity allows the brain to readily learn and adapt, which helps the adolescent develop strategies, skills, and habits. If a child is exposed to traumatic experiences, the habits and strategies he or she is taught can significantly influence his or her ability to cope with the trauma. It is therefore critical that adults provide the support children and adolescents need to develop positive habits and strategies instead of allowing negative ones to take root.

Research has proven that trauma and traumatic experiences significantly impact brain structure. Specifically, a brain that has experienced trauma has significantly diminished frontal lobe structure. The frontal lobe is the executive of our brain. This region is the command center that helps us control our impulses, regulate our emotions, and make thoughtful decisions. Because the frontal lobe plays such a key role in both behavior and functioning, children who have experienced trauma display a wide variety of symptoms. Not surprisingly, many children who exhibit trauma symptoms are misdiagnosed with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), disruptive mood dysregulation disorder (DMDD), as well as many others. Discussing trauma and misdiagnosis, Bessel van der Kolk states,

Before they reach their twenties, many patients have been given four, five, six, or more of these impressive but meaningless labels. If they receive treatment at all, they get whatever is being promulgated as the method of management du jour: medications, behavioral modification, or exposure therapy. These rarely work and often cause more damage.

Bessel van der Kolk, M.D., The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma 159 (2014).

While the symptoms of trauma can present in a variety of ways that make proper diagnosis difficult, misdiagnosis can be very detrimental to a child’s treatment. Take, for example, the distinction between hyperactivity and hypervigilance.  Hyperactivity (e.g., the inability to sit still or focus) is more closely associated with ADHD. Hypervigilance (including enhanced sensory sensitivity, increased arousal, and high responsiveness to stimuli) can appear the same as hyperactivity but has an added component of anxiety and is more closely associated with post-traumatic stress disorder (PTSD). The symptoms of these disorders can look very similar, but it is important for a child to have access to a clinician who is careful and cognizant of nuances so the child can receive the most appropriate treatment and support.

Why, you may be asking, is this discussion pertinent to lawyers? Children with “behavioral” symptoms are often labeled as problem kids. Because of the punitive nature of our systems of school discipline, these students often receive suspensions or are arrested by school resource officers instead of receiving therapeutic interventions. This is true even when therapeutic interventions are laid out in a legal document such as an Individualized Education Plan or 504 Plan. Punishment for school related behavior is often the cause of a student’s first interaction with the juvenile justice system, but it most likely won’t be the last. Juvenile offenders are at much greater risk of becoming adult offenders. Even on an individual level, working to disrupt this pattern by providing therapeutic support over punishment can start a trend for changes in the larger system.

Tips for Lawyers Representing Children and Teens

  1. Remember that trauma significantly impacts brain structures that are meant to help with impulse control, decision making, and emotional regulation.
  2. Always approach clients using TIC practices.
  3. Look for therapeutic supports that are trauma informed.
  1. Advocate for mental health support as opposed to punitive measures whenever possible.
  2. Work collaboratively with mental health, physical health, school, and justice system providers.
  3. Do some reading about trauma!
  • The New Jim Crow, Michelle Alexander
  • Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others, Laura van Dernoot Lipsky with Connie Burk
  • The Boy Who was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook – What Traumatized Children Can Teach Us About Loss, Love, and Healing, Bruce D. Perry, M.D., Ph.D., and Maia Szalavitz
  • The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Bessel van der Kolk, M.D.
  • Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror, Judith Lewis Herman

Kirstie MacEwen is a graduate of Simmons College School of Social Work.  She is an In Home Therapist for the Justice Resource Institute SMART Team.  In this capacity, Ms. MacEwen serves children and families who are engaged in the juvenile justice system.  She is passionate about juvenile justice reform and disrupting the school to prison pipeline.


Transition H.O.P.E.: Boston Public Schools’ Efforts to Assist System-Involved Youth

DAconley

by Janelle Ridley

Viewpoint

Janelle Ridley works for the Boston Public Schools (BPS) as the Coordinator for System-Involved Youth. She is an expert in identifying and implementing services to aid youth in transitioning from detention back to BPS, and seeks to intentionally foster educational equity and actively work to dismantle the school-to-prison pipeline.

No one can contest that Black and Brown boys are overrepresented in the juvenile and criminal justice systems. Boston is not an anomaly; this has been a national crisis since the 1980s when zero-tolerance policies were introduced by former President Ronald Reagan’s administration at the onset of the “War on Drugs.” Once Congress passed the Drug-Free Schools and Campuses Act of 1989, school districts across the nation implemented zero-tolerance policies that have since criminalized seemingly innocuous behavior that is often due to trauma, poverty, and a plethora of reasons that make it impossible for students to function in a traditional school setting. Thus, agencies and individuals alike must be intentional about our approach in working with our youth to address the root causes and not merely criminalize the symptoms. In light of the aforementioned, this article will explore the efforts of Boston Public Schools (BPS) and others are making to ensure EVERY student has access to equitable educational opportunities. First, I will outline my work in this area.  Next, I will describe Transition H.O.P.E., a pilot program launched in Summer 2018 to assist youth who have been detained at DYS facilities.  Finally, I will describe efforts BPS is making to develop an intentional approach to assist youth more generally.

Background

As the District Coordinator for System-Involved Youth at BPS, I have been pioneering new ground for academic and social integration for youth who have been exposed to systems including, but not limited to, the Department of Youth Services (DYS) and the Department of Children and Families. Through strategic transdisciplinary partnerships, I am ensuring that BPS is holding the fidelity of its mission to provide access to equitable educational opportunities to EVERY student. Concomitantly, I am working tirelessly to dismantle the cradle-to-prison pipeline while creating a path from prison-to-school. Ultimately, my objective is to disrupt the generational cycle of America’s mass incarceration crisis on Boston’s youth, and the debilitating effects of trauma on underrepresented communities. Prior to my work at the District, I devised Street Trauma, a transformative curriculum that empowered my former students at East Boston High to speak as experts of their lived experiences and enjoined educators to be more intentional about how they interacted with Black and Brown youth. Though I am no longer in the classroom, I have expanded my curriculum to colleges/universities where I serve as an adjunct professor to reach individuals seeking to work in urban settings.

BPS Office of Social Emotional Learning and Transition H.O.P.E

Transitioning back to BPS from the DYS is a nonlinear reorientation process that requires youth to sever ties with their former ways of life, both good and bad aspects, to embrace the new. Change is inevitable and a part of life, but the transition process for system-involved youth is complex and strenuous. Furthermore, the majority of the youth detained at DYS by the courts have experienced some amount of school failure and are often already behind in their educational attainment. Therefore, even short periods of detention may result in further isolation from their school communities and exacerbate opportunity gaps.

Determined to disrupt the odds stacked against the youth, I launched Transition H.O.P.E. in Summer 2018, a pilot program through BPS Office of Social Emotional Learning & Wellness with a holistic framework designed to ensure all system-involved youth have access to educational equity by: holding High Expectations for each and every young person; providing Opportunities that are realistic and within their perspective; helping the youth envision Pathways to Success by taking ownership of decisions for desired long-term outcomes; and providing Encouragement to help youth acknowledge that success is theirs to claim and define irrespective of the past. The pilot was launched at the DYS Metro Pre-Trial Detention unit with a total of 16 youth. After a successful summer, we plan on expanding Transition H.O.P.E. in the Fall of 2018 to additional DYS units and facilities serving youth assigned to BPS.

Transition H.O.P.E., powered by strategic partnerships with Lesley University, engages youth in college-level academic discourse and exposes them to pathways beyond high school.  Lesley tutors worked diligently with youth to build higher order thinking skills and foster the ability to see beyond the limitations placed upon them. As a result, two of our youth enrolled at Benjamin Franklin Institute of Technology (BFIT) upon release and are exploring career options that they would otherwise not have imagined they could attain. Moreover, going on our mantra, “When you engage a youth, you reach the family,” one of the youth’s brother also enrolled at BFIT this summer and they are now attending classes together while serving as a strong support system for each other.

BPS is intentional about cultivating a culture of accountability to the success of these youth and pursuing transformational leadership to unearth the passion, purpose, and potential buried within all youth. It is also essential that the transitional process consists of positive affirmations and the presence of consistent adults in their lives. With the support and guidance of mentors (including former professional basketball players, Becoming a Man, Mass Mentors), youth are devising roadmaps to success in the academy and beyond.  The H.O.P.E. team stresses accountability through periodic check-ins with both the youth and their mentors.  As Frederick Douglass asserted, “It is easier to build strong children than to repair broken men.” Thus, BPS is intentional about integrating the following frameworks in its approach:

  1. Holistic Development: Employ a whole-child framework to cultivate cognitive, cultural, emotional, physical, social, and spiritual development.
  2. Open-minded Attitude: Employ a growth-mindset framework to teach our youth that their attitude, not aptitude, determines their altitude.
  3. Purpose Cultivation: Employ a visualization framework to activate the subconscious mind to create new neural pathways for the manifestation of desired aspirations.
  4. Engaged Citizenship: Employ a civic engagement and transformational leadership framework to build capacity for individual and collective responsibility.

The incorporation of youth voice is essential to each of these integrated components. BPS district leaders made several visits to DYS over the past year to listen to the needs of the youth and wrestle with tough questions like “How can teachers be better equipped to engage with youth who are subject to complex trauma?” It is impossible to narrow the opportunity gap and dismantle the prison pipeline without giving youth platforms to be heard.

The partners who are working with our inner-city youth are recognizing the harm caused by the school-to-prison pipeline, including collateral consequences in employment, education, housing, and beyond upon involvement in the justice system.  Research has shown that concepts such as “trauma-informed learning” and “social emotional learning” have gained significant traction over the past few years as alternatives to exclusionary discipline practices.  These constructs posit that the microsystems youth inhabit, like their communities, homes, and schools are critical to addressing their needs. At the recent Coalition for Juvenile Justice Youth Summit, youth from across eighteen states described their school experiences as “inhumane” and their communities as “unsafe” due to the high concentration of poverty and crime that stems from systemic inequality and policies from the “War on Drugs.”

Recognizing that isolation is the enemy of transformative progress, BPS is extending an invitation through Transition H.O.P.E., to partner with us and alongside Mass Mentors, William James College, Benjamin Franklin Institute of Technology, Timothy Smith Network, the Juvenile Detention Alternative Initiative, Northeastern Center for the Study of Sport and Society, Harvard University Transformative Justice Series (located in the Charles Hamilton Houston Institute for Race and Justice), Brandeis University, Suffolk County Sheriff Department Family Matters Program, Boston Police Department, STAR and most certainly Lesley University. If you have any interest in aligning work, please feel free to email me at jridley@bostonpublicschools.org.


Successful Alternatives: Juvenile Diversion and Restorative Justice in Suffolk County

DAconleyfraywitzerfraywitzer

by Former Suffolk County District Attorney Daniel F. Conley, Assistant District Attorney Michael V. Glennon and Erin Freeborn, Executive Director of Communities for Restorative Justice

Heads Up

Since 2017 prosecutors in Suffolk County have made efforts to improve and modernize their approach to juvenile justice. These efforts include an ambitious juvenile diversion program and, more recently, a restorative justice initiative, in partnership with Communities for Restorative Justice to give victims of crime an opportunity to address the people who have harmed them. The diversion program seeks to identify the needs and risk factors that pre-date offense and arrest, and to address them outside the traditional juvenile justice system. The restorative justice initiative is a voluntary process by which offenders, victims, and members of the community come together to collectively identify and address the harms, needs, and obligations created by, and identified as a result of, a criminal act. The combined result is a model that may prove valuable for other prosecutors’ offices nationwide.

Most juveniles who enter the justice system have a complex set of needs and risk factors that pre-date offense and arrest. Research shows that identifying and addressing these makes for effective rehabilitation efforts. For too many young people, however, the opportunities for this type of assessment are frequently missed until their conduct brings them into contact with the juvenile justice system, and is often delayed until after a juvenile has been charged, prosecuted, and adjudicated delinquent. In a busy, urban court system, where most juveniles are released to their parents, this process can take months or years – during which time those needs and risks may remain unaddressed.

Prosecutor-led diversion efforts, such as the Juvenile Alternative Resolution Program (“JAR”), can fill this gap meaningfully and effectively. Overseen through the DA’s Juvenile Unit, the Suffolk County JAR program seeks to support juveniles with a moderate or high risk assessment, while low-risk juveniles (those charged with first- or second-time misdemeanor offenses) are usually diverted informally with minimal supervision. Only the most serious offenses – sex offenses, gun crimes, and crimes causing serious injury to a victim – are automatically ineligible for diversion. Since the JAR program launched last year, it has accepted 70 juveniles charged with more than 100 separate offenses. Only three participants – less than 5% – have been removed from the program for violating the terms of participation. Thirty have successfully completed the program and the remaining 40 are on track to do so. Since the pilot phase ended, JAR has expanded to include more neighborhoods in Boston and is expected to nearly double in capacity, taking in close to 100 juveniles during the second year. Overall, about 65% of Suffolk County delinquency proceedings, or over 500 cases, are diverted informally or formally through JAR – 10 times more than are subject to youthful offender indictments

This success is particularly notable because the JAR program accepts juveniles who present with higher risk factors, which is possible because candidates complete a two-stage screening process to determine the level and nature of services appropriate to their circumstances. Courtroom prosecutors first assess the juvenile using the Ohio Youth Assessment System – Diversion (OYAS-DIV) tool to determine risk level and help the prosecutor determine whether informal diversion, formal diversion through JAR, or traditional juvenile proceedings are appropriate. For JAR-eligible candidates, the DA’s diversion coordinator meets with the juvenile and guardian separately to perform a more extensive assessment interview, including completion of the Youth Level of Services/Case Management Inventory (YLS/CMI) 2.0 assessment, which determines the juvenile’s criminogenic needs and strengths. Specific risk factors and needs that lead to criminal behavior are identified and categorized. Once the areas of highest risk are identified, the juvenile immediately enters programming tailored to their needs in order to mitigate them and lower the likelihood that they will re-offend. This has resulted in successes like “John,” who entered the juvenile court essentially homeless after being charged with Receiving Stolen Property and Breaking and Entering. John was assigned to work with the Detention Diversion Advocacy Program (DDAP) where he received resources, including a mentor, therapist, and support leading to summer employment. He successfully completed JAR, received no criminal record, is doing well in school and has not recidivated.

Chronically underfunded district attorney’s offices in Massachusetts do not have the financial resources, staff, or training to provide rehabilitation services. As a result, Suffolk prosecutors have built strong partnerships with community-based agencies who carry out the programing recommended through the screening process. Candid and collaborative alliances with non-profits, social service providers, and other agencies working directly with youth, families, and communities are essential in this regard. The majority of diverted juveniles complete three to nine months of individualized programming through the partner agencies, including therapy, job preparation and placement, educational support, mentorship, life skills training, substance abuse counseling, and more. To ensure honest participation at each stage, the juvenile is protected with a contract ensuring that nothing they disclose will be used to prosecute the underlying case.

Targeting the risk factors that have the greatest likelihood for recidivism advances the interests of public safety, offender accountability, rehabilitation, and satisfaction for both the victim and the community, all while reducing future barriers to success. Speed is important to the program’s success, both in the rapid assessment of the juvenile’s risk factors and needs and in following through with the recommendations as quickly as possible.

Because prosecutors direct most JAR participants into diversion prior to arraignment, the underlying charges do not appear on the juvenile’s criminal record – a decision that prosecutors made for its significant long-term implications. Having a criminal record can complicate important, stabilizing life choices such as pursuing higher education, seeking stable employment, and applying for a loan. Despite these considerations, creation of a criminal record may be necessary given the seriousness of the offense and the risk the offender poses to their community. By reducing the number of juveniles who enter adulthood with a record, prosecutors are confident that they can balance public safety with the enduring public benefit of emphasizing diversion over traditional juvenile prosecution.

In addition to the more traditional diversion programs described above, a JAR assessment may recommend the use of restorative justice circles as a key process to give victims, communities, and the juvenile a voice, while also addressing any threats to public safety. Through this process, the offender accepts responsibility for their actions and takes steps to repair the harm they have caused to a victim and the community. A highly trained volunteer facilitates the meeting process over a period of months. The process is tailored to each participant and may involve regular group meetings, known as circles. Circles may involve the victim, other community participants, law enforcement officials, and the offender. Undertaken appropriately, restorative justice leads to long-term healing for the offender and the community while lowering the likelihood of recidivism.

Communities for Restorative Justice (C4RJ) promotes and facilitates these circles to give victims of crime an opportunity, in a safe environment, to address the people who have harmed them and determine how the harm may be repaired. The offender is held meaningfully accountable, comes to understand the impact of their actions, and makes amends to those affected by the underlying offense.

C4RJ’s restorative circles already operate in numerous jurisdictions. They have a recidivism rate of just 16% and a 98% participation satisfaction rate last year as measured by offenders and victims. Restorative justice works because the offender learns empathy and gains stronger connections to the people affected by their actions, while the victim and community become more engaged in the process and outcome.

The restorative justice collaboration among stakeholders inside and outside the criminal justice system has produced an outstanding result: reliable, validated assessment data matched with specific, individualized programming to place the right juveniles in the right programs to address their unique needs and cut short the cycle of recidivism.

The spread of C4RJ’s effective programming and the proven successes of the Suffolk County District Attorney’s JAR program should encourage all justice partners to look at evidence-based alternatives to “business as usual.” Those engaging in restorative work across the Commonwealth should consider partnerships with their local criminal justice professionals, many of whom have proven themselves to be open and enthusiastic supporters of new and innovative ideas. The pieces are all on the board – together, we can keep moving them forward.

Getting Involved

The Suffolk County District Attorney’s office is eager to partner with qualified individuals and agencies to improve diversionary outcomes. By enhancing the restorative justice component in an already effective diversion model, prosecutors believe they can achieve short-term benefits for individuals and long-term benefits to the community. Interested candidates for JAR partnerships should contact Juvenile Unit Deputy Chief Michael V. Glennon at Michael.V.Glennon@MassMail.State.MA.US.

Communities for Restorative Justice needs community volunteers who are interested in doing this work in Suffolk County. If you would like to help make a difference in your community, you can learn more at http://www.C4RJ.org or fill out a volunteer application at https://bit.ly/2ya8z5K.