Better options for troubled teens

More than 1 million American youth end up in juvenile court every year, and about 160,000 of them are referred to residential placements, including detention centers, residential treatment centers, correctional institutions and group homes, according to a 2011 Social Policy Report by the Society for Research in Child Development.

However, the report finds that such settings often do more harm than good, causing depression, thoughts of suicide, acting-out behaviors and recidivism among these youth. Recognizing this problem, many states have enacted a variety of community-based "diversion" programs aimed at keeping offending youth out of the court system, particularly those who have committed nonviolent crimes or "status" offenses such as truancy, running away from home or defying parents or other authority figures.

Diversion services, though, are extremely diffuse in their design and in the populations they intend to serve, say psychologists in the area of juvenile justice. What's more, most programs that communities use are not backed by science.

"The literature is pretty consistent that you're better off diverting the less serious offenders out of the juvenile justice system, and if possible, hooking them up with services," says Medical University of South Carolina psychologist Scott Henggeler, PhD. "But you can be diverted to services that make the situation worse. So for me, diverted to what is really the question."

The good news is that psychologists and other social scientists are creating diversion programs that address this concern, dramatically improving outcomes such as re-offense rates and family relationships, thus saving the juvenile justice system a great deal of money, says University of Connecticut psychologist Preston A. Britner, PhD, the incoming co-chair of APA's Committee on Children, Youth and Families, who also helped the state of Connecticut create and implement an evidence-based diversion program for status-offending kids.

In addition, these programs are being studied using advanced research methodology, and they recognize that young people's entire environments — growing up in drug-ridden or violent areas, for example — are part of why they end up in trouble.

"There's a growing awareness that you don't just change the kid or the parent or the schools, but you also need to look at neighborhood and community contexts as well," Britner says.

What these programs have in common, he adds, are a strong research base, a focus on improving family relationships and a bent to foster youngsters' strengths. Here's a look at some of them.

Thirty-five years and counting

William S. Davidson II, PhD, distinguished professor at Michigan State University, never imagined that his graduate dissertation would become a model diversion program that has been running now for 35 years. But that's what has happened with his Adolescent Diversion Project, which pairs undergraduate students and adolescents found guilty of breaking and entering, larceny and other crimes. These relationships have been found to cut the youths' recidivism rate in half, and the program has won a number of national awards, including the Jimmy and Rosalynn Carter Award from Campus Compact and the APA Task Force on Prevention's Exemplary Prevention Research designation.

In the model, undergraduate psychology students take a two-semester course that trains them in the program's theory and practice. They then spend eight hours a week for 18 weeks mentoring young offenders and their families on how to communicate and negotiate effectively with each other. In addition, the psychology students connect the kids with positive, community-based activities that tap their interests, such as computer labs, machine shops, dance studios and tae kwon do centers. "It's about finding out what this kid is interested in, what his or her strengths are and how we can build on them," Davidson says.

After launching a successful pilot of the program in 1976, Davidson devoted 15 years to improving and replicating it in several Michigan cities with funds from the National Institute of Mental Health. In Lansing, the model has evolved into a partnership among the university, the county Juvenile Court and community members, including police and judges. The students continue to partner with the young offenders, and the rest of the team works together to help the young people achieve positive goals and steer clear of crime. 

The program has strong research backing. A 2006 article by Marisa L. Sturza and Davidson in the Journal of Prevention & Intervention in the Community reports that for youth in the program, overall crime rates over a 30-month follow-up were consistently half of those randomly assigned to no treatment or to treatment-as-usual control conditions. And the program costs about a fifth as much as usual court processing, Davidson says.

Undergraduate students also benefit from participating in the program, finds a 2010 study in the American Journal of Community Psychology. Compared with matched peers, they're more likely to go on to graduate school, choose human service careers, see themselves positively and have better attitudes toward youth. "It's a very positive educational tool," Davidson says.

A family-centered approach

Psychologist Stephen Gavazzi, PhD, a family therapist and professor at The Ohio State University, has developed a diversion program that addresses what he perceives as key limitations in many such programs: a lack of family involvement in treatment and an over-emphasis on problem behaviors. He's developed versions of the program tailored to status offenders, young people who have committed misdemeanors or lower-level felony offenses, and higher-level felony offenders.

Drawing from a primary prevention program he developed called Growing Up FAST (Families and Adolescents Surviving and Thriving), his program makes parents and caregivers an integral part of treatment; focuses on the strengths of the child and family instead of their weaknesses; and asks families to identify the issues they want to work on.

The intervention also helps juvenile offenders avoid problem behaviors and develop effective life strategies, for example, by asking the youth and adult family members to define what it means to be a successful adult and what steps are needed to get there. Program implementers — who may include psychologists, social workers, family therapists, school guidance counselors, paraprofessionals and parent advocates — coach caretakers in helping the child meet those goals.

Implementers also help the young person face and learn from the problem that got him or her into trouble, and think about alternatives to that action. Meanwhile, parents or caretakers are invited to ask as many questions about the incident as they want. This exercise tends to reveal additional information that the family needs to address, such as a child's clandestine substance use.

Juvenile offenders who participate in the program are 50 percent to 65 percent less likely to be arrested again than matched peers who did not go through the program, according to a 2000 article by Gavazzi and colleagues in Aggression and Violent Behavior. Gavazzi has trained approximately 650 mental health professionals, paraprofessionals and others in five states in the model, and more recently, has modified the framework for use in school systems, discussed in his 2010 book "Strong Families, Successful Students."

In Gavazzi's view, part of why the program works is its ability to illuminate what is driving the young person's behavior, whether it is negligent parenting, substance use or emotional difficulties within the family. "Criminal activity is often just a symptom of a much larger set of things that are going on," he says.

Progress in Connecticut

In a similar vein, a program in Connecticut developed by Yale University psychologist Elena Grigorenko, PhD, is helping young people already in the criminal justice system learn from and take responsibility for their actions. Grigorenko used an American Psychological Foundation grant to create a 10-week behavioral intervention that uses writing assignments, role play and guided discussions to help more serious young offenders understand and "own" the behavior that landed them in trouble. Her model is now being used throughout Connecticut in both detention and probation centers, and has led to the creation of an assessment device — the situation-judgment inventory — being used to monitor youth compliance and socially oriented changes in thinking and behavior while they're in detention.

Meanwhile, another statewide effort in Connecticut involving psychologists is helping to dramatically reduce the number of status-offending youth who end up in court. The system takes a tiered approach that individualizes services based on the level of a youth's risks and offenses — for example, providing comprehensive services to kids who have run away from home multiple times but not to those who have skipped school once or twice. Before filing a formal complaint against a youth, families, schools and other community members are urged first to seek other solutions to the young person's problems, including through existing community resources. If that doesn't work and caretakers deem that a child needs it, the young person is sent to one of four regional family support centers in the state.

After an initial screening and assessment, the family and child craft individual, social and community, school and family goals. Once that plan is in place, center staff initiate a "wraparound" system of services that includes 24/7 crisis intervention and family mediation, educational support and evidence-based treatment programs tailored to the child's situation.

So far, the program has yielded impressive results, finds a 2010 evaluation by Florida's Justice Research Center. Between 2006 and 2009, the number of status-offense complaints dropped 41 percent, suggesting that the tiered system works to keep such problems from escalating. In addition, status offense cases handled by the courts in that same time frame dropped from 50 percent to 4 percent.

Like Davidson's and Gavazzi's models, the Connecticut program looks like it will save the system a lot of money, too, says Britner. As a rough estimate, it costs approximately $4,000 for youngsters to undergo the family service center intervention, which takes about three months, versus about $10,000 to detain a young person for the same length of time.

But while the results in Connecticut are impressive, they also highlight remaining issues for researchers, Britner and others say. For instance, research suggests that many status offenders wouldn't reoffend anyway — that their aberrant behavior is the result of a common adolescent tendency to act out that goes away with age, says Henggeler. In fact, research shows that about a third of kids engage in delinquent behavior, then "age out" of it, according to a 2006 report by the Justice Policy Institute.

"Where we are now is that in Connecticut, this model works in a general sense, but there's a lot more work to do to understand specifically what works for whom and why," Britner says.

The good news is that researchers will be able to figure that out in the coming years, he adds. "We now have the systems and the psychologically informed measurements in place to start finding those answers."

Tori DeAngelis is a writer in Syracuse, NY