Correctional Psychology in Juvenile Settings

Posted by permission of Dr. Thomas O’Connor. Copyright by T. O’Connor.

 

“Juvenile delinquency is just a fancy term for what we all did as kids.” Anonymous

Many forensic psychologists are concerned about matters of juvenile justice. Their concerns range from the competency of waivers, to the questionable effectiveness of intervention programs, to the death penalty for juveniles. School violence is also of concern. Some most of these areas have been covered in previous lectures, except for intervention programs, this lecture note will focus primarily on the forensic psychology of correctional treatment and the effectiveness of rehabilitation programs. One of the major differences between juvenile and adult corrections is the large number of private facilities in the juvenile system. Private facilities have the luxury of being able to “cherry-pick” their clients, and they can also sometimes do things and perform treatments that public facilities cannot do. One of the big problems in public juvenile justice is how long it takes to get an arrested juvenile tried and adjudicated as a delinquent. Only after they have been so adjudicated can they technically be placed in a “rehabilitation” program, and obviously, this kind of delay exacerbates the problem of delivering psychological services in a timely fashion. Juveniles who are still in detention status can only receive substance abuse treatment, sex education, remedial education, and crisis intervention services.

It goes without saying that the juvenile justice system is a complex, vast network of programs and facilities. The correctional subsystem is indeed, perhaps, the largest and most complex part of the juvenile justice apparatus. There are short-term facilities (detention centers), as well as shelters and reception and diagnostic centers. Long-term facilities include training schools, ranches, forestry camps, boot camps, farms, halfway houses, and group homes. There are more of the latter than the former. In addition, there are numerous private institutions and a number of psychiatric hospitals and treatment centers. The correctional landscape of juvenile justice is quite different from the correctional system in the adult world. While most facilities are small, the United States does have about 70 large facilities for juveniles.

It is customary to distinguish between “secure” facilities, with “secure” meaning a place where no status offenders, only adjudicated delinquents, can be found; and “semi-secure” facilities, referring mostly to the community-oriented or shelter-care facilities that were part of the decarceration or deinstitutionalization movement in the 1970s defined by the attempted removal of status offenders from the system. There are also some types of institutions that still qualify as “nonsecure” facilities, such as foster homes, certain group homes, halfway houses, camps, ranches, experience programs, and wilderness projects. The average length of time served in all types of facilities is six to seven months (Champion 2003). Forensic assessments and evaluations for adjudicative competence or amenability for rehabilitation are usually only conducted in secure facilities. In addition, any facility housing an adjudicated delinquent must evaluate them for their ability to communicate with a lawyer as well as participate in their postconviction plea (i.e., appeal of the delinquency finding). A correctional psychologist working in juvenile corrections must be prepared to do a lot of assessments.

THE MENTAL HEALTH NEEDS OF JUVENILE OFFENDERS

It is common for juveniles in need of rehabilitation to have multiple problems. Sometimes, the multiplicity of co-occurring problems is so great that the (over)use of competency and insanity determinations is tempting. For example, it is not uncommon for a correctional facility to receive a juvenile who is a mildly retarded, slightly brain-damaged, sex offender who abuses alcohol and drugs and has a history of suicide attempts. Sometimes, such offenders get caught up in “three strikes” laws and get waived to adult court for a possible life term in prison. However, sometimes such offenders get caught up in “juvenile insanity” hearings which abort the waiver to adult court. In other words, incompetency and insanity pleas may very well represent loopholes in the juvenile system where the offender is seeking to escape punishment.

Estimates of mental health problems among juvenile inmates run as high as 90% (Ulzen & Hamilton 1998), but the prevalence of serious mental illness is only about 30%, ten percent higher than the frequency of serious mental illness in the juvenile population as a whole. “Serious” mental illnesses, it will be remembered from the Estelle standard, consist of psychoses, clinical depression, and schizophrenia, the only conditions for which there is a Constitutional right to treatment. The most common diagnoses are Conduct Disorder (the juvenile version of Antisocial Personality Disorder) and Oppositional Defiant Disorder. These conditions generally co-occur with serious Attention Deficit Hyperactivity Disorders and/or Alcohol/Drug Dependence. Conduct disordersare characterized by frequent aggression toward all kinds of people (especially those trying to help – important safety note for correctional psychologists), a tendency toward senseless destruction of property, and a constant wanderlust which manifests itself as a desire for geographical getaways and frequent escape attempts. Juveniles with conduct disorder are also unlikely to be good candidates for treatments requiring any flexibility in thinking.

Attention Deficit Hyperactivity Disorder is characterized not only by further deficits in thinking, but a level of forgetting that borders on looking like day-to-day amnesia. Having such a condition usually means that there is no desire to participate in anyone else’s games, as such persons only have an interest in doing whatever it is that they come up with impulsively at the moment. While it is possible to medicate the condition with drugs, there is not likely to be much success if the condition co-occurs with other illnesses, especially a substance abuse disorder. It is no wonder then, that many juvenile treatment programs have a sort of “ad hoc” or unstructured nature to them.

Whitehead & Lab’s (1989) meta-analytic review of treatment effectiveness found that, for the most part, “nothing works” and that, in fact, many juvenile treatment programs make the problem worse, and exacerbate recidivism. It is therefore important to take care in decisions about which treatment program to implement. Hard data on which programs work and which programs don’t, however, is not available. Science has not progressed to the point where effective interventions can be picked or chosen from a list. The reality is that there are only suggestive or promising “leads” most likely dealing with specific components of a program, and there are, of course, different or alternative outcomes that can be achieved (e.g., increased motivation to participate further) if one is willing to give up the seemingly hopeless search for “cures.”

TREATMENT AND REHABILITATION PROGRAMS

As Bartol & Bartol (2004) suggest, there are approximately seven (7) different models of treatment for juvenile offenders. Not all of them are as successful as can be expected, but treatment programs for juveniles tend to take on a life of their own. The list below is presented in no particular order, and only represents programs which have found some acceptance, usage, or recognition in forensic psychology:

• group home models — group homes are the most common type of semi-secure or insecure facility, and their existence is justified on the principle that the least restrictive alternative should be used, unless facts warrant otherwise. Models include the Achievement Place approach (Phillips 1968) and African Unity-based approaches like the House of Umojah in Philadelphia. It has been clearly shown that programs which contain a celebration of cultural identity or heritage component are successful at motivating offenders to learn.

• multisystemic models — “multisystemic” is loosely a term for approaches based on Bronfenbrenner’s (1979) family systems theory, which in short, implies that the best approach is one which ignores the offender, and joins him or her in blaming their family, their peer group, their school, and their neighborhood. It seeks to build up so-called “resilience” or self-esteem factors and find conventional things the offender “liked” or succeeded at. The most commonly encountered version of it is called “functional family therapy.”

• substance abuse models — these are generally relapse prevention programs that are delivered on an inpatient (avg. stay 6 months) or outpatient (twice weekly) basis where “community” meetings are held and clients set goals for themselves. Research suggests that programs which fail do so because of staff turnover and inconsistent commitment (by staff) to a “culture of rehabilitation.”

• boot camp models — these are faddish government programs, most popular from 1987-1997 which attempt to instill military-style discipline, respect for authority, and boost self-esteem. There have been highly publicized abuses (e.g. in Maryland) and most research indicates a negative impact on recidivism and self-efficacy.

• wilderness and adventure models — these are (usually private) programs which take status offenders and nondelinquents, “cherry-picked” delinquents and a few delinquents given a “last chance” before going to a more secure facility. Besides the outdoor challenges (e.g. ropes course), programs typically represent a de-emphasis on traditional classroom models of learning and seek to develop more “active” learning styles such as those taught via drama therapy (which if often a component). Research indicates that the skills learned do not normally transfer back to a conventional community environment.

• violence “unlearning” models — The most common approach here is Aggression Replacement Therapy (Goldstein & Glick 1987) which attempts to replace whatever status rewards the offender has received for being “bad” with rewards for prosocial behavior, like learning how to ask permission, having a conversation, giving a compliment, etc. Research suggests that running such programs inside the prison environment almost guarantees failure if the other inmates engage in sabotage.

• sex offender treatment models — although a few prisons may use pharmacological approaches to suppress libido (never under age 16 though), the most common programs involve peer groups which either focus on relapse prevention, social assertiveness skills, or the confrontation of thinking errors. Relapse prevention appears to work the best, especially if the client can be taught to avoid “triggers” or slippery places, like playgrounds or pornography.

It should be noted that diverse mixtures of components of various models can be found, and sometimes such mixtures or admixtures are called “multimodal” programs, especially when the components being mixed involve individual treatment, peer group treatment, and an attempt at applying some sort of family systems theory. Since the most common family systems theory is called “multisystemic,” it is not uncommon to see juvenile correctional psychologists champion the cause of “multimodal and multisystemic approaches to treatment” which may very well qualify as the fanciest buzzwords in all of criminal justice.

THE ROLE OF PSYCHIATRIC CORRECTIONS

Although most correctional psychologists would disagree, arguing that the best treatment can only be delivered in semi-secure, unsecure, or community environments, this author (O’Connor & Scott 2004) has gone on record arguing that there is a place for secure facilities to house and treat the most violent, serious, and chronic offenders. Larned Juvenile Correctionalis one such place where practically everything is structured. Research has strongly indicated that at least a 25% drop in recidivism is possible with programs which are heavily structured, yet still meaningful and culturally sensitive.

REFERENCES
Arrigo, B. (2000). Introduction to Forensic Psychology: Issues and Controversies in Crime and Justice. NY: Academic Press.

Ashford, J. (2001). Treating Adult and Juvenile Offenders with Special Needs. Washington, DC: APA.

Barbaree, H., Marshall, W. & Hudson, S. (Eds.) (2005). The Juvenile Sex Offender, 2e. NY: Guilford Publications.

Bartol, C. & Bartol, A. (2004). Introduction to Forensic Psychology. Thousand Oaks, CA: Sage.

Boesky, L. (2002). Juvenile Offenders with Mental Health Disorders. Lanham, MD: ACA.

Bronfenbrenner, U. (1979). The Ecology of Human Development. Cambridge, MA: Harvard Univ. Press.

Champion, D. (2003). The Juvenile Justice System, 4e. Upper Saddle River, NJ: Prentice Hall.

Clements, C. (2000). “Prisons and Correctional Institutions.” In A. Kazdin (ed.). Encyclopedia of Psychology. NY: Oxford Univ. Press.

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Goldstein, A. & Glick, B. (1987). Aggression Replacement Training. Champaign, IL: Research Press.

Holt, C. (2001). “The Correctional Officer’s Role in Mental Health Treatment of Youthful Offenders.” Issues in Mental Health Nursing 22(2): 173-180.

O’Connor, T. & Scott, R. (2004). “Treatment in Transition: The Role of Psychiatric Corrections.” Pp. 514-26 in P. Kratcoski (ed.) Correctional Counseling and Treatment, 5e. Long Grove, IL: Waveland Press.

Phillips, E. (1968). “Achievement Place: Token Reinforcement Procedures in a Home-style Rehabilitation Setting.” Journal of Applied Behavior Analysis 1: 213-223.

Roth, L. (1986). “Correctional Psychiatry.” Pp. 429-468 in W. Curran, A. McGary & S. Shah (eds.). Forensic Psychiatry and Psychology. Philadelphia: Davis.

Schwartz, B. (Ed.) (2003). Correctional Psychology. Kingston, NJ: Civic Research Institute.

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Ulzen, T. & Hamilton, H. (1998). “The Nature and Characteristics of Psychiatric Comorbidity in Incarcerated Adolescents.” Canadian Journal of Research 43: 57-63.

Walker, L. & Shapiro, D. (2004). Introduction to Forensic Psychology: Clinical and Social Psychological Perspectives. NY: Kluwer Academic/Plenum.

Weinberger, L. & Sreenivasan, S. (1994). “Ethical and Professional Conflicts in Correctional Psychology.” Professional Psychology 25(2), 161-167.

Whitehead, J. & Lab, S. (1989). “A Meta-Analysis of Juvenile Correctional Treatment.” Journal of Research in Crime and Delinquency 26:276-95.

Wrightsman, L., M. Taflinger & M. Linsenman. (2000). Forensic Psychology. Belmont, CA: Wadsworth.

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