Trauma Treatment Planning for a Youngster

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Table of Contents

Case Background
Problem Identification and Prioritization
The Treatment Team
Assessment Trauma Tool and Intervention Phase
Possible Solutions
Potential Strengths and Barriers
Potential Triggers and Stressors
References

Case Background

The case is about James, who has PTSD and engages in acts of juvenile delinquency, which affects his education and social life. His sisters were transferred to a foster family, whereas the boy is under the physical custody of his uncle, Patrick. James’s mother and uncle experienced severe child abuse themselves. There is an issue of parental drug abuse, such as cocaine and marijuana. Both parents consume drugs on a regular basis with little interest in their children, and they are incarcerated for drug possession and selling. Although James’s father used to abuse him and his sisters physically, the case illustrates that their mother used to abuse them verbally and emotionally, especially under the effects of the drugs.

Problem Identification and Prioritization

Priority 1

Juvenile delinquency behavior is the most important priority of James’s case since it can lead to severe punitive measures. Some argue that mental health issues are not due to incarceration but to abusive parents, where the punitive measure simply exacerbates the condition (Morgan-Mullane, 2017, p. 200). In other words, if James becomes involved in a major delinquency act, he risks becoming a long-time offender.

Priority 2

James’s separation from his sisters is an issue that needs to be addressed. Evidence suggests that “parental incarceration impairs children’s well-being throughout the life course” (Turney & Goodsell, 2018, p. 147). The source directly supports the claim of the long-lasting effect of parental incarceration on children’s mental health. Therefore, further separating already vulnerable children puts them at an even greater risk of complications.

Priority 3

Parental incarceration is a significant contributor to James’s PTSD, which impacts his mental health despite the parental abuse. A study found that children “with incarcerated parents are at elevated risk for mental health problems, and strong parent-child relationships partially buffer children from risk” (Davis & Shlafer, 2017, p. 120). Evidence directly supports the claim in regard to vulnerability.

Priority 4

James’s education and academic achievement are critical to addressing since they will determine his future success and independence. It is important to ensure that the above problems are addressed since the effects of trauma on education can be detrimental. Subsequent failures in life make children more prone to develop mental health problems and experience child abuse with lasting effects.

The Treatment Team

It should be emphasized that the treatment team needs to involve the current guardian and Uncle Patrick. The case worker’s involvement is critical in order to manage legal matters and provide expertise to both James and Patrick. Since the core approach proposed below is centered around a combinatory use of motivational interviewing and cognitive behavior therapy in a multisystemic format, a counselor will be necessary.

Assessment Trauma Tool and Intervention Phase

When it comes to juvenile delinquency, there are a number of assessment approaches, that factor in strategies and goals. A justice system usually operates within three distinct modes or considerations, which include rehabilitation, deterrence, and retribution or punishment (Young, Greer, & Church, 2017). It is reported that “in the case of juvenile offenders, the principle of rehabilitation is often assigned the greatest weight” (U.S. Department of Justice, 2020, p. 22). Therefore, the primary method of treating the problem is a rehabilitation-based measure. Although preventative strategies play a critical role in minimizing the rate of occurrence, punitive measures tend to be less effective. The main reason is that juveniles are not always well aware of the potential consequences of their actions due to their lack of education and inexperience. Therefore, the core modality of action and treatment revolves around deterring minors from violating the law. However, if a violation takes place, then rehabilitation is most often prescribed since such a person needs to undergo the correctional procedure to properly reenter society as a functional and valuable member.

In the case of interventions, the main measures include education, employment, communication, and language. One of the main problems among juvenile offenders is their unproductive time spent. Evidence states, “Only 10% of this time was spent engaging in productive activities, such as employment or education, with 57% used for passive leisure activities, a level 30% higher than that of their non-offender peers” (Young et al., 2017, p. 25). Therefore, the most effective interventions include programs with an emphasis on education and practical skills, such as CRAFT, which is “a specialized vocational and employment training program” (Young et al., 2017, p. 25). The use of CRAFT showed that juvenile offenders were “significantly more likely to be in employment, to have attended an educational diploma program and to have attended for a significantly longer period of time” (Young et al., 2017, p. 25). In other words, the vulnerable adolescents were able to regain some of their undeveloped skills to properly reenter society as functional and productive people.

Moreover, juvenile offenders require interventions when it comes to language and communication. A study suggests that in the case of language and communication skills, these individuals fall “into the poor or very poor categories ranging from 46 to 67%” (Young et al., 2017, p. 25). Another research shows that social skills training or SST is an effective tool to address the stated problems, which makes it easier for the offenders to rehabilitate (Van der Stouwe et al., 2020). SST is based on multiple cognitive approaches, structured learning theory, social information processing, operant learning theory, and social learning theory (Van der Stouwe et al., 2020). However, SST is better used in conjunction with other methods because “SST is successful in improving social skills, but it is not superior to an alternative treatment in doing so” (Van der Stouwe et al., 2020, p. 382). Thus, juvenile offenders tend to have poor communication and language skills, which require development and training in order to ensure that they can avoid another instance of delinquency. Complex measures need to be incorporated to ensure the effectiveness of any training program because juvenile delinquency is a multifactorial issue.

Possible Solutions

When it comes to treatment and interventions, the former part is mainly focused on treating mental health illnesses, whereas the latter part is about education, opportunity, and communication. It is reported that PTSD is the most prevalent mental health illness among juvenile offenders, which means that PTSD treatment is a core method of addressing almost a quarter of such delinquencies (Young et al., 2017). Cognitive-behavioral therapy, or CBT, is an effective treatment strategy to minimize the effects of PTSD, which is highly common among adolescent gang members and offenders. Mood and anxiety disorders also substantially contribute to juvenile delinquency, which can also be effectively treated with CBT (Young et al., 2017). However, the main difference lies in the fact that group therapies are better suited for mood disorders.

Another mental health problem negatively impacting the youth, which makes them more likely to engage in juvenile delinquency, is conduct disorder. It is stated that “multisystemic therapy (MST) is a family-focused intervention targeting characteristics related to antisocial behavior, including family relationships and peer associations” (Young et al., 2017, p. 24). In other words, MST is a family-based treatment where the emphasis is put on a family’s inner dynamics to minimize the problem’s effect. In addition, substance abuse and addiction among the given age group can also be considered mental health issues. Motivational interviewing, or MI, is proven to be highly effective as both a standalone treatment as well as in combination with other interventions (Young et al., 2017). MI is also effective because it can be conducted in a group setting, which makes it more potent in addressing cultural deviations.

Potential Strengths and Barriers

James has shown strength in possessing some form of control over his PTSD episodes by avoiding major delinquency behaviors. His motivation is primarily driven by his desire to reunite with his sisters, which he sees as his top priority. Therefore, there is a strong driver for James to comply and follow the treatment in order to fully strengthen his ability to manage his PTSD. However, some barriers include that James cannot be completely reunited with his sisters since Patrick is unable to provide for all of them. The parental absence and their state of incarceration make it difficult for James to cope with Patrick being his new guardian.

Potential Triggers and Stressors

Some potential triggers for James include minor school conflicts, bullying, and specific subjects on drugs and sexual abuse. Remembering them can provoke an angry response in him, which can result in outbursts of rage. In addition, disagreements between James and Patrick can easily escalate into heated exchanges where the triggers can be manifested. Educational pressure and demanding homework stressors make James unmotivated and unwilling to follow the treatment recommendations. Conflicts at school can be strong stressors as well as triggers for James’s PTSD.

References

Davis, L., & Shlafer, R. J. (2017). Mental health of adolescents with currently and formerly incarcerated parents. Journal of Adolescence, 54, 120-134. Web.

Morgan-Mullane, A. (2017). Trauma focused cognitive behavioral therapy with children of incarcerated parents. Clinical Social Work Journal, 46, 200-209. Web.

Turney, K., & Goodsell, R. (2018). Parental incarceration and children’s wellbeing. The Future of Children, 28(1), 147-164. Web.

U.S. Department of Justice. (2020). 38.”Juvenile” defined. Web.

Van der Stouwe, T., Gubbels, J., Castenmiller, Y. L., van der Zouwen, M., Asscher, J. J., Hoeve, M., … Stams, G. J. J. M. (2020). The effectiveness of social skills training (SST) for juvenile delinquents: A meta-analytical review. Journal of Experimental Criminology, 17(3), 369–396. Web.

Young, S., Greer, B., & Church, R. (2017). Juvenile delinquency, welfare, justice and therapeutic interventions: A global perspective. BJPsych Bulletin, 41(1), 21–29. Web.

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