![Page 1: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/1.jpg)
What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project
DR LORRAINE JOHNSTONEConsultant Clinical and Forensic Psychologist
Senior Research Fellow and Project Lead
and
DR KATE BLACKClinical Psychologist
HEATHER IRVINGConsultant Social Worker (RMA)
With thanks to
The Scottish Government The Centre for Youth and Criminal Justice, Strathclyde University
![Page 2: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/2.jpg)
Overview
To describe the IVY project: Why, what, where, for whom? To reflect some of the surprising (and less surprising) insights from working with
high risk males To maintain a practice based focus and acknowledge some of the real challenges
that face services working with vulnerable youth Invite reflections and feedback from the audience on what the IVY findings mean
for services Disclaimer
The views expressed today are our own These views do not necessarily represent the position of the Scottish
Government or the Centre for Youth and Criminal Justice, Strathclyde University
![Page 3: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/3.jpg)
Youth Violence
![Page 4: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/4.jpg)
The data are astounding…
Internationally, youth homicide accounts for 41 per cent of premature deaths (World Health Organisation, 2011).
Sexual violence (Radford et al., 2011; Vizard et al., 2007), cybercrime (Gersen & Rappaport, 2011; Mishna et al., 2012), violent extremism (Home Office, 2011), stalking and harassment (Brewster, 2013), gang fighting (HM Government, 2011; Madden, 2013), and fire-setting (Mackay et al., 2014; Watt et al., 2014) by youths are also at worrying levels.
In the US, between 15 and 20 percent of all crime is committed by youth under the age of 18 years (Slobogin & Fondacaro, 2011).
In Scotland, with a population of only approximately 600,000 young people between the ages of 8 and 17 years, the data for 2012 to 2013 revealed:
43,117 detected crimes were accounted for by this age group; > than 1300 of those were related to violence - murder, attempted murder, serious assault, robbery and assault with intent to rob,
threats and extortion, cruelty to children, rape, assault with intent to rape, indecent assault and sexual offences against children (Scottish Government, 2013).
In England and Wales during 2011/12, 13.6 per cent of all arrests were of people aged between 10 and 17 years of age; in 2012/13 young people were primarily convicted of violent offences (over 19000) and over 1300 sexual offences (Ministry of Justice,
2014).
All in the context of the “dark figure of crime”
![Page 5: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/5.jpg)
Long tradition of research tells us…
![Page 6: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/6.jpg)
Violent Victims
Boswell’s findings in 1995 from an examination of 200 cases of juvenile violent offenders revealed…
72% had experienced emotional, sexual, physical and/or organised abuse as children
53% had experienced the loss of a significant figure to whom they were emotionally attached, via bereavement, cessation of contact
91% cases had a recorded history of abuse or loss
![Page 7: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/7.jpg)
The findings of this report reveal that a high proportion of young people who have committed violent or murderous offences have themselves been the victims of childhood trauma in the form of abuse and/or loss and frequently both. This does not mean, of course, that all youthful victims of trauma will become violent or murderous offenders. That is liable to depend on a whole variety of other variables…Self-evidently, however, many members of the current survey had not been effectively helped to think through, interpret or resolve the traumatic event(s) which had occurred in their earlier lives. Whilst this may move the debate one step nearer to potential cause it is probably of most help in considering the kind of work that still needs to be effected with these young offenders. The growing body of work on post-traumatic stress disorder confirms that children suffer the after-effects of traumatic stress in a similar way to adults, and that one way in which unresolved fear or grief can manifest, particularly in adult males, is in later aggressive or violent behaviour
![Page 8: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/8.jpg)
But!
![Page 9: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/9.jpg)
Access to Services
![Page 10: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/10.jpg)
Over-reliance on cumulative and delinquency models
Evident in assessment Risk assessment imported from adult forensic literature Cumulative risk models – where did formulation go? Neglecting recent developments in trauma and attachment models
![Page 11: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/11.jpg)
Despite evolving theories and models of understanding
“...trauma consistently appears to be the connecting factor for multifaceted expressions of violence endured or perpetrated.”
(Ardino, 2012)
![Page 12: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/12.jpg)
Models of Trauma and Violence Incubated in terror: neurodevelopment factors in the cycle of violence
(Perry, 1997, 2008)
increased activity or reactivity of the brainstem
(e.g. chronic traumatic stress)
and/or
decreased moderating capacity of limbic or cortical areas
(e.g. neglect)
Increased aggression, impulsivity, capacity for violence
![Page 13: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/13.jpg)
Vulnerable Youth : relevant models
Resource Loss model (Cloitre)
“The Interrupted Life” (Cloitre, 2010)
![Page 14: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/14.jpg)
The over-reliance on delinquency and criminogenic models is
Evident in treatment/interventions R&R, Cognitive Skills, Anger Management Vintoc Ointoc Boot camps
![Page 15: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/15.jpg)
Even though…as Gitta Sereny put it…
“How can any individual – whether child or adult – who has been subjected to traumatic events which have affected his development and behaviour, be expected to come to terms with them, with his fears, with his actions, with himself unless he be permitted and helped to face up to these memories”
![Page 16: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/16.jpg)
Also evident in disposals
Evident in disposals – “adult crime, adult time” Her Majesty’s Pleasure Indeterminate Sentencing Order for Lifelong Restriction Life without Parole*
![Page 17: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/17.jpg)
The Irony…
![Page 18: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/18.jpg)
So, when working with vulnerable youth,
it can leave you feeling like this…
![Page 19: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/19.jpg)
Enter IVY a small and modest step forward
![Page 20: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/20.jpg)
Who? “John” – referred by consultant psychiatrist and clinical psychologist – has threatened to perpetrated a
sexual homicide; has entered unknown females premises; has history of cruelty to animals including decapitation
“Harry” – referred by police; distributing right wing and violent extremism materials; attempting to purchase bomb making materials via internet; openly endorses the use of violence for political ends; advocates Nazism and other extremist philosophies; attempting to form networks
“Jake” – referred by secure estate; convictions x3 rape; ongoing violence towards staff and peers; aggressive towards family; highly negative attitudes towards females and past victims; due for return to local community.
“Lenny” – hx of raping x2 toddlers (sodomy) and sexual assault of vulnerable peer; had constant supervision since (around 3 years), due to exit childcare system; remains preoccupied with sexually explicit and pornographic materials and openly admits that would take an opportunity to offend against a child.
![Page 21: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/21.jpg)
What do we do?
THE CONSULTATION (ASSESSMENT AND FORMULATION) All referrals Referral Form is submitted which provides relevant information on
risk, background, mental health, placements, etc. Format: Consultants, who are specialists, assist the consultee(s) to assist
with the case; Consultants are active agents to achieving solutions (understanding)
and strengthening the consultee’s competencies to address similar issues in the future
2 hours per case direct time* Report provided to lead professional within 2 weeks of consultation Content: All aspects of the SPJ Paradigm
![Page 22: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/22.jpg)
Background
Formulation
Formulation Scenarios
Document
Document
Management
Management
Risk Factors
Risk Factors Structured Professional Judgement
Family composition and functioningAttachment and parenting
TRAUMA AND LOSSDevelopmental Hx.Educational/School
Placements etc.Mental and Physical Health
Substance UseOffending
Relationships/PsychosexualRecreation/Interests, etc.
![Page 23: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/23.jpg)
Background
Formulation
Formulation Scenarios
Document
Document
Management
Management
Risk Factors
Risk Factors Structured Professional Judgement
e.g., Structured Assessment of violence RiskRisk for Sexual Violence Protocol,
Short term assessment of risk and treatabilityNorthgate Fireraising Tool
Stalking Assessment ManualViolent Extremism Risk Assessment
Internet -AIM
THE SPJ PARADIGM
![Page 24: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/24.jpg)
Background
Formulation
Formulation Scenarios
Document
Document
Management
Management
Risk Factors
Risk Factors Structured Professional Judgement
![Page 25: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/25.jpg)
Predisposing FactorsPredisposing Factors
Precipitating Factors/Destabilisers Precipitating Factors/Destabilisers
Protective/Inhibitors Protective/Inhibitors FactorsFactorsPerpetuatingPerpetuating
Factors Factors
Drivers/MotivatorsDrivers/Motivators
VIOLENCEVIOLENCE
![Page 26: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/26.jpg)
WitnessedDomestic Violence
VIOLENCEVIOLENCE
Describe risk processes
![Page 27: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/27.jpg)
IVY: REFERRALS
First 15 months: 66 referrals 2 Education
1 Forensic Psychology
1 police 1 parent
9 health 52 social work
![Page 28: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/28.jpg)
PRESENTING RISKS
*63% co-morbid risk to other presentations*approx 30% suicide/self-harm*approx 25 % concerns about victimisation
![Page 29: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/29.jpg)
IS TRAUMA RELEVANT?
![Page 30: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/30.jpg)
TRAUMA INFORMED FORMULATIONS
CASE EXAMPLES
![Page 31: What do we know about trauma in adolescent males with forensic needs? Some Insights from the Interventions for Vulnerable Youth Project DR LORRAINE JOHNSTONE](https://reader034.vdocuments.site/reader034/viewer/2022051620/56649ec05503460f94bcc1b1/html5/thumbnails/31.jpg)