Background

Defining trauma is complex, as it is a phenomenon that requires both a particular kind of event and a particular kind of reaction to that event. Adverse childhood experiences (ACEs) are commonly referred to in research and practice and are a list of ten traumatic or stressful experiences which can occur in a person’s life before the age of 18.

A 2021 study which explored the links between serious youth violence and ACEs found that in a survey of 200 children, two-thirds had five or more ACEs, and over a fifth had eight or more ACEs.

The increase in diversionary measures in England and Wales has reduced the number of children entering the youth justice system for the first time. Those children remaining within the system are more likely to present with adversity, trauma and complex needs. Many of the effects of trauma develop as a way to help the child survive stressful experiences. However, some of the same traits can increase the risk of anti-social or offending behaviour, which helps to explain why there is a strong link between involvement in the youth justice system and adversity and trauma.

Due to this prevalence, youth offending teams (YOTs) are increasingly working in a ‘trauma-informed’ way, with a focus on establishing a sense of safety for the children they work with, avoiding practices which might inadvertently cause further trauma, and staff being aware of how trauma can impact upon a child’s behaviour.

Find out more about trauma-informed practice

The extent of trauma among the YOT population

Justice-involved children often come from the most disadvantaged families and communities, with high levels of exposure to social and economic deprivation, neglect, and abuse. They are a particularly vulnerable group, frequently with a history of child protection interventions, social care placements, family breakdown, and school exclusions.

In a study commissioned to understand the extent of adversity, abuse and vulnerability of justice-involved children in one area, it was found that out of a selected sample of 80 cases:

• 71 per cent were suspected or confirmed to have been abused
• in nearly half of the cases, the child had witnessed domestic violence, and this was suspected in a third of cases
• over three-quarters were confirmed as having experienced family violence or child abuse
• 25 children had been subject to multi-agency referrals as potential victims of child sexual exploitation.

The impact of trauma on child development and behaviour

Aside from its immediate negative impact, early child maltreatment interrupts normal child development, especially the processes through which emotions are managed. Trauma can complicate development, resulting in children who are on constant alert for danger, and who are quick to react to threats via fight, flight or freeze. The way in which trauma can blunt a child’s capacity to manage emotions can have implications for the formation and maintenance of relationships. Children who have experienced trauma are more likely to face attachment difficulties, feel extremely isolated, and have attitudes of mistrust towards strangers (such as YOT workers).

The video below, produced by the UK Trauma Council, provides a general introduction to what happens in the brain after children face traumatic experiences in childhood, like abuse and neglect.

Disclaimer: an external platform has been used to host this video. Recommendations for further viewing may appear at the end of the video and are beyond our control.

Moving away from offending behaviours requires a level of self-awareness and self-efficacy which can be blunted by the effects of previous trauma. The impairment of neuro-cognitive development may make it difficult for children to understand and comply with interventions and to comprehend the consequences of breaching them. This reduces the scope for deriving benefits from many programmes designed to promote desistance, such as anger management and victim empathy, and some cognitive-behavioural therapy (CBT). These interventions tend to be designed to address behaviour rather than the factors which drive such behaviours. As such, the impacts of trauma may be linked to higher rates of non-engagement or disengagement in such programmes.

Approaches are required which are layered or sequential, with early stages of work focusing more directly on basic routines and physical safety, since these are prerequisites for later articulation about (and processing of) previous traumatic experiences. The focus is upon a holistic understanding of the child in the context of their life experiences.

Enhanced Case Management

Enhanced Case Management (ECM) incorporates the trauma-informed approach (Trauma Recovery Model) into intervention planning as a framework against which a child’s behaviour and development needs are considered in order to inform how youth justice interventions are sequenced and delivered. For example, if the child is leading a chaotic lifestyle characterised by instability, an initial trauma-informed response would be to help them to develop a settled routine and to feel more secure. In terms of youth justice practice, this is likely to mean regular appointments with their worker (same time and same place) to help to build a routine and rapport, from which it will then be possible to start to address the problems they are experiencing.

ECM is supported by a clinical psychologist who does not work directly with any children but supports YOT practitioners to develop trauma-informed responses arising from recommendations made in a multi-agency meeting and at further reviews of progress. Clinical supervision is offered to YOT practitioners to support them to manage cases and to provide the opportunity for reflection and discussion.

A 2021 mixed-methods evaluation of the implementation of ECM identified a number of positive key findings:

• YOT workers found the multi-agency case formulation to be one of the most critical components of the ECM process. The formulation improved information sharing between agencies, which led to the gathering of more accurate and detailed information on the child’s history compared to standard assessment methods
• the psychologist’s skills and experience were regarded as essential in the case formulation for highlighting more nuanced issues and making links between ACEs, trauma, and the child’s behaviour
• children said that they greatly benefited from having that ‘one person’ they could talk to, and that talking with their ECM worker had helped them to calm down.

The evaluation also highlighted challenges which still exist with this approach:

• while the integrity of the psychologist’s support added validation to YOT workers decision-making, YOT workers also felt that it reinforced pre-established perceptions of low credibility from managers and with other agencies in terms of their own professional abilities
• as part of the ECM, children could continue to engage with YOT workers on a voluntary basis when YOT contact would normally cease. However, YOT workers described challenges in understanding how to manage risk and safeguarding concerns that arose during voluntary engagement
• there were some challenges in arranging incremental transitions to the probation service where there was less flexibility in the approach to missed appointments, for which children were not prepared
• staff reported that further work was needed across the criminal justice system to remove labelling language and prevent children from being treated as fully responsible adults.

Staff training and support

High-quality training on working with trauma should be provided to practitioners so that they can develop clear and suitably consistent responses to children who may not have previously had stability in their lives and have learned not to trust. With more insight into how traumatised children behave, staff can then work more effectively with them, helping children to gain an understanding of their behaviour, take responsibility, and develop positive relationships. A study undertaken at one YOT found that integrating restorative practice and awareness of bias and inequalities into the trauma-informed approach helped practitioners to create a safe and trusting environment and build a multi-faceted approach that took account of individual, family and institutional trauma.

Staff need to take care to avoid any re-traumatisation or replicating any disempowering dynamics. At the same time, it is important to recognise that youth justice staff can be at risk of developing vicarious (secondary) trauma from working with some children; there is thus a need for them to receive clinical supervision. Particular children may also generate some negative feelings in staff, including frustration, despair and anger. Staff need to be able to disclose and explore their emotions in a supportive environment in order to manage their feelings effectively. Staff working intensively with children should also be assisted in building their own psychological resilience – mapping out their vulnerabilities and strengths and protecting themselves against vicarious trauma.

Screening and assessment

Specific assessment for trauma, abuse, and significant loss has been identified as beneficial given the high prevalence in justice-involved children, although the timing of such work needs careful thought, and the following should be considered:

• young custody-leavers frequently complain about what they regard as over-assessment
• children are often resistant to assessments which are perceived to label them as victims or as having emotional/mental health problems
• many children have commented that they are subject to numerous tests but then ‘nothing happens’ – assessment should be followed by suitable and timely service provision.

It is important that staff avoid quantifying ACEs as a measure of risk, as this is at odds with trauma-informed approaches to working with children. Focus should instead be placed on gaining an understanding of the impacts ACEs might have on individual children, their behaviour, and the best ways in which to support them.

Trauma-informed assessment should also see a shift in how the child is viewed, impacting on the language used to describe the child in reports, plans and in communications with other agencies. For example, instead of placing the blame on the child for not engaging, assessments should be more specific as to the reasons why the child is finding it difficult to engage, such as the fact that they are not at a developmental stage to articulate their issues or they appear to find face-to-face contact threatening.

Interventions

There is evidence to support the use of the following approaches:

• Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is a therapeutic intervention for children and families who have been exposed to a traumatic event. It is based on the assumption that children can have difficulty processing complex and strong emotions that can result from exposure to trauma. TF-CBT therefore aims to create an emotionally supportive environment in which children and their parents learn cognitive strategies for managing the difficult emotions that arise from trauma. There is evidence of a short-term positive impact on child outcomes both in relation to supporting their mental health and wellbeing, and in terms of preventing crime, violence, and antisocial behaviour
• the Trauma Recovery Model (TRM) highlights that trauma during early development and/or impairment in the attachment relationship between child and caregiver can lead to problems which can be focused inwardly (anxiety, depression, suicidal thoughts) or outwardly (offending, aggression, impulsivity). TRM also suggests that children who experience childhood trauma are trapped at an early stage of emotional development; the model takes young people through a series of developmental stages over a period of time. The ECM approach to working with justice-involved young people is grounded upon the TRM; in the 2021 ECM evaluation, staff reported that they found TRM a useful tool to help sequence interventions according to the child’s needs and what they could realistically engage with.

Further evidence pages will be published in due course covering specific types of delivery and specific sub-groups.

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Last updated: 10 March 2023