What do justice-involved youth want from integrated youth services? A conjoint analysis.

Background: Many youth in the criminal justice system are affected by mental health and/or substance use (MHS) challenges, yet only a minority receive treatment. One way to increase access to MHS care is integrated youth services (IYS), a community-based model of service delivery where youth can access evidence-based treatment for their MHS problems and other wellbeing needs, in one location. However, it is unknown what IYS services justice-involved youth prioritize. Objective: This study explored what components of IYS justice-involved youth deem to be the most important in meeting their MHS service needs, in comparison with non-justice-involved youth, by conducting a secondary analysis of data gathered from a larger Ontario-wide study. Method: Using a conjoint analysis, n = 55 justice-involved youth, and n = 188 non-justice-involved youth, completed thirteen choice tasks representing different combinations of IYS. Results: Both justice-involved and non-justice-involved youth exhibited preferences for a broad range of core health services, including mental health services, substance misuse counseling, medication management, and physical or sexual health services. They also preferred a broad range of additional support services, in addition to fast access to care in a community setting that specializes in mental health services, with the incorporation of e-health services. Justice-involved youth prioritized working with a trained peer support worker to learn life skills and help them with the services they need. The importance of youth playing a leadership role in making decisions within IYS organizations was also a distinguishing preference among justice-involved youth. Conclusions: Tailoring IYS to meet the service preferences of justice-involved youth may enhance service utilization, potentially leading to better outcomes for justice-involved youth and their communities.

Contexte: Nombre de jeunes dans le système de justice pénale sont affectés de problèmes de santé mentale et/ou d'utilisation de substances (SMS), pourtant seule une minorité reçoit un traitement. Une façon d'élargir l'accès aux soins SMS consiste dans les services intégrés à la jeunesse (SIJ), un modèle communautaire de prestation de service dans lequel les jeunes peuvent avoir accès à un traitement fondé sur les données probantes pour leurs problèmes de SMS et autres besoins de bien-être en un seul lieu. Cependant, on ne sait pas à quels SIJ les jeunes impliqués dans la justice accordent la priorité. Objectif: La présente étude a exploré quelles composantes des SIJ sont jugées les plus importantes par les jeunes impliqués dans la justice pour répondre à leurs besoins de service de SMS, en comparaison avec les jeunes non impliqués dans la justice, au moyen d'une analyse secondaire des données recueillies d'une étude plus vaste à l'échelle de l'Ontario. Méthode: À l'aide d'une analyse conjointe, n = 55 jeunes impliqués dans la justice, et n = 188 jeunes non impliqués dans la justice ont répondu à treize tâches à choix représentant différentes combinaisons de SIJ. Résultats: Tant les jeunes impliqués dans la justice que les jeunes non impliqués ont affiché des préférences pour une large gamme de services de santé de base, notamment les services de santé mentale, la consultation pour abus de substances, la gestion des médicaments, et les services de santé physique ou sexuelle. Ils préféraient également une large gamme de services de soutien additionnels, en plus d'un accès rapide aux soins dans un milieu communautaire qui se spécialise en services de santé mentale, avec l'incorporation de services de santé en ligne. Les jeunes impliqués dans la justice accordaient la priorité au travail avec un pair aidant formé pour apprendre les compétences de la vie et les aider dans les services dont ils ont besoin. L'importance pour les jeunes de jouer un rôle de leadership dans la prise de décisions au sein des organisations de SIJ était également une préférence distincte chez les jeunes impliqués dans la justice. Conclusions: Adapter les SIJ pour répondre aux préférences de services des jeunes impliqués dans la justice peut améliorer l'utilisation des services, et mener potentiellement à de meilleurs résultats pour les jeunes impliqués dans la justice et leurs communautés.

Integrated Youth Service Preferences of Caregivers of Justice-Involved Youth: A Discrete Choice Conjoint Experiment.

Introduction: Mental health and/or substance use (MHS) challenges affect approximately 95% of youth in the criminal justice system, with only three in ten justice-involved youth receiving treatment. Caregivers of justice-involved youth have identified fragmented care as a barrier to youth accessing MHS services. One suggested solution to this problem is the implementation of integrated youth services (IYS). However, it is unknown which IYS components caregivers of justice-involved youth prioritize. Methods: Using a discrete choice conjoint experiment (DCE), n = 46 caregivers of justice-involved youth, and n = 204 caregivers of non-justice-involved, completed thirteen choice tasks representing different combinations of IYS. Results: Both caregiver groups exhibited preferences for involvement and access to information regarding their youth's treatment, and fast access to broad range of core health and additional services, in a community setting, with the incorporation of e-health services. Caregivers of justice-involved youth showed a unique preference for involvement in family counseling with their youth. The incorporation of this service feature may help to engage caregivers of justice-involved youth in their youths' MHS treatment 3-fold. Conclusion: Data gleaned from this analysis provides an understanding of what components of IYS models may help to engage caregivers of justice-involved youth.

Change in Level of Service Inventory-Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves.

The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual's overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory-Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

Distinguishing among weapons offenders, drug offenders, and weapons and drug offenders based on childhood predictors and adolescent correlates.

BACKGROUND: Weapons and drug offences incur a large cost to society and tend to be strongly associated. Improved understanding of their antecedents could inform targeted early intervention and prevention programmes. AIM: This study aimed to examine differences in criminal careers, childhood predictors and adolescent correlates among weapons-only offenders, drugs-only offenders and a versatile group of weapons + drugs offenders. METHOD: We conducted a longitudinal records study of 455 young Canadians charged with drug and/or weapons offences who started their offending in late childhood/early adolescence. RESULTS: Consistent with expectation, differences emerged in their criminal careers as the versatile group had a longer criminal career and desisted from offending at a later age than weapons-only offenders. Against prediction, weapons-only offenders experienced the greatest number of childhood predictors and adolescent correlates. CONCLUSION AND IMPLICATIONS FOR PRACTICE: The three offending groups could be differentiated on offending trajectories and developmental factors.In making links between past events and later behaviour, life-course criminology may inform development of effective early intervention and prevention strategies.As weapons-only offenders experience the greatest level of adversity in childhood and adolescence, they may benefit most (of these three groups) from early intervention and prevention programmes.A reduction in weapon carrying and use might be achieved by early identification of children risk factors (e.g. family adversity) and appropriate intervention.

Potential mediators between child abuse and both violence and victimization in juvenile offenders.

Juvenile offenders are at risk for involvement in both fighting behavior and peer victimization. Understanding the potential causal mechanisms leading to these outcomes is important to address the needs of this population. The present study tested four mediator models of violent perpetration and peer victimization in a sample of 112 incarcerated youth (68 males and 44 females). In the models, the relationship between child physical and emotional abuse and fighting and victimization was expected to be mediated by impulsiveness, depression, and drug use. Multiple mediator models were tested according to Preacher and Hayes (2008). Depression fully mediated the relation between child emotional abuse and victimization and partially mediated the relation between child physical abuse and victimization. Drug use fully mediated the relation between child emotional abuse and fighting. These results suggest that treatment of depressive symptoms and drug use among juvenile offenders with a history of child physical or emotional abuse may limit violent perpetration and peer victimization in this population.

Cumulative childhood maltreatment and depression among incarcerated youth: impulsivity and hopelessness as potential intervening variables.

Youth involved in the juvenile justice system are at high risk for mental health problems, particularly depression. Furthermore, these youth often present with a history of childhood maltreatment. Despite research consistently demonstrating a link between childhood maltreatment and depression, our understanding of intervening factors of this relationship remains limited. This study examined impulsivity, hopelessness, and substance use as potential explanatory variables in the relationship between cumulative childhood maltreatment and depression severity among 110 incarcerated youth. The data were analyzed using path analysis. As hypothesized, cumulative maltreatment maintained a strong direct relation with depression severity in the context of the additional variables in the final model. Cumulative maltreatment also had an indirect relation with depression severity through both impulsivity and hopelessness. Contrary to expectation, substance use was not an explanatory variable in the model. These findings suggest that impulsivity and hopelessness might be important factors to consider in future studies on the relation between childhood maltreatment and depression symptoms among incarcerated youth.

Can we distinguish juvenile violent sex offenders, violent non-sex offenders, and versatile violent sex offenders based on childhood risk factors?

Understanding the developmental precursors of juvenile violent sex offending can contribute to the promotion of effective early intervention and prevention programs for high-risk children and youth. However, there is currently a lack of research on the early characteristics of adolescents who commit violent sex offenses. Drawing on the literature regarding the generalist and specialist positions of criminal behavior, the aim of the present study was to compare childhood risk factors for three groups of juvenile offenders: (a) pure sex offenders (PSO; n = 28); (b) violent non-sex offenders (VNSO; n = 172); and (c) versatile violent sex offenders (VVSO; n = 24). Nineteen risk factors comprising four life domains (individual, family, peer, and school) were identified from a file review. Three hierarchical logistic regression analyses examined associations between risk factors and offender groups. The results reflected the underlying heterogeneity of the sample, offering support for both the specialist and generalist positions of criminal behavior. PSOs differed from VNSOs on the basis of higher odds for precocious sexual behavior. Second, VVSOs differed from VNSOs on the basis of higher odds for precocious sexual behavior, criminal family members, and an adolescent mother, as well as lower odds for poor school behavior. Third, PSOs were marginally more likely to have engaged in early overt antisocial behavior compared with VVSOs. Fourth, many of the childhood risk factors examined were not associated with any offender group. In conclusion, VVSOs appeared to differ on the greatest number of risk factors from VNSOs, suggesting that VVSOs share a more similar developmental pathway with PSOs. The prevention and future research implications of these findings are discussed.

Evaluation of a targeted cognitive-behavioral program for children with conduct problems--the SNAP Under 12 Outreach Project: service intensity, age and gender effects on short- and long-term outcomes.

This study tested the effectiveness of a multifaceted, cognitive-behavioral therapy (CBT) program for antisocial children--the SNAP Under 12 Outreach Project (ORP)--in relation to age, sex and indices of treatment intensity. Study participants were 80 clinic-referred children (59 boys and 21 girls) aged 6-11 years assigned to one of the following groups: control (CG; n = 14) who did not receive the ORP, matched (MG; n = 50) who received the ORP, and experimental (EG; n = 16) who received an enhanced version of the ORP. Results indicated significant pre-post changes for the EG and MG for Child Behavior Checklist (CBCL)-measured delinquency and aggression, but no improvement for the CG. Positive relationships between the number of individual ORP components (e.g. number of children's CBT sessions) received and CBCL change scores were also found. Statistical associations tended to be larger for girls and older children (i.e. 10-11 years old) who may have been more cognitively advanced. Also, the number of children's CBT sessions predicted later convictions, even after controlling for prior CBCL delinquency scores. Findings from this study support the effectiveness of the ORP, but also highlight the need to take into account client characteristics when offering clinical treatment.

The relationship between maternal attitudes and young people's attitudes toward children's rights.

Relations between maternal socio-political attitudes and parenting style and young people's and mothers' attitudes toward young people's nurturance and self-determination rights were examined. Both young people (n = 121) and mothers (n = 67) were more supportive of nurturance than self-determination rights, although young people were more supportive than their mothers of self-determination rights and mothers were more supportive than young people of nurturance rights. Maternal conservatism was unrelated to young people's support for rights and negatively related to mothers' support for both types of rights. Last, young people who perceived their mother to be either authoritarian or uninvolved showed stronger endorsement of self-determination rights than young people who perceived their mother to be authoritative. The implications of these findings for the development of young people's attitudes toward rights within the context of various family factors are discussed. In particular, it is suggested that a balance needs to be achieved between assertion of rights and a respect for the rights of others.

Effects of a relapse prevention program on sexual recidivism: final results from California's sex offender treatment and evaluation project (SOTEP).

Final results from a longitudinal investigation of the effectiveness of cognitive-behavioral treatment with sexual offenders are presented. The study was a randomized clinical trial that compared the reoffense rates of offenders treated in an inpatient relapse prevention (RP) program with the rates of offenders in two (untreated) prison control groups. No significant differences were found among the three groups in their rates of sexual or violent reoffending over an 8-year follow-up period. This null result was found for both rapists and child molesters, and was confirmed in analyses using time to reoffense as the outcome and those controlling for static risk differences across the groups. Closer examination of the RP group's performance revealed that individuals who met the program's treatment goals had lower reoffense rates than those who did not. Although our results do not generally support the efficacy of the RP model, they do suggest a number of ways in which this kind of treatment program can be improved. This study also emphasizes the importance of including appropriate control groups in treatment outcome research. Additional controlled investigations are needed to address the many questions that remain about when and how treatment works for sexual offenders.

Examining the therapeutic utility of restraints and seclusion with children and youth: the role of theory and research in practice.

Restraining and secluding children living in residential facilities, though controversial, are commonly practiced by staff to manage disruptive behavior. In an effort to address some of the ongoing issues about the practice, this article examined the reasons for their use, their theoretical underpinnings, and extant empirical evidence in support of the theories. It is suggested that the current array of theories be updated and comprehensive research programs be encouraged to assess their clinical utility with various populations in a variety of settings.