Introduction

Early life adversity has long been associated with the onset and course of criminal behavior and juvenile justice involvement (Widom, 2017). Violence, trauma, and adversity are among the most salient empirical antecedents to criminal behavior and legal system involvement; the rates of trauma among incarcerated youth are substantially higher than youth in the general population (Abram et al., 2004; Ford et al., 2013; Fox et al., 2015). For some youth of color, the prevalence of violence or trauma exposure have significant consequences for their safety, mental and behavioral health, and developmental outcomes (DeGruy et al., 2012; Graves et al., 2010; Kerig, 2018; Quinn et al., 2022). Studies report approximately 90% of justice-involved youth have had at least one traumatic exposure (Abram et al., 2004; Dierkhising et al., 2013) with an average of 14 total experiences (Abram et al., 2004). This concept of poly-victimization or cumulative trauma resulting from exposure to more than one type of adversity (Finkelhor et al., 2007) represents a more comprehensive approach to encapsulating multiple trauma exposures and multi-dimensional experiences of trauma. Research has indicated that among youth with an average of 4 different forms of trauma, each additional trauma exposure increased delinquent activity by 13% (Layne et al., 2014).

Nevertheless, there is a paucity of research on the differential experiences of early life trauma and trauma symptomology among youth of color in the juvenile justice system (JJS). Disproportionate Minority Contact or overrepresentation of youth of color—including black or African American and Latinx or Hispanic youth—occurs at every point in the JJS, from surveillance to release (Hanes, 2012; Mooradian, 2012; Piquero, 2008; Puzzanchera, 2013; Rosenthal, 2019). Of note, arrest rates, including those for violent offenses have been at their lowest level in almost four decades, but the declines have been greater for males than females and for white versus black youth in the same period, respectively (Puzzanchera, 2020). Therefore, the overrepresentation of black youth in JJS is an indicator of significant mental and/or behavioral health needs (Quinn et al., 2022). Overrepresentation has been attributed to racist processes embedded in various systems, from schools to health care to policing (Barnes & Motz, 2018; Stewart et al., 2009). Moreover, youth of color have trauma exposures that are vastly different from those of their white counterparts, including experiences of structural inequities, discrimination, segregation, misogyny, racism, and race-based stereotypes (McLaughlin et al., 2019). Such experiences, theoretically understood as race-based traumatic stress (Carter et al., 2005) or cultural racism and race related stress (Quinn et al., 2019), have been linked to adverse physical and mental or behavioral health outcomes, including delinquency (Comas-Diaz et al., 2019). However, conventional trauma instruments used in the JJS yield limited cultural relevance or applicability to racially minoritized justice involved youth.

While research has explored the relative effects of racial trauma above and beyond other traumatic experiences among minoritized youth in the JJS (Kang & Burton, 2014; Mendez et al., 2022), differential trauma experiences and differential effects between trauma and delinquency among racial groups have not been extensively explored. Between-group comparisons, triangulated with extant research using instruments capturing race-based traumatic stress, can elucidate the extent to which youth of color have distinctively different exposures to and/or symptoms of adversity. Knowledge expansion in this area would facilitate exploration into more inclusive conceptualizations of trauma and support anti-oppressive participatory action-based research strategies to infuse voices of justice-involved youth in developing relevant race-based traumatic stress measurement instruments and targeted trauma interventions.

Raced-Based Traumatic Stress

Race-based traumatic stress is related to historical trauma and referred to as “a complex and collective trauma experienced over time and across generations by a group of people who share an identity, affiliation, or circumstance” (Mohatt et al., 2014, pp. 128). African Americans who have experienced historical traumas like slavery and discrimination tend to show a higher incidence of disease even decades after the original trauma occurred (Quinn, 2018; Sotero, 2006). Specifically, in the explanation of the Post Traumatic Slave Syndrome, DeGruy (2001) suggests that the hundreds of years African Americans spent enslaved has resulted in a legacy of debt—pain—and trauma that is similar to the effect of historical trauma, i.e., delinquency and criminality. Despite this plethora of evidence supporting the relationship between trauma and delinquency, there is limited information on how traumatic experiences are a unique or contributing risk factor for delinquency or legal system involvement among racially minoritized youth. Youth of color may be differentially exposed to trauma experiences that are not currently captured in typical trauma instruments but are critical risk factors for legal system involvement and sustainment. For instance, among a stratified sample of youth in detention, white male youth were more likely than other racial groups to report the specific trauma of having been physically attacked or beaten (Abram et al., 2004), with implications for empirical inquiries to broaden studies to include contextual factors like community violence. In another sample of youth in one state Department of Youth Services system, black youth had higher rates of delinquency relative to white youth; while there were no differences reported in the overall trauma index, there were higher rates of witnessing injury or death among black youth (Vaughn et al., 2008). Importantly, a recent study found that Hispanic and white youth in the JJS reported higher rates of cumulative trauma (Duron et al., 2021), which is somewhat inconsistent with a previous study that found black or African American youth in detention to be at greater risk for poly-victimization (Ford et al., 2013). Neither study examined the differential impact of trauma experiences or symptom expression on delinquency between racial groups, nor did the contextualization of findings center on racialized trauma, obscuring the relevance of implications for targeted intervention.

Racialized trauma experienced by minoritized youth can leave a lasting impact (Saleem et al., 2020) and experiences of discrimination during adolescence can contribute to adverse psychological outcomes in adulthood (Assari et al., 2017). Moreover, and most relevant to African American youth in the general population, cultural racism, discrimination, and institutional racism are associated with higher rates of depression, anxiety, and psychiatric illness (Lewis et al., 2015; Williams & Mohammed, 2013; Williams-Butler et al., 2022). Raced-based traumatic stress theory is a framework that underscores the effects of racism, discrimination, and cultural stressors on psychological well-being (Carter, 2007). The theory argues that research has not comprehensively accounted for experiences of systemic racism in understanding traumatic stress responses despite the clear association between racial discrimination and psychological and behavioral distress (Carter, 2007). In essence, while racism has been identified as a significant life stressor associated with poor health outcomes among minoritized groups (Assari et al., 2017; Lewis et al., 2018), the integration of cultural or racial constructs in theoretical models and research studies is significantly lacking (Bernard et al., 2021), specifically within research studies on youth of color (Saleem et al., 2020). Indeed, incidents of racialized trauma may have a similar or exacerbated impact on behavioral outcomes compared to conventionally studied trauma events (Carter, 2007). One study found that black adolescents in the general population averaged approximately 5 racist experiences daily that were associated with depressive symptom expression (English et al., 2020). Theoretical scholars have applied a critical race perspective to the JJS by positing that both systemic racism and trauma exposures are central experiences for legal system-involved youth of color (Crosby, 2016). Under the theoretical framework of race-based traumatic stress, even the same traumatic event exposure (e.g., natural disasters) can produce variation in racial and cultural traumatic responses such that there may be differences in behavioral, emotional, or psychological adaptation across racial or cultural groups according to socially constructed norms and experiences (Carter, 2007; Perilla et al., 2002). Nevertheless, trauma-specific screening and instrumentation within the JJS lack conceptualizations that racism and discrimination are inherently traumatic.

Conventional Trauma Tools

Given the overrepresentation of racially minoritized youth in JJS, the high rates of early life trauma, and the long-standing connection between trauma and youth violence, we need to better understand the extent to which conventional trauma tools detect the relative traumatic experiences of youth of color. Conventional trauma tools may yield limited cultural relevance or applicability to racial minoritized legal system-involved youth; the vast majority of instruments used to screen youth for traumatic experiences or trauma symptoms have limited inclusion of indicators capturing race-based traumatic stress (Dierkhising & Branson, 2016). In fact, commonly used risk assessment tools in JJS fail to integrate concepts of trauma altogether (Kerig, 2018), as they focus predominantly on criminogenic risk factors, or those dynamic factors that are malleable (Skeem et al., 2014). Nevertheless, it is highly recommended that the JJS screen youth for trauma (see: National Child Traumatic Stress Network; NCTSN, 2007); many state and local systems have begun to institute large-scale efforts to detect trauma outside of conventional risk assessment protocols to more appropriately link to necessary therapeutic services (Dierkhising & Branson, 2016).

Commonly used screening instruments being deployed in JJS include the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2; Grisso et al., 2012); the Juvenile Victimization Questionnaire (JVQ; Hamby et al., 2005); the Survey of Children’s Exposure to Community Violence (SCECV; Richters & Saltzman, 1990); the Traumatic Events Screening Inventory (TESI; Edwards & Rogers, 1997); the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI; Steinberg et al., 2013); or the Revised Inventory of Adverse Childhood Experiences (ACEs; Finkelhor et al., 2015), which is similar to but less robust than the Childhood Trauma Questionnaire (CTQ; Bernstein et al., 1994) used in the current study. Each of the tools have notable limitations, with the primary drawback of the instruments being the unspecified racial and cultural relevance to racially minoritized groups. More specifically, the instruments fail to account for racial and cultural differences in emotions, experiences, or internalization, and they lack integration of items that may fully encapsulate traumatic events and responses of racially minoritized legal system-involved youth (McCoy, 2014). The description and limitations of the specific instruments are elucidated below.

The MAYSI-2 is a mental health screening used by 44 states in probation and correctional intake processes (Grisso et al., 2012). The MAYSI-2 includes 52 dichotomized items that measure seven scales: Alcohol/Drug Use, Angry-Irritable (AI), Depressed-Anxious, Somatic Complaints, Suicide-Ideation, Thought Disturbances, and Traumatic Experiences (Grisso & Barnum, 2000); all except for the Traumatic Experiences subscale are used for clinical assessment. The MAYSI-2 fails to identify the race-based trauma experienced by minoritized youth before entering JJS. Further, the interpretation and racial implications of items in the survey such as “shaky” or “jumpy” has cultural and contextual implications that differ between racial groups (McCoy, 2014). Additionally, like many other screening instruments, generational and historical trauma are not included as traumatic experiences.

The JVQ is another commonly used instrument with 34 dichotomized items, and one-item concerning “bias-attack,” which investigates physical attacks due to race, religion, family of origin, ability, or sexual orientation (Hamby et al., 2005). This bias-attack item does not include non-physical and non-violent racial trauma, nor does it consider the traumatic impacts of institutional and systemic racialized oppression. The JVQ is also limited in its applications to racialized youth in JJS as it was validated with a white sample and has not been validated with justice-involved youth (Wevodau, 2016). Similarly, the SCECV instrument is based on the “Things I’ve Seen and Heard” scale, which asks youth how they have experienced, seen, or heard about violence. It used a 9-point Likert scale to indicate the frequency of exposure to 18 different traumatic events (Richters & Saltzman, 1990). The included questions align with other instruments of trauma, focusing on violence perpetrated against a youth, someone the youth knows, someone in the community, or a stranger. While the instrument has been validated with a large population of racially minoritized youth and some justice-involved youth (Wevodau, 2016), it does not include items specific to incidents of racial trauma.

The TESI is an instrument with 15 to 26 dichotomized items in which participants are asked if they have experienced various traumatic events (e.g., natural disasters, accidents, threats of violence, perpetrated violence, etc.) with subsequent follow up questions if the participant answered yes to an item (Edwards & Rogers, 1997). The TESI has been validated with legal system-involved youth, but there has not been any study investigating racial or ethnic differences in accuracy (Wevodau, 2016). The UCLA PTSD-RI is a three-part instrument that begins with 13 dichotomized items about national disasters, accidents, war, physical abuse, sexual abuse, and medical trauma (Steinberg et al., 2013). Part two allows participants to answer questions about what event is “most traumatizing,” (Steinberg et al., 2013) which requires participants to determine a singular traumatizing event. Racially minoritized youth might not have the opportunity to identify racialized trauma as the “most traumatizing”, not only because there are not items specific to those experiences, but because racialized trauma may be better understood as an accumulation of discrimination and oppression as opposed to a discrete event.

The Revised ACEs tool expands on the original ACE measure to include alternative forms of child traumatic experiences. The tool comprises 14 dichotomous items. The questions are similar in concept to the questions within the CTQ used in the present study, but the CTQ is arguably more robust in responses (frequency responses) and number of items (five items per trauma construct). Finally, the racial respect measure has been described as focusing on protective factors based on the culture, experience, and codes of black people in the USA, particularly young black males (DeGruy et al., 2012). Specifically, racial respect can be defined as “a prosocial attitude that arises from the recognition of one’s inherent self-worth, the honoring of one’s racial origins by the self, peers, and others in society, and an appreciation of the contributions made by oneself, one’s family, and African Americans as a group” (DeGruy et al., 2012, p. 398). This measure requires individuals to complete 20 items to assess the extent to which the youth felt respected (both individually and, more generally, as an African American) by their family, peers, and society (DeGruy, 2001). None of the named instruments include all the impacts of multiple instances of microaggressions, underlying impacts of historical trauma, and persistent racial trauma. Additionally, identifying singular events does not consider the poly-victimization that many minoritized and non-minoritized youth alike may experience.

Despite limited inclusion of race-based trauma instruments in JJS, two known research studies on legal system-involved samples have examined the confluence of race-based traumatic experiences and conventional trauma experiences and responses represented in the vast majority of trauma tools. First, Mendez and colleagues (2022) studied the consecutive and relative effects of post-traumatic stress and racial discrimination, finding that racial discrimination accounted for increases in variance explained when associating with delinquent outcomes. A similar stepwise approach was used with a sample of African American incarcerated youth; conventional trauma measures (CTQ and the Trauma Symptom Checklist) and a racism/discrimination measure were explored in tandem with delinquent outcomes (Kang & Burton, 2014). Results showed significant effects of all measures, and significantly greater variance was explained when racism and trauma symptoms were included in the model (Kang & Burton, 2014). While the race-based traumatic stress tools used in each study have some limitations (i.e., The 3-item dichotomized tool used in the Mendez study or the non-validated tool in the Kang & Burton study), the studies are some of the first to consider the impact of race-based trauma on legal system-involved youth.

Study Purpose

Overall, there are inconsistent findings on legal system-involved racial minority experiences of conventional traumatic events, including cumulative trauma or poly-victimization. Further, there is limited knowledge on the delinquency patterns between racial groups and whether there are differential effects between trauma and delinquency among racial groups; there is not sufficient information on the differential experiences of conventional trauma incidents and whether they are associated with delinquent outcomes. Such knowledge can inform a greater understanding of the ways in which standard trauma tools are developed and delivered in juvenile justice service settings. The current study addresses these gaps through three primary research questions. RQ1. Are racially minoritized youth overrepresented in this sample? RQ2. Using conventional trauma instruments, are there disparate rates of early life trauma experiences and symptomatology among minoritized groups? RQ3. Are there differences in delinquency by racial group such that trauma experiences impact delinquency differentially for youth of color? These results, combined with research using race-based trauma measures will inform implications for participatory action approaches in the development and delivery of trauma instrumentation for racially minoritized justice involved youth.

Methodology

Sample and Procedures

Self-report data were collected from youth involved in the juvenile justice system (N = 336) in a Western state and a Midwestern state during the years 2015 and 2019, respectively. With university IRB approvals and the support of respective state agency partners, adjudicated youth between the ages of 11–21 housed in community correctional facilities or residential placements were asked to participate in an optional cross-sectional survey. Prior to data collection, passive or active parental consent was obtained (based on agency policy) and youth either consented (≥ 18 years of age) or assented (< 18 years of age) to participate in the study. The youth completed a battery of instruments that included well known surveys pertaining to early life victimization, trauma symptomatology, and delinquency behavior prior to arrest.

Youth completed the survey in approximately 50–70 min with research and staff support. The data collection process included a group-based format with approximately 10–15 youth per group with either $15 gift cards or pizza offered as participation incentive; the type of incentives allowed were dictated by facility policy. Importantly, mental health professionals and staff were present during the administration of the surveys in the event that youth experienced emotional or physical distress. However, there were no noted reports of such incidents. Exclusionary criteria included the presence of a significant developmental delay, or a serious psychotic disorder as indicated by a mental health professional; reading competence below a 5th grade level as determined by their counselor; or under the age of 11 or over the age of 21.

The average age of the sample was 16.74 years of age (SD = 1.83; range: 11–20). The entirety of the sample participants will be referred to as ‘youth’, representing some individuals who are technically above the age of 18, but would classify developmentally as a youth. Much of the sample identified as male (n = 309; 92%), and indicated that on average, they completed 10th grade (SD = 1.66 grades). The youth described their family of origin where 28% (n = 94) reported being raised in two-parent/biological mother and father families; 31% (n = 105) reported single-maternal caregiver families; 4.2% (n = 14) reported single-paternal caregiver families; 12% (n = 40) reported maternal caregiver/biological mother and partner families; 3% (n = 11) reported paternal caregiver/and partner families; 7% (n = 23) reported grandparents or other relatives; 4% (n = 14) reported foster families; 8% (n = 26) reported other families; and two cases had missing data (0.6%). The racial identities of the youth are presented in the measures below, given they are a critical part of the data analyses.

Measures

Dependent Variable: Cumulative Trauma Index

Childhood Trauma Questionnaire

Two measures were administered to assess cumulative trauma: the Childhood Trauma Questionnaire (CTQ; Bernstein et al., 1994) and the Domestic Adversity Scale (DAS; Burton et al., 2011). The CTQ is a 25-item measure that asked youth to report the frequency (0 = Never, 1 = Rarely, 2 = Sometimes, 3 = Often, 4 = Very Often) of five different forms of abuse and/or neglect (physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect) while growing up with example items such as “I was punished with a belt, board, cord, or some other hard object”, “I felt that someone in my family hated me”, “Someone molested me”, “ I didn’t have enough to eat”, and “There was someone in my family whom I could talk to about my problem”. This tool has strong internal consistency (α = 0.910).

Domestic Adversity

Other experiences of cumulative trauma were captured through the 12-item DAS (Burton et al., 2011), which assesses the indirect experiences of adversity within the youth’s home while growing up. The items, such as “Having a parent with an alcohol or drug problem”, “Hitting, slapping, punching or other violence between parents and children”, or “Mental health problems in the family”, had Likert scale responses (0 = Not at all like my home; 1 = A little like my home; 2 = Somewhat like my home; 3 = A lot like my home; 4 = Exactly like my home). The items were also dichotomized (0 = no; 1 = yes) and summed to create a range of responses from 0 to 12 (M = 4.36, SD = 3.05) with strong internal consistency (α = 0.811). This study used the full DAS as a dependent variable to determine group differences in the individual traumatic experiences. To create the cumulative trauma composite, the CTQ dichotomized subscales and the DAS dichotomized items were summed with scores ranging between 0 and 37 (M = 13.86, SD = 7.25) with a strong internal consistency (α = 0.866). Importantly, in this sample, 333 (99.1%) youth indicated at least one traumatic experience and 319 (95%) youth indicated four or more. The mode was 12, with 23 youth endorsing 12 experiences.

Dependent Variable: Individual Trauma Events

This study used the subscales of the CTQ, including each traumatic experience, as dependent variables to determine group differences in traumatic experiences. Composites including physical abuse (M = 0.84, SD = 1.00), sexual abuse (M = 0.39, SD = 0.84), emotional abuse (M = 0.96, SD = 1.08), emotional neglect (M = 1.36, SD = 1.31), and physical neglect (M = 0.67, SD = 0.75) were created by averaging youth items across each subscale. Furthermore, physical abuse (α = 0.885), sexual abuse (α = 0.882), emotional abuse (α = 0.804), and emotional neglect (α = 0.946) had good to strong internal consistency. Physical neglect had a lower, but acceptable internal consistency (α = 0.690). The DAS composite (M = 0.82, SD = 0.76) was created by averaging items and also modeled as a dependent variable with strong internal consistency (α = 0.847).

Dependent Variable: Trauma Symptoms

Trauma symptoms were measured via the Trauma Symptom Checklist-40 (TSC; (Elliott & Briere, 1992; Briere & Runtz, 1989). Youth were asked to self-report how often they have experienced 40 distinct trauma related indicators in the previous two months with responses on a 4-point Likert scale (0 = Never to 3 = Almost all of the time). There are six subscales in the TSC-40: depression (e.g., sadness), anxiety (e.g., anxiety attacks), dissociation (e.g., feeling that you are not always in your body), sleep disturbances (e.g., nightmares), sexual problems (e.g., sexual overactivity), and a sexual abuse trauma index (e.g., fear of men). Items representing the respective clinical subscales were averaged to create a composite approximating the construct of trauma symptomatology (M = 0.71, SD = 0.62) with strong internal consistency (α = 0.942).

Dependent Variable: Delinquency Prior to Arrest

The Self-Report Delinquency Scale (SRD; Elliott & Ageton, 1980) was used to measure delinquency actions prior to the youth’s current arrest. The scale contains 32 items that include questions on a 7-point Likert scale assessing frequency ranging from 0 = Did not do to 6 = 2–3 times a day. The instrument includes person and non-person offenses, and some example items included “Before I was arrested, I purposely damaged or destroyed property that didn’t belong to me” or “I broke or tried to break into a building or vehicle to steal something or just look around”. This subscale (M = 1.18, SD = 0.90) demonstrated strong internal consistency (α = 0.903).

Independent Variable: Racial Groups

The racial identities of the youth were determined with a single item “What racial group you most closely identify with”? Approximately 26% (n = 86) identified as black or African American; 22% (n = 73) identified as Latino or Hispanic; 41% (n = 139) identified as white; 1% (n = 3) identified as Asian; 3% (n = 9) identified as Native American; 5% (n = 18) identified as Other; and there were eight cases with missing data (2.4%). For the purposes of this study, and to ensure there were enough cases per category, the Asian, Native American, and pre-determined “other” categories were coalesced to create the “Other” category used in this analysis (n = 30; 9%). We recognize this approach is reductive and fails to account for within and between group variations of racial diversity. We will proceed with the analyses, but will take initiatives in next data collection efforts to capture true racial identities. We discuss this limitation later.

Analytic Plan

Data were analyzed using IBM Statistical Software Package SPSS for Windows version 27 (IBM Corp., 2020). Given there was 5% or less missing data on all variables of interest,

listwise deletion was employed (Cheema, 2014). To answer the research questions three separate analytic steps were conducted. The first step was to proportionally compare minority representation between this sample of justice-involved youth relative to the respective state populations from which the samples were derived (i.e., Western and Midwestern). To do this, the state-level 2010 U.S. Census data were used as it most approximated the time at which the data state were first collected for the Western state in 2015. While the 2020 Census data would more closely approximate the data collection timeframe (2019) for the Midwestern state, the use of Census data for a period of time after data was collection is not appropriate. Thus, the 2010 state level census data were pulled for each state, separately; the split file command was utilized to truncate the file by state. Descriptive statistics (frequencies and percentages) were run on the racial categories for youth in each sample separately. In this way, this sample could be compared to the state population with greater demographic specificity.

The second step included a multivariate analysis of variance (MANOVA) to test mean differences between racial groups (independent variable) on dependent variables, including cumulative trauma, domestic adversity, physical abuse, sexual abuse, emotional abuse and neglect, physical neglect, and delinquency. A MANOVA is an appropriate statistical test to determine mean differences among multiple correlated dependent variables as a function of the independent grouping variable (Carey, 1998). For all significant F tests, Levene’s metric was used to determine whether the assumption of equal variances was met. Scheffé’s post hoc test was performed if equal variances were assumed (p > 0.05) and the Games–Howell test was used if equal variances were not assumed (p < 0.05). The tests were selected as the most conservative for unequal sample sizes among groups (Shingala & Rajyaguru, 2015). The results also report the partial eta squared statistic or measure of the effect that indicates the proportion of the variance in the dependent variables explained by the independent variables while holding all other variables constant (Richardson, 2011). While subsumed under the third research question, this analysis also included delinquency as a dependent variable to determine racial group differences.

The third and final step was to split the file by racial group and conduct bivariate correlations for each group, separately. This was done to determine relative associations between all trauma indicators, including individual traumatic exposures (i.e., sexual, emotional, or physical abuse, and physical and emotional neglect), cumulative trauma, trauma symptoms, and delinquency. The associations between trauma events and trauma symptoms were also reported for further context.

Results

RQ1. Sample Representation

Western State

When compared to the 2010 state-level census data on the Western state used in this sample (US Census Bureau, 2020), the descriptive data from this study showed that black and Hispanic/Latino individuals are overrepresented in the sample; while black individuals represented 4.0% and Hispanic/Latino individuals represented 20.7% of the overall state population, they respectively represented 16.8% and 32% of individuals in the Western state sample. On the contrary, white individuals were underrepresented in this sample; while white individuals comprised 81.3% of the overall state population, they represented just 37.1% of the individuals in this Western state sample.

Midwestern State

When compared to the 2010 census data on the Midwestern state used in this sample, the descriptive data from this study showed that black and Hispanic/Latino individuals are overrepresented in the sample; while black individuals represent 13.4% and Hispanic/Latino individuals represented 3.1% of the overall state population, they respectively represented 39% and 7.4% of individuals in this Midwestern state sample. Similar to the Western state, in the Midwestern state white individuals were underrepresented in this sample; while white individuals represent 84.5% of the overall state population, they represented just 48.5% of the individuals in the sample. It should be noted that these numbers are based on this specific sample, which was highly dependent on the geographic regions from which the data were collected. As noted also in the limitations, this sample may not adequately represent all youth in the JJS within each state and there is potential over-or under-estimation of the true disproportionality within either geographical location.

RQ2. Trauma Experiences Among Racial Groups

The one-way MANOVA revealed a statistically significant multivariate main effect for racial groups, Wilks’ λ = 0.824, F(27, 312) = 2.21, p < 0.001, partial eta squared (pη 2) = 0.063, Power (1-β) = 0.999. The F test was significant, and thus, the main effects were examined. Only the statistically significant mean differences will be presented in the results. To see the full MANOVA results, refer to Table 1. The results revealed statistically significant mean differences between racial groups on cumulative trauma (F = 4.89, p = 0.002), trauma symptoms (F = 4.23, p = 0.006), physical abuse (F = 3.76, p = 0.011), sexual abuse (F = 4.48, p = 0.004), emotional abuse (F = 5.74, p < 0.001), emotional neglect (F = 3.81, p = 0.010), and physical neglect (F = 3.11, p = 0.021).

Table 1 Descriptive Statistics and Multivariate Analysis of Variance Results
Full size table

Post hoc Results

Games-Howell post hoc tests were run for all significant results with equal variances not assumed based on homogeneity of variance (HOV) tests (p < 0.05). Thus, all dependent variables except emotional neglect (HOV: p = 0.127) used Games Howell post hoc tests. Results revealed statistically significant pairwise mean differences (MD) between black and white youth on rates of cumulative trauma (MD = 3.50, p = 0.001), with white youth reporting higher rates. All other racial groups revealed lower rates than white youth, but not to a statistically significant degree. Results revealed significant pairwise mean differences between Hispanic and white youth on rates of trauma symptoms (MD = 0.27, p = 0.003), with white youth reporting higher rates. Interestingly, the Other racial category reported a higher score than white youth, but given the difference in group sizes, the effect of the mean difference was not detected. The rates of trauma symptoms were relatively similar between black and white youth.

The results revealed a notable pattern among physical abuse, sexual abuse, and emotional abuse whereby white youth demonstrated statistically significant higher rates relative to both black and Hispanic youth. Results revealed significant pairwise mean differences between black and white youth (MD = 0.39, p = 0.027) and Hispanic and white youth (MD = 0.40, p = 0.027) on rates of physical abuse, with white youth reporting higher rates in both cases. Similarly with sexual abuse, there were significant pairwise mean differences between black and white youth (MD = 0.36, p = 0.014) and Hispanic and white youth (MD = 0.37, p = 0.015). Finally, with emotional abuse, there were significant pairwise mean differences between black and white youth (MD = 0.57, p < 0.001) and Hispanic and white youth (MD = 0.46, p = 0.014). Results revealed significant pairwise mean differences between black and Other youth on rates of physical neglect (MD = 0.47, p = 0.008), with Other youth reporting higher rates. Results from Scheffe’s post hoc test results also revealed significant pairwise mean differences between black and Other youth on emotional neglect (MD = 0.83, p = 0.028), with Other youth reporting higher rates.

Interestingly, relative to other racial groups, black youth reported the lowest scores on all individual trauma event indices and the cumulative trauma index, yet they reported similarly high rates of trauma symptoms as white youth. Furthermore, Hispanic youth reported lower rates than white youth on three commonly assessed dimensions of trauma including physical, sexual, and emotional abuse. The Other race category—composed of racially diverse youth—reported higher rates of physical and emotional neglect relative to black youth. They had notably higher mean scores of trauma symptoms relative to the remaining racial groups, though differences were not statistically significant given the group size differences.

RQ3. Racial Group Differences on Trauma Experiences and Delinquency

Delinquency

The MANOVA analysis also included delinquency as a dependent variable to determine racial group differences. The results revealed a notable finding whereby all youth, irrespective of racial group, reported similar rates (about once a month) of delinquency. There were no statistically significant mean differences between racial groups (F = 1.07, p = 0.360) (Table 2).

Table 2 Significant Correlation Results
Full size table

Black Youth

The bivariate correlations revealed there were no statistically significant associations between any trauma indicators (individual trauma events, cumulative trauma, or trauma symptoms) and delinquency prior to arrest. For black Youth, the only events associated with trauma symptoms were domestic adversity (r = 0.296, p = 0.008), physical abuse (r = 0.231, p = 0.042), emotional neglect (r = 0.274, p = 0.016), and physical neglect (r = 0.333, p = 0.003).

Hispanic/Latino Youth

The bivariate correlations revealed no statistically significant associations between trauma events and delinquency. For Hispanic/Latino youth, the trauma events associated with trauma symptoms were cumulative trauma (r = 0.402, p < 0.001), sexual abuse (r = 0.350, p = 0.003), and emotional abuse (r = 0.461, p < 0.001).

White Youth

The bivariate correlations revealed there were statistically significant associations between several trauma indicators and delinquency; cumulative trauma (r = 0.320, p < 0.001), domestic adversity (r = 0.299, p < 0.001), trauma symptoms (r = 0.301, p < 0.001), physical abuse (r = 0.226, p = 0.009), emotional abuse (r = 0.183, p = 0.034), and physical neglect (r = 0.235, p = 0.006) were positively associated with delinquency. Interestingly, for white youth, there were a lower number of trauma events associated with trauma symptoms that included cumulative trauma (r = 0.241, p = 0.005) and emotional abuse (r = 0.223, p = 0.010).

Other Youth

The bivariate correlations revealed there were statistically significant associations between delinquency and cumulative trauma (r = 0.671, p < 0.001), domestic adversity (r = 0.748, p < 0.001), trauma symptoms (r = 0.433, p = 0.017), physical abuse (r = 0.404, p = 0.027), and emotional abuse (r = 0.445, p = 0.014). Furthermore, for this group, the only trauma events associated with trauma symptoms were cumulative trauma (r = 0.442, p = 0.014), emotional abuse (r = 0.466, p = 0.009), and physical neglect (r = 0.373, p = 0.042).

Discussion

The purpose of this study was to examine differential racial group experiences of trauma incidents and associations with delinquent outcomes for youth. The results from this study revealed the nuanced experiences of trauma among racial groups in the sample. First, and unsurprisingly, the results showed that when broken down by geographic region, black and Hispanic individuals in both states were overrepresented in juvenile justice settings, consistent with previous research (Piquero, 2008). Understanding sample-based over representation of racially minoritized youth aligns with the larger focus of this study; differential experiences of early adversity among racially minoritized youth may create risks that uniquely impact disproportionate pathways to the juvenile justice system and thus can become prevention targets. We can more acutely contextualize and study the precursors to overrepresentation, including raced-based trauma (i.e., discrimination, racism, or impacts of racial poverty). The results conclude that white youth likely have differing experiences of trauma altogether. So, when deciphering antecedents to overrepresentation in juvenile justice, we can integrate this critical lens and develop prevention and early intervention programming in the JJS from a race-based trauma framework. In essence, this paper is proposing a model of differential risk, as opposed to differential offending or differential treatment that are predominant frameworks for understanding DMC (Development Services Group, Inc, 2014). In this way, we are contextualizing the differential developmental pathways to legal system-involvement by naming race-based traumatic stress as a key antecedent, rather than merely critiquing decisions made by system-wide actors, either before or after the delinquent behavior, as perpetuating disadvantage (i.e., bias theory). While DMC has been discussed as a function of a “racialized society” (National Research Council, 2013 p. 239), the idea of differential risk with race-based traumatic stress as the core underpinning, can be a new conceptualization that creates large scale system change towards DMC assessment and prevention.

Secondly, the results demonstrated significant group differences relative to early life trauma events and symptoms. In many of the results, particularly on the cumulative trauma index and the physical, sexual, and emotional abuse subscales, white youth had significantly higher rates than black youth despite white and black youth having similarly high rates of trauma symptomatology. When anchoring these findings to the correlation results, the associations between trauma events and trauma symptoms revealed that black youth had experiences that were different from the experiences of white, Hispanic, or Other youth. Arguably, the experiences of domestic adversity and emotional and physical neglect are more contextual in nature and the experiences of emotional abuse (as found in white youth) or sexual and emotional abuse (as found in Hispanic youth) are more relational (Briere & Runtz, 1990; Hayashi, 2022). Perhaps contextual adversity more closely maps onto experiences of racism and discrimination (Goings et al., 2022) not captured by the tools used in this study or may indicate that black and Hispanic youth experience racism and discrimination as concurrent trauma events that account for their similarly high levels of trauma symptoms.

Moreover, the variation in trauma responses, especially by black youth could reflect the specific effects of racism and culture resulting in their voices being suppressed. The presumption that youth of color will easily share their experiences with practitioners despite incidents of oppression and disconnection, or the break in connection, which restricts and blocks psychological growth, as well as social identity development may be erroneous (Jenkins, 2000; Johnson & Munch, 2009; Quinn & Grumbach, 2015). Previous research studies with black adolescents and African American women with incarceration histories indicate they are less likely to report mental health issues, including PTSD, depression, etc. (Lu et al., 2017). This has also been described in relation to African American women as it involves internalized dominance/oppression that damages the connection to self and others. Black adolescent females are the fasted growing group involved in the youth legal system accounting for slightly more than a third of all youth arrests (Kalu et al., 2020; Kerig, 2018; Sherman & Balck, 2015; Tam et al., 2019). Black girls continue to be arrested at higher rates than boys and other racial and ethnic groups even though as of 2019, arrest rates were the lowest they have been in four decades (Puzzanchera, 2020), which promotes their ongoing overrepresentation in the youth legal system (Hockenberry & Puzzanchera, 2017; Office of Juvenile Justice and Delinquency Prevention [OJJDP], 2019). Factually, Black girls under age 18 years comprised about 35% of those who were involved with the legal system even though they comprise only 14% of the national population of American girls (OJJDP, 2019; Sickmund et al., 2020; Vafa et al., 2018). Despite their system-involvement and high rates of need (Kalu et al., 2020), they continue to be marginalized simply because their numbers are smaller compared boys; while the study sample of girls may be small (8%), it is imperative to focus on girls in research studies and consider their JJS trajectories from an intersectional lens.

Given that the over 90% of the sample are adolescent males, there could be stigma associated with disclosing the traumatic experiences they have had. In Tony Porter's TED Talk (Porter, 2010), he notes the fear that holds men hostage to a “man box…the twisted beliefs” focused on only one side of the binary, i.e., being strong and not openly expressing emotions (except for anger), not showing weakness or fear, not seeking consultation to make decisions-does not need help, etc. He further states that the man box stifles manhood and wholeness, and most men ascribe to this consciously and unconsciously and being in the box is more important than anything else. Even when men decide they want to get out of the man box that it is so difficult because they are afraid—afraid of the stigma associated with the being outside of it (Porter, 2010). Perhaps adolescent males in this study fear disclosing their trauma histories because being ‘in the man box’ by not disclosing their feelings/experiences is more important.

White youth also had higher rates of physical, sexual, and emotional abuse than Hispanic youth. This is somewhat inconsistent with extant research that finds Hispanic and white youth are racial groups with the highest rates of trauma exposure (Duron et al., 2021). Moreover, Hispanic youth had the lowest rates of trauma symptomology between all groups, with significantly lower rates than white youth. However, the traumatic experiences associated with trauma symptoms among Hispanic and white youth are similar in that they reflect both relational types of trauma experiences and the additive experience of polyvictimization. Perhaps there are cultural differences in either reporting rates of trauma experiences or internalization of those experiences. Research has found cultural betrayal trauma theory (CBTT), or the experience of internalized prejudice or intracultural pressure to protect the minority ingroup from racism or discrimination, to be an outcome of intra-racial trauma exposure (Gómez, 2019). While Hispanic or black youth in this sample may be experiencing CBTT, we also need to account for the cultural differences in coping or resilience strategies that may play a role, as there are multicultural differences in seeking formal or informal support (Tummala-Narra, 2007). From this perspective, it is possible that socialization or connection with one’s own intra-racial group may build post-trauma resilience for some racial minority groups (Helms & Cook, 1999). African American youth with high levels of racial respect were less likely to use of violence, even if they histories of high violence exposure (DeGruy et al., 2012). Specifically, racial respect reflects African American cultural values and youth with strong support from their families, peers, and communities promotes their capacity to be more hopeful about their future. Racial respect also fortifies their ability to believe in their own inherent worth, e.g., “African Americans recognize their inherent worth in the context of relationships formed at multiple levels: with their family, with their peer group, and within the society as a whole” (DeGruy et al., 2012, p. 400). Further, this research suggests the significance of racial respect as a method of harm reduction that protects (moderates or buffers) African American youth who witness violence as a typical neighborhood experience. Either way, the results have significant implications for better engagement strategies with justice-involved youth that center and elevate youth’s voices to fully understand why and how trauma experiences differ.

Youth in the Other category reported higher rates of physical and emotional neglect compared with black youth. This is an area of further inquiry among the racial groups identified in the Other category. This group also had the highest rates of trauma symptoms, and when triangulating these findings with the correlations results only physical neglect stood out in its relation to trauma symptoms. Given the vast diversity of racial groups (Asian, Native American, and self-reported Other) in this category, further research with larger subgroup sizes is warranted to clarify underlying factors contributing true group differences or similarities on trauma indicators and symptomology.

As noted in this study, while black youth and white youth had similarly high rates of trauma symptoms, different trauma event exposures were associated with them. The results illuminate that there may be vastly different experiences of early trauma between racial groups. By failing to account for the trauma events distinctive to youth of color, prevailing trauma instruments—used widely in the JJS—may prevent us from effectively comparing how raced-based trauma events relate to trauma symptom expression and subsequent delinquency. Furthermore, the event exposures are distinctive to racial groups may lead to differential internalizations of those experiences (Gómez, 2019). The mechanisms underlying these differences may be a byproduct of intra-racial protection or group preservation (Gómez, 2019) that manifests in low level reporting. Importantly, according to the theory of race-based traumatic stress, researchers have not fully considered the impact of racism on post-traumatic stress symptoms. Although minoritized individuals tend to have high rates of post-traumatic stress symptoms, the symptoms are not fully explained by commonly measured traumatic events (Carter, 2005). In fact, some scholars argue race-based trauma has been altogether misdiagnosed among racial minoritized groups (Frueh et al., 2002; Tummala-Narra, 2007). The notion of post-traumatic stress symptoms is itself rooted in Western culturalization with the ideology that specified symptom expression indicates underlying pathology (Tummala-Narra, 2007). Thus, using such conventional white-normed metrics, we would expect variation in racial groups.

Interestingly, there were no group differences on self-reported delinquency. While white youth had the most trauma indicators associated with delinquency, there were no associations between trauma indicators and delinquency involvement among black or Hispanic youth. So, although the groups are reporting equivalent frequency of delinquency, there are vastly different trauma-based risk correlates according to racial group. Given the focus of trauma as a developmental antecedent to youth violence and delinquency, this finding may suggest that the trauma indicators defined and operationalized in this study may be more salient for white youth. Perhaps the ways in which trauma is measured in conventional instruments, which have been developed and validated with primarily white samples, fails to adequately integrate alternative trauma experiences aligned with the histories of minority youth, such as race-based trauma.

Limitations

One central limitation to this study is the inability to directly study race-based traumatic stress. The researchers designing this project did not integrate measures of racialized trauma, which, on one hand, has led to the critical appraisal of the tools used, but on the other, fails to account for a critical experience of minoritized youth in this sample. Another significant limitation to this way of assessing racial diversity in the sample is the lack of consideration of mixed racial groups or allowing youth to identify as mixed race. Furthermore, the recognition that all youth may not “neatly” fit into one of the racial categories we created could further contribute to racism, discrimination, and perpetuating harm towards marginalized identities.

There are several limitations related to procedures for data collection. First is that the data are cross-sectional, with trauma experiences being assessed retrospectively, introducing the potential for recall bias. The developmental distinctions among youth in the sampled age ranges may also introduce bias in reporting. Though research indicates youth over the age of 8 years old can reliably self-report health outcomes using multi-point scales, reliable recall periods vary dramatically by age (Coombes et al., 2021). Moreover, we do not fully understand the impact of maltreatment and trauma on memory creation and retrieval, with some work indicating youth have a clear memory for negative stimuli due to their attunement to threat, and others suggesting that trauma exposure is associated with errors of commission in recall (Goodman et al., 2019). There is also potential that youth have not accurately reflected their experiences due to social desirability or confidentiality concerns. Though youth were separated into small groups and spaced out in accordance with the space available, close proximity to other youth, mental health staff, and the researchers could have elicited concerns about confidentiality and influenced honesty in self-disclosures.

The data were also collected from a non-random sample of youth from two distinctive geographic regions and may not be generalizable to the broader population of incarcerated youth. Similarly, relative to the first research question, there are limitations of self-selection bias, limited generalizability, and potential over-or under-estimation of the true disproportionality and overrepresentation within the respective states’ geographical locations. It is important to note that this sample is not necessarily representative of the larger state demographic make-up during the time at which this data were collected. Also of note, the first state’s data collection was in 2015—about 7 years ago. The landscape of the juvenile justice sectors in each state, including the demographics have shifted slightly. While over-representation of youth of color remains a central issue facing many states, there have been de-criminalization and de-institutionalization initiatives taking place across both states in the sample, with efforts towards trauma-informed care. Also, we have seen a socio-political shift since 2020, with more needed focus on diversity, equity, inclusion, and social justice in the juvenile justice sector. As such, this cross-sectional data has limitations that include the policy, programmatic, and population shifts that have occurred since its original collection. This does indeed have impacts on generalizability and timeliness of this paper.

Although the analyses focused on trauma histories by race, the analyses did not assess these factors by gender or by gender and race, which could also provide useful review of these tools. However, as is, the results fail to account for the experiences of minoritized girls and boys in this sample. This is key information since arrest rates for girls have not decreased and black girls remain overrepresented in the JJS, so their pathways to delinquent behavior likely account for the heightened levels of trauma among this population (Puzzanchera, 2020). Future research should consider the utility of qualitative and mixed methods study designs. To address the first limitation, qualitative findings may provide some context for these quantitative findings. Mixed methods findings could highlight and/or compare the views and survey results about racialized trauma as well as cultural race related stress. This information could help with the development of developing a survey that is culturally tailored as it would be based on the population’s views. Further, this would provide an opportunity to investigate the concepts of racial respect and the man box across race and gender based on feedback from the study participants. Some scholars suggest the need to consider and incorporate other aspects like healing to reduce stigma associated with youth of color being viewed as their trauma (Ginwright, 2018). Future studies should also consider analytical ways to address small sample sizes, aside from encapsulating them in “Other”, which could be taken when conducting future anti-oppressive and social justice research. Including small sample sizes is warranted because system-involved populations often have high rates of unmet need, yet because of their small numbers, they continue to be marginalized or excluded altogether. Consequently, research needs to focus on and target them in future studies and employ techniques like oversampling to increase these populations as study participants. Moreover, engaging in community-based participatory and mixed methods approaches to assessing trauma exposures among each of these groups can offer greater insights. We view this as the first step with implications for further inquiry.

Longitudinal studies would assuage the issues associated with cross-sectional studies, such that multiple time points could shed light on some of these trauma measures over time. In addition, systematic racism and oppression that African American youth have experienced due to their overinvolvement with the youth and criminal justice system should be investigated (Alexander, 2010; Sidanius et al., 2020; Williams-Butler et al., 2022). Tackling the systemic issues within the JJS for youth of color, especially African Americans could be a more useful approach to address this oppression than the sole focus on micro level mental health treatment for trauma. Yet, it is essential to consider both aspects for youth who are currently involved within the system to address their pre-existing and high rates of trauma and mental health issues.

Implications

Attending to the individual experiences of trauma within minoritized racial groups can help to inform screening, onset and course of delinquency, and treatment and delivery services in the JJS. The theory of race-based traumatic stress posits that research has yet to study detailed experiences or features of racism that could lead to traumatic stress responses or psychological distress (Carter, 2005). This is a prominent problem in the field of juvenile justice where there is a paucity of standardized trauma instruments that integrate experiences of race-based traumatic stress. Further, the race-based traumatic stress instruments used in extant research have not fully encapsulated the relative and unique experiences of racism among justice-involved youth nor have they considered the impact of CBTT and the way it may be expressed differently according to racial and ethnic group membership.

In short, the JJS is not attending to the unique needs of minoritized youth if, at minimum, there is limited use of tools that assess traumatic experiences differentially among youth of color. In an effort to develop more culturally responsive and trauma informed practices, youth participatory action approaches (YPAR) for racial minoritized youth in the JJS can support the development of instruments to more precisely ascertain aspects of racism that create the most significant psychological distress. YBPAR is a grass-roots effort to engage youth in the process of research through reducing researcher bias and elevating voices of and empowering the youth participants in research studies (Rodriguez et al., 2015). The use of participant driven instrument development can more poignantly capture youth and stakeholder perspectives of traumatic experiences in a non-paternalistic approach. Youth driven classifications of trauma and how those traumatic experiences are relatively and differentially experienced can be a tangible step towards robust detection of all traumatic experiences and responses. Further, youth voices can support development of tools that not only capture self-reported discrimination, but also how discriminatory experiences are coded and internalized as racialized trauma, or how additional incidences may be experienced as traumatic. It can also lead to a better understanding of whether CBTT is a response to intra-group trauma exposures.

The relationship between trauma and delinquency has long been a critical area of inquiry among criminal and juvenile justice scholars. In bridging the results of this study with the known research conducted by other scholars who have integrated measures of race-based trauma (e.g., Kang & Burton, 2014; Mendez et al., 2022), the implications for race-based and culturally responsive trauma treatments emerge. Taken together, the evidence suggests that youth in the JJS may have traumatic events that link to their delinquency outcomes, but the traumatic events vary based on the positionality and racial identity of youth. Hence, not only should the JJS respond with tailored race-based trauma measures and screening tools, trauma supportive services should target the very different exposures that lead to emergence of symptomatology or risk for continuation in the JJS.

Extensive reviews on policy responses to address disproportionate minority contact in the juvenile justice system largely demonstrate their ineffectiveness at mitigating selection bias and racial and ethnic overrepresentation of minoritized youth (Lieber & Fix,2019), with the best case showing mixed results in reform-oriented states (Zane, 2021). While diversion from formal court processes can help reduce the degree to which racial minoritized youth are impacted by system contact, recent research has demonstrated diversion can only be effective insofar as risk assessments recognize and address racial biases inherent to the juvenile justice system and diversion selection processes (Schlesinger, 2018). While responses to the vague requirements of these policies have focused on individual factors, such as implicit bias awareness training, results may continue to be impotent while operating within broader racist systems. Moreover, current implementation efforts are targeted within systems rather than pre-contact. This leaves racialized youth who advance to the JJS inherently at risk for additional forms of racialized trauma exposure, such as police contact, which has been shown to be harmful to black youth and has been associated with the expression of trauma symptoms (Jackson, 2021).

Findings from the present study highlight the need for collaborative work which elevates the voices of youth in the process of developing assessment tools and relevant interventions. The process of co-creation will allow youth to provide feedback through bi-directional engagement and promote access to services specific to the needs of minoritized groups. Having participatory models guided by critical race theory can shine a light on racist systems to target areas for change and can give a platform to the unique needs of racial minoritized youth and youth with intersectional identities who face compounded forms of oppression (Crosby, 2016). Adopting a culturally informed ACEs model (C-ACEs) can also aid researchers in considering the impact of and developing tools responsive to racism and generational forms of trauma that impact racial minoritized youth (Bernard et al., 2021), and correspond with differential access to needed mental health services among justice-involved youth (Williams-Butler et al., 2022). Ultimately, understanding the unique trauma events and symptom presentations among racial minoritized youth, promoting higher utilization of community-based interventions, and minimizing formal system contact can help us move towards employing transformative justice approaches, which may be the most effective and developmentally appropriate strategies to achieve true racial equity in our juvenile justice response.

Practice and research efforts that build upon racial respect and healing is prudent. Specifically, racial respect provides protective aspects that are promotive for African American youth who witness violence in their communities. as a typical neighborhood experience. Specifically, this could be done in companion with a healing justice framework that requires oppression be viewed as community and collective trauma that “restores individuals and communities to a state of well-being” (Ginwright, 2015, p. 9). These activities could also focus on racial healing – healing-centered engaged activities are holistic, strengths-oriented approaches to trauma, which also involves “culture, spirituality, civic action, and collective healing” (Ginwight, 2018, p. 3). Race-based trauma-focused services with a focus on healing is a viable, new, and relatively unexplored area of research for youth in the JJS.