What is the impact of trauma in the criminal justice population?Ralph Fretz, Ph.D., ABPP
There has been an explosion of research connecting the experience of trauma, particularly complex or multiple traumas with a risk for criminal behavior (Vitopoulos et al., 2019). The current research on trauma and criminal behavior point to early childhood trauma, particularly maltreatment in childhood, as defining the difference between adolescents who commit offenses in a time-limited manner with adolescents who continue to re-offend into adulthood (Baglivio, 2017). At this time, there is sufficient research evidence to warrant assessing and treating trauma in the criminal justice population starting with the juvenile justice system. Researchers have found that approximately 75% of incarcerated adults report histories of trauma exposure with some studies showing an even higher rate for reports of trauma histories (Allely & Allely, 2020).
How can trauma be assessed in the criminal justice population?
There are a number of methods to evaluate trauma in the criminal justice population. Trauma evaluation should be conducted at intake to aid in the development of a risk and needs treatment. For example, the Level of Service Inventory instruments for adults (Level of Service/Case Management Inventory) and adolescents (Youth Level of Service/Case Management Inventory) have Responsivity sections that ask questions about whether the individual has been a victim of violence, a victim of sexual abuse, and other trauma-related questions. The Youth Version of the Level of Service instruments breaks down family trauma items and individual trauma items. Other risk/needs instruments also ask questions about trauma.
After completing risk/needs assessment instruments that have trauma or trauma-related general questions, further assessment can be accomplished through the use of specific instruments such as the PTSD Checklist for DSM-5 (PCL-5) with Life Events Checklist for DSM-5 (LEC-5). The Adverse Childhood Experiences (ACES) questionnaire is not considered an evaluation for trauma, although the questionnaire has proven quite useful for conducting research related to trauma.
How do the RNR model and trauma assessment and treatment fit with each other?
The RNR Principles are currently the most researched assessment and treatment model for criminal justice programs. RNR is a flexible model that incorporates new research findings, and well-validated meta-analyses into its format and structure. Trauma has been considered a specific Responsivity factor to assess and treat in the RNR model. Newer neurophysiological research has shown the depth and breadth of symptoms that can be caused by trauma, particularly complex trauma. It’s clear that the research indicates that the RNR model considers trauma as a required factor to rule out when evaluating individuals. Depending on the severity of the trauma symptoms, trauma-informed treatment may be necessary before the individual can meaningfully engage in other forms of treatment, including cognitive-behavioral programs. Trauma symptoms may prevent the person from following a treatment program, due to the person being locked into a “fight or flight” process. The person may need to feel that the treatment environment is “safe” and learn techniques to lower the constant physiological signs related to trauma sequelae.
Moving forward by assessing trauma
Staff assessing individuals in the criminal justice system need to be trained in understanding trauma, trauma symptoms, and other related concepts. Staff evaluating and re-evaluating individuals should ask the trauma-related questions already embedded in some of the validated and researched risk/needs assessment instruments. Awareness of trauma and its effects on individuals in the criminal justice system and staff who work with traumatized people should be heightened. When trauma assessment becomes a routine part of a risk/needs assessment battery, individuals can be referred to validated and well-researched trauma programs while still incarcerated or under supervision. Trauma and its effects should be a routine part of any risk/needs assessment training, similar to how Motivational Interviewing concepts have become incorporated into many risk/needs assessment instruments training programs.
The time has come for trauma assessments and treatment to be a standard part of the correctional treatment paradigm. There is too much well-designed research available to ignore or minimize the potential effects of trauma on the criminal justice population. The RNR model, due to its proven effectiveness and flexibility incorporates the need for trauma assessment and treatment. In fact, the Level of Service instruments, based on the RNR model, already contain trauma items in their Responsivity sections that assist with assessing whether an individual should be evaluated further.
Watch Dr. Ralph Fretz’s recent webinar on the intersection of trauma and Risk-Need-Responsivity (RNR) Principles.
About the author:
Specializing in forensic psychology, Dr. Ralph Fretz works primarily in forensic evaluations and clinical therapies, such as trauma assessments and trauma-informed care, and in the past, treated first responders who worked at the World Trade Center post 9/11. Dr. Fretz is a Master Trainer for the Level of Service instruments. He has been trained in the Risk, Need, Responsivity Principles by Dr. James Bonta and the late Dr. Don Andrews.