Clinical Issues in the Treatment of
Adolescents Who Have Engaged in Sexually
Abusive Behavior and the DJJ Treatment
Model
May 9, 2014
WELCOME
Topics for discussion:
• Traditional treatment model
• Current research
• DJJ SBTP structure and components
• Measuring impact
2
What People Imagine When They Hear “Sex
Offender”
But who are they really?
Still providing treatment sometimes feels
like….
Juvenile and Young Adults vs. Adults

Traditionally put into 1 category

A wide body of knowledge clearly shows that these
groups are dramatically different.

Research now promotes the need to approach treatment
with juveniles differently.
6
Traditional Treatment Approach

Use of “cookie cutter” treatment from adult model.

Family therapy and possible reunification was not
advised.

Success was solely the responsibility of the youth.

Little focus on healthy living models.

Lack of treatment resources to address individual
treatment issues.
7
What We Know Today

CBT-based models continue to have evidence of
effectiveness.

Evidence that use of motivational techniques are effective
to help with engagement.

3 factors are significant indicators of successful outcomes:
1) Therapeutic intervention philosophy
2) Serving high risk offenders
3) Quality of implementation (i.e., standardization, fidelity)
8
What We Know Today

Interventions that quickly bring behavior under control
have greatest potential for efficacy.

Interpersonal skill development through CBT is effective
in addressing sexual behavior problems.

Interventions during teen years have greatest impact
since this is highest risk time.
9
Evidenced Based Practice for Juveniles

Research is “weak” in the area of juveniles.

No comprehensively defined EBT currently exists
specifically for JSO, yet several E-B components have
been identified for juveniles.

Family work appears to be the most important to help
reduce delinquency and sexual aggression.

Mentoring has shown moderate effects especially in the
areas of school, drugs and some aggression.
Using what we know about Juveniles

Sexual recidivism rates between 7-14%

General recidivism rate 53%

Offense specific treatment lowers recidivism

BUT need to fill in the gaps.
Using what we know about Juveniles

Confrontational styles not as effective.

Therapeutic relationship important to developing a trusting
environment for disclosure.

Treatment should target skill development, not focus solely on
discussing the offense.

Offense specific issues can be addressed individually.
Understanding Adolescence
“” Youth are heated by Nature as Drunken men by wind.”
Aristotle
“I would that there were no age between 10 and 23, for
there’s nothing in between but getting wenches with
child, wrongdoing the ancestry, stealing, fighting…”
Shakespeare
13
Adolescent Development

Abstract thinking and reasoning are developing

Developing social and emotional skills

Evolving attitudes and beliefs

Shorter attention spans

Greater impulsivity

Self-focus and narcissism are developmentally normal

More dependent on their social environment

Traumatic effects of maltreatment may be immediate

Maltreatment may be ongoing
14
Adolescent Development

Adolescent brain development plays significant role in
offending behaviors—impulsivity and differential
perceptions of risk-reward.

Sexual deviance & ingrained sexual behavior patterns
inconsistent with adolescent development research.

Criminal behavior peaks at 15-17 yrs.
15
Adolescent Development

Offenses more opportunistic, less “predatory”.

Arousal patterns appear less set.

Motivations of juveniles may be more curiosity based,
related to social problems, less due to compulsivity or
cycle patterns.
16
Development Factors

Cognitive

Brain

Social

Moral

Sexual
17
Cognitive Development

Youth in early stages of development are not capable of
complex planning.

Difficulty understanding perspective of others.

Limited coping strategies.
18
Cognitive Development
 Increasing capacity for abstract thought.
 Expanding intellectual interests.
 Mostly interested in the present with limited thought to
the future.
 As youth approach 18 and older they begin to develop
the ability for moral reasoning, have thoughts about
the meaning of life, and are more able to delay
gratification.
Brain Development
It is no accident that insurance rates are reduced for
youth when they turn 25 years old.
The brain has not completed full maturity until
around the age of 25 or later.
Brain Development


3 major regions – brain stem,
limbic and cortex.
Frontal lobes, essential to
problem solving and reasoning
and the inhibition of emotion
and behavior are not fully
developed until early
adulthood.
21
Brain Development and Risk Taking
 Juveniles have a greater tolerance than adults for
ambiguous or unknown risks.
Brain Development and Risk Taking

Youth will more likely make decisions based on
perceived benefits, particularly social rewards, than on
negative consequences.
Theories on Risk Taking: All Drive and No
Brakes

Increased need for risk taking in breaking away from
parents.

May be caused by immature connections between the
limbic system (the emotional driver) and the pre-frontal
cortex (the brakes).

Teens have more difficulty making up their minds as
compared to adults.
Teaching the Remodeling Brain

With the right rewards, youth will spend more time
attempting to make the right decision.

It has been shown that young adolescents use more of
their pre-frontal cortex to a greater extent when
evaluating positive performance feedback.

Older adolescents have been shown to use more of the
pre-frontal cortex during negative performance feedback.
Teaching the Remodeling Brain

Help youth understand their shifting emotions and mood
swings.

Educate them about the changes that are happening in
their brains.

Ask open ended questions to allow them to talk about
their feelings.

Help them to understand how others may be feeling as
they shift from self-focused to other focused.
Encouraging Pre-Frontal Cortex Development

Help youth create written or visual systems to manage
their time and organize tasks.

Use interactive exercises such as role play, forced
choice scenarios, and value discussions.

Incorporate physical activities to emphasize learning.
Encouraging Pre-Frontal Cortex Development

Give youth concrete examples and utilize more abstract
thinking as they mature.

Use visual aids whenever possible to assist in creating
connections in the brain.
Brain Development and Trauma

Studies show both structural and functional neurological
differences between traumatized and non-traumatized
individuals.

Effects depend on age trauma occurred, frequency of
traumatic exposure and availability of caregivers to
provide supportive resources.

Base-line changes in resting heart rate for individuals
with significant trauma experiences.
29
So What Does This Mean
This impacts:

Emotions and attitudes towards self and others

Attachment - unable to trust self and environment

Moral perceptions - right/wrong is skewed/distorted

Thinking and behaviors - socially and sexually

Decision making and problem solving
30
So What Does This Mean
Youth will have:

Greater difficulty analyzing their own behavior and
behavior of others.

Greater risk of demonstrating anger and depression.

Decreased ability to develop coping skills.

Increases in mood shifts and reduced emotional balance.

Difficulty learning and processing information in situations
that are emotionally charged.

Right and persistent thinking/attitudes/beliefs despite
negative results.
31
Social Development

Relationship to caregiver affects the development of
emotional regulation.

Trauma/neglect impact the ability to develop positive
relationships and ways to deal with intimacy and
loneliness.

Healthy vs. unhealthy attachment to others
32
Social-Emotional Development
 Struggle with sense of identity
 Feel awkward about one’s self and one’s body
 Increasing conflict with parents
 Shift from parent focus to peer focus
 Increased moodiness
 Tendency to return to ‘childish’ behavior when
stressed
Moral

Preschool to middle school involves learning to follow
rules, avoid punishment, and learn to be obedient.

Adolescents/young adults involves a desire to do
greatest good to greatest number of people, adherence
to self chosen ethical principles.

Adolescents very good at pointing out hypocrisy.
34
Sexual Development

The stages of sexual development coincide with social,
moral, cognitive, and attachment development.

Trauma/neglect impact the natural development of
sexuality.

Sexual behavior can become used as way of coping
and self-soothing.
35
Sexual Development




Tradition model of avoidance is not appropriate.
Sexual behavior should be assessed in the context of
“normal” sexual development.
Important to normalize appropriate sexual thoughts and
behavior.
Creating an treatment environment that allows for
discussions about appropriate sexual behavior is key in
helping youth develop healthy sexual identities and
behaviors.
36
Sexual Development



What is “normal”?
YouTube Generation
Internet and smart phones = 24/7 access
37
Research and Risk

Our understanding of how adolescents and adults differ
should play an important role in how we assess risk to
reoffend.
Understanding Risk

What is it - sexual vs. non-sexual

Why it is important to treatment

High, moderate and low risk
39
Understanding Risk

Risk Prediction relies on “static” factors
Goal: predicting violent behavior

Risk Management relies on “dynamic” factors
Goal: determining what increases or reduces an
existing or preexisting condition
Understanding Risk

Adolescents are moving targets when it comes to
predicting risk.

A comprehensive assessment is necessary when trying
to determine risk. Limitations should be addressed and
an “expiration date” provided.

Risk factors vary in the course of development for an
adolescent. Therefore, what was a risk at age 14 may
not be a risk at age 16.

Protective factors play an important role when looking at
the complete picture of risk.
Understanding Risk

Typically, the younger the individual, the more important
dynamic risk factors are and the less important static risk
factors.

Risk factors do not operate in isolation, they are
complexly interactive.

The more “dynamic” the risk picture, the harder it is to
predict - education, treatment, family, social, trauma
impact etc.
42
Static Risks to Reoffend

Prior convicted sexual offenses

Multiple victims

Stranger victims

Prior treatment failure
Dynamic Risks to Reoffend

Deviant sexual interest

Sexual preoccupation/obsession

Environments supportive of reoffending.
(2012)

Attitudes supportive of offending*

Social Isolation

Difficulties establishing peer
relationships

Family dysfunction
General Risks to Reoffend

Prior legally charged offenses

Family functioning

School achievement and behavior

Negative peer relationships

Substance use and abuse

Use of recreation time

Antisocial/pro-criminal attitudes

Out of home placements
Factors Not Likely Related to Reoffending

Denial

Victim empathy

General psychological problems
Protective Factors






Having strong attachments and bonds
Good self-regulations and impulse control
Positive self-perception
Self-efficacy
Connections to pro-social peers
Connections to pro-social environments
Therefore…
There are several important considerations
research has shown should be taken when treating
youth who sexually offend.
48
A Holistic Treatment Approach
49
Developing a “Whole” Person Treatment
Approach

Confrontational styles not effective.

Therapeutic relationship important in developing a trusting
environment for disclosure.

Treatment focused on helping youth develop skills to become
a healthy adult, not solely on discussing the offense.
Treatment

Understanding that the youth is still developing as
a person.

Normalize developmentally appropriate behavior.

Recognizing the positive strengths of youth to
help them through the program.
Treatment

Dialogue with youth about
motivation and change.

Developing dialogue with
individuals’ environment,
family, community.

Assessing and strengthening
emotional regulation is
important for success.
52
Treatment

Recognize trauma exists and understand how it impacts
beliefs, thinking, attitudes, feelings, behaviors, learning,
attachment and interpersonal skills.

Provide environment where trust can be established to
explore the impact traumas.
Treatment Components
•Cognitive
•Skills
behavioral
based
•Forward
•Family
•Focus
focused
Involvement
on dynamic risk
Treatment Targets
•Attitudes
and justifications supportive of offending
•Emotional
•Social
Competence/Relationship skills
•Healthy
•Ability
Management
Sexuality
to establish peer relationships
Treatment Targets
•General
self-management skills
•Family
Education/Functioning
•Sexual
Deviation or Sexual Preoccupation (if applicable)
•Development
of Positive Life Goals
•Individualized
Issues as Needed
What Does This Mean?
Letting
go of past practice in order to
embrace what we now know.
Future-focus
& new coping skill development
maintains center stage.
Treatment
is less focused on sexual
offending and more focused on intra- and
interpersonal development.
Adult
treatment is emphasized for specialized
needs.
57
The DJJ Treatment Model
58
Program Guide

Entrance and exit criteria

Program structure and guidelines

SBTP staff orientation packet

SBTP youth orientation packet

Quality assurance criteria

Adjunct treatment services
59
Program Overview
Clinical Framework:
•
•
•
•
•
•
CBT-Based Treatment
Risk-Need-Responsivity Framework
Strengths-Based, Forward-Focused Orientation
Developmentally-sequenced stage work
Group work designed to leverage influential factors throughout
process.
Addresses multiple learning styles & promotes individual
creativity/autonomy.
Treatment Continuity:
•
•
•
Interplay of thoughts, behaviors, & affect
Good Life Plan and Re-Entry Planning
Healthy Living
60
SBTP Orientation/Transition Unit





SBTP Orientation
Cases on Appeal
“One Step Forward” Program
Transition
Peer Mentors
61
SBTP Orientation Major Components
62
SBTP Standardized Assessment
Dynamic
Risk
Functional
Ability
Academic
Outcome
PretestPosttest
Substance
Use
Academic
Performance
Social
Support
Trauma
63
Assessments

Comprehensive SBTP assessment

Re-assessment

Post assessment
64
Risk Assessment Tools

J-SORRAT-II

STATIC 99R

J-SOAP-II

Structured Risk Assessment Forensic
Version (SRA-FV)

STABLE/ACUTE 2007
65
Assessment Tools

ERASOR Version 2.0
(Estimate of Risk of Adolescent Sex Offender
Recidivism)
Assessment Tools
Viljoen et al (2012):
Found all juvenile instruments were adequate
in that those with higher scores tended to reoffend more than those with lower scores. (6467%)
However, no ONE risk factor predicted who
would sexually reoffend.
Case Conceptualization Assessment
Youth Version:
Adult Version:
Substance Abuse Subtle Screening
Inventory – Adolescent 2
Substance Abuse Subtle Screening
Inventory
Juvenile Sex Offender Assessment
Protocol II / JSORRAT II
Structured Risk AssessmentForensic Version Light/ Static 99
Child and Adolescent Functional
Assessment Scale
Global Assessment of Functioning
Trauma Symptom Inventory
Trauma Symptom Checklist-40
CA-YASI
CA-YASI
68
Good Lives Assessment and Plan

Good Lives Theory: Normalize the desire for the need
and develop healthy skills to obtain them.

Strength based approach

Good Lives vs. Relapse

“Red Thread” Assignment for SBTP
Good Lives Plan: Six Needs

Life: Having basic needs met; caring for physical health,
safety.

Knowledge: Feeling that you have sufficient information
and understanding of yourself and the world.

Friendship: Having close connections to family, peers,
romantic partners or other individuals.
70
Good Lives Plan: Six Needs

Community: Possessing a sense of belonging to a
larger group of individuals with shared interests.

Happiness: Overall feeling of contentment with life.

Creativity: Having the ability to express self in unique
ways that bring meaning.
71
Good Lives Plan Assignment

Orientation

Stage One

Stage Four

Stage Six
72
Healthy Living Curriculum
Unit One: Orientation

Multiple Intelligence
Unit Two: Physiological
Development


Assessment of sexual beliefs
(pre-post test)

Stages of development
(prenatal–death)
Normal brain development
73
Healthy Living Curriculum
Unit Three: Psycho-Social
Development

1.
2.
3.
4.
5.

1.
2.
3.
4.
5.
Adolescent Development
Establishing identity
Establishing autonomy
Establishing intimacy
Accepting your sexuality
Achievement
Five Parts of Human Sexuality
Sexualization
Sensuality
Intimacy
Sexual Identity
Sexual Health and Reproduction
Unit Four: Healthy
Communication


3 parts of face to face
communication
3 basic communication styles
Can you hear me?
74
Healthy Living Curriculum
Unit Five: Non-Sexual
Relationships


Components of a strong
relationship
Create a sociogram
Unit Six: Trauma and
Development


Learn the definition of trauma
How trauma affects brain
development
75
Healthy Living Curriculum
Unit Seven: Healthy Sexuality

4 R’s of Sexuality
1.
Respect
Responsibility
Recognition
Relationship
What is healthy sexuality
2.
3.
4.

Unit Eight: Myths, Facts and
Sexual Health



Correctly name male and female
body parts
STD’s symptoms and treatment
Contraception
76
Healthy Living Curriculum
Unit Nine – Sexuality and the
Law




Sexual Harassment
DJJ’s Sexual Harassment Policy
Megan’s Law
Jessica’s Law
Unit Ten – Bringing it all
together


Summary
Babe and activity
77
Family Involvement
The SBTP recognizes the importance of youth and family
involvement in enhancing the youth’s rehabilitation and
treatment outcomes
A youth’s inability to have a healthy relationship is one of
the biggest risks for re-offense
78
Family Involvement

Contact begins at Orientation Unit.

Specific procedures for family reunification.

Goal for SBTP is to have at least 1 family/support
member engaged in the youth’s treatment at all times.
79
Family/Support During Orientation
1) Early Identification and Engagement

Clinician completes Parent Assessment form.
Youth identifies support individual during initial case conference.
Collaborative effort of staff to help youth identify a support member.

Youth fills out family/support survey consent form.


80
Residential Sexual Behavior Treatment
Program
81
Major Program Components
Outcomes
Evaluation
Stage
Work
Resource
Groups
Mental
Health Tx.
Ind/Family
Therapy
Integrated
SA Tx.
Embedded
Journaling
Re-Entry
Planning
Plant/Pet
Care
BiblioTherapy
Video
Rap
Series
Family
Support
82
Residential Program
Provides an intense therapeutic community and various
services including:

Individual treatment based on risk of recidivism and
offense dynamics

Specific abusive/offending sexual behavior treatment

Psycho-educational and clinical resource groups

Individual and family counseling

Frequent re-assessment of dynamic sexual offending
risk factors, including both criminogenic factors and
protective factors that are on going
83
TREATMENT STAGES
Orientation
7: Moving
On
1:Autobiography
6: Re-Entry
Planning &
Good Life
2:
Responsibility &
Accountability
3: Attachment,
Loss, & Early
Connections
5: Effective
DecisionMaking
4:
Behavior
Patterns &
Restorative Justice
Standardization Of Stage Work





About the Stage
Primary Purpose, Major
Objectives & Major
Components
Facilitator Grid for Facilitated
Exercises
Projected Timeframe for
Completion
Number of Hours of
Homework







Integrated Interactive
Journal Work
Red Flags
Suggested Activities
Group Work
Expected Affect and
Behavior
Evaluation of Stage
Work
Treatment Team
Authorization
Youth Manual & Youth Activities
Detailed instructions throughout to guide youth and
prompt youth when staff involvement is needed
 Illustrative vignettes to promote increased
understanding
 Attempts to be inclusive through representations in
pictures, vignettes, books, films
 Projected number of homework hours indicated per
stage—use as broad gauge
 2nd to 9th grade reading levels
 Interactive Journal work embedded throughout stage
work
 Learning objectives and exercise checklist provided
Exercises: Facilitated, Reviewed, Debriefed with a
Treatment Team member, or completed independently

Facilitator’s Manual
All-Inclusive Treatment Guide
Format
 Instructions for Use & Symbol Key (review
symbol key)
 Facilitator Instructions
 Embedded Youth Manual
 Group-Guided Stage Work Activities
(embedded)
Appendices
 Experiential Group Activities Section
 Biblio-Therapy Curriculum Section
 Video-Therapy Curriculum Section
 Family Forum Guide Section
 Resource Group Curriculum Section
 Outcomes Evaluation Section
Stage One: Autobiography
Timeline
Re-Entry
Plan
Eco Map
Good Life
Plan
Genogram
Delinquent,
Sexual, SA,
& Gang
History
Connections
Cultural
Identity
88
Stage Two: Responsibility and Accountability
BARJ
Good
Life
SelfMgmt.
Skills
Personal
Responsibility
Thoughts,
Feelings,
Affect in
Action
Past
experiences=
opportunities
for learning
Behavior Checks



Starts in Stage Two continues until end of program.
Youth should be working on two behavior checks at all
times.
Youth discuss success and struggles during groups and
individual sessions.
90
Stage Three: Attachment, Loss, and Early
Connections
91
Interpersonal Checks



Starts in Stage Three continues until end of program.
Youth should be working on two behavior checks at all
times.
Youth discuss success and struggles during groups and
individual sessions.
92
Stage Four: Behavioral Patterns &Restorative Justice
Behavioral
Work
Victim
Awareness
Restorative
Justice
Progress
Report
Stage Four Progress Report




1.
2.
3.
4.
Behavior Change Progress Report
Good Life Plan Progress Report
Re-Entry Plan Progress Report
Youth summarizes and presents the following:
What have you learned about yourself so far in terms of how you
think, feel and behave.
What have you learned about the way in which your thoughts,
feelings, and behaviors are related to each other?
How you saw yourself when you first began treatment & now
What you will need to focus on now to ensure your long-term
success in the program.
94
Stage Five: Effective Decision Making
Effective
DecisionMaking
Old Me/New Me
New Decision-Making Skills
How I See Me
Challenging/
Disputing
Faulty Messages/Faulty Language
(REBT-based work)
Stage Six: Re-Entry Planning & Achieving My
Good Life
96
Stage Seven: Moving On
Personal
Journey
Good
Life Plan
Group
Gifts
Letting
Go
New
Coping
Skills
97
Resource Groups
98
SBTP Core Resource Groups
1.
2.
3.
4.
5.
Orientation Resource Group: Introduction to the SBTP
Skill of the Week
Express Yourself
Moods Matter
Restorative Justice
99
SBTP Specialized Resource Groups
1.
2.
3.
4.
5.
Substance Abuse Treatment
Anger Control Training (ACT)
Criminal Thinking Errors
Surviving Trauma
Interpersonal Skills and Development
100
Experiential Group Activities
Incorporated
into stage group sessions as prescribed
or needed
Diversity
of experiential type activities
Developed
7
for repeat use
primary themes consistent w/SBTP model
Promotes
continuity of treatment through reinforcement
101
Experiential Group Exercises
1.
2.
3.
4.
5.
6.
7.
Popping Gender Messages
Feeling Charades
My Strengths/Your Strengths
Taking Control of Peer Pressure
Not Letting Negative Peers Control Us
Hot Topics
The Power of Group
102
Plant and Pet Care


Starts at Stage 3
Responsibility of care is progressive
103
Biblio-Therapy Curriculum

Use of stories/reading to promote increased understanding of key issues

Addresses universality & provides alternative narratives

Personal accounts or stories that highlight significant relevant messages
and/or lessons
Selection Criteria:

Relevance of central issue & potential ability to relate to major
characters

Readability based on broad range of developmental levels

Appropriateness of content and language
104
Books
Gifted
Hands: The Ben Carson Story (autobiographical; overcoming odds
and achieving significant personal success through work
There
are no Children Here: The Story of Two Boys Growing up in the
Other America (family survival through violence and tough times)
Out
of the Madness (autobiographical; parental addiction; youth survival)
Med
Head: My Knock Down, Drag Out, Drugged Up Battle with my
Brain (biographical; adolescent mental health issues)
Across
the Wire: Life and Hard Times on the Mexican Border
(immigration, poverty)
Always
Running: (autobiographical; gang culture; breaking free from gang life)
105
Video-Therapy


Built on same premises as Biblio-Therapy using film as
the medium
Intended for large group, can be used in small groups, as
needed
Selection Criteria

Relevance of central issue

Relevance/potential ability to relate to major characters

Appropriateness of content and language

Diversity of overall selections
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Films
Antoine Fisher
The Blind Side
Coach Carter
Freedom Writers
Glory Road
Hoop Dreams
Pay It Forward
The Pursuit of Happyness
Remember the Titans
Stand and Deliver
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Family/Support During Residential

Family forums

Family Counseling
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SBTP Family Forums







Each youth has at least 1 participant
Co-facilitated by 2 members of Treatment Team
Information dissemination & facilitated discussion,
Time for informal discussions among participants and
shared meal
Promote engagement throughout treatment.
Aid re-entry planning
Promote broader support networks among
clients/supports
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Family Forum Guide Topics
1.
2.
3.
4.
5.
6.
7.
Family and/or Support Orientation to Treatment
Support & Nurturing: Building Healthy Relationships
The Legal System and Legal Issues related to Sexual
Behaviors
Building Bridges from Within: The Power of Social Support
& Dealing with Stigma
Re-Entry Planning: Preparing for a Successful Future
A Celebration of Support: Facilitated Discussion, Open
Forum, and Luncheon
Family/Support Topic Choice
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Family Counseling
Multi-systemic therapy works

Reduces parent and youth denial about offense

Removes barriers to effective parenting

Enhances parenting knowledge

Promotes affection and communication among family
members
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Most Importantly

Conjoint work with family members and other
appropriate persons in the youth’s social ecology is
essential in the development of plans for risk reduction,
relapse prevention and victim’s safety.
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Transition

Provides different levels of treatment for those who
completed SBTP and for whom the Core Program is
not appropriate

Focuses on probation preparation

Mentors for Orientation Unit
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Specialized Versions



Spanish versions of youth manual
Spanish version of books
Use of Spanish sub-titles
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SBTP Outcome Measures

Major/Primary Outcomes
1.
Sexual recidivism = data from those released
Non-Sexual recidivism = data from those released
Dynamic Risk (J-SOAP/SRA-FVL & CA-YASI) = orientation, six
months, completion
Functional Ability (CAFAS/GAF) = orientation, three months,
completion
Trauma = orientation, following trauma treatment, completion
Substance Abuse* = orientation, following substance abuse
treatment, completion
Social Support Network = initial engagement and sustained
participation (at least 6 months)
2.
3.
4.
5.
6.
7.
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SBTP Outcome Measures

Secondary Outcomes
1.
3.
Academic Performance = pre DJJ GPA, 2nd period GPA, completion
GPA
Academic Outcomes = Completion of GED or diploma
Therapeutic Alliance = Helping Alliance questionnaire II, 6 months

Other Data Points
1.
Youth Surveys
Family Surveys
Compliance/Audit Tool
2.
2.
3.
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Resources

Neari Press: www.nearipress.org

Safer Society Press: www.safersociety.org
Ethnicity and Family Therapy 3rd Edition 2005
McGoldrick, M., Giordano, J.& Garcia Preto, N.


Current Perspectives: Robert E. Longo & David Prescott

Current Applications: Robert E. Longo & David Prescott
Additional Questions
118
THANK YOU!
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