Foster care, Treatment complex trauma, Youth Justice

Review launches devastating critique of the Trauma Model

The recent Juvenile Justice Review[1] questions the relevance of the trauma model for custodial settings. Given that this is the first pubic critique of the model, it raises the question of whether the model will be called into question in the child protection/OoHC space more generally.

The rise and fall of psychological theories of the decades

Psychological theories have risen and fallen over the decades. In Australia, starting in the 1950s/60s, psychoanalysis or Freudian psychology was the dominant psychological theory. The 1970s saw the emergence of behaviourism or behaviour modification; the 1980s saw the rise of group therapy, e.g. guided group interaction; the 1990s saw the rise of the cognitivists, i.e. cognitive behaviour therapy (CBT) and, finally, in the mid-2000s, saw the emergence of the so-called trauma model (see side bar). Treatment interventions in OoHC and juvenile justice have closely paralleled these trends.

The critique of the Trauma Model

The Review acknowledges that youth justice services should not re-traumatise young people but critiques the trauma model on two grounds:

  1. It questions whether custodial staff sufficiently understand the model to put it into practice. With a wonderful sense of understatement, it states:

The Review is concerned that the application of this model in a custodial setting is extremely ambitious. The Review is not convinced that staff sufficiently understand, nor can put into practice, the essential elements of what is fundamentally a clinical approach to a therapeutic intervention.

And

Translating this [trauma] model into a non-clinical sense is ambitious and challenging. (Part 2:Page 48)

 

  1. More importantly, the Review questions whether all offenders are victims of trauma and, if this is the case, whether the trauma is the causal factor behind the offending.

Trauma-informed approaches are not part of the solution to address and reduce offending. It is well established that the majority of highly traumatised young people do not offend.

And

However, it must be clearly understood that while addressing trauma in a young person is necessary to meet their mental health needs, it is not sufficient to reduce their level of risk of re offending. (Part 2:Page 48)

This is a devastating critique. Not only does the trauma approach not reduce offending, it is additionally very difficult to implement.

What it means for child protection and OoHC services?truama 5

The question now is whether this critique will spread to trauma-informed care models that currently underpin most child protection and OoHC services. For example, in Victoria, ‘therapeutic residential care’ is based on the trauma models of Bruce Perry and/or Sandra Blooms’ Sanctuary Model. All agencies proclaim themselves to be ‘trauma informed’.

 

However, anecdotally, there is evidence that providers of residential care are implementing behavioural programs (e.g. Positive Behaviour Programs (PBP) and Teaching Family Home (TFH) concurrently with ‘trauma informed care’). Ten years ago, this would have been unthinkable; behavioural approaches were considered an anathema to the trauma proponents.

 

Personally, I do not see the trauma model passing into the ‘dustbin’ of history. Rather, the time of trauma-informed models being the only intervention available to Practitioners is over. All services will remain, or strive to be, trauma informed but increasingly will be supplemented with other approaches – these are likely to be behavioural in nature.

 

[1]  Youth Justice Review and Strategy: Meeting Needs and Reducing Offending conducted by Penny Armytage, former Secretary of the Department of Justice and Regulation, and Professor James Ogloff AM, Director of the Centre for Forensic Behavioural Science at Swinburne University

 

About graemembaird

I am a psychologist with a special interest in improving the outcomes of families, children and young people in the Out of Home Care and Juvenile Justice systems.
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2 thoughts on “Review launches devastating critique of the Trauma Model

  1. I find your comments interesting, as I find the outcome of the review equally interesting. To understand therapeutic care in any residential setting (community or custodial) one must first understand the model.Workers build relationships, provide safety and security and work within a plan developed by a Therapeutic Specialist. They know how to, and are strong enough to say ‘No’ and hold the line. Therapeutic Specialists and specially trained workers support the implementation of therapeutic care through a well researched multi disciplinary review, audit and strengths based developmental plan based on all available information. A comprehensive care plan/team monitor and plan ongoing work with the support of the Therapeutic Specialists and workers. For me, having almost 40 years experience in residential and therapeutic care across statutory and CSO systems in a variety of positions, the general moral panic surrounding residential care generally keeps escalating and expecting workers to provide more and more quality reporting and recording and evidence in a very risk aversive environment, with the result that the workers who can effect the most change are constrained. Therapeutic Residential Care is also the ‘Whipping Program’ of the child and adolescent system. It is incredibly political. However it needs to be remembered that residential care exists due to the complete failure of all other child and adolescent systems. Therapeutic and residential workers are asked to ‘fix’ these young people when it has taken often 15 years for them to be this hurt. Any further acting out which emerges in care, is usually due to the depth of young persons pain, the shame they feel and failure of other systems. However it is seen wholly, by media, bureaucracies and systems as a result of residential care. There are so many deeply committed Therapeutic Residential Workers who often place themselves in danger, doing a fantastic job in custodial and community settings to try and give these young people a better chance to rebuild their whole of life.
    Thank you for the opportunity to comment. Glenys

    1. I too come from a deep historical perspective. I did my Dip Crim 39 years ago this year. In reading the blog I was reminded of the state of criminological theory at the time. The search for THE CAUSE of juvenile offending was just being abandoned as a fruitless exercise and Sutherland had just come up with the notion of “differential association” ie. young people could have the same experiences but end up with different outcomes depending on their social environment. The factors leading to young people offending were complex, multiple and interactive.

      In many ways I think THE CURE needs to be subject to the same approach. Is it simplistic to expect that one approach will work for all young people despite the diversity of maturity, background and experience? Adults choose from a range of approaches to address their needs and that suit their maturity, beliefs and situation. As a social worker in residential care I liked to think I had a tool kit of approaches from which I would select as appropriate – crisis management theory, relationship building, even behaviour mod if a situation urgently needed stabilising. Understand Maslow and treat the most basic needs first… boy that sounds like I am a fossil!!

      Which leads to one of the dilemmas of providing care and intervention in young people’s lives. Rather than prescribing AN APPROACH we need the best possible assessment that selects a strategy suited to where the young person is at that time. Which in turn leads to the need for residential care staffing that can react selectively and specifically to the presenting person. A big ask. But I suspect behind the models and prescribed approaches staff have always been making these judgements. John

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