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理解创伤与刑事少年司法系统的视角:用创伤知情视角实现有意义和持久的变革。

A Perspective for Understanding Trauma and the Criminal Juvenile Justice System: Using a Trauma-Informed Lens for Meaningful and Sustained Change.

机构信息

From the Department of Psychiatry, Oregon Health Sciences University (Dr. Moreland); Harvard Medical School (Dr. Ressler); McLean Hospital, Belmont, MA (Dr. Ressler).

出版信息

Harv Rev Psychiatry. 2021;29(3):216-224. doi: 10.1097/HRP.0000000000000290.

Abstract

Trauma exposure and posttraumatic stress disorder are common and are associated with a wide range of negative psychiatric and physical outcomes. Furthermore, a large percentage of justice-involved youth have high rates of trauma exposure and trauma-related symptoms. Addressing these issues would improve outcomes at the level of the justice system overall and in the lives of justice-involved youth. Nonetheless, awareness, education, and implementation of trauma-informed approaches in the criminal juvenile justice system are lacking. This article explores current literature that operationalizes trauma-informed practices and approaches in the criminal and juvenile justice systems. Unfortunately, there is no shared understanding or definition of trauma and no predictability in trauma-informed practices and approaches in the criminal juvenile justice system. Despite the presence of written policies, the application and execution of such policies are limited and inconsistent throughout the system. These limitations contribute to ongoing, systemic institutional racism, lack of mental health or substance abuse treatment, limited diversion options, and unnecessary jail and prison sentences, which together amplify financial and humanitarian costs. We argue that in order for the criminal juvenile justice system to become trauma-informed, it should (1) meet basic needs of clients, (2) check and change narratives, and check underlying assumptions, (3) focus on skill building/habilitation, (4) move away from punishment and toward rehabilitation and humanitarian approaches, and (5) heal and support members that work in and for the system. We conclude that there is a need to improve processes for education, training, and coaching in, and consistent application of, trauma-informed practices and approaches within the criminal and juvenile justice systems.

摘要

创伤暴露和创伤后应激障碍很常见,与广泛的负面精神和身体后果有关。此外,很大比例的涉及司法的青年有很高的创伤暴露率和与创伤相关的症状。解决这些问题将提高整个司法系统和涉及司法的青年的生活水平。尽管如此,刑事少年司法系统中对创伤知情方法的认识、教育和实施仍很缺乏。本文探讨了在刑事和少年司法系统中实施创伤知情实践和方法的现有文献。不幸的是,对创伤没有共同的理解或定义,也无法预测刑事少年司法系统中创伤知情的实践和方法。尽管有书面政策,但在整个系统中,这些政策的应用和执行都很有限且不一致。这些局限性导致了持续存在的、系统性的机构种族主义、缺乏心理健康或药物滥用治疗、有限的转移选择以及不必要的监禁和监禁判决,这些判决共同加剧了财政和人道主义成本。我们认为,为了使刑事少年司法系统变得对创伤知情,它应该:(1)满足客户的基本需求;(2)检查和改变叙述,并检查潜在的假设;(3)注重技能建设/康复;(4)从惩罚转向康复和人道主义方法;(5)治愈和支持在系统内工作和为系统工作的成员。我们得出结论,需要改进刑事和少年司法系统中关于创伤知情实践和方法的教育、培训和辅导过程,以及一致应用这些方法。

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