STAT 3300 Homework #6Due Thursday, 03282019Note Answe.docx

STAT 3300 Homework #6
Due Thursday, 03/28/2019
Note: Answer these questions on a separate piece of paper. In
the top right corner, include
your name, SMU ID, and course number. Please include a title
for the assignment so that
it is clear to the graders. If you miss class the day the
assignment is turned in, submit this
before class in order to receive credit.
Question 1 (25 points total)
Kiplinger’s “Best Values in Public Colleges” provides a ranking
of U.S. public colleges based on a combination
of various measures of academics and affordability. The dataset
“EX11-18BESTVAL.csv” includes a sample of
25 colleges from Kiplinger’s 2015 report. Let’s focus on the
relationship between the average debt in dollars at
graduation (AveDebt, the response variable) and the explanatory
variables Admit (admission rate), GradRate
(graduation rate), InCostAid (in-state cost per year after need-
based aid), and OutCostAid (out-state cost
per year after need-based aid).
a) (2 points) Write out the statistical model for this analysis,
making sure to specify all assumptions.
b) (3 points) Run the multiple regression model in R and report
the fitted regression equation.
c) (5 points) State the null and alternative hypothesis for the

overall F test, report the overall F statistic,
its degrees of freedom, and the p-value. What do you conclude
based on this test result?
d) (2 points) Obtain the residuals from part (b), construct a
residual plot of residuals against the predicted
outcome ŷ, and check assumptions. Is Baruch College an
unusual case? Provide a brief summary.
e) (3 points) Run the same multiple regression model but this
time without Baruch College, and specify the
fitted regression equation. Again comment on the residuals (i.e.,
construct a residual plot of residuals
against the predicted outcome ŷ and check assumptions).
f) (5 points) For the model in part (e) (i.e., the multiple
regression model without Baruch College), report
the overall F statistic, its degrees of freedom, and the p-value.
What do you conclude based on this
test result?
g) (5 points) For the model in part (e) that included all p = 4
explanatory variables, only InCostAid is
found significant using the individual parameter t tests. This
raises the question whether these other
three variables further contribute to the prediction of average
debt given in-state cost is in the model.
Conduct a partial F test to answer this question.
1
Question 1 (25 points total)
Learning Objectives
After studying this chapter, you should be able to accomplish

the following objectives:
▪ Describe the philosophical shift that has occurred in reducing
juvenile delinquency.
▪ Summarize the importance of prevention and treatment.
▪ Explain the principles of effective intervention.
▪ Explain how need factors contribute to risk for delinquent
behavior.
▪ Describe each generation of risk and need assessment tools.
▪ Explain the significance of responsivity factors with regard to
treatment.
▪ Summarize the philosophy behind cognitive behavioral
programs.
▪ Analyze the model treatment programs and why they work.
▪ Explain the importance of relapse prevention techniques.
Prevention
and Treatment
10
Toby Talbot/Associated Press
© 2019 Bridgepoint Education, Inc. All rights reserved. Not for
resale or redistribution.
Chapter Outline
10.1 Introduction
10.2 What Is Treatment and Prevention?
10.3 Evidence-Based Treatment: The Principles of Effective
Intervention

10.4 Risk and Need Factors
10.5 Classification and Assessment
▪ First-Generation Assessment Tools
▪ Second-Generation Assessment Tools
▪ Third-Generation Assessment Tools
▪ Fourth-Generation Assessment Tools
10.6 Responsivity Factors
▪ Motivation to Change
▪ Approaches to Motivational Issues
10.7 Treatment Services
10.8 Examples of Effective Treatment Programs: Model
Programs
▪ Functional Family Therapy
▪ The Incredible Years Series
▪ Big Brothers Big Sisters Community-Based Mentoring
Program
▪ Promoting Alternative Thinking Strategies
▪ Life Skills Training
▪ Multisystemic Therapy
▪ Multidimensional Treatment Foster Care
▪ Nurse-Family Partnership
▪ Model Programs: Why They Work
10.9 Connecting the Dots: Relapse Prevention
In 1988, 7,000 youth were waived to adult court for criminal
proceedings. In 1992, that num-
ber hit nearly 12,000 youth. The increase in waivers to adult

court occurred in the context of
the decade-long movement to get tough on crime. This get-
tough movement was characterized
by an increased use of punishment with the purpose of deterring
crime. In real terms, these
punitive measures included an increased reliance on
incarceration for juveniles, a policy shift
to allow younger juveniles to be transferred to adult court for a
broader range of offenses, and
the increased use of tougher sanctions in the community such as
boot camps.
The get-tough movement was politically popular for years. As
discussed in Chapter 2, the
tough-on-crime agenda was popular among both political
parties. For example, the Anti-Drug
Abuse Act, which led to mandatory minimum sentences for drug
offenders, was passed while
Section 10.1Introduction
Ronald Reagan was president. But equally punitive “three
strikes and you’re out” laws were
passed in many states during Bill Clinton’s administration.
Fast-forward to more recent times, and the stories sound more
like this: “When Harry Coates
campaigned for the Oklahoma State Senate in 2002, he had one
approach to crime: ‘Lock ’em
up and throw away the key.’ Now Coates is looking for that
key” (Murphy, 2011). News stories

throughout the country are documenting the resulting effects of
the get-tough movement on
state budgets. States are faced with enormous budget shortfalls
that place criminal justice
expenditures in the crosshairs. Many states have repealed their
mandatory sentencing policies
for drug use and revised their three-strikes policies. For the first
time in many decades, states
are reducing prison populations and relying more on
community-based alternatives for pun-
ishing offenders. Although economic conditions may be a
primary catalyst for this shift, studies
also support treatment and prevention efforts as a cost-effective
way to maintain public safety.
10.1 Introduction
Juvenile justice policy tends to change (sometimes
dramatically) over time. Rehabilitation as
a guiding philosophy of the juvenile justice system fell out of
favor by the late 1970s. At that
time, psychologist Robert Martinson (1974) examined whether
youth who received treat-
ment services had lower recidivism rates. He found that
receiving treatment did not lead to
significant reductions in crime. This finding led him to proclaim
that “nothing works” when it
came to treatment. At the same time, the public was very
concerned about the rise in juvenile
drug use and violent crime. Concerned as well, lawmakers
began to suggest that the juvenile
justice system was too soft on crime and advocated for harsher
punishments (Baird & Samu-
els, 1996).
Nearly 25 years later, the juvenile justice system is in the midst
of another philosophical shift.

This time the shift is back toward rehabilitation. Why is the
system moving back to what it
once abandoned? Just like before, there are a variety of reasons.
As mentioned in the opening
story, the first reason is fiscal. In the 1980s and 1990s, states
were willing to spend money to
crack down on crime and send a message to would-be offenders.
However, as illustrated in
the accompanying Spotlight feature on criminal justice reforms
taking place in Utah, many
states are rethinking some of the earlier get-tough strategies
(Scott-Hayward, 2009).
Spotlight: Criminal Justice Reforms: Utah
According to the Pew Center on the States (2009), corrections
ranks as the second highest
expenditure in the United States. With over 7 million adults
under some form of correctional
supervision, 1 in every 15 state general fund dollars is now
spent on corrections. Between
1982 and 2002, the budget for corrections increased 255%. As a
result, many states are in a
financial crisis and can no longer afford to incarcerate people at
the same rate.
Utah is one state that felt this crisis. In 2013, the state spent
$269 million on corrections.
Moreover, many of those on parole were failing at a higher rate
than 10 years ago. State poli-
cymakers decided that something had to be done to reduce costs
and failure rates. In 2015,
(continued on next page)

Section 10.1Introduction
The shift back toward rehabilitation is also being driven by
studies supporting its use. Since
Martinson’s “nothing works” statement, multiple studies have
found that treatment services
can reduce criminal behavior among juvenile offenders by as
much as 30–35% (Aos, Phipps,
Barnoski, & Lieb, 2000; Bonta & Andrews, 2007). In addition,
Mark Lipsey (2009) examined
what types of programs worked better than others. He argued
that structured, intensive ser-
vices focused on the youth’s problems were much more
effective than other programs in
reducing recidivism. His research also found that services
delivered in institutions (youth
prisons) tended to be less effective than those in the community.
Finally, Lipsey noted that
there were in fact some programs that did not work. As a result,
he and others began to argue
that Martinson’s claim of “nothing works” should have been
that not all programs work. In
other words, some programs are more effective than others.
We can see evidence of this shift toward rehabilitation in state
and federal policy. One note-
worthy example is in RECLAIM Ohio, a program designed to
reduce the use of state juvenile
prison beds by encouraging counties to provide services to
youth in their own communities.
For every youth who could have been sent to a juvenile
institution but was instead kept in

the community, the state of Ohio would give money to the
community. The state encouraged
counties to use the money to develop and pay for rehabilitation
programs. The initiative has
been successful at reducing recidivism rates and is considered a
more cost-effective option
than prison (Latessa, Turner, Moon, & Applegate, 1998).
Another example of a rehabilitation-based policy is the Second
Chance Act of 2007 (passed in
2008). The act supports a variety of services for adults and
juveniles who are reentering the
community, including aftercare programs that focus on areas
such as employment and educa-
tion, as well as the Strengthening Relationships Between Young
Fathers, Young Mothers, and
Their Children grant program, which provides family-based
services and focuses on treat-
ment for the parent. For more information, see
https://csgjusticecenter.org/nrrc/projects/
second-chance-act/.
Spotlight: Criminal Justice Reforms: Utah (continued)
the Utah Commission on Criminal and Juvenile Justice
developed policy options that were
based on data-driven solutions to increase public safety while
simultaneously reducing the
prison population. The legislation was aimed at reducing the
incarceration of drug offend-
ers, increasing community-based alternatives, and improving
and expanding reentry ser-
vices. According to the Utah governor, “[T]his package will
enhance public safety and put the
brakes on the revolving prison door. H.B. 348 will establish
better treatment resources and

alternatives for nonviolent offenders, ensuring our citizens get
the best possible return on
their tax dollars” (Pew, 2015, para. 6).
Many states are favoring lower-cost, community-based options
like drug treatment
and enhanced community supervision to reach better outcomes
with both their
adult and juvenile populations. For more on reforms in Utah and
other states, see
http://www.pewtrusts.org/en/about/events/2015/criminal-
justice-reform-panel
and http://www.pewtrusts.org/en/research-and-
analysis/articles/2017/04/
podcast-the-story-behind-the-drop-in-us-incarceration.
https://csgjusticecenter.org/nrrc/projects/second-chance-act/
https://csgjusticecenter.org/nrrc/projects/second-chance-act/
http://www.pewtrusts.org/en/about/events/2015/criminal-
justice-reform-panel
http://www.pewtrusts.org/en/research-and-
analysis/articles/2017/04/podcast-the-story-behind-the-drop-in-
us-incarceration
http://www.pewtrusts.org/en/research-and-
analysis/articles/2017/04/podcast-the-story-behind-the-drop-in-
us-incarceration
Section 10.2What Is Treatment and Prevention?
A third policy initiative that has gained popularity is the Justice
Reinvestment Initiative (JRI).
Launched in 2006, the JRI is based on the premise that we can

reinvest criminal justice dol-
lars into what has been shown to work in reducing recidivism.
The Bureau of Justice Statistics
and the Pew Center on the States have provided resources and
tools to states to guide them
through a four-step process to increase the effectiveness of their
criminal justice systems. The
four-stage process includes (a) analyzing data to understand
factors driving jail and prison
population growth; (b) developing and implementing policy
options to generate savings and
increase public safety; (c) reinvesting in select, high-risk
communities and measuring the
impact of policy changes and reinvestment resources; and (d)
enhancing the accountability
of criminal justice system actors and policies.
Each of these policy initiatives uses evidence-based strategies
to effectively treat and
prevent crime.
10.2 What Is Treatment and Prevention?
What exactly is treatment for juveniles? Treatment refers to a
set of actions or services
designed to rehabilitate or change an individual. Treatment for
juvenile offenders can include
a range of activities such as group therapy, individual sessions,
school-based interventions,
and/or community mentoring programs. Treatment services can
occur in homes, prisons, or
schools, or in various agencies in the community. Treatment
services can also act as preven-
tion programs. Prevention programs are designed to avert a
situation or prevent one from
worsening. For example, teaching juveniles the importance of
avoiding drugs and alcohol is

intended to prevent youth from experimenting with them.
However, prevention strategies
may also be implemented after a youth has committed a crime in
an effort to reduce the
youth’s likelihood of committing another crime or a worse
crime. For example, teaching youth
about the consequences of drug use could be beneficial to those
who may have already exper-
imented with drugs. In this case, the program’s goal would be to
stop the youth’s use from
escalating. In this context, prevention can be both proactive and
reactive.
Prevention programs are often categorized into three levels
based on who or what is being
targeted. For example, the first level attempts to prevent
delinquency from occurring at all,
the second level attempts to intervene early in the youth’s
involvement in delinquency, and
the third level attempts to stop the youth from escalating in his
or her delinquent career. The
three prevention levels are labeled primary prevention,
secondary prevention, and tertiary
prevention. Let’s take a look at them in more detail.
Primary prevention programs focus on the conditions that could
lead to delinquent behavior
such as truancy, poor parenting, and prenatal exposure to
toxins. These types of approaches
target at-risk juveniles and may include after-school programs
to keep youth busy or a tru-
ancy reduction program to keep youth in school. Another
example might include wellness
campaigns around prenatal care for mothers. The prenatal care
would include educating new

Section 10.3Evidence-Based Treatment: The Principles of
Effective Intervention
mothers on the dangers of smoking, drinking, or using drugs
during pregnancy. These types
of programs act as barriers to protect against or prevent
delinquency.
Secondary prevention programs shift the focus of services to the
delinquent youth and
address the delinquent behavior at its earliest stages. By
intervening early with youth, these
programs attempt to slow or stop their potential progression into
crime. These types of pro-
grams may include diversion programs and mentoring programs
such as Big Brothers Big
Sisters. A big brother or sister can help the youth get back on
the right track by providing
support and encouragement to stay in school and avoid drugs
and alcohol.
The third level, tertiary prevention, is focused on reducing
recidivism among those who
are already in the juvenile justice system. In that sense, these
programs are more reactive
approaches. The prevention efforts focus on limiting the
problems and issues faced by the
youth. Treatment programs for anger management, addictions,
family functioning, and
relapse prevention are examples of services designed for youth
who have a high probability

of continuing their delinquent behavior.
As the preceding discussion illustrates, there are various
treatment and prevention programs
for juveniles. One potential problem facing the juvenile justice
system is figuring out which
program, policy, or strategy to choose. Not all programs are
created equal, and it is difficult
to decide who needs what services and for how long.
Researchers have found that some pro-
grams are more effective than others, but questions still remain.
For example, does every
juvenile who has been arrested need treatment? Should all
juveniles receive the same treat-
ment services? Should all juveniles participate in prevention
programs, and if so, where? Are
the services worth the taxpayer costs? Should we mandate
prevention for school-aged chil-
dren or for their parents?
10.3 Evidence-Based Treatment: The Principles of
When it comes to rehabilitation, no one-size-fits-all approach is
likely to solve every problem
facing juveniles. The challenge to rehabilitate juvenile
delinquents can be daunting if we con-
sider all the different problems they could be facing: poverty,
failing schools, family conflict,
addictions to drugs or alcohol. We do know, however, that some
approaches seem to work
better than others. As a result, for the past few decades, juvenile
justice treatment reforms
have shifted to what is commonly referred to as a “what works”
or “best practices” model.

Juvenile justice agencies and treatment programs are often
required to show that they are
using strategies or programs that have been proven to be
effective with juveniles. The reason
for this is twofold: (a) funding agencies need to make sure they
are getting the most for their
money, and (b) studies have found that if programs follow
certain principles or strategies
they are more likely to see reductions in recidivism (Manchak &
Cullen, 2015). For example,
the Florida Department of Juvenile Justice has embarked on a
“what works” initiative that is a
comprehensive program improvement project to increase the
effectiveness of juvenile justice
services throughout the state. The department is attempting to
incorporate only empirically
supported treatment models and techniques. In particular, the
state requires thorough train-
ing and pilot testing of curricula and assessment instruments
(Chapman, 2005).
Section 10.3Evidence-Based Treatment: The Principles of
In an effort to identify strategies that were effective in reducing
recidivism, researcher Paul
Gendreau (1996) developed the principles of effective
intervention. These principles are
recommended strategies and practices that characterize effective
programs. The principles
are based on his experiences working with offenders in prison

and on research by others in
the field. On the surface, these principles are not
groundbreaking. However, they were con-
sidered fairly radical for a field that was entrenched in the get-
tough movement that focused
primarily on increased use of punishment. The following is a
list of the core principles:
• Match treatment services to the offender’s risks and needs.
• Use treatment models that are behavioral and cognitive
behavioral in nature.
• Develop a range of rewards and consequences for behavior.
• Provide relapse prevention strategies.
Gendreau also identified programs that
did not work. Many of the programs that
he identified as ineffective were deter-
rence-based programs commonly used
during the get-tough movement. Deter-
rence-based programs use severe punish-
ments with the goal of scaring youth from
coming back into the system. In other
words, the hope was that youth would
avoid crime in the future in order to avoid
a punitive sanction. Popular deterrence-
based programs used during this time
included chain gangs, boot camps, and
Scared Straight programs. Research found
that youth who went through these types
of programs still had high recidivism rates
(Wilson & Lipsey, 2000). Further, as seen
in the accompanying Spotlight feature,
boot camps had even greater problems, as
several youth died while participating. In general, it was argued
that these strategies were not
effective because they did little to identify the causes of crime

or to teach youth how to act
differently once released back into their communities.
Terry Barner/Associated Press
In this 2007 photo, supporters of Martin Lee
Anderson, foreground, listen at the trial of
eight former boot camp employees from the
Bay County, Florida, Sheriff ’s Office. The former
guards and nurse were on trial for Anderson’s
death.
Spotlight: Boot Camps: What Went Wrong?
Martin Lee Anderson was a Florida teenager sentenced to the
Bay County juvenile boot
camp for trespassing. He died on January 6, 2006, after guards
repeatedly beat him while
restrained. Anthony Hayes, a 14-year-old from Arizona, was
sent to a boot camp for a charge
of shoplifting. He died July 2001 after being required to spend
several hours standing outside
in 112-degree heat. Gina Score, a 14-year-old South Dakota girl
sent to a boot camp for shop-
lifting, died of heatstroke when she collapsed after a run and lay
unattended for three hours.
In every case, staff members were charged in connection with
the deaths. What is most-
Section 10.4Risk and Need Factors

10.4 Risk and Need Factors
Youth are considered “at risk” for delinquency if they are
exposed to certain environments or
have certain personal traits. These high-risk environments can
exist in youth’s communities,
schools, and families. These environments and traits are often
referred to as criminogenic
needs. Criminogenic needs are known correlates of delinquency
and include associating
with high-risk peers, experiencing family dysfunction,
substance use, impulsivity, and poor
school achievement (Andrews & Bonta, 2010). The more
criminogenic needs the person has,
the greater risk the person has for delinquency. The criminal
justice system uses the word risk
to refer to the probability that someone will recidivate. A high-
risk person has a high prob-
ability of delinquency in the future. Take the example of
associating with delinquent peers.
This puts a youth at risk for delinquency because our close
friends have a big impact on our
behavior in terms of the modeling they provide as well as peer
pressure. Fortunately, once
these needs are identified, criminal justice practitioners can
intervene to reduce them (e.g.,
creating opportunities for youth to associate with positive
peers).
Let’s think about this using a medical example: When a doctor
is visited by a patient who
is concerned about the potential for heart disease, the doctor
will discuss risk factors for
Spotlight: Boot Camps: What Went Wrong? (continued)

striking is that in each case staff members were accused of
either using excessive force or
failing to attend to the youth while they were in a medical
crisis.
Developed for juvenile offenders in the early 1980s, the boot
camp model was popular politi-
cally. Modeled after the military, boot camps for juvenile
offenders were designed to use
rigorous, physically demanding activities to develop discipline
and respect for authority.
Boot camps typically employed staff who would act as drill
sergeants teaching the youth the
benefits of working hard, not quitting an activity, and showing
deference to adults. The idea
was that the boot camp would break the youth down in an effort
to change their destructive
and disrespectful behavior. The public and policymakers liked
the idea of tough love, and by
1995 most states were operating boot camps.
Although some boot camps still exist, most were eventually
closed. Many of the closures
came after the deaths and stories of abuse, which were widely
publicized by the media. How-
ever, their closure was also due to the growing number of
findings that, with a few excep-
tions, boot camps were not effective in reducing recidivism
(Parent, 2003).
Various reasons have been offered as to why boot camps were
unable to achieve their stated
goals. First, some argued that boot camps did not focus on the
issues that brought the youth
to the camp. By relying only on coercive physical punishment,
the camps failed to address

key issues facing youth within their families, schools, and
communities. This is also one of
the reasons wilderness type programs (covered in Chapter 8)
lacked effectiveness. Second, in
the traditional military model, participants are sent to military
training after they complete
the boot camp. As part of their training they are given housing,
meals, and support. Juvenile
boot camp participants were simply sent home to the same
environment after they com-
pleted their boot camp training. Finally, some argued that teens
felt boot camps were inher-
ently unfair and cruel and reported feeling defiance and anger
toward guards. Ironically, this
hostility toward authority was exactly what the boot camp
guards were trying to eradicate
(Robinson, 2001).
Section 10.5Classification and Assessment
the disease. Those risk factors include gender, age, family
history, cholesterol level, weight,
whether the person smokes, physical activity, and so on. An
older male with a history of heart
disease in his family, who has high cholesterol, gets limited
physical activity, is overweight,
and smokes is at a higher risk for heart disease. Risk factors for
delinquency work the same
way. The risk factors for delinquency were not picked at
random. Research studies have estab-
lished that these factors are correlated with crime (Andrews &

Bonta, 2010).
The more risks or problems individuals experience, the more
likely they are to engage in crim-
inal behavior. Not everyone has the same number of risk
factors. For some, school achieve-
ment may be the only problem area and otherwise they are
doing well. In that circumstance,
a probation officer may conclude that the juvenile is at low risk
for future criminal behavior.
In contrast, a youth who is having difficulty in school and/or
with his or her parents, who is
addicted to drugs, and who chooses to associate with other
delinquent peers is at a higher
risk of delinquency. Determining which factors are important
for each person requires that
the probation officer conduct a risk assessment. The assessment
of risk is typically based on
a classification tool.
10.5 Classification and Assessment
Classifying juveniles into groups is a common practice in the
criminal justice system. Juve-
niles are grouped based on characteristics such as age, gender,
suicide risk, addiction severity,
and so on. In general, an assessment is a
tool that evaluates how likely a youth
might be to engage in criminal behavior.
An assessment of a youth’s risk for crimi-
nal behavior may include an evaluation of
his or her needs (e.g., peers, personality,
and lifestyle factors). Assessing a youth’s
risk for future criminal behavior often
uses what is referred to as a risk and need
assessment tool.

Before we discuss some of the more pop-
ular risk and need assessment tools, it
is important to understand the history
behind assessment for juveniles. The his-
tory of assessment is often discussed
in the context of generations or phases
(Andrews, Bonta, & Wormith, 2006).
First-Generation
Assessment Tools
First-generation assessment tools are not actually tools but are
unstructured “gut-level”
assessments of an individual’s risks and needs. An example of
this type of assessment would
be a meeting that might happen between a probation officer and
his or her client. The interac-
tion might sound something like this:
Bill Haber/Associated Press
Probation officers evaluate the personalities and
lifestyles of juveniles in hopes of assessing the
risks of criminal behavior.
Probation Officer (P.O.): Why do you think you got into trouble
this time?
Client: I keep hanging around with this buddy of mine, and we
always just
seem to get into trouble.

P.O.: Don’t you think you should stop hanging around with this
friend of yours?
Client: Yeah, I will see what I can do. I don’t know, though, we
are pretty tight.
P.O.: Are you in school?
Client: I try to go when I can.
P.O.: You are going to have to go to school to do well on
supervision.
Client: OK. I will see what I can do.
P.O.: OK. I will see you next time, and I expect to hear that you
have been
attending school.
Based on this abbreviated interaction, the probation officer
might assign a risk level to the
youth. The probation officer might conclude that the youth is at
moderate risk for future
criminal behavior because the youth is associating with other
delinquents and is truant from
school. But this “assessment” of risk will be based on the
probation officer’s intuition or gut-
level reasoning about the youth’s probability for future criminal
behavior. The assessment is
not guided by an actual paper-and-pencil assessment tool. The
disadvantage of this approach
is that gut-level intuition or unguided clinical judgment tends to
be inaccurate and provides
an incomplete picture of the important risk factors for
delinquency (Grove, Zald, Lebow, Snitz,

& Nelson, 2000). First-generation assessments are often
inaccurate due to bias. For example,
let’s assume for a moment that a probation officer believes that
most juvenile delinquents
get into trouble because they have parents who do a poor job
with discipline. When that
same probation officer interviews a youth, the probation officer
would likely spend more
time questioning the youth about family interactions and
discipline styles than other risk
factors (e.g., looking at the youth’s peers). It is natural for
people to bring personal biases
into their interactions with others; however, these biases can
lead some people to overlook
certain aspects of a youth’s life that might be important.
Second-Generation Assessment Tools
Second-generation assessment tools are structured
questionnaires that guide the interview
process. The tools also assign a value to each risk factor. For
example, a youth with a violent
prior record would receive more points than a youth with a
nonviolent record. Second-gen-
eration assessments remove the bias by assigning points and
providing an overall risk score.
The problem with second-generation tools is that they focus
primarily on historical factors.
These historical factors are also referred to as static risk
factors. A static risk factor is a cir-
cumstance in a youth’s life that cannot be changed because it
happened in the past. For exam-
ple, if a youth has a long prior record, a history of substance
abuse, and a history of violence,

a second-generation tool would likely tell us that the youth is at
high risk for future criminal
behavior. However, the risk factors are all static because they
happened in the past. Relying
on historical factors misses some of the other problems the
youth faces and does not provide
a clear path for treatment. These disadvantages led to the
development of third-generation
assessment tools.
Third-Generation Assessment Tools
The third-generation assessment tools became popular in the
late 1980s. Third-generation
assessment tools combine both static and dynamic factors to
give a broader portrait of the
likelihood that a youth will commit a crime in the future.
Dynamic risk factors, also referred
to as criminogenic needs (described earlier), are important risk
factors in the individual’s life
that can be changed. An example of this type of tool is the
Youth Assessment and Screening
Instrument (YASI). The YASI covers a number of dynamic and
static risk factors such as crimi-
nal history, education, family relationships, peers, substance
use, and antisocial attitudes. The
tool also provides an overall risk score from no risk to high
risk. The third-generation tools
give the therapist an idea of what areas to work on in treatment
but do not emphasize the
need to reassess youth as they progress through treatment.

Fourth-Generation Assessment Tools
Fourth-generation assessment tools are now considered a best
practice in the field. Like their
predecessors, the fourth-generation tools build on the benefits
of the third generation by tar-
geting both static and dynamic risk factors. In addition, the
fourth-generation assessment
tools are designed to take the juvenile’s treatment plan from
intake to case closure. Reassess-
ment is key to the process of treatment, because it helps
determine whether a program had an
impact on an offender’s risk and it guides changes in the
treatment or case plan. An example
of a fourth-generation tool is the Youthful Level of
Service/Case Management Inventory (YLS/
CMI) (Hoge, Andrews, & Leschied, 2002). The YLS/CMI asks
questions about eight areas in a
youth’s life including prior record, family, school, peers,
substance abuse, leisure/recreation,
personality, and attitudes. The tool provides a risk score in each
of the eight areas and an
overall risk score. The tool also has a section where the assessor
can provide a reassessment
score. The developers encourage reassessment every 6–12
months depending on the amount
of time the youth spends under supervision.
Another recently developed fourth-generation assessment tool is
called the Ohio Youth
Assessment System (OYAS). The OYAS was developed by
Edward Latessa and associates at
the University of Cincinnati. The assessment contains five
separate tools that can be used as
standalone tools or as a set, depending on the juvenile’s case
plan. The instrument covers
all of the major risk factors including history; family and living

arrangements; peers; educa-
tion and employment; prosocial skills; substance abuse; mental
health and personality; and
values, beliefs, and attitudes. Each of the sections contains risk
factors that are scored in a 0
(no problem) or 1 (evidence of a problem) format. The items are
then summed to provide an
overall risk score. The summary results provide caseworkers
with a graphic illustration of the
risk factors as well as the youth’s overall risk. The risk factor
information should be used for
case planning and treatment assignment (Latessa, Lovins, &
Ostrowski, 2009).
Section 10.6Responsivity Factors
10.6 Responsivity Factors
Even when appropriately assessed and placed in treatment, some
youth seem to do bet-
ter than others. Sometimes other issues influence the success of
treatment. These issues,
referred to as responsivity factors, are not risk factors for
delinquency, but they are barriers
to treatment (Palmer, 1974). Responsivity factors are
characteristics of the person or the
person’s environment that may act as obstacles to treatment
and/or supervision. The barri-
ers can include personal or internal factors and environmental
or external factors. Internal or
personal barriers can include factors such as motivation,
personality, and intelligence. Intel-

ligence may act as a barrier to treatment if the topic presented
in a treatment group is too
difficult to understand. For example, if a therapist is trying to
teach a client how to be more
empathetic, the therapist might say, “Try to put yourself in
someone else’s shoes, and think
about how he or she would feel.” A client with a lower IQ might
have a difficult time with this
concept, because imagining what others might be thinking or
feeling requires a fairly high
level of cognitive functioning.
Factors in the environment, or external factors, could impact
treatment as well. External fac-
tors can include how well the therapist and client get along,
whether the treatment happens
in an institution or in the home, and even something simple like
transportation. Youth who
have difficulty finding transportation to the treatment agency
may not do well simply because
they are unable to attend. All of these factors can be important
and impact treatment, but one
responsivity factor that has received a considerable amount of
attention is a client’s motiva-
tion to change.
Motivation to Change
It was once thought that if individuals were not motivated to
change their behavior, then little
could be done to help. People would often talk about how
addicts needed to hit “rock bottom”
before they were ready to engage in treatment. Although it is
now understood that coerced or
involuntary treatment can work even if someone is not
motivated at the outset (Anglin &
Hser, 1990), corrections professionals cannot ignore resistance;

rather they need a plan in
place to diminish it over time.
We can think of motivation as existing
on a continuum with people who are not
motivated on one end and people who
are highly motivated on the other. In the
1980s, two researchers developed cat-
egories to capture the different levels of
motivation people progress through when
deciding whether to change their behavior.
They referred to these levels as the stages
of change (Prochaska & DiClemente,
1983). In the first stage, referred to as pre-
contemplation, individuals are not actively
seeking to change their behaviors. They
may be unaware that the behavior needs
to be changed or simply do not see their
“problem” as something to be addressed.
KatarzynaBialasiewicz/Getty Images
In the first stage of change, precontemplation,
individuals aren’t trying to change problem
behaviors.
Section 10.7Treatment Services
An example would be juveniles who do not see that their
marijuana use is causing a problem
in their lives. The belief may exist even in the presence of
evidence that the drug use is having

a negative impact on school, family relations, peers, and so
forth.
In the second stage, contemplation, the youth may understand
that the problem exists but
has yet to commit to change. In the marijuana use example, the
youth may recognize that the
marijuana use is causing problems with school in terms of both
attendance and performance,
but still wants to get high and is not committed to stopping. In
the third stage, preparation,
the youth may begin taking steps that will lead to change but is
not fully committed to imple-
menting the behavior. In this stage, individuals may decide that
change is needed and begin
to think about other activities that would help keep them busy
during the times that drug use
typically occurs (e.g., after school, on weekends).
In the fourth stage, action, the youth commits to change and
begins to modify the behavior
in question. In this stage, the youth would stop the use of
marijuana. The final stage, mainte-
nance, is when the youth develops clear steps to maintain the
behavioral change. The mainte-
nance stage would include relapse prevention strategies such as
avoiding high-risk situations
and friends that could trigger a lapse.
Approaches to Motivational Issues
Several tools and approaches are used to assess the issue of
motivation to change. For exam-
ple, the Motivation to Change Inventory for Adolescents
(Bauman, Merta, & Steiner, 2001)
measures motivation to engage in substance abuse treatment. As
part of this process, the

scale examines issues such as social support, self-efficacy, and
life skills.
Another popular approach to measuring and addressing
motivational issues is called moti-
vational interviewing (Miller & Rollnick, 2004). Motivational
interviewing is an interview-
based technique designed to reduce an individual’s resistance to
engaging in treatment. The
therapist would work to have the youth understand why the
behavior in question needs to
be changed. For example, if the youth does not want to stop
using marijuana, the therapist
can discuss the reasoning behind the youth’s resistance and the
impact drug use is having.
By helping the youth see the problems that marijuana use is
creating, the theory is that the
person will see the benefits of changing the behavior.
Techniques used in motivational inter-
viewing include being nonconfrontational, rolling with
resistance, and supporting the client’s
self-efficacy. Proponents of this approach suggest that by
working with rather than coercing
clients, the likelihood of increasing intentions to change is
greater and longer lasting (Li, Zhu,
Tse, Tse, & Wong, 2018; Miller & Rollnick, 2004).
10.7 Treatment Services
Once an individual’s risk, need, and responsivity factors have
been assessed, the next stage
is to begin treatment. As mentioned earlier, the principles of
effective intervention outline
certain features of effective programs but stop short of
recommending particular groups or
programs. That said, there are many existing programs and
services that can be effective, par-

ticularly if they are implemented well and for a reasonable
length of time. Some of the more
popular approaches are based on cognitive and social learning
theories.
Section 10.7Treatment Services
Studies find that clients who exhibit antisocial logic and have
poor problem-solving and cop-
ing skills are more likely to be involved in delinquency. Put
another way, people who believe it
is acceptable to commit crime by justifying and minimizing
their criminal behavior are more
likely to engage in that behavior (Cullen & Gendreau, 2000).
Cognitive behavioral therapy
is a type of treatment approach focusing primarily on the way
people think and subsequently
how they behave. Cognitive behavioral therapists try to teach
clients that how they think
about situations tends to influence how they act in those
situations. In other words, if a youth
believes that the police cannot be trusted, every interaction the
youth has with the police will
be influenced by this belief. That belief itself often has a
greater influence over the interaction
with the officer than the interaction itself. Two main types of
therapy fall under the umbrella
of cognitive behavioral programming: cognitive restructuring
and cognitive skill.
Cognitive restructuring therapy attempts to change antisocial

cognitive beliefs or thoughts.
This therapy is based on the idea that people react as a result of
how a situation is processed
cognitively. When those cognitions are distorted (also popularly
referred to as thinking
errors), the reaction is often negative. For example, a juvenile
delinquent may blame others
or minimize the role smoking marijuana played in a criminal
act. The youth may feel that
marijuana should be legal and uses that belief to justify the drug
use. The aim of cognitive
restructuring therapy is to teach people to recognize the
situation, address how they perceive
that situation, and as a result change the outcome or the
response.
Cognitive skills therapy, while similar, is intended to develop a
set of skills individuals can
use when confronted with a problem or high-risk situation. For
example, cognitive skills ther-
apy may involve increasing problem-solving or social skills, or
teaching someone how to use
a coping skill such as self-talk. When people feel angry or
frustrated, they may calm down
by telling themselves that everything will turn out fine. For
example, Donald Meichenbaum
(1977) explored anger management techniques with juveniles
and found that a commonly
used technique such as saying “Check yourself ” worked to
reduce anger responses. That is,
if a juvenile is feeling angry or is exhibiting angry behavior, the
counselor would say, “Check
yourself,” and that would signal the youth to deal with those
emotions differently. Programs
based on cognitive restructuring and cognitive skills have been
found to be very effective in

reducing recidivism (Cullen & Gendreau, 2000).
Cognitive behavioral therapies can be run in a variety of
settings and can be guided by a num-
ber of different curricula. Notable approaches include Albert
Ellis’s rational emotive behavior
therapy (Ellis & MacLaren, 1998) and Stanton Samenow’s
(1998) Commitment to Change.
The curricula allow clients to see the connection between
attitudes and behavior and attempt
to teach clients how to manage their own emotions when they
encounter difficult situations.
Thinking for a Change (T4C) is a popular cognitive behavioral
curriculum that is discussed in
the accompanying Spotlight feature. T4C, developed by the
National Institute of Corrections,
is used with both juveniles and adults.
Spotlight: Thinking for a Change (T4C)
Thinking for a Change (T4C) is a cognitive behavioral
curriculum developed by Bush, Tay-
mans, and Glick (1997) for the National Institute of
Corrections. The curriculum consists of
Section 10.8Examples of Effective Treatment Programs: Model
Programs
In addition to these programs and curricula, other treatment and

prevention programs have
been identified as effective. The programs are referred to as
model programs and are cur-
rently considered best practices in the field. In the next section,
we highlight several curricula
to illustrate the different types of programs available.
10.8 Examples of Effective Treatment Programs:
Model Programs
In the field of juvenile justice treatment, it can be difficult to
determine which program to
choose. To make this task easier, the Center for the Study and
Prevention of Violence at the
University of Colorado, Boulder, developed an information
clearinghouse to identify violence
and drug prevention programs, policies, and practices in the
field. Their Blueprints for Vio-
lence Prevention Initiative is designed to identify effective
treatment programs and services
that could be replicated in communities across the nation.
According to the center’s website,
The Blueprints mission is to identify truly outstanding violence
and drug
prevention programs that meet a high scientific standard of
effectiveness. In
Spotlight: Thinking for a Change (T4C) (continued)
22 lessons integrating both cognitive restructuring and cognitive
skills exercises. The curric-
ulum has three components: cognitive self-change, social skills,
and problem-solving skills.
Each section uses a variety of techniques to allow individuals to
see how their thoughts influ-

ence feelings and behaviors. Group members are taught
problem-solving skills that they can
use when confronted with high-risk situations. Each lesson is
formatted in a similar way,
allowing for participants to learn a particular skill, practice the
skill in front of others (role
play), and receive constructive feedback from the group.
In the cognitive self-change section, the curriculum offers a tool
called a Thinking Report.
Thinking Reports have the youth identify the risky situation he
or she experienced. An exam-
ple of a high-risk situation for a participant might be when the
youth is asked by a group of
friends to use drugs after school, so he follows along and gets
high. The counselor would
work with the youth to determine what thoughts the youth had
prior to deciding to meet up
with his friends to get high (e.g., “I really want to go,” “I don’t
want to get in trouble,” “getting
high would feel good”). The counselor then probes the youth to
identify what feelings the
youth may have had in the situation (e.g., feeling anxious,
excited, apprehensive). Finally, the
counselor probes the youth to think a little deeper about the
attitudes or values he or she
has about the situation (e.g., “using drugs is normal for teens”).
Going through this step-by-
step process, the youth can see how the thoughts, feelings, and
attitudes about the situation
made it more likely that he or she would decide to use drugs. By
working to develop this
awareness, the counselor can then help the youth consider
thinking differently about the
situation in the future.

Each lesson is designed to occur within a two-hour format once
a week; however, groups
can be held more than once per week. T4C has been
implemented in hundreds of agencies
nationwide (Bush et al., 1997).
Programs
doing so, Blueprints serves as a resource for governments,
foundations, busi-
nesses, and other organizations trying to make informed
judgments about
their investments in violence and drug prevention programs.
(https://cspv
.colorado.edu/blueprints/index.html)
Center staff members categorized programs as either “model”
programs, which indicates
they are effective with a variety of clients and agencies, or
“promising” programs, which are
effective but need to be replicated elsewhere.
Another initiative similar to Blueprints, but not focused solely
on violence and drug preven-
tion, is an initiative funded through the Office of Justice
Programs. The Evidence Integration
Initiative is designed not only to inform agencies and
policymakers on best practices in crim-
inal justice but also to assist them as they integrate the evidence
into their current systems.

One part of this initiative is the development of a clearinghouse
similar to the Blueprints
initiative that identifies programs as effective, promising, or
having no effect. The clearing-
house lists various programs that show effectiveness in reducing
recidivism in juveniles (see
[http://www.crimesolutions.gov).
As we might expect, a considerable amount of overlap exists
between the two initiatives in
the programs they identify as effective. The following sections
describe programs identified
as either model or effective by the respective agencies.
Although there are undoubtedly other
effective programs and services, these programs have been
reviewed extensively and hold the
most promise for reducing juvenile delinquency.
Functional Family Therapy
Functional Family Therapy (FFT) is a
family-based intervention that targets
youth ages 10–18 with wide-ranging
issues. The therapy can take place in vari-
ous settings including home, school, or
community agency offices (e.g., proba-
tion, parole, child welfare). The interven-
tion is relatively short, lasting on average
3–4 months. The program requires train-
ing for agency workers who wish to facil-
itate FFT.
Before the program begins, there is a pre-
treatment phase. At this point in the ther-
apy, the therapist works to establish referral sources and review
assessments and potential
services that might already be in place. The program itself

consists of five components:
• The engagement phase focuses on establishing a good rapport
with the family and
any other agencies or sources providing services to the youth
and family. Within this
context, the FFT therapist acts to develop a therapeutic alliance
with the family in
order to gain trust and commitment.
• During the motivation phase, the FFT therapist works with the
family and youth to
develop a positive outlook and goals (similar to motivational
interviewing). The
Fstop123/Getty Images
Functional Family Therapy works with the entire
family to help troubled youth.
https://cspv.colorado.edu/blueprints/index.html
https://cspv.colorado.edu/blueprints/index.html
http://www.crimesolutions.gov
Programs
therapist also works to move the functioning of the family from
a negative cycle that
might include blaming and justification to one that is more
optimistic and strength
focused.

• The relational assessment phase focuses on analyzing and
working with assessment
information regarding the functioning of the family and its
issues.
• The behavioral change phase is a crucial aspect of the therapy
and one that focuses
on skill-building activities. This phase is designed to provide
the platform for change
within the family.
• The final component, the generalization phase, includes
developing and sustain-
ing existing linkages in the community and assisting the
families with developing
relapse prevention plans.
The FFT organization has also developed a case management
model to assist probation and
parole officers in their work with the youth’s families. Studies
have found that these programs
reduce recidivism among youth and increase family
communication.
Learn more at https://www.fftllc.com.
The Incredible Years Series
The Incredible Years Series program targets not only the family
and youth but also the school
system. The program is designed for younger children, ages 2–
10, who have shown to be at
risk or have a diagnosis of conduct disorder. The program
consists of three series.
The first series, which is noted as the most important
component, is called the Incredible

Years Training for Parent Series. The parent series consists of
three core components:
• The BASIC program teaches parents skills such as relating to
their children, playing
with their children, and effective approval and disapproval.
• The ADVANCE program teaches parents more advanced skills
around support, anger
management, and communication.
• The SCHOOL program teaches parents how to encourage,
support, and engage in the
youth’s education.
Studies suggest that parents who complete the series are more
likely to use effective parent-
ing strategies, such as praise and limit setting, and they are
more likely to report better inter-
actions with their children.
The second series, referred to as the Incredible Years Series for
Teachers, focuses primarily on
building skills around classroom management. The focus of this
series rests with the manage-
ment of difficult behaviors in the classroom through the use of
redirection, rewards for posi-
tive behavior, and teaching problem solving. Studies suggest
that teachers who complete the
program are more likely to use praise and have better
interactions with youth and families.
Even more important, teachers who complete the program report
reduced aggression among
youth in the class.
The third and final series, called the Incredible Years Training

for Children, teaches youth age-
appropriate skills around self-management and self-control. The
series also includes a pre-
vention curriculum that teachers can deliver to the entire class.
Youth who completed this
https://www.fftllc.com
Programs
program were found to be less likely to have problems at home
and school and more likely to
use cognitive problem-solving strategies.
Read more at http://www.incredibleyears.com.
Big Brothers Big Sisters Community-Based Mentoring Program
Developed in 1904, Big Brothers Big Sisters is one of the
country’s oldest delinquency pre-
vention programs. It provides mentoring services to youth ages
6–18 from at-risk single-par-
ent homes. These mentoring programs
are designed to allow youth to interact on
a regular basis with meaningful mentors,
typically volunteers who agree to engage
in activities with the youth at least twice a
month. A mentor can be someone in the
youth’s family or community. This is often
referred to as a natural mentor. If the
youth has no natural mentors in his or her
life, a mentor can be assigned. The youth

and the mentor are encouraged to engage
in fun outings or activities, such as picnics
at a park, attending movies, or going shop-
ping. The purpose is to have someone
there for the youth if he or she wants to
talk or needs advice, or just to engage in a
prosocial activity. The program offers ser-
vices in both rural and urban areas.
The Big Brothers Big Sisters program offers special programs to
meet the needs of disadvan-
taged communities. Each of these programs attempts to match
an adult of a similar back-
ground to the youth. Included are the following programs:
• African American mentoring
• Native American mentoring
• Hispanic mentoring
• Mentoring military children
• Amachi program (for children with an incarcerated parent)
The programs have been implemented in all 50 states and 12
countries. The Big Brothers Big
Sisters organization indicates that they currently have over
240,000 volunteers nationwide.
Studies suggest that this program is able to reduce drug use,
interpersonal conflict, and tru-
ancy among youth who participate. Mentoring programs in
general have become a popular
approach to treating youth in the community.
Learn more about this program at http://www.bbbs.org.
Graham Cullen/Associated Press
At-risk youth can enroll in a mentoring program

through Big Brothers Big Sisters.
http://www.incredibleyears.com
http://www.bbbs.org
Programs
Promoting Alternative Thinking Strategies
The Promoting Alternative Thinking Strategies (PATHS)
curriculum is a school-based inter-
vention designed for children ages 5–10. Although the program
is designed to occur at school,
the curriculum also involves work that can be done at home
between parent and child. The
program uses a social cognitive approach to improve problem
solving and self-control.
The curriculum is designed to teach children how to use
reflective listening, to recognize dif-
ferent emotions they may be feeling, to have empathy for
others, and to teach problem-solv-
ing skills to reduce conflict. The underlying logic of this
program is that children are unable
to regulate emotions well and often do not have the coping
mechanisms necessary to manage
complex emotions like anger and frustration. Through various
age-appropriate stories and
characters, the program teaches youth to recognize their
emotions, to take a break and think
about the situation, and then ask for help by explaining the
problem and how they are feeling.

Children are also taught to assist their peers with the same
process. Ultimately, the program
aims to increase self-control, self-esteem, and self-confidence
in children.
Studies suggest that the PATHS program is effective at teaching
youth emotional regulation
strategies to deal with difficult emotions like anger and sadness.
The program was also shown
to be effective when combined with the Big Brothers and Big
Sisters program.
Learn more about the program at
http://www.pathstraining.com/main/.
Life Skills Training
There are many life skills programs in existence that target a
variety of behaviors. For exam-
ple, a life skills program in the community might work with
youth to teach them basic hygiene
and appropriate dress for school. Other life skills programs
might focus on employment and
teach youth about resume building or job interviewing. The
Lifeskills Training program noted
by the Blueprints initiative is a substance abuse prevention
program designed for youth in
grades K–12. The classroom-based program is broken down into
three curricula: one for ele-
mentary schools, one for middle schools, and one for high
schools. The program also includes
a transition program as an aftercare or maintenance-type
program for high school students.
Each curriculum has a number of sessions designed to teach
youth problem-solving skills to
avoid drug and alcohol use. For example, the elementary
curriculum contains 24 sessions, the

middle school contains 30 sessions, and the high school
program consists of 10 sessions. The
program includes three components:
• Drug resistance training: Youth are educated about drugs and
taught skills for
dealing with peer pressure.
• Self-control skills training: Youth are taught to critically
analyze situations, recog-
nize their consequences, and develop strategies for dealing with
them effectively.
• General skills training: Youth are taught to develop general
social skills including
communication, assertiveness, and anger management.
The program also offers booster sessions once youth complete
the program. The booster ses-
sions provide additional, follow-up sessions to check in with
youth and allow them to work
http://www.pathstraining.com/main
Programs
through any problems they may be having at that time. Studies
suggest that the program is
effective at reducing cigarette smoking, marijuana use, and
alcohol use.

Learn more about the program at
https://www.blueprintsprograms.org/factsheet/
lifeskills-training-lst.
Multisystemic Therapy
Developed in the mid-1970s, the Multisystemic Therapy (MST)
program is an intensive
wraparound service-based approach that targets not only youth
but also their entire system,
including family, school, and the community. The program is
designed for youth who have had
chronic behavioral problems and typically have a long
involvement with the criminal justice
system. The target age for the program is 12–17 years, and it
includes both girls and boys.
The program tends to be more intensive than most interventions
for youth. The therapist(s)
working with youth and their families are on call 7 days a week,
24 hours a day. Therapist
visits will include home visits, school meetings, and meetings
with community agencies to
develop a supportive network for youth and their families.
Providing services to youth in
these settings is seen as a better way to effect change than is
simply providing services to
youth in an office only to send them back to the families and
communities that may play a role
in their delinquent behavior.
Youth are encouraged to participate in prosocial activities,
develop prosocial friendship net-
works, and improve their academic achievement. Therapists
work with parents to increase
their problem-solving skills, develop effective communication
styles with their sons and

daughters, and improve their parenting skills with the use of
consistent reinforcement and
consequences. The therapist may meet weekly (even daily) with
participants in the beginning
and then taper involvement as the family and youth stabilize.
A wealth of studies show the effectiveness of MST. In fact, the
MST program has withstood
even more rigorous study designs (random assignments) than
those found with research on
other treatment programs. These studies conclude that the
program results in both short-
and long-term reductions in criminal behavior, including
substance use and violence. More-
over, studies suggest MST positively impacts family functioning
and the rate of out-of-home
placements.
Learn more at http://www.mstservices.com.
Multidimensional Treatment Foster Care
The Multidimensional Treatment Foster Care (MTFC) program,
developed in the 1980s, is
designed to decrease problem behavior among youth who are in
out-of-home placements.
Referrals for service often come from juvenile justice agencies,
foster care, or mental health
agencies. Like Multisystemic Therapy, MTFC is multifaceted
and targets youth and their fami-
lies, schools, and communities. Although the youth is in out-of-
home placement at the time
of the referral, the program considers the biological family as
an integral part of treatment.
As part of the program, youth are placed in a foster care setting
for 6–9 months and live with
a trained MTFC family. The MTFC parents are trained to

provide a consistent and support-
ive environment and maintain close contact with the youth’s
treatment team. The primary
https://www.blueprintsprograms.org/factsheet/lifeskills-
training-lst
https://www.blueprintsprograms.org/factsheet/lifeskills-
training-lst
http://www.mstservices.com
Programs
therapy is behavioral in nature and focuses on appropriate and
consistent reinforcement and
consequences for behavior. The program also focuses on skills
training, academic support,
and positive attachments to adults and peers.
The program can serve children as young as preschool age to
youth as old as 17. There are
three versions of the MTFC program:
• MTFC-P for preschool children ages 3–6: This program has
been in existence
since 1996 and is designed as an alternative to residential
placement. The program
attempts to promote secure attachments to adults in foster care
with the eventual
goal of placement with the biological or adoptive family. The
treatment is provided
through therapeutic play groups, and youth are seen as being

delayed in maturation
rather than simply exhibiting behavioral problems.
• MTFC-C for elementary school children ages 7–11: This
program targets youth
who are in out-of-home placements often for severe emotional
or behavioral prob-
lems. The program targets the biological family from the
beginning of treatment in
order to prepare the family for the youth’s eventual return.
• MTFC-A for adolescents ages 12–17: This program targets
youth who have been
placed out of home due to significant antisocial behavior. Many
of the youth may
have failed other programs and have multiple out-of-home
placements. The youth
may be coming to the MTFC program via juvenile detention or
group homes. The
purpose of this program is to prepare the youth to live in a
family or independent
living situation.
Studies suggest this intervention has been effective in reducing
criminal behavior, including
general delinquency, violence, and days spent in detention.
Learn more at https://www.blueprintsprograms.org/factsheet/
treatment-foster-care-oregon.
Nurse-Family Partnership
The Nurse-Family Partnership is a non-
profit organization designed to provide
prenatal and postnatal care to at-risk first-
time mothers. A nurse assigned to the
mother provides weekly or bimonthly ser-

vices in the mother’s home. The services
can continue until the child’s second
birthday. The focus of prenatal care often
includes wellness education, birth prepa-
ration, and education. The focus of post-
natal care includes caring for infants,
expectations for children, and appropriate
discipline techniques. The program also
provides emotional support for mothers
and encourages them to consider further-
ing their education and employment skills.
L. Mueller/Associated Press
The Nurse-Family Partnership supports at-risk
mothers through the birthing process before and
after the arrival of the baby.
https://www.blueprintsprograms.org/factsheet/treatment-foster-
care-oregon
https://www.blueprintsprograms.org/factsheet/treatment-foster-
care-oregon
Section 10.9Connecting the Dots: Relapse Prevention
The Nurse-Family Partnership program has three goals:
• Improving pregnancy outcomes through preventive care. These
prenatal services
include nutrition counseling and counseling regarding the
effects of alcohol, tobacco,
and illicit drug use on the developing fetus.

• Working with mothers to ensure responsible care for the
infant.
• Assisting mothers with financial needs, including helping
them gain access to educa-
tion or employment opportunities.
Studies suggest that the program succeeds in reducing child
maltreatment, increasing health
among infants, reducing arrest rates for mothers and children,
and reduction in hospital
admissions for accidents and poisonings.
Learn more at https://www.nursefamilypartnership.org.
Model Programs: Why They Work
These model programs have several features in common that
likely influence their
effectiveness.
• They target the criminogenic risk factors that have been shown
to reduce criminal
behavior. Risk factors such as attitudes supportive of crime,
associating with other
delinquent peers, low school achievement, and problems within
families are core
problems for juvenile delinquents.
• Many of these programs also include the community as part of
the treatment
approach. The community can include schools, social service
agencies, neighbor-
hoods, and networks of support. A key to sustained change is
the recognition that
treatment should focus not just on the individual but also on the
social context in

which the youth lives.
• Many of these programs are age appropriate, providing
services designed to be
responsive to the youth’s risk and needs as well as their
developmental stage.
• Each of these programs has developed a comprehensive
framework to assist with
implementation.
It is more likely that agencies will be effective at rehabilitating
youth if they rely on these best
practices.
10.9 Connecting the Dots: Relapse Prevention
In the final stage of treatment, many programs introduce relapse
prevention strategies,
which are designed to prevent or inhibit the likelihood of
criminal behavior in the future.
It is not sufficient for staff to convince youth to stop using
drugs only while they are in the
treatment program. Staff also need to convince youth to
continue abstinence over the course
of their lives. Relapse prevention strategies teach youth ways to
anticipate and cope with
https://www.nursefamilypartnership.org
Section 10.9Connecting the Dots: Relapse Prevention
high-risk situations to avoid lapses. Without a comprehensive

set of coping and problem-
solving skills, the belief is that juveniles are likely to relapse
when placed back into the same
environment. Relapse prevention programs also attempt to
increase the client’s sense of self-
efficacy, which refers to the individual’s ability to master a
situation and feel confident in his
or her ability to handle challenging situations. The client is
often taught that the power of
change comes from developing skills to handle adversity rather
than simply relying on will-
power (Parks & Marlatt, 1999). In other words, if the troubled
youth is confident that change
is possible and can be maintained, then a positive outcome (e.g.,
abstinence) is more likely.
Relapse can have a reciprocal effect on self-efficacy as well.
Clients who do not relapse and
use their coping skills effectively are likely to increase their
sense of self-efficacy or mastery
of a particularly problematic situation. Those who do not cope
well are more likely to feel they
are unable to successfully navigate their environment. One
strategy taught to clients is that a
minor lapse does not need to become a full relapse. In the case
of drugs and alcohol, a minor
lapse in drug use can be stopped if clients are taught to accept
that failures can happen but
that they need to be addressed quickly so that the client can get
back into a pattern of sobriety
(Marlatt & Gordon, 1985). If a minor lapse is viewed as a
failure, the client is more likely to fall
into a full-blown relapse that will make it more difficult to
recover. Relapse prevention is a
common component of substance abuse programs but can also
be found in most cognitive

behavioral programs and is relevant for all types of problem
behaviors. The accompanying
feature provides a closer look at one such program.
Featured Program: TARGET
http://www.advancedtrauma.com/Services.html
Trauma Informed Care (TIC) has become a popular approach in
juvenile justice. One cur-
riculum, referred to as TARGET (Trauma Affect Regulation:
Guide for Education & Therapy),
was developed for adults with chronic mental health issues in
2000 and then adapted for
juveniles in 2004.
The TARGET curriculum is a manualized, strengths-based,
present-focused approach that
focuses on teaching self-regulation skills to adolescent trauma
survivors. Across 10 sessions,
TARGET teaches a simple sequence of seven skills, described
by the mnemonic FREEDOM.1
The skills are designed to help youth to gain control of how
they react to triggers in their
lives. Teaching skills for self-regulation is a direct way to
address symptoms of posttraumatic
stress disorder (PTSD) and enable individuals to safely process
stressful current experiences.
Self-regulation is needed to manage unwanted trauma memories,
to regain a sense of well-
being, to build and sustain healthy relationships, and to feel in
charge of oneself. TARGET can
be offered in individual or group sessions conducted by case
managers, clinicians, rehabilita-
tion specialists, or teachers. The model is intended to be used to
mobilize the adolescent’s
own resources and build on her or his internal strengths.

Prior studies report several key systemic benefits for program
participants, including
improvements in depression, anxiety, and reports of hope and
optimism (Ford & Hawke,
2012; Marrow, Knudsen, Olafson, & Bucher, 2012).
1Focus, Recognize triggers, Emotion self-check, Evaluate
thoughts, Define goals, Options, and Make a contribution.
http://www.advancedtrauma.com/Services.html
Summary of Learning Objectives
Describe the philosophical shift that has occurred in reducing
juvenile delinquency.
• A philosophical shift is taking place in juvenile corrections,
shifting from get-tough
polices to an emphasis on treatment, prevention, and
rehabilitation.
• The philosophical shift supporting a greater use of treatment
and prevention pro-
grams is due to economic conditions as well as to studies
supporting the effective-
ness of such programs.
• Programs are considered effective if they are supported by
research studies that
document positive outcomes.

Summarize the importance of prevention and treatment.
• There are three types of prevention programs: primary,
secondary, and tertiary.
• Prevention programs are important, as they can reduce the
costs associated with
processing youth and have long-term benefits of keeping youth
out of crime and
in school.
Explain the principles of effective intervention.
• The principles of effective intervention are recommended
strategies and practices
that can increase the effectiveness of a treatment program.
• The principles of effective intervention include treating those
who are at higher risk
of recidivism, in the community, and with proven strategies
such as cognitive behav-
ioral techniques.
Explain how need factors contribute to risk for delinquent
behavior.
• Certain need factors increase a youth’s risk of recidivism.
• Need factors related to recidivism include high-risk peers, a
dysfunctional fam-
ily system, school difficulties, substance use, and attitudes
supportive of criminal
behavior.
Describe each generation of risk and need assessment tools.

• Risk and need assessment tools measure the likelihood of
recidivism among youth.
• The risk and need assessment tool identifies the factors in a
youth’s life that can be
addressed through treatment services.
Explain the significance of responsivity factors with regard to
treatment.
• Responsivity factors can impact the effectiveness of treatment.
• Responsivity factors include internal factors such as
motivation and external factors
such as transportation.
Summarize the philosophy behind cognitive behavioral
programs.
• Cognitive behavioral therapies are growing in popularity and
recognize that how an
individual processes information influences his or her behavior.
• Cognitive behavioral programs teach youth how to identify the
relationship between
thoughts, feelings, and behaviors.
• Cognitive restructuring attempts to change antisocial cognitive
beliefs or thoughts.

• Cognitive skills therapy teaches clients how to cope with high-
risk situations and
triggers.
Analyze the model treatment programs and why they work.
• The Blueprints for Violence Prevention Initiative and the
Evidence Integration
Initiative are comprehensive efforts to identify effective
programs operating in the
community.
• The model programs identified vary in terms of settings,
intensity, and target popu-
lation and are shown to be effective by numerous research
studies.
Explain the importance of relapse prevention techniques.
• Relapse prevention programs teach clients to anticipate
problem situations and
effectively cope with them to avoid relapse.
Critical Thinking Questions
1. Would you recommend that every juvenile delinquent receive
some type of treat-
ment program? If so, what would that/those program(s) be? If
not, whom would you
exclude?
2. Should we consider giving risk and need assessments to the
general population (e.g.,
in schools) to determine risk for delinquency before it happens?
If so, what are the

potential pitfalls of this approach?
3. What are the potential problems with implementing cognitive
restructuring and
cognitive skills programs for juveniles?
4. Imagine you are in charge of a probation agency. Would it be
sufficient to adopt just
one of the model programs? Why or why not?
Key Terms
assessment A tool that evaluates how
likely a youth might be to engage in criminal
behavior.
Blueprints for Violence Prevention Initia-
tive An initiative designed to identify effec-
tive treatment programs and services that
could be replicated in communities across
the nation.
cognitive behavioral therapy A type of
treatment approach that focuses primarily
on the way people think and subsequently
how they behave.
cognitive restructuring therapy Therapy
that attempts to change antisocial cognitive
beliefs or thoughts.
cognitive skills therapy Therapy that
intends to develop a set of skills individuals
can use when confronted with problems or
high-risk situations.
criminogenic needs Also referred to as

dynamic risk factors; important risk factors
in the individual’s life that can be changed.
Evidence Integration Initiative An initia-
tive designed to inform agencies and policy-
makers on best practices in criminal justice
and to assist them as they integrate the
evidence into their current systems.
motivational interviewing An interview-
based technique designed to reduce an indi-
vidual’s resistance to engaging in treatment.
primary prevention Programs focusing on
the conditions that could lead to delinquent
behavior such as truancy, poor parenting,
and prenatal exposure to toxins.
principles of effective intervention Rec-
ommended strategies and practices that
characterize effective programs in reducing
recidivism.
relapse prevention Strategies designed to
prevent or inhibit the likelihood of criminal
behavior in the future.
responsivity factors Characteristics of the
person or the person’s environment that

may act as obstacles to treatment and/or
supervision.
secondary prevention Programs that shift
the focus of services to the delinquent youth
and address the delinquent behavior at its
earliest stages.
static risk factor A circumstance in a
youth’s life that cannot be changed because
it happened in the past.
tertiary prevention Programs focused on
reducing recidivism among those who are
already in the juvenile justice system.
treatment A set of actions or services
designed to rehabilitate or change an
individual.
_Hlk525284123
Article
Treatment Services in
the Juvenile Justice System:
Examining the Use and
Funding of Services by
Youth on Probation
Clair White

1
Abstract
Youth enter the juvenile justice system with a variety of service
needs, particularly for mental
health problems. Research has examined the extent to which
youth have mental health disorders,
primarily among detained youth, and factors associated with
treatment referrals, but little
research has examined youth on probation and the actual use of
services. Using data obtained
from the Maricopa County Juvenile Probation Department from
July 2012 through August 2014
(N ¼ 3,779), the current study examines (1) the factors
associated with receiving treatment
services while on probation and (2) the factors associated with
receiving treatment services
through different funding streams. Findings reveal that only
about 25% of the sample of youth on
probation received treatment services, suggesting the
underservicing of youth. Consistent with
prior research, there were also racial and ethnic disparities
concerning treatment use, with Blacks
and Latinos less likely to receive services. Additionally, certain
characteristics of youth and their
background influenced the funding source for treatment
services. Implications for policy and
research are discussed in light of these findings.
Keywords
probation, treatment services, service use, juvenile justice,
racial/ethnic disparities
The juvenile justice system has multiple responsibilities often
serving conflicting goals of punitive

sanctions and rehabilitative treatment (Bishop, 2006; Lipsey,
Howell, Kelly, Chapman, & Carver,
2010). The system must not only address the current delinquent
behavior but also, in many cases,
consider the health and well-being of the youth. Youth come
into the juvenile justice system with
more complex problems and greater needs for mental and
behavioral health services, which has
resulted in more attention on efforts to rehabilitate and address
youth’s mental and behavioral
1
Center for Evidence-Based Crime Policy, Criminology, Law and
Society, George Mason University, Fairfax, VA, USA
Corresponding Author:
Clair White, Center for Evidence-Based Crime Policy,
Criminology, Law and Society, George Mason University, 4400
University Dr., MS 6D12, Fairfax, VA 22030, USA.
Email: [email protected]
Youth Violence and Juvenile Justice
2019, Vol. 17(1) 62-87
ª The Author(s) 2017
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/1541204017728997
journals.sagepub.com/home/yvj
https://sagepub.com/journals-permissions

https://doi.org/10.1177/1541204017728997
http://journals.sagepub.com/home/yvj
http://crossmark.crossref.org/dialog/?doi=10.1177%2F15412040
17728997&domain=pdf&date_stamp=2017-09-08
service needs (Myers & Farrell, 2008). Research has examined a
number of issues related to mental
health and behavioral health problems of youth in the juvenile
justice system, particularly identify-
ing the rates of mental health problems and service needs among
youth and factors associated with
treatment referrals of youth in different systems of care (i.e.,
juvenile justice system and mental
health system).
Research on mental health problems in justice-involved youth
has primarily focused on the
service needs of youth and where they have been referred to
meet these needs and not on whether
they actually received those services. Additionally, much of the
work examines youth in detention or
compares youth sentenced to community versus correctional
supervision rather than youth on
probation which is the predominate sentence in the juvenile
justice system. The current study uses
juvenile probation data from a large, urban jurisdiction in

Arizona to examine these issues. More
specifically, legal and extralegal factors associated with the use
of treatment services among youth
on probation supervision are examined. Furthermore, the extent
to which services are funded by the
juvenile justice system has not been empirically examined,
therefore, whether these services are
funded by the juvenile justice system or external funding
sources such as Medicaid or private
insurance is also examined.
Unmet Service Needs and Treatment Referrals
Youth involved in the juvenile justice system often experience
multiple adversities or risk factors,
such as economic disadvantage, experiences of abuse and
neglect, unstable family environments,
exposure to drugs and alcohol, and mental illness (Esbensen,
Peterson, & Taylor, 2010; Huizinga,
Loeber, Thornberry, & Cothern, 2000; Loeber & Farrington,
1998). Research has generally found
that 65–70% of youth in juvenile justice facilities, primarily
detention centers and correctional
facilities, suffer from at least one mental health disorder
(Shufelt & Cocozza, 2006; Teplin, Abram,
McClelland, Dulcan, & Mericle, 2002; Wasserman,

McReynolds, Lucas, Fisher, & Santos, 2002),
while rates among youth on probation are approximately 50%
(Wasserman, McReynolds, Ko, Katz,
& Carpenter, 2005).
Additionally, comorbidity, or the presence of more than one
mental or behavioral disorder, is
particularly high among youth in juvenile justice settings
(Abram, Teplin, McClelland, & Dulcan,
2003; Kessler et al., 1996; Teplin et al., 2002). Shufelt and
Cocozza (2006) found that roughly 79%
of those who met criteria for at least one mental health disorder
had two or more diagnoses.
Unfortunately, many of these mental and behavioral service
needs are not met in the community
(Flisher et al., 1997; Jensen et al., 2011; Kataoka, Zhang, &
Wells, 2002; Ringel & Sturm, 2001). As
a result, the coexistence of multiple disorders in addition to
other criminogenic risk factors makes
prioritizing mental and behavioral service needs more
challenging for the juvenile justice system
(Grisso, 2004).
Research has examined factors related to unmet service needs
and the avenues through which
youths’ mental health needs are met through various service
sectors, such as the mental health

system and juvenile justice system (Burns et al., 2004; Stahmer
et al., 2005; Thompson, 2005).
Among the general population, children and adolescents with
mental and behavioral health problems
are gravely undertreated with high rates of unmet service needs
(Angold et al., 1998; Flisher et al.,
1997; Horwitz, Gary, Briggs-Gowan, & Carter, 2003). Studies
have examined characteristics of
children with unmet mental health needs and their families
using various samples to identify key
predictors of treatment service use and unmet service needs.
Among the primary factors associated with unmet service needs
are elements related to economic
disadvantage such as living on public assistance, lack of health
insurance, and transportation prob-
lems (Chow, Jaffee, & Snowden, 2003; Cornelius, Pringle,
Jernigan, Kirisci, & Clark, 2001; Haines,
McMunn, Nazroo, & Kelly, 2002). Race and ethnicity are also
strong predictors of unmet service
White 63
needs with Whites being more likely to receive mental health
services compared to minorities

(Angold et al., 2002; Garland et al., 2005; Kataoka et al., 2002;
Thompson, 2005; Yeh, McCabe,
Hough, Dupuis, & Hazen, 2003). Studies have also found that
minorities have limited opportunities
to access mental health services (Arcia, Keyes, Gallagher, &
Herrick, 1993), and once they start
treatment they are less likely to complete treatment (Kazdin,
Stolar, & Marciano, 1995).
Research has also found involvement in the mental health
system increases the likelihood of
being referred to the juvenile justice system (Cohen et al., 1990;
Evens & Stoep, 1997; Rosenblatt,
Rosenblatt, & Biggs, 2000). In addition, younger adolescents,
females, and White youths are more
likely to be referred to the mental health system, while
minorities, males, and youths with more
serious and disruptive mental health disorders are more likely to
be referred to the juvenile justice
system (Atkins et al., 1999; Cohen et al., 1990; Dembo, Turner,
Borden, & Schmeidler, 1994; Evens
& Stoep, 1997). In general, service needs of disadvantaged and
minority youth are often not
recognized until their contact with the juvenile justice system
(Golzari, Hunt, & Anoshiravani,

2006; Rawal, Romansky, Jenuwine, & Lyons, 2004; Rogers,
Pumariega, Atkins, & Cuffe, 2006).
Upon entering the juvenile justice system, service needs often
continue to go unmet even after
identification of need for treatment (Rogers, Zima, Powell, &
Pumariega, 2001; Shelton, 2005).
Shelton (2005) found that only 23% of youth diagnosed with
mental health disorders received
treatment and that having a mental disorder was not a
significant predictor of receiving services.
A recent study conducted by Hoeve, McReynolds, and
Wasserman (2014) found that youth with
externalizing disorders and substance use disorders were more
likely to receive referrals, while only
40% of youth with internalizing disorders referred to service.
Consistent with the findings from the
general public, Whites are more likely to be referred to services
compared to Black youth in the
justice system (Dalton, Evans, Cruise, Feinstein, & Kendrick,
2009; Lopez-Williams, Stoep, Kuro,
& Stewart, 2006; Maschi, Hatcher, Schwalbe, & Rosato, 2008;
Rogers et al., 2006), but there are
some mixed findings (Breda, 2003; Hoeve et al., 2014). Shelton
(2005) concluded that
while the total responsibility for the well-being of children does

not lie solely with the juvenile justice
system, the decision not to provide treatment services to youth
in need and under their care implies
neglect . . . it implies a perception that these youth will go
away, be treated elsewhere, or grow out of their
problems. (p. 110)
These prior studies do not provide a clear set of predictors for
service referrals and many studies
were not able to control for offense severity and criminal
history (Dalton et al., 2009; Lopez-
Williams et al., 2006; Rawal et al., 2004), which are likely to
influence referrals for services.
Regardless, there were discrepancies in service referrals in the
juvenile justice system. Receipt of
service referrals was not found to be dependent entirely on the
need for services but may be
influenced by other factors that create disparities in the health
of youth. Furthermore, these studies
did not take into account access (i.e., availability, health
insurance, etc.) to referred services or
whether youth were actually using the services.
Many of the studies previously discussed use referrals for
treatment services as the outcome of

interest, but little research has examined the actual receipt or
use of treatment services by youth
(Teplin, Abram, McClelland, Washburn, & Pikus, 2005). Teplin,
Abram, McClelland, Washburn,
and Pikus (2005) found that roughly 16% of youth who had
been identified as needing mental health
services during detention received services within 6 months
from detention or by disposition.
Additionally, 11% of youths received services but did not meet
the definition of need. Johnson
et al. (2004) examined substance abuse treatment need and use
among youth entering juvenile
corrections and found that nearly half of youth with need for
substance abuse treatment received
services. Rawal, Romansky, Jenuwine, and Lyons (2004)
examined racial differences in mental
health needs and service use among incarcerated youth. The
authors found that Blacks had the
64 Youth Violence and Juvenile Justice 17(1)
greatest level of mental health needs, but the lowest level of
prior and current service use. In general,
these studies emphasize how few individuals actually receive
services for their mental and beha-
vioral service needs as well as the “benign neglect” of the

juvenile justice system in addressing
mental and behavioral service needs (Herz, 2001).
Lastly, receiving referrals for treatment or participating in
certain programs and treatment does
not necessarily translate into needs being met (Grisso, 2004).
The justice system has the difficult task
of distinguishing youths’ need for specific programs that target
criminogenic risk factors from the
need for treatment services that address their overall mental
well-being. Given limited training and
resources, some needs are often prioritized over others, leaving
other needs unaddressed (Haqanee,
Peterson-Badali, & Skilling, 2015). Responsivity is a key
component of the risk-needs-responsivity
(RNR) model in offender treatment, emphasizing matching
program and treatment plans to meet the
unique reoffending risks and risk factors (i.e., criminogenic
needs) of offenders through evidence-
based rehabilitative programs that are tailored to an individual’s
strengths and capacities (Andrews
& Bonta, 2010; Andrews, Bonta, & Hoge, 1990; Hoge &
Andrews, 1996). Rather than general
mental health (GMH) care, the RNR model is focused on
reducing future delinquency and recidi-

vism but has been criticized for not addressing more basic,
noncriminogenic, human needs, such as
mental health (T. Ward & Stewart, 2003; T. Ward, Yates, &
Willis, 2012). Additionally, treating
mental health and substance abuse disorders may or may not
address other criminogenic risk factors
and prevent future delinquency (see Wibbelink, Hoeve, Stams,
& Oort, 2017) but may have impli-
cations for youths’ responsiveness to treatment goals and
success in addressing criminogenic needs
(Haqanee et al., 2015). Nevertheless, programs that adhere to
the principles of RNR have been
successful in reducing recidivism (Andrews & Bonta, 2010).
One of the primary RNR assessment tools, the Youth Level of
Service/Case Management Inven-
tory (YLS/CMI), has been validated for its ability to predict
recidivism among youth (Catchpole &
Gretton, 2003; Jung & Rawana, 1999; Onifade et al., 2008;
Vieira, Skilling, & Peterson-Badali,
2009). However, agencies and practitioners face many
challenges to develop clear treatment plans
and effectively implement services despite identifying risks and
needs through assessment (Flores,

Travis, & Latessa, 2004; Latessa, Cullen, & Gendreau, 2002;
Sutherland, 2009), resulting in many
youths’ needs left unaddressed (Vieira et al., 2009). This
“implementation gap” is often the result in
the availability of quality, evidence-based programming, such
as cognitive behavioral therapy
(Haqanee et al., 2015). For example, Flores, Travis, and Latessa
(2004) found in one state jurisdic-
tion that the RNR tool (YLS/CMI) was widely used, but when it
came to services in the treatment
plans, they rarely targeted the needs identified in the
assessment. In sum, there have been great
strides in recognizing and measuring criminogenic risks and
needs that when addressed can improve
outcomes for youth. Mental illness, however, is often not
considered one of those criminogenic
needs (Haqanee et al., 2015), so practitioners may continue to
use their clinical judgment and
experience over the use of risk assessment tools (C. Schwalbe,
2004), and services received may
not target the needs/risks identified.
Funding Treatment Services
While the juvenile justice system has a legal mandate to provide
treatment services, it does not have

to be the one to administer that care (Grisso, 2004). When a
youth is required to receive court-
ordered treatment services as a condition of probation
supervision, there are multiple avenues or
sources of funding that can pay for these services. If the youth
has no means (i.e., health insurance)
to pay for treatment services ordered by the court, the juvenile
justice system has a financial
responsibility to fund the treatment services it is requiring.
The juvenile justice system has used outside agencies and
external funds to reduce the burden of
providing treatment services—they typically contract out to
private providers or other government
White 65
agencies such as public mental health service providers.
Similarly, the treatment services can be
funded through different sources such as private insurance or
public health care, but if those avenues
are not available, the juvenile justice system is responsible to
fund the treatment services. Families
of youth in the juvenile justice system often have limited
knowledge and resources to navigate the

health-care system; therefore, youth often are more likely to be
uninsured and their mental and
behavioral conditions are not addressed. Furthermore, services
provided through Medicaid are often
restricted to children with the most severe mental disorders due
to lack of funding (Kerker & Dore,
2006). As a result, children with less serious problems are often
ineligible for services and those who
do qualify receive inconsistent and fragmented care. Finally,
studies have found that lack of health
insurance is a major impediment to obtaining mental and
behavioral health services (Farmer, Stangl,
Burns, Costello, & Angold, 1999; Flisher et al., 1997; Kataoka
et al., 2002).
In light of the health-care debate, the current research also
speaks to the issue of funding and
resources for mental health care and substance use disorder
services that are often subject to social,
political, and economic influence. The coverage for mental
health and substance use disorders by
insurance companies and the availability and eligibility of
Medicaid will likely have implications for
practices in the juvenile justice system and the extent to which
treatment services are court-funded.

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