ASSESSMENT AND TREATMENT TO SUPPORT YOUTH INVOLVED IN THE CRIMINAL JUSTICE SYSTEM: A PRACTICUM REPORT ON YOUTH FORENSIC PSYCHIATRIC SERVICES by Emma van Vliet B.S.W University of Western Ontario, 2015 PRACTICUM REPORT SUBMITTED IN PARTIAL FULFILLMENT OF T HE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK UNIVERSITY OF NORTHERN BRITISH COLUMBIA February, 2020 Ó Emma van Vliet, 2020 ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM ABSTRACT This practicum report explores a social work role at the Ministry of Children and Family Development’s Youth Forensic Psychiatric Services (YFPS), located at the North Region Outpatient Clinic in Prince George, British Columbia. YFPS receives referrals through court orders and probation officers to offer comprehensive assessment and treatment services to youth who are involved with the youth criminal justice system. Youth may become involved with the justice system for various reasons and, once involved with the justice system, have multiple options for treatment and/ or rehabilitation. This report explores some of the resources youth may become involved with and how social workers through YFPS play a role in supporting youth in the justice system. The main goal of my graduate practicum was to broaden my social work skills by exposing myself to a new social work field and client population. Within this larger goal, my learning objectives focused on increasing knowledge and skills in conducting and writing assessments and broadening my clinical knowledge, as well as focusing on how my work at YFPS fit into Trauma-Informed and Anti-Oppressive lenses. Overall, I was able to develop new skills and work collaboratively to offer comprehensive services to youth who were involved in the justice system. i ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM ii ACKNOWEDGEMENTS My MSW opportunity was made possible first and foremost through the generosity of Youth Forensic Psychiatric Services Prince George Outpatient Clinic. To my direct supervisor, Alan Huggett, thank you for offering knowledge and wisdom in a field I was new to, and for allowing me to learn from you in so many ways. I appreciated your ongoing support and encouragement which allowed me to be a valued member of the YFPS team. To the rest of the YFPS staff, especially the YFPS Regional Manager, Erica Moore, I so appreciated you welcoming me to learn from, and alongside, you. My MSW journey was also supported by the UNBC faculty and social work program. I would like to thank my academic supervisor, Dr. Nancy Jokinen, for the ongoing support and encouragement to stay on track and work efficiently through my MSW process. I would like to thank my committee member, Dr. Susan Burke, for bringing her perspective to my practicum experience to ensure I was staying reflective in my practice. Additionally, this MSW opportunity would not have come to fruition without the dedication and sacrifices of my family. First, my husband, Brent, encouraged and supported me to take this opportunity to learn and grow and for that I am forever thankful. I appreciate the ongoing support from my parents and my sister to continue my learning journey and for encouraging continued education in my life. It has been a great experience; one that I will look back on with fond memories. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM iii TABLE OF CONTENTS ABSTRACT......................................................................................................................... i ACKNOWEDGEMENTS .................................................................................................. ii TABLE OF CONTENTS................................................................................................... iii CHAPTER 1: INTRODUCTION ....................................................................................... 1 Key Concepts .................................................................................................................. 2 Overview of the Practicum Setting ................................................................................. 4 Learning Goals and Objectives ..................................................................................... 13 CHAPTER 2: THEORETICAL ORIENTATION............................................................ 16 Personal Standpoint ...................................................................................................... 17 Trauma Informed Approach (TIP) ................................................................................ 18 Anti-Oppressive Practice (AOP)................................................................................... 19 CHAPTER 3: LITERATURE REVIEW .......................................................................... 22 History of the Youth Justice System ............................................................................. 22 Prevalence of Justice-Involved Youth .......................................................................... 23 Factors Contributing to Youth Justice Involvement ..................................................... 24 Outcomes of Justice-Involved Youth............................................................................ 27 Approaches of Responding to Justice-Involved Youth ................................................ 28 Social Work with Justice-Involved Youth .................................................................... 30 Conclusion .................................................................................................................... 33 CHAPTER 4: LEARNING OUTCOMES ........................................................................ 34 ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM iv Increased Knowledge of Youth Justice System ............................................................ 34 Increased skills in writing assessments ......................................................................... 39 Increased Knowledge in Youth Forensic Psychiatric Treatment .................................. 40 Increased Skills to Implement Youth Forensic Psychiatric Treatment ......................... 42 Evaluated and Changed Self-Care Strategies as Needed .............................................. 44 Reflected on Central Theories of TIP and AOP ........................................................... 45 Additional Learning Experiences ................................................................................. 53 Conclusion .................................................................................................................... 55 CHAPTER 5: IMPLICATIONS FOR SOCIAL WORK PRACTICE ............................. 56 Conclusion .................................................................................................................... 59 References ......................................................................................................................... 61 APPENDICIES ................................................................................................................. 67 Appendix A: Learning Contract.................................................................................... 67 ASSESMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 1 CHAPTER 1: INTRODUCTION This practicum report summarizes a Masters’ level practicum with the Youth Forensic Psychiatric Services (YFPS) in Prince George provided by the Ministry of Children and Family Development (MCFD). The report explores a social work role that aligns with the goals of YFPS: assessment and treatment services with youth involved in the justice system. Adolescence can be a tumultuous time in a person’s life. From a human development perspective, adolescent years are characterized by experimentation, risky behaviours, rule breaking and, at times, ‘moral panic’ (Drinkard, Estevez, & Adams, 2017) as youth attempt to navigate their world and explore their individuality. Scholars have agreed that children and youth are particularly vulnerable to harm because of their age and stage of development (Allen & Superle, 2016; Bennett, 2019; Department of Justice Canada, 2018; Van der Kolk, 2014). In 2003, the Canadian criminal justice system agreed upon treating youth differently in terms of punishment and accountability for criminal code offences and they implemented the YCJA (2002) (Allen & Superle, 2016; Department of Justice Canada, 2018). Social workers play various roles in supporting and working with youth involved in the justice system. Many community programs are preventative in nature, attempting to target youth who may be at risk of being involved with crime. Once a youth becomes involved in the justice system, social workers can assist with assessment, treatment, and reintegration to living a healthy and crime free life. The intricacies of working with youth involved with the criminal justice system, specifically from that YFPS lens, are explored in this practicum report. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 2 The first chapter of this practicum report introduces and defines some key concepts within this specific YFPS practicum setting, gives a brief overview of the practicum setting, and introduces my learning goals. Chapter Two outlines the theoretical orientations that I implemented during my work at YFPS. Chapter Three reviews current literature on youth involved with the justice system. Chapter Four expands on how I achieved my learning goals and objectives during the practicum at YFPS and brings to light the themes that emerged from my learning experience. Finally, Chapter Five outlines the implications of my learning at YFPS for my future social work practice and potentially the practice of other social workers. Key Concepts This practicum report deals with language and concepts specific to the work at YFPS. Each key concept will be defined for the reader to enhance the understanding of the practicum setting. This section will define the following concepts: youth, criminal justice system, justice-involved youth, assessment, treatment, and forensic psychiatric services. Youth. Youth, for the purpose of this practicum report, refers to young people aged 12-17 (Department of Justice, 2018). This definition of youth is derived from the Canadian Youth Criminal Justice Act (YCJA) (2002). This definition was chosen because the YCJA (2002) is the legislation used for young offenders who are the practicum client group at Youth Forensic Psychiatric Services practicum site. Criminal justice system. According to the British Columbia Ministry of Children and Family Development (n.d.), the Criminal Justice System “is made up of the law, processes and programs involved in preventing and responding to crime. It is part of a ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 3 broader justice system, designed to resolve all sorts of legal problems” (p. 1). The Criminal Justice System includes the legislation that oversees the process of people being accused, determined innocent or guilty, and receiving sentencing for a crime. Currently, the youth justice system is based on the YCJA (2002) which was enacted in 2003 (Department of Justice Canada, 2018; Goodwin-De Faria & Marinos, 2012). The YCJA (2002) was put in place in an attempt to restructure the previous youth justice legislation, which had been critiqued regarding over-incarceration and dealing with repeat offenders (Department of Justice, 2018). The introduction of the YCJA (2002) was tightly bound to the United Nations Convention on the Rights of the Child (CRC) (Allen & Superle, 2016; Goodwin-De Faria & Marinos, 2012). The CRC strives to ensure that children accused of crimes are treated appropriately based on their age, and focuses on the reintegration of the child into society in a productive manner (Allen & Superle, 2016). While the youth justice system has flaws, it has come a long way from previous legislation. Justice-involved youth. The above two definitions are combined to create a clear definition of what is meant in this report when referring to justice-involved youth, or youth involved in the justice system. In Canada, justice-involved youth refers to anyone “between the ages of 12 and 17 who get into trouble with the law” (Department of Justice, 2018, para. 1). Assessment. Assessment, from a social work or social support perspective, refers to gathering pertinent information. This may include a client’s family and social history, family composition, early childhood experiences, lifestyle, cognitions, emotions, and ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 4 behaviours (Jones-Smith, 2016). YFPS has a very specific type of assessment, which is further discussed while exploring the practicum setting of YFPS. Treatment. Within YFPS, treatment includes offering various avenues to support change to a youth’s severe mental illness symptoms and management, or risk of repeating violent or sexual offences (Province of British Columbia, 2019c). The services offered under the category of treatment through YFPS are explored in more depth in the overview of the practicum setting. Forensic Psychiatric Services. Forensic is a word that is used to denote the study of something in relation to the law or legal system (Pozzulo, Bennell, & Forth, 2015). Specifically, forensic psychiatry refers to “a field of medicine that deals with all aspects of human behaviour as it relates to the law or legal system” (Pozzulo et al., 2015 p. 279). The above definitions and brief introduction provide the reader with an understanding of key concepts discussed in this final practicum report for the Master of Social Work program. Overview of the Practicum Setting The purpose of this section is to give a concise description of the services provided by YFPS. This will include a statement of the YFPS mission and values, a brief history of YFPS in the province of British Columbia, an overview of the client group served, the specific services offered by YFPS, the source of funding, and the ideological continuums that exist in the organization. There are five YFPS regional centers across the province located in South Burnaby, the Lower Mainland, Vancouver Island, Interior BC, and Northern BC. The Northern Regional Outpatient facility, which was the location of my practicum, is located in Prince George, BC (Province of British Columbia, 2019c). ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 5 Mission and Values The YFPS mission statement and values set the stage for their overall goals and how they approach working with clients. According to the British Columbia Ministry of Children and Family Development (n.d) 2015/2016 Fiscal Year Annual Report, the YFPS mission statement is as follows: Utilizing a multidisciplinary approach, the mission of YFPS is to provide quality court-ordered and court-related assessment and treatment services to young persons in conflict with the law pursuant to the Youth Criminal Justice Act (YCJA); and young persons found Unfit to Stand Trial or Not Criminally Responsible on Account of Mental Disorder (NCRMD). (p. 6) Furthermore, three main values underlie the work at YFPS in keeping a childcentered approach that “respects the integrity, dignity, and rights of the adolescent” (p. 6). YFPS staff also prioritize working with parents and guardians and recognizing the importance of caregivers as “the key resource and support in providing a consistent, structured, and caring environment” (p. 6), and recognizing the diversity of the youth they serve. Overarching Laws and Acts The Criminal Code (1985) regulates criminal offences for youth and adults in Canada (Government of Canada, 2019a). Many other acts come into play that support YFPS’s work with youth with mental health issues, as well as following the regulations set out about working specifically with youth involved in the justice system. These will be discussed further below. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 6 British Columbia’s Mental Health Act (1996) (MHA). The MHA (1996) in BC is a set of procedures and guidelines that set out how the province can and should work with people with mental illnesses. The act also sets out regulations for mental health facilities and the admission and detention of patients. Any hospitals and mental health facilities must follow these processes. Under the MHA (1996) the Mental Health Review Board is an independent tribunal that conducts review panel hearings under the MHA (1996). Patients can request to go before the review board if they want to challenge their legal certification made by their doctor (Province of British Columbia, 2019a). British Columbia Youth Justice Act (2003) (BCYJA). The BCYJA (2003) is much like the YCJA (2002) but specific to the proceedings of youth justice in British Columbia. The BCYJA (2003) sets out regulations that oversee the youth justice elements such as proceedings against a young person, youth probation officers and justice staff, youth justice programs, youth custody, and the complaints process. This is an important act as it recognizes and provides the guidelines for various services accessed by youth involved in the justice system. British Columbia’s Forensic Psychiatry Act (1996). The BC Forensic Psychiatry Act oversees the work done specifically by forensic psychiatry as it assists the courts in British Columbia. This includes assessments and reports for those held in remand for psychiatric assessment, assessments for those held under the MHA (1996) or Criminal Code of Canada (1985), those who need psychiatric care while in custody, or persons held under a court order. It also oversees any expert forensic psychiatric evidence for the court. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 7 YFPS Historical Background The history of YFPS is unclear and widely undocumented although it has likely been closely aligned with the establishment of the Canadian Youth Justice System legislation and funding attributed to working with these youth. Over the last 100 years, there has been a shift in the youth justice legislation beginning with the Juvenile Delinquents Act (JDA) in 1908, moving to the Young Offenders Act (YOA) in 1984, and currently settling in the Youth Criminal Justice Act (YCJA) instated in 2003 (Department of Justice Canada, 2015). Each of these pieces of legislation had different values and likely a range of funding for support in managing young people involved with the law (A. Huggett, personal communication, March 26, 2019). A clear picture of these changes and how they specifically impacted services like YFPS is difficult to track in the literature. In the 1990s, YFPS came into effect after taking over Youth Court Services. This shift aligned with the responsibility for youth justice in British Columbia changing from the Attorney General to the Ministry of Children and Family Development (MCFD) (A. Hugget, personal communication, March 26, 2019). The most recent reign of conservative federal power, in approximately 1996, significantly impacted the YFPS programs and the work the organization could accomplish with young people (A. Huggett, personal communication, March 26, 2019). The history and future of YFPS is apparently tightly bound to legislation, political power, and the impacts of those two factors on funding. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 8 YFPS Client Group Consistent with the YCJA (2002), youth include young people between the ages of 12 and 17 (Department of Justice Canada, 2018). The population served through YFPS includes youth who are involved in the justice system, specifically those who have been referred by a judge for assessment or treatment, or who have been identified by a probation officer as needing support. According to their mission statement, YFPS serves “young persons in conflict with the law pursuant to the Youth Criminal Justice Act, and young persons found Unfit to Stand Trial or Not Criminally Responsible on Account for a Mental Disorder (NCRMD)” (Province of British Columbia, n.d. p.6). YFPS Services YFPS services are situated within various legislative contexts. The services offered through Youth Forensics are “mandated under the authority of the Criminal Code of Canada, the Forensic Psychiatric Act, the Youth Criminal Justice Act, and the Youth Justice Act (B.C.), the Mental Health Act (B.C.) as well as other provincial legislation”. (Province of British Columbia, 2019b, para. 6) YFPS provides assessment and treatment services to youth who are in custody or who have community supervision plans due to their involvement in the criminal justice system. The province of British Columbia states that youth are referred to YFPS primarily because of the intersectionality of crime with mental illness or involvement in violent or sexual offences (Province of British Columbia, 2019c). These assessment and treatment services are offered through outpatient services in various cities across British Columbia. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 9 As mentioned above, YFPS provides two main streams of services: assessment and treatment. The goal of the assessment services is to provide a medical, psychiatric or psychological assessment to help the court make a decision; the primary purpose is legal, not medical or psychological (Province of British Columbia, 2019c). A difference that exists in assessment services through YFPS compared to other social work assessments is that there is no emphasis on the therapeutic relationship between the person gathering information for the assessment and the young person undergoing this type of assessment (Province of British Columbia, 2019c). The assessment process is strictly about gathering information from collaterals and is usually done with very little interaction with the youth. Another facet of the assessment process at YFPS is supporting the court to try to determine whether a youth is fit to stand trial (fitness), or if a youth is Not Criminally Responsible on Account of Mental Disorder (NCRMD). YFPS psychiatrists are asked to assess youth to see if they meet the requirements for each of the aforementioned labels. Being unfit to stand trial is defined in the Criminal Code of Canada (1985): “It means that the accused person is unable, because of a mental disorder, to defend against the charge(s) they are facing or to tell their lawyer what they want to do with their case” (Law Facts, n.d. para 11). The definition looks at the accused’s ability to understand the intricacies of the courtroom, the accused’s ability to understand their charges and plea options, and if the accused can properly communicate with their lawyer (Law Facts, n.d.). If a person is found unfit to stand trial, they have no criminal repercussions. The Review Board will determine the best course of treatment for that individual and oversee it. The Review Board could also decide that with appropriate treatment and education a person ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 10 could be coached to become fit to stand trial in the future (Law Facts, n.d.; Province of British Columbia, 2019a). Furthermore, if a youth is found fit to stand trial, they could still be found NCRMD, as defined in the Criminal Code of Canada (1985): No person is criminally responsible for an act committed or an omission made while suffering from a mental disorder that rendered the person incapable of appreciating the nature and quality of the act or omission or of knowing that it was wrong. (Government of Canada, 2019b) The Forensic Psychiatrist completes an assessment to determine how much a person’s mental status at the time of a crime impacted their actions, and how they should be treated moving forward. If a person is found NCRMD, their treatment is overseen by the Review Board, and they are sometimes sentenced to spending time in a psychiatric facility to support their wellness and public safety. If a person is found fit to stand trial, and denied NCRMD status, they proceed with usual court proceedings for their charges (BC Mental Health & Substance Use Services, 2019). Youth who are receiving treatment services through YFPS are provided with various supports to assist them in mitigating severe mental illness or risk of repeating violent or sexual offences. The services offered under this category of treatment include medication, cognitive behavioural therapy, functional family therapy, and general mental health services (Province of British Columbia, 2019c). Throughout all of these services, an important aspect present within YFPS is the use of multidisciplinary teams, which offer a breadth of theories, practices, and approaches to best serve the client (British Columbia Ministry of Children and Family Development, n.d.). ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 11 YFPS Funding YFPS is funded jointly through the federal Government of Canada and provincial Government of British Columbia as set out in the Youth Justice Services Funding Program (YJSFP). The federal government is responsible for criminal law (including the Criminal Code of Canada (1985) and the YCJA (2002)) while the provinces and territories are responsible for its administration, including the provision of youth justice programs and services. The federal YJSFP is a cost-share contribution program with all provinces and territories for the delivery of youth justice programs and services (Department of Justice Canada, 2016, para. 1). In British Columbia, funding for YFPS is filtered through the Ministry of Children and Family Development as part of their overall budget (A. Huggett, personal communication, March 26, 2019). Ideological ‘Continuums’ The ideology of crime is important to explore. From a criminological perspective, it is important to understand that various aspects of crime range from the Classical School to the Positive School of Criminology (Jeffery, 1959). The Classical School and Positive School of criminology each have their own opinions on the definition of crime, causes of crime, and the best approach to dealing with crime (Jeffery, 1959). The range of this continuum, and where YFPS sits, is discussed below. On one end of the continuum, the Classical School of criminology was developed to keep the state from imposing harsh and arbitrary actions against the accused such as historically approved methods of exorcisms, stoning, burning at the stake, and other forms of torture (Schram & Tibbetts, 2018). The Classical School emphasizes the free will of the individual in the cause of crime, the fact that people weigh benefits and ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 12 consequences and act based on that, and theorizes that punishment deters people from committing crimes again (Jeffery, 1959). This ideology puts blame on individuals and the choices that they make, and assumes that punishments are a valid way to prevent future crime (Jeffery, 1959; Schram & Tibbetts, 2018). Alternatively, the Positive School of criminology was developed in the 1800s as an alternative method to the Classical School which focused on applying “scientific methods to the study of the criminal” (Jeffery, 1959, p. 4). Instead of focusing on an individual’s free will, the Positive School believes in determinism, which is the belief that everything is predetermined by existing causes and free will does not exist. Additionally, the Positive School disagrees with punishment as a deterrent, and rather thinks that treatment should be calculated to protect society. Additionally, the Positive School emphasizes looking not only at the individual characteristics of a criminal but also their family background, neighbourhood, and social inclusion: “An explanation of human behaviour is an explanation of crime” (Jeffery, 1959, p. 4). In terms of the preceding continuum, the current YCJA (2002) falls within the Positive School as it strives to combat the previous Young Offenders Act (1985) which was criticized for overuse of courts, incarceration for less serious crimes, and unfairness in how the legislation was implemented (Department of Justice Canada, 2017). While the change toward the YCJA (2002) was an attempt at blending punitive and restorative approaches, the justice system in general is still a punitive tool that seeks to give proportionate punishment for the offence committed and provides very few avenues for a truly restorative approach (A. Huggett, personal communication, March 26, 2019). ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 13 YFPS must work within the YCJA (2002), yet it has some freedom to work with youth and provide an all-encompassing assessment to enable the courts to make a decision to treat that youth appropriately as well as consider how to reduce harm to society. Within the therapeutic approach, each YFPS staff has the opportunity to use more restorative types of approaches. Overall, through an exploration of the mission and values, history, client group served, services, funding, and ideological ‘continuums’, my hope is that the reader has a deeper understanding of YFPS. Learning Goals and Objectives My overall learning goal of my MSW practicum was to broaden my clinical social work knowledge, skills and abilities in work related to youth involved in the justice system. I hoped that the practicum setting would offer me opportunities and knowledge that were different from my previous work experience. Within this overall goal of increasing knowledge, skills and abilities, I focused on five specific learning objectives that are discussed below, alongside some proposed activities and tasks to assist in this learning. The Youth Justice System My first objective was to increase my knowledge, skills and abilities to competently work within the Youth Justice System. Reaching this goal depended on various learning activities and tasks which included reading about policies and procedures, being entrenched in the Youth Forensic services as a part of the youth justice system, having opportunity to learn from others in the system including going to court, connecting with youth probation, engaging with the Prince George Urban Aboriginal Justice Society, and engaging in ongoing supervision. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 14 Written Formal Assessments To support my second objective of learning and experience in written assessments, I engaged in activities in which I reviewed and familiarized myself with existing assessments to get an idea of what the assessments entail, worked with my supervisor to conduct and prepare assessments, and engaged in the necessary tasks including collecting collateral information from other services and family. I also worked on the writing skills that met the requirements for a formal court assessment. Implementation of Forensic Psychiatric Treatment My third objective was the implementation of specific treatments for youth involved with the criminal justice system. My learning activities included initially learning about the types of treatment including functional family therapy, specific sexual offence treatment, and other treatment modalities, participating in goal setting with clients and the team, attending monthly case reviews to track progress, participating in case consultations, and finally creating treatment plans with clients and the multidisciplinary team. Additionally, part of the treatment services at YFPS included being part of an interprofessional team. My learning included observing and working with other professionals including counsellors, psychiatric nurses, and being part of the psychiatric rounds. Self-Care Strategies My fourth objective was to be aware of my self-care. In my time at YFPS I worked with a population that I had not worked with before and I wanted to ensure a continued emphasis on self-care as part of my learning plan. I began my practicum having good self-care techniques that include physical activity, time away from work, ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 15 routines to help me leave work at the office, and seeking support when I need it. I focused on evaluating my current self-care on an ongoing basis throughout the practicum to determine if my self care strategies needed to change or be increased. The activities that I used to observe this included ongoing journaling and staying reflective in my practice. Practically, I also planned to take part in workplace activities of self-care such as walks at lunch hour. Trauma-Informed and Anti-Oppressive Practice My final objective was to keep a trauma-informed and anti-oppressive lens at the center of all of the work that I did at YFPS. The activities that I engaged with in order to do this included keeping a journal of thoughts and reflections throughout my practicum and discussing individual and systemic ethical considerations at ongoing supervision times. I asked questions and reflected on how the above mentioned lenses can fit into the work that I was doing, and where it might point to the need for advocacy and change. Overall, these learning objectives were central to guide my experience at my practicum placement. I feel that I was able to adhere to them as much as possible, but I also allowed myself to be open and flexible to new opportunities or directions that arose. A full version of the formal learning contract can be found at Appendix A. This introduction chapter permitted the reader to be familiarized with, and understand the context of, my MSW practicum experience at YFPS by introducing the key concepts, and overview of the practicum setting, and my intended learning goal and objectives. Chapter Two explores the theoretical orientations that influenced my practicum work at YFPS. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 16 CHAPTER 2: THEORETICAL ORIENTATION This chapter aims to give the reader a deeper understanding of the various lenses and experience that impacted my work with YFPS. To begin, I explore my personal standpoint on working with youth involved in the justice system. This personal standpoint outlines my previous experience, both personal and professional, that inevitably impact the work that I do as a social worker and the way I see the world in general. Then, I will explore the two main theories that I chose to keep central to my work at YFPS: Trauma Informed Practice and Anti Oppressive Practice. My personal theories and experience are placed within the theoretical orientation of YFPS. As noted in the 2015/2016 Annual Report, YFPS was working towards ensuring that youth receive individually tailored treatment(s) for their identified mental health concern(s), based on a comprehensive assessment, which may include specialized approaches such as violent offence treatment, sexual offence treatment, or functional family therapy. This recommendation was made, in part, due to the recognition of the clinically complex youth served by YFPS. For example, in addition to engaging in offending behaviours, most youths treated by YFPS clinicians have mental health issues that include emotional or behavioral dyscontrol, substance misuse, and major mental illnesses such as mood, anxiety, or psychotic disorders. Many have also experienced significant trauma, such as child maltreatment. Consequently, this model enables YFPS staff to more readily tailor treatment to address significant and complex mental health needs. (p.5) ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 17 The YFPS clinical goals align closely with the theories that I hold central to my practice and will discuss below. Personal Standpoint I identify as a cisgendered, straight female of white settler descent. I believe that it is important to position myself in terms of these characteristics because of the information that we have about the overrepresentation of Indigenous youth (Cesaroni, Grol, & Fredericks, 2019) and LGBTQ+ youth (Ramirez, 2018) in the justice system. As someone who has historically played a role in colonization, and who continues to benefit from institutions that have fewer biases toward white people, I need to understand how this could impact my work with Indigenous clients. Furthermore, my position as a cisgendered, straight person means that I do not experience the oppression that LGBTQ+ people do at the hands of individuals and institutions. In my work with youth from various backgrounds, I believe it is important to understand my position and be able to identify it and speak to it if needed. I recognize the privilege that I carry by just being who I am, and that it impacts the relationship I have with clients. I was not involved with the justice system as a youth or an adult and, at the commencement of the practicum, did not have an in-depth understanding of the justice system. As a professional, my social work experience was primarily working with adult victims. I had not held a position that focused on working with youth, nor had I ever worked with those who are accused or convicted of a crime. The main focus of my past work has been supporting victims of domestic violence, which is often a very different client group than those in YFPS. I believe that this is something that I had to keep in ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 18 mind and at the forefront of my reflective practice to ensure that I focused on who my clients were and the goals in supporting them. Throughout this practicum, my goal was to keep two of my personal theoretical orientations central to how I approached my clients, viewed their challenges, and found solutions to those challenges. My focus throughout my placement was to utilize a traumainformed approach, and anti-oppressive practice, which will now be explored further. Trauma Informed Approach (TIP) Historically, the youth justice system has not been specifically trauma informed, yet there are recent efforts to try to incorporate as many assumptions about trauma as possible into work within the justice system (Griffin, Germain, & Wilkerson, 2012; Layne et al., 2008; Maschi & Schwalbe, 2012). In terms of youth justice specific practice, research states that practitioners need appropriate screening questions or tools so that they are aware of trauma that impacts youth (Cimino, Mendoza, Nochajski, & Farrell, 2017; Griffin et al., 2012; Maschi & Schwalbe, 2012; Yoder, Bender, Thompson, Ferguson, & Haffejee, 2014). Once a history of trauma is identified, appropriate practices must be put in place so that the understanding of trauma and its impact is kept at the core of the work (BC Provincial Mental Health and Substance Use Planning Council, 2013). Although many social workers utilize a trauma informed approach, there has been a recent movement to put a name to this type of service and better integrate it into institutions and policies (BC Provincial Mental Health and Substance Use Planning Council, 2013). Trauma-Informed Practice, or taking a Trauma-Informed Approach, are recent ‘catch-phrases’ in the helping professions. This approach seeks to emphasize the need to acknowledge the impacts of trauma, and work in a way that creates safety and ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 19 reduces further traumatization for our clients (BC Provincial Mental Health and Substance Use Planning Council, 2013; Griffin et al., 2012; Joseph & Murphy, 2014; Layne et al., 2008). In broad terms, a Trauma Informed Practice acknowledges the prevalence and impacts of trauma, and strives to implement practices that are built on supporting survivors of trauma (Levenson, 2017). Social workers who use TIP “rely on their knowledge about trauma to respond to clients in ways that convey respect and compassion, honor self- determination, and enable the rebuilding of healthy interpersonal skills and coping strategies” (Levenson, 2017, p.105). A trauma informed approach adheres to five basic principles on how to work with clients that focus on safety, trust, choice, collaboration, and empowerment (BC Provincial Mental Health and Substance Use Planning Council, 2013; Levenson, 2017). Most youth within the justice system distrust the system, and feel unsafe and that they have no choice or control over their situation, which negates the core principles of a trauma-informed approach (Goodwin-De Faria & Marinos, 2012; Maschi & Schwalbe, 2012; Penner, Shaffer, & Viljoen, 2017). There have been recent steps toward looking at the youth justice system as a whole and trying to make systemic changes to integrate a trauma-informed approach (Griffin et al., 2012). Anti-Oppressive Practice (AOP) Anti-oppressive Practice (AOP) social work is a framework that positions social problems as inherently rooted in oppression (Baines, 2007; Baskin, 2011; Mullaly, 2002; Wilson, 2002). Oppression is defined as a personal act or policy that “enacted unjustly against an individual (or group) because of their affiliation to a specific group” (Baines, ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 20 2007, p.2). AOP stems from theoretical contributions of Marxist, socialist, and radical ideologies, which are similar ideologies that fueled the feminist movement and other emancipatory movements (Sakamoto & Pitner, 2005). AOP argues that these types of movements need to continue to overcome oppression in our society (Sakamoto & Pitner, 2005). Social workers should acknowledge and understand how oppression impacts clients, as well as work towards influencing larger structural changes to overcome oppressions that exist in our society. The goals of AOP position a social worker to acknowledge and challenge oppression. The first goal is to work towards removing oppression within individual interactions and community building activities that social workers engage in on a day-today basis (Bishop, 2002; Strier, 2007). This goal is rooted in the fact that power dynamics exist within social work: between the client and worker, worker and agency, and the agency and the larger funding and policy structures (Strier, 2007). AOP seeks to reduce this power by building agendas with clients and moving toward a common goal of dismantling oppressive power (Bishop, 2002). The second goal of AOP is to ensure that the link is made that the ‘personal is political’ (Mullaly, 2002); the idea is that individual situations that a person is experiencing can be linked to larger institutional and political agendas and structures. Making the personal political draws attention to the impacts that society, politics, and institutions have on individual wellbeing. As social workers, we must be aware of the impacts of larger structures and work toward creating change that will positively impact our society on both an individual and structural level. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 21 AOP aligns closely with the field of social work. Today, even by the standards of the British Columbia College of Social Workers (BCCSW) Code of Ethics, one can grasp that the focus is multifaceted. Not only should social workers focus on notions associated with AOP such as self-determination and safety of the client, but also larger scale social change as is demonstrated in the Code of Ethics Principle 2.14 with its focus on social justice (British Columbia College of Social Workers, 2009). The reader should now have a good understanding of the theories that I focused on in my practicum experience at YFPS. Next, a review of the relevant literature on youth involved in the justice system will be explored. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 22 CHAPTER 3: LITERATURE REVIEW This chapter explores the literature in regards to youth involved in the justice system. Over time, information and opinions about youth have evolved. Relatively recently in history, Canada created a justice system designed specifically for youth involved in criminality (Department of Justice Canada, 2015). The most recent legislation enacted the YCJA (2002) (Department of Justice Canada, 2017). Over time different thoughts emerged about how best to approach punishment and accountability when dealing with youth. This review of the literature explores these changes and differences in opinion as well as some factors that may contribute to youth becoming involved in the justice system. Finally, relevant information on social work practice within the youth justice system is explored. History of the Youth Justice System As mentioned above, criminal legislation related to youth has seen various changes. In 1908, Canada created its first set of laws to deal with young offenders for the first time– the Juvenile Delinquents Act (1908). This act was criticized for being based on a child welfare approach, and having significant discretion as to how the informal procedures were implemented (Department of Justice Canada, 2015). In 1984, the Young Offenders Act (1985) (YOA) replaced the Juvenile Delinquents Act (1908). The YOA (1985) was based on a criminal justice approach and had more focus on youth and the special rights that they hold (Department of Justice Canada, 2015). From 1984 to 1998, the YOA saw various amendments, which were primarily concerned with increasing sentences that could be given to youth (Department of Justice Canada, 2015). In 1996, a task force evaluated the YOA (1985) and suggested ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 23 various legislative reforms that needed to be put in place. These recommendations essentially resulted in the introduction of the YCJA (2002) which was enacted in 2003 (Department of Justice Canada, 2015; Goodwin-De Faria & Marinos, 2012). Ideally, the YCJA (2002) focuses more on the rights of children and working with them appropriately (Department of Justice Canada, 2015). Prevalence of Justice-Involved Youth Using 2014 Canadian statistics, approximately 101,000 youth had been accused of Criminal Code violations. In 2014 the youth crime rate was 1.8 times higher than the adult crime rate (Allen & Superle, 2016), yet there was also evidence of a declining trend in terms of youth crime rates (Allen & Superle, 2016; Calhoun & Pelech, 2010).. The 2014 statistics also provided proof of a continued declining trend in terms of youth crime rates; since 1991, there has been a steady decline of youth crime (Allen & Superle, 2016; Calhoun & Pelech, 2010). Another factor that is more common in youth crime compared to adult crime, youth are more likely to take part in crime where there was more than one accused person (Allen & Superle, 2016). Furthermore, most offences involving youth were not considered serious, with most being mischief and theft under $5000 (Allen & Superle, 2016). Using more recent Canadian statistics, Mary Allen (2018) researched updated youth crime statistics in Canada using 2017 data. She reported the first significant increase in youth crime since 2007, as the Youth Crime Severity Index increased by 3%. The most notable increases were in youth robbery and youth homicide. There was also a decrease in non-violent youth crimes including breaking and entering and theft under ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 24 $5000 (Allen, 2018), although no causation was discussed in the reason for this declining trend. Factors Contributing to Youth Justice Involvement Researchers have discussed a number of variables that may be present in situations where young people are involved with the law. These variables include childhood maltreatment and trauma, mental health diagnoses, child apprehension and involvement in foster care, and a homelessness lifestyle. These factors are also apparently mitigated by a young person’s perceptions and understanding of police and the legal system. Each of the aforementioned variables are discussed in further detail below. Although most literature and research seeks to understand the factors that put youth at risk for criminality, a Risk and Resiliency Model gives weight to both the risk factors in a child’s life as well as the resiliency factors that exist to support that child to change, grow, and ultimately come through their experience with a positive outcome (Yoder et al., 2014). A Risk and Resiliency Model better conveys that both risk and resiliency co-exist. While risk factors exist, it is important to remember various resiliency or protective factors also exist including positive youth characteristics, access to external resources and positive support (Yoder et al., 2014). Childhood trauma and maltreatment. Experiencing maltreatment or trauma as a child (e.g. physical, sexual, emotional, psychological abuse or neglect) is associated with various negative outcomes (Cimino et al., 2017; Griffin et al., 2012; Mallett, 2014; Maschi & Schwalbe, 2012; Yoder et al., 2014). Trauma impacts children in specific ways. When a child experiences intense horror or fear that exceeds their ability to cope, detrimental effects on their feelings of safety increase the likelihood that they may ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 25 interpret neutral stimuli as dangerous, and additionally decreases their ability to regulate their emotions (Greenwald, 2002). Childhood trauma, which is sometimes referred to as developmental trauma, is especially impactful because of the stage of development that a child is in (Van der Kolk, 2014). Being maltreated as a child has been linked to earlier arrest, more formal community supervision after an arrest, and later antisocial behaviour (Mallett, 2014). Griffen et al. (2012) suggest that about 92% of youth involved in the justice system have experienced some sort of childhood trauma. Almost all of the factors discussed below are linked to some sort of childhood traumatizing experience, and while each factor presents its own risks, much of the impact can be traced back to childhood trauma. Mental health diagnosis. Mental health difficulties, regardless of origin, create difficulties for children (Mallett, 2015). Children with a mental health diagnosis (whether it be depression, anxiety, personality disorders, etc), do not only face the symptoms of that condition but also face the stigma involved with having a mental health diagnosis (Mallett, 2014). Children with mental health diagnoses often face comorbid symptoms of emotional disturbances and learning disabilities (Mallett, 2014). There is a much higher prevalence of mental health disorders within youth involved in the justice system compared to the rest of the population (Mallett, 2015). Approximately 60-80 % of justice-involved youth have a mental disorder (Penner et al., 2017). One difficulty that children diagnosed with mental health disorders face is that many do not seek treatment and those who do are often not treated appropriately (Mallett, 2015). According to the National Crime Prevention Centre (NCPC) (2012) , only one in five children in Canada who need mental health support receive it. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 26 Homelessness. Homelessness is associated with delinquent behaviour most often through two streams: illicit drugs and survival behaviours (Boyd, Fast, & Small, 2016; Yoder et al., 2014). Experiencing homelessness apparently increases a youth’s interactions with police and ultimately the justice system (Boyd et al., 2016). The first mentioned pathway for this involvement with crime is through illicit drugs. Homeless youth are at higher risk for having substance use concerns and, as discussed next, often turn to the drug trade as a means of survival. The second link to delinquent behaviour that may involve youth with the justice system is what Boyd et al. (2016) describe as survival behaviours. These are behaviours that youth engage in to support themselves such as panhandling, selling drugs, entering the sex trade or petty theft (Boyd et al., 2016). In these circumstances, youth are choosing criminal behaviour as a means to an end, and may not choose criminality if they were in different circumstances. Additionally, experiencing homelessness increases a young person’s experiences of oppression and stigmatization (Nichols & Braimoh, 2018). Generally, Nichols and Braimoh (2018) have found that some support systems, such as social housing, actually recreate the oppression that youth have experienced in other aspects of their lives, and can actually continue to traumatize youth instead of supporting them. If we want youth to feel safe accessing services, we need to find ways to decrease their experience of oppression. This is important for social workers to keep in mind while offering services through these larger systems that may still be oppressive or traumatic at their core. Perceptions of police and the legal system. The final factors that influence a youth’s experiences with the justice system include their previous experiences with the ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 27 legal system, their perceptions and understanding of legal rights, their belief in the fairness and justice of the system, as well as parental beliefs related to the police (Goodwin-De Faria & Marinos, 2012; Penner et al., 2017). Legal socialization is a concept which explores how a youth learns about the dynamics of the justice system, and how this sets them up for their future interactions with the same (Madon, 2017). Madon (2017) found that youth age 10-14 have the poorest perception of police and after age 15 perceptions become more positive. Outcomes of Justice-Involved Youth As explored above, the literature clearly provides information on factors that may contribute to youth becoming involved in the justice system. The literature also informs about connections that can be made between criminal justice involvement and life outcomes. An immediate outcome for a justice involved youth includes involvement with the police system. From there, youth can either be charged for their crime or police can choose to deal with repercussions in other ways, called extrajudicial measures. If a youth’s criminal act goes to court they can be referred to treatment and placed on probation, be referred to restorative justice programs, or be put in custody (Adorjan & Ricciardelli, 2018). Incarceration is also an outcome for youth when they become involved in the justice system, although with the implementation of the YCJA (2002) fewer youth are being put in custody centres. While incarceration rates are low, statistics about incarceration rates still may not be accurate given that “youth serve two thirds of their custody and supervision orders in custody” (Adorjan & Ricciardelli, 2018, p. 661). ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 28 Some of the other long-term outcomes that are associated with youth involvement in the justice system include acquiring a registered disability, increased hospitalization (Piquero, Shepherd, Shepherd, & Farrington, 2011), and increased self harm and suicide attempts (Shepherd, Spivak, Borschmann, Kinner, & Hachtel, 2018). Youth involved with the justice system have been identified as a sub-population that is at higher risk for self-harm and suicide attempts (Shepherd et al., 2018). Self-harm and suicide attempts are linked to poorer health outcomes and shorter life-span for youth, and it has been confirmed that suicide is the leading cause of death for youth in detained settings (Shepherd et al., 2018). Finally, youth who are involved with the justice system are at higher risk for incarceration as an adult, or at least with involvement in the adult criminal justice system (Mallett, 2015). Approaches of Responding to Justice-Involved Youth There are various opinions and perspectives on the best way to approach justice, punishment, and accountability with youth. Four approaches to responding to youth criminality are discussed below: retributive, restorative, rehabilitation, and risk management. These approaches are broad criminal justice approaches used in the context of both adult and youth justice. Retributive approach. The retributive approach to wrongdoing attempts to identify universal rights and wrongs and assign particular consequences to various wrongdoings (Calhoun & Pelech, 2010). In this approach, guilt is based on facts that point to guilt or innocence; it is an individualistic approach to criminality and does not take into account any contextual information (Calhoun & Pelech, 2010). This approach to punishment is that an offender should be handed a punishment assigned by someone in ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 29 power, usually a judge, deemed sufficient enough to deter them from offending again (Calhoun & Pelech, 2010). This approach removes an offender’s actions from context, but also ignores the needs and inclusion of the victim in the justice process (Calhoun & Pelech, 2010). The downfall of this approach is that in isolating a person’s actions from the larger context (i.e. the person they have done harm against) it limit’s the opportunity for that person to understand how their actions impacted others (Calhoun & Pelech, 2010). Restorative approach. Opposite to the retribution approach lies the restorative approach, which emphasizes restoring the social equality that has been disrupted by the crime (Calhoun & Pelech, 2010). The focus is on relationships that were broken or taken advantage of, and on working collaboratively to build the relationships onto a healthy and equal foundation (Calhoun & Pelech, 2010). This approach is contextual and inclusive of everyone who was involved in the wrongdoing, not just the offender. This approach may be difficult for some offenders because a crucial step in the restorative process is the acknowledgement of harm done by the offender. It is hinged on empathy and safety, which is not always achievable (Calhoun & Pelech, 2010). Risk management approach. The risk management approach is closely aligned with a restorative approach as it attempts to calculate risk to be able to predict, and hopefully reduce reoffending; the idea is that if we know the risks, we can be better prepared to minimize that risk and reduce crime (Sampson & Themelis, 2009). One critique is that a risk management approach tends to ignore the context of various risk factors, and the idea that each individual youth navigates these risk factors differently; there is not one way for a risk factor to be experienced and dealt with, and they can ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 30 change with context. Another critique is that while risk may appear simple and straightforward on paper, the actual frontline work of helping youth to understand their risk factors and make changes to that risk can be very difficult (Sampson & Themelis, 2009). Rehabilitation approaches. Rehabilitation is based on the belief of human malleability, or the concept that people can, and have, the capacity to change (Adorjan & Ricciardelli, 2018). This approach has a goal of changing unwanted behaviour, attitudes, and beliefs of convicted offenders. Through this approach, an offender is asked to learn behaviour that is deemed acceptable by society (Adorjan & Ricciardelli, 2018). Adorjan and Ricciardelli (2018) state that recent research suggests that the rehabilitation approach has been pushed aside by other ideologies, or if it is still used, it is often used as a “lip service” (p. 98) to what rehabilitation actually represents, or is interpreted in vastly different ways by parole officers. Many programs have policies to align with rehabilitative approaches, but in reality, this is not how the practice plays out (Adorjan & Ricciardelli, 2018). Social Work with Justice-Involved Youth Within this broad and complex context of youth involved in the justice system, what role do social workers play, and where are the gaps that social workers can help to address? Based on some of the identified risk factors and outcomes, social work can assist in both preventative and reactive measures to support youth. The literature is clear that a trauma informed approach is necessary regardless of the type of service provided by a social worker. (Greenwald, 2002; Griffin et al., 2012; Layne et al., 2008; Maschi & Schwalbe, 2012; Yoder et al., 2014). ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 31 Front-line prevention and intervention. Based on the risk factors for youth becoming involved with the justice system, we can see areas where social workers might be able to intervene prior to criminal involvement or assist to mitigate risk. Social work interventions that target mental health concerns, substance use difficulties, learning disabilities, homelessness, and childhood trauma all hold the potential to decrease risk of criminal involvement (Mallett, 2014, 2015). Some of these interventions may include school programming to address concerns (Mallett, 2015), support workers to help navigate the intricacies of homelessness (Boyd et al., 2016), involving families in working to create a healthier and stable living environment (Mallett, 2015), or implementing community programs to assist youth in identifying problems that lead to criminality and working to find solutions to those problems (Sampson & Themelis, 2009). Trauma Informed Practice. Trauma is defined as an incident that is so frightening that it overwhelms a person’s ability to cope. When this inability to cope occurs, a person’s brain and body react in very specific ways (O’Neill, Fraser, Kitchenham, & McDonald, 2018). The prefrontal cortex shuts down, reducing the ability to think logically. The sympathetic nervous system activates to increase heart rate, dilate pupils, and prepare the body to deal with the threat. The HPA axis, a set of neurological and hormonal reactions, initiates to push a person’s body into a fight, flight, or freeze response (O’Neill et al., 2018). While this response is natural and adaptive, and exists to help keep us alive, it also impacts the way we store memory. Trauma memories are stored differently and are left as fragmented sensory pieces with no ‘script’ to put it all together (Bombay, Matheson, & Anisman, 2014; O’Neill et al., 2018). ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 32 The majority of the trauma literature explores single trauma, complex trauma, developmental trauma, and cultural trauma. According to the BC Provincial Mental Health and Substance Use Planning Council (2013), single trauma is one event that overwhelms a person’s coping. This could include events such as a car accident, a death, or witnessing a crime. Complex trauma refers to a situation a person is in that continues to cause them to be traumatized, such as circumstances involving domestic violence, human trafficking, or war. Lastly, the Planning Council indicated developmental trauma can be single or complex, but is developmental in nature because it occurs during childhood and disrupts physical, psychological and emotional development. Finally, O’Neill and colleagues (2018) suggest cultural trauma exists when members of a group feel that they have been exposed to an extremely overwhelming event or treatment that leaves long-lasting impacts on their collective consciousness. Another important aspect of cultural trauma is that the traumatic event is inflicted by an ‘other’ or ‘outsider’; the source of trauma is imposed by one group onto another group (O’Neill et al., 2018). The literature is clear that working with youth involved in the justice system must be trauma informed and individual social workers, within their role supporting youth involved in the justice system, should ensure their approaches are trauma informed (Griffin et al., 2012; Maschi & Schwalbe, 2012). As mentioned in Chapter Two, a TIP approach hinges on the basic themes of creating safety, trust, collaboration, and empowerment (BC Provincial Mental Health and Substance Use Planning Council, 2013). To do this, a social worker must have a basic understanding of trauma, enhancing abilities to speak to youth about trauma and teaching youth about the impacts of trauma, as well as having connections to trauma specialists if a youth is needing more in-depth ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 33 trauma work (BC Provincial Mental Health and Substance Use Planning Council, 2013; Layne et al., 2008). Ultimately, however, the justice system as a whole needs to commit to transitioning to a trauma-informed approach otherwise individual clients will continue to be re-traumatized by the system (Griffin et al., 2012; Layne et al., 2008). Conclusion The youth justice system is a large and complex system with ever-evolving perceptions and practices tied to various standpoints on what justice and punishment should look like. Youth who become involved in crime often share some risk factors that may contribute to their participation in the justice system. One of the most important factors to consider is childhood trauma. It is this factor that contributes to the current literature on how to best support and engage youth in the justice system: from a traumainformed lens. There are recent examples of how the justice system, and those working with youth involved in the justice system, can implement trauma-informed approaches to effectively work with these youth including engaging youth before crime based on risk factors, and implementing a trauma informed approach. The next chapter provides an overview of the learning outcomes from my practicum at YFPS. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 34 CHAPTER 4: LEARNING OUTCOMES Through my 450 hours of practicum experience, I was able to take part in various learning activities, which ultimately assisted me in reaching all of my learning goals. This chapter outlines each of the learning objectives I had set out and how I reached each of those objectives. Furthermore, I explore additional learning opportunities that arose that had not been part of my initial plan but are noteworthy. Increased Knowledge of Youth Justice System One of the initial priorities in my practicum was to gain a better understanding of the youth justice system. My education and previous experience to this point had focused very little on the justice system, therefore I used various learning tasks and activities to achieve this goal. I read through various documents including the YCJA (2002), the YFPS Policies and procedures manual, the YFPS Core Competency document, and a number of risk assessments used in the field including the Juvenile Sex Offender Assessment Protocol ( J-SOAP II), Structured Assessment of Violent Risk in Youth (SAVRY), and the Estimate of Risk of Adolescent Sexual Offence Recidivism (ERASOR). Reading these various documents assisted me to get a basic understanding of the laws, legislation, and procedure for using the youth justice system. Although I found the YCJA (2002) initially confusing, it was helpful to have read it so that it could be more easily referenced throughout my practicum. The YFPS Core Competency document was by far the most helpful document in seeing how various laws and acts related to the specific work done at Youth Forensics. Furthermore, familiarizing myself with the various assessments supported my knowledge in risk factors for offending and reoffending. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 35 Aside from reading formal documents, I was also able to gain a broader understanding of the youth justice system by being entrenched in the day to day work at YFPS and the intricacies faced when legislation is implemented in the real world. Through ongoing shadowing, attending YFPS meetings, Integrated Case Management (ICM) meetings, and formal supervision, I was introduced to how the charges, sentencing, and ongoing support looks for youth who have become involved in the youth criminal justice system. It was extremely beneficial to sit in on formal and informal supervision between my supervisor and his manager and experience the various complications and ethical dilemmas that can arise in cases at YFPS. I found that the team at YFPS was very open with reaching out for consultation and discussion was ongoing for many cases. I was introduced to various services and experiences outside of YFPS including shadowing a youth probation officer and staff at Prince George Youth Custody Services (PGYCS), informational meetings at the Prince George Urban Aboriginal Justice Society (PGUAJS), team meetings and screening meetings with Camp Trapping, bi-weekly houseparent meetings with the STRIDE program. I expand on each of these related services now, and how each contributed to my knowledge of the youth criminal justice system. I was fortunate to spend an entire day shadowing a youth probation officer. I was able to understand their role of protection of the public, and how they work with the youth, the lawyers, and the court system to balance public protection and a youth’s best interest. It was helpful to gain their perspective and spend a day shadowing the work that they do. I was able to witness the probation officer give an official verbal presentence ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 36 report to a judge, and saw two youth sentenced in court. Through this process I was also able to get an idea of legal processes that take place between crown counsel and defense lawyers in order to ultimately come to an agreement before going to the judge. I found it an extremely beneficial experience. Next, at the PGUAJS, I learned how systems not directly connected to the court are working to support individuals and assist them through the justice system. Although UAJS does not work solely with youth, they have programs to assist youth to have a safe drop-in place, as well as liaison work with youth in custody and in the community to connect them with culturally appropriate support and healing methods. I was able to experience a group offered to youth attending Camp Trapping (explained in further detail below) to explore their artistic talents. I learned about various community cultural experiences that UAJS connect youth with such as Sweat Lodges, culturally appropriate sobriety programs, and connections to Elders in the community. I spent a few days out at Camp Trapping, a First Nations and nature-based full time attendance program (FTAP). An FTAP is ordered by a judge as a way to hold youth accountable for their actions as well as to get the support they need. The FTAP order is then enforced by a Youth Probation Officer. My experience at Camp Trapping and in meetings to screen for potential new candidates assisted me to understand how FTAP programs work, and pros and cons they might have for youth who access them. I was able to reflect on the usefulness of programs that take youth away from their usual environments. A program like Camp Trapping can act as a way for youth to experience routine and structure, clear consequences for their behaviour, the opportunity to abstain from using substances, and eat well and exercise (the program has a mandatory run ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 37 program where youth work up to running 25 km.by the time they graduate). The youth have time to learn about emotional regulation, how to tolerate stress, and how to build healthy relationships. I also experienced some of the potential challenges this type of program faces as a youth who graduated from the program returned home and immediately re-engaged in unhealthy behaviours that were risk factors to their criminality. The STRIDE program is another FTAP for youth specifically with sexual offence charges that I was able to be engaged with during my time at YFPS. The STRIDE program houses youth with trained caregivers and provides structure. The main goal is for youth to access to YFPS specific sexual offence treatment. This wrap-around approach tries to ensure that youth’s needs are being met in all aspects, and that they are also provided with 24/7 supervision. The STRIDE program, in conjunction with Axis Family Resources which is responsible for all other support and overseeing the program, provides education on life skills, healthy boundaries, and sexual education. Youth also see a YFPS clinician to have offence-specific treatment. The youth may also be connected to education programs, work programs, psychiatrists, psychologists, and family physicians while in STRIDE. My time at PGYCS introduced me to the processes of youth who are detained in custody. This included a tour of the secure facility, a safety training in the custody centre, and the opportunity to do mental health intakes and check-ins with youth. Youth spend time at the custody centre for various reasons: remand, awaiting court appearances, and sentence time. Upon each new admission to PGYCS, YFPS staff conduct a mental health intake to gather historical information as well as see how the youth is currently doing by ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 38 gauging suicidal ideation, difficulty on the unit, current medications, etc. If youth are connected with YFPS, a clinician will see them during their stay in custody to provide treatment. If a youth does not have a current YFPS file, YFPS can still provide general mental health support but cannot do offence-specific work. All youth who are incarcerated at the custody centre have the opportunity to see the general mental health clinician approximately five days a week. Increased Knowledge of Youth Forensic Assessments Similar to my initial lack of knowledge about the youth justice system, I came into this practicum with limited knowledge of the specific assessments undertaken by YFPS. There are two specific types of assessments, social history and treatment needs, that a social worker completes at YFPS. I increased my knowledge of both of these assessments by reviewing assessments completed by social workers, as well as reviewing other psychological and psychiatric assessments to gain a broader understanding of the entire package that is presented to the court (courts usually request psychological, psychiatric, and social history assessments). Furthermore, I was able to broaden my knowledge and understanding of the material needed for these assessments by sitting in on the process, including going through historical documentation, and gathering collateral information from family, schools, MCFD, etc. I took part in two case conferences which involved all assessment writers (psychologist, psychiatrist, social worker) coming together to decide what they would offer as recommendations to the court. Treatment needs assessments are similar to the social history assessments that I was able to experience writing. The referral source determines whether a social history or ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 39 treatment needs assessment is done. Essentially, if a youth is referred by a judge through an official Section 34 report, a full social history assessment is prepared. Alternatively, youth can be referred to YFPS while on bail, or by their probation officer without a formal Section 34. If this is the case, the assigned clinician completes a treatment needs assessment with less collateral information, but with the same goal as a social history assessment to determine what type of treatment would be useful for that specific youth. The treatment needs assessment is completed solely by the social worker, as opposed to Section 34 assessments that are completed in conjunction with formal psychological and, if requested, psychiatric assessments. Increased skills in writing assessments After my initial opportunity of reading completed assessments, I was asked to support my supervisor in writing three social history assessments. I reviewed school records, medical records, MCFD records, and collateral information gathered from family to formulate a comprehensive social history for the youth being sentenced. I was able to sit in on a social history parent interview, and conduct another with minimal support. These experiences supported me in understanding the in-depth information that is needed and brought to the court. It was also very promising to know that the social history, essentially the context of that child’s life and behaviours, is just as important as a psychological or psychiatric report. After the information gathering process, the actual writing of the social history assessment takes time to condense the information and present it in a concise manner. Initially I found this task was difficult for me because I did not want to risk missing any pertinent information. Through the support of my direct supervisor and other YFPS staff, ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 40 alongside using existing assessments as templates, I was able to formulate large segments of assessments on my own, and ultimately create an entire assessment and sign off as the primary author. This was a process that I ended up thoroughly enjoying. It was interesting to have detailed information about a youth’s life and able to put it together to notice patterns of experiences and behaviour. At times it was tedious work, piecing together missing information or disordered information and trying to consolidate all of the information appropriately. It was also very interesting to see this information in conjunction with the psychological and psychiatric reports, and how they all complement each other. Combined, these reports give a judge an in-depth understanding of a youth’s current circumstances, what might cause them to reoffend, and how to best support them moving forward. During my practicum at YFPS, I did not encounter a youth who came through without a formal order to assess, and therefore did not complete a treatment needs assessment, only formal Section 34 social history assessments. Increased Knowledge in Youth Forensic Psychiatric Treatment The second main component of my practicum at YFPS was the treatment aspect. My first objective in this facet was to increase my knowledge of specific forensic psychiatric treatment with youth. I learned about various forms of treatment and clinical modalities in this setting. I also read some specific treatment manuals such as Pathways that focus on offence-specific treatments. I also spent time shadowing my supervisor and other clinicians implementing individual treatments. Shadowing allowed me to see how treatment can be completed with various youth depending on their individual motivation, cognition, and environment. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 41 One of my steepest learning curves was trying to find ways to work with more resistant clients. Although treatment at YFPS is mandated, which increases attendance rates, some clients are extremely resistant to treatment and do not engage in traditional ‘talk’ therapy. It was extremely helpful to watch how my supervisor integrated modeling, experiential learning, and other more covert ways of engaging youth in treatment (such as getting out of the office and engaging in conversation while going for a walk). Beyond individual treatment, I experienced family therapy that took place with one youth on my caseload. Although I did not facilitate many of the family sessions because I was not trained in or familiar with the Functional Family Therapy model, I was able to see how helpful it can be to engage the family to support the youth in reducing risk factors and increasing safety factors. Family work can be done with parents, siblings, or other caregivers (e.g. foster parents or group home staff). For many youth, however, family work is not appropriate or useful, so it is up to the discretion of each clinician if involving the family would be beneficial for that youth’s treatment and lead to increased safety and decreased risk. Another experience that was helpful to learn about treatment, and later supported the development of my skills to implementing treatment, were the Monthly Clinical Case Reviews (MCCRs). On a weekly basis the entire clinical team, including the psychiatrist and psychologist, would present cases from their caseload; the goal was that each case would be heard at least once a month. The MCCRs focused on updates of the youth’s situation, current treatment, and a time to discuss future treatment needs and goals. Sitting in on these meetings gave me an in-depth overview of the types of cases that exist in YFPS, as well as how various clinicians were working on treatment goals. The ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 42 atmosphere in these meetings was extremely supportive and collaborative. This also gave me a clear picture of the YFPS interdisciplinary team, where everyone’s opinion was valued and colleagues were able to discuss cases and support one another. I also learned about and experienced the process for assessing youth for fitness to stand trial, and being Not Criminally Responsible on account of a Mental Disorder (NCRMD). I spoke with psychiatrists and other team members about this process and standards in making the determinations. I read assessments and was also able to sit in on a BC Review Board hearing. The Review Board ultimately decides whether a person is fit to stand trial or is NCRMD, and then is responsible for overseeing their care upon discharge through a YFPS Case Manager. I attended an initial hearing where the Review Board was deciding if indeed a youth was fit or unfit to stand trial, and if he could be coached to fitness. This was an interesting process to witness as it involved the board and lawyers questioning and hearing testimony of YFPS staff and psychiatrists to truly determine a youth’s understanding of the court and ability to direct their counsel. While this is a complicated legal process that I likely still do not know all the intricacies of, it was really beneficial to observe a hearing and reflect on written policy. Increased Skills to Implement Youth Forensic Psychiatric Treatment After some initial observation and learning, I started to implement this knowledge by working with youth more independently. In various sessions, I was assisted or took the lead in planning activities to support treatment goals. On multiple occasions I independently completed a treatment session with a youth and debriefed with my supervisor about the task. During the observation period, I was able to get to know the ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 43 youth and build rapport and trust. This seemed to build the youth’s comfort level and willingness to work with me one-on-one. The caseload that I was part of with my supervisor was comprised of six to eight youth who we saw at least on a weekly basis while they were in Prince George. We had less contact with some individuals because they were in Prince George for a short time and were being returned to their home community. The clients that I was able to work with were considered on the spectrum of lower functioning. Each of these clients had been diagnosed with either autism, intellectual delays, processing delays, low intelligence, or fetal alcohol spectrum disorder (FASD). I learned a lot and was challenged to engage youth in ways that I had not previously engaged clients before. My supervisor and I spent a lot of time using experiential therapy models: playing games, going for walks, and working on interactive projects such as carving paddles to try to engage youth beyond cognitive-based talk therapy. For each youth I was involved with, I read the initial assessments to ensure that our current treatment plan and goals remained on track from the psychiatric and psychological recommendations. This was a learning curve for me because in my previous social work experience, treatment goals can change as the individual client and staff saw fit. Within youth forensics, however, it is a complicated dynamic because in the report to the court you have committed to specific treatment goals that the judge has agreed to. Although there is some leeway, you ultimately work to fulfill the treatment agreed to by the court which focuses on increasing protective factors and decreasing risk factors. This means that everything you do within treatment must be linked back to an agreed-upon recommendation. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 44 Another part of implementing treatment on my own included completing the appropriate documentation for each client. Case notes after each session documented what was done and what the outcome was. Additional documentation was required of any collateral conversations or meetings that took place in regards to youth; completing any transfer packages sent to other YFPS locations if a youth was being relocated; and the MCCR monthly notes for each youth. For me, this began again with reading case notes and MCCR reports to see how other clinicians documented the information, and then writing case notes and MCCR reports in conjunction with my supervisor. Eventually I completed and signed off on these tasks with very limited support. Evaluated and Changed Self-Care Strategies as Needed When I confirmed my practicum experience at YFPS, I was very conscious of the fact that I was entering a field where all of the clients have been involved in harmful acts towards someone else. I was aware that this was a field that I had had very little exposure to and that some of the material might be difficult to read and talk about. Because of these factors, I wanted to ensure my own mental health was cared for and self-care was practiced. The ways in which I did this are discussed below. First, I used a journal to track self-care activities that I took part in on both a daily and weekly basis. By using this strategy, I was able to see what I was doing and gauge its effectiveness. At least once a week, I looked at my current self-care and compared it to how I was feeling about how the work was impacting me. Overall, although the work inevitably impacted me, it was never disproportionate to the ways in which I was finding time to take care of myself and let go of things from work. What I did notice was how much events outside of work (family stress, health issues, etc.) impacted my mental state. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 45 I think that I have been fortunate to find a way to create boundaries about my work so that I do not carry inappropriate responsibility with me and am able to keep work at work, and home life at home. Additionally, self-care is something that is emphasized and supported within the YFPS work environment. All staff make an effort to get out of the office for lunch breaks and many walk or go to the gym during lunch. Frequent check-ins both formally and informally amongst the staff support keeping your own mental health and wellbeing at the forefront of the work. Various discussions with my supervisor and other staff hinged on the concept of finding ways to do work with the justice-involved youth while also taking care of yourself and not becoming jaded with the system. It was really helpful to talk to more experienced practitioners who have done this work for years and the ways in which they have found to ensure their own lives do not take a toll from the work. Reflected on Central Theories of TIP and AOP and How They Exist While Working With the Youth Justice System As a reminder to the theory introduced in Chapter Two, Trauma Informed Practice (TIP) is a way of working with people that understands and appreciates the things they have gone through and how that trauma impacts their lives. TIP holds central themes of trauma awareness; emphasis on safety and trustworthiness; choice, collaboration, and connection; and strengths-based support (BC Provincial Mental Health and Substance Use Planning Council, 2013). Anti-Oppressive Practice (AOP) situates social problems within oppression. It has goals that include larger social justice movements, as well as consciousness raising to support individuals recognize that the “personal is political” (Mullaly, 2002). Within the justice system, I believe that taking ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 46 both a trauma informed and anti-oppressive approach will be difficult, but I also believe that the role of a social worker is to be part of those difficult discussions and to strive for change that will benefit both individuals and institutions as a whole. My learning related to TIP and AOP was the most reflective of all. Within all of my learning activities, I looked at how certain assessment and treatment processes fit within TIP and AOP perspectives. On an ongoing basis, I kept notes in my journal about various themes or thoughts that came up for me in individual situations and how they seemed to fit or not fit within TIP or AOP. In reviewing my journal, various themes emerged from my practicum experience. These themes and their connection to TIP and/or AOP are now discussed. Confidentiality versus public protection. This theme was brought up consistently within Youth Forensics and Probation. My supervisor shared a past case example with me that included a young person returning to their home after treatment and doing very well. However, the Probation Officers advocated for a community announcement to be made that an offender would be living there. While these types of statements do not identify youth by name, they may still cause great difficulty for the young person and stigmatize them. For me, it raised the question about confidentiality and if someone truly poses high enough risk to others that safety and public protection takes priority. From a TIP perspective, safety of the client is integral to creating an environment where they can be impacted less by trauma. At times, the TIP perspective of an individual may go against the TIP perspective of a community; the safety needs of an individual youth may not coincide with the safety needs of a community. Sometimes, keeping one ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 47 individual safe puts others potentially at risk. Another TIP principle is choice and collaboration. Sometimes, choice and collaboration are taken away from youth under the realm of community safety. Ultimately, a social worker must think of all of the perspectives and attempting to make a decision that mitigates risk for everyone involved. TIP versus safety. In various conversations I had with colleagues during my practicum, points were made that Trauma Informed Practice was not always aligned with the goal of safety within the justice system. The first example I saw of this was at the youth custody centre. A youth, who had experienced extreme adversity including sexual exploitation and homelessness, came into custody and was having problems with wetting the bed. Since youth have to request to be let out of their rooms and be attended to by a custody worker, the nurse suggested that the youth keep a urinal cup in his room so that he would not have to worry about getting to the bathroom quickly at night. Although this seems like a simple and thoughtful answer to this youth’s difficulties, it was not an immediately positive response because of potential harm to youth custody staff that might occur. In the past, there were issues with youth urinating in water bottles and throwing the bottles filled with urine at staff. It made me acutely aware that what might seem like an appropriate TIP response has to be looked at through various lenses to protect not only the youth but also the staff. I think that examples like this show how complicated it is to implement TIP within a system that is not necessarily fully trauma informed. TIP versus programming models and timelines. By nature, TIP is very individualized (different people experience trauma differently and manifest their reactions to trauma differently) and its implementation has changed the way that programs run. I was able to see some of the potential benefits and limitations of ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 48 conducting individualized treatment and programs as opposed to previous ‘one size fits all’ programming. At YFPS, programming used to be quite standardized with clinicians following structured programs and manuals with each client. Furthermore, connected programs such as STRIDE (mentioned above as a FTAP for those who have committed sexual offences) used to run with set intake dates and program timelines including sexual offence groups. In more recent years, with the evolution of TIP as well as other research emphasizing the need for individualized programming, these models have shifted at YFPS. Individual treatment now uses information from standardized offence-specific models as a flexible tool, as well as implementing other treatment that suits an individual youth as recommended by psychiatry or psychology. The STRIDE program now offers flexible intakes for youth as well as individualized programming instead of a standard timeline for progress. One downside of more flexible programming is that it has led to the cessation of treatment groups through STRIDE and YFPS because youth are not doing the same work at the same time and are not working through the program at the same pace. I think that groups could be extremely useful for some youth to learn in a peer group setting, although STRIDE and YFPS would have to have high enough numbers of youth ready and appropriate for the group, which recently has proven difficult as will be discussed further below. TIP versus consequences and enforcement. In many conversations throughout my practicum, trauma informed practice was equated to leniency and lack of consequences for youth. In interactions with Youth Probation Officers, the impression I got at times was that trauma informed practice meant that youth were not held ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 49 accountable, and more likely to be at risk of reoffending. Although I believe that consequences can still be trauma informed, and supporting a youth can be individualized to their needs, it did point out the intricacies of finding ways to enforce consequences from a TIP lens. It raised the question for me: “What does trauma-informed consequence and accountability look like?” I experienced probation officers who were collaborating well with all of a youth’s supports to try to establish appropriate consequences for individual youth, which I believe is a step in the right direction toward trauma-informed accountability. TIP and strengths-based versus realistic. Part of the draw to YFPS for me as a practicum opportunity was the fact that it is different from any previous work that I had done. Inherently, this brought new information and forced me to shift my thinking to integrate new perspectives. One shift in thinking that I personally found difficult was integrating the principles of TIP into the justice system’s priority on safety and risk. The intricacies of working with people who are known to be potentially unsafe, and often to be less forthcoming with the truth, was something that I had to learn. I found that I was perhaps a bit naive and was very willing to trust people. For me, trust and belief in people’s truths was always something that I aligned closely with TIP and strengths based work. Yet this practicum has helped me to better understand that I can recognize and be realistic about a person’s behaviours and patterns, and not be blind to them, and still implement a TIP and strengths based practice. The steady decline of caseload at YFPS. Although this theme did not initially occur to me as fitting in part of my TIP and AOP reflection, through continued conversations about the factors that drive caseloads at YFPS, the change could be ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 50 speculated to be part of a TIP and/or AOP lens. With the 2003 implementation of the YCJA (2002), the way that youth were charged and sentenced changed to take into consideration the unique developmental needs of youth (Drinkard et al., 2017). The YCJA (2002) attempted to align itself more closely with TIP values by trying to better understand a youth and what would be the most appropriate approach to achieve the best outcome for that youth given their crime and their circumstance while maintaining the safety of the community. This often meant that youth were given less custody time, and more flexible sentencing where appropriate. Involvement with YFPS is connected with being charged and convicted of a crime, and so when fewer charges are being made and more youth are being diverted from the justice system to other supports, YFPS has fewer youth on their caseload. A procedural shift would need to take place within the justice system to enable YFPS services to engage with youth even when they are not formally convicted of a crime; if the system is shifting, then the access to supports needs to shift as well. The justice system as a social resource. This theme emerged often in terms of the ability of the justice system to appropriately support youth. On various occasions, it was evident that a youth’s involvement in crime was completely intertwined with various social factors associated with crime (e.g. poverty, homelessness, addictions, etc). When these factors are the primary contributors to criminal activity, it is much more difficult to appropriately sentence youth because they lack very basic resources to support reducing their risk. I noticed that in many cases youth were kept in custody beyond what a normal custody sentence would be, not for reasons to do with the justice system but for reasons in regards to the lack of social and community resources. For me, this theme links ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 51 directly to some basic principles of AOP, namely, the personal is political. As we have recognized for a long time, the criminalization and intervention that many youth face is so intrinsically tied with larger political and social structures. Additionally, I saw that a lot of families and caregivers were frustrated with the system that made it difficult to find support when initial risk factors became evident, yet, once a formal sentence was given, then the youth could access more comprehensive support. This speaks to our systems being reactive instead of preventative in nature (Layne et al., 2008). Uprooting youth from their environment for risk or treatment needs. Although YFPS has contract workers all over Northern BC, Prince George is the north region hub. Any youth who have been requested by the court to have an assessment done must travel to Prince George to have it completed. Additionally, if a judge requires a youth to obtain a specific type of treatment or attend a specific program, many of these treatments and programs exist in Prince George or even other areas of the province – not necessarily the youth’s home community. Finally, if a youth is placed in custody, there are only two youth custody centres currently operating in the province: one in Prince George and the other in Burnaby. Rural and remote communities face difficulties when trying to offer proper support to people in need. During my practicum at YFPS, I saw that this often meant that youth had to be uprooted from their usual environment and put somewhere else to receive support or treatment. While the idea is to benefit the youth by being able to give them more in depth support, this uprooting may also cause difficulties and frustration for some youth. For example, many youth that I met had histories of abandonment, relocations, ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 52 and various adjustments to make throughout their childhood. Forcing them to again move elsewhere to receive appropriate treatment and programming plays into their trauma experiences. Conversely, keeping them in the same potentially traumatic environment at home does not necessarily support them learning and implementing new healthy behaviour. From a TIP perspective, it raises the question what option do less harm, and how can clinicians work in a way that understands a youth’s trauma as well as support them to get the help they need. I do not think the answer is simple or clear and is often dictated by their location and availability of health and social services. Indigenous overrepresentation in youth justice. The last theme that fit in my AOP reflection was the vast overrepresentation of Indigenous youth in the justice system. AOP states that individual situations fit within the larger context of a society. In Canada, historic and current racism continues to be a root cause of overrepresentation of Indigenous children and youth in various social care systems (Cesaroni et al., 2019). These systems all intertwine and continue to oppress Indigenous people and put them at higher risk for things like addiction and criminality (Cesaroni et al., 2019). My experience at YFPS matches the literature. I saw far more Indigenous young people involved with our services and at the custody centre than those of white settler heritage. From an AOP perspective, it is important to help with ‘consciousness raising’ in the Indigenous population to support them in understanding the historical and current societal factors that impact their oppression, and the ways in which they can challenge it. These conversations are complicated but, from my experience at YFPS, there were times when this education occurred and discussions held about moving forward from a personal and political standpoint. In reality, however, I learned that a lot of youth I worked with ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 53 were not currently in a place to have this conversation. For some, this meant working to increase their knowledge about history and current power dynamics. For others, it meant continuing to focus on their current emotional needs and decide to put consciousness raising aside at this time. It was encouraging to see that other professionals at YFPS also worked from an anti-oppressive lens. In a specific case where an indigenous youth and his family had been historically and currently involved with a lot of oppressive systems, the psychologist suggested allowing the family to plan the youth’s return to community. The goal was to put the power back to the youth and his family because for so long they had been in a position where decisions were only mad for them. Additional Learning Experiences Throughout my practicum at YFPS I also had experiences that I had not initially counted on. I took part in the YFPS Northern Regional Conference, which brought together clinicians, psychologists, and psychiatrists from across the Northern Region to a two-day conference. There were presentations by various staff members on topics such as Adverse Childhood Experiences, the pros and cons of risk assessments, working with youth who had callous and unemotional traits, the impact of youth’s denial on treatment, cybersex and cybercrimes, and the reconciliation process. This was a great learning experience and came relatively close to the start of my practicum which was beneficial timing. Through the community youth mental health connections, I participated in a oneday workshop called Building Healthy Youth Relationships put on by the RCMP Crime Prevention Team. Throughout the day we explored ways of engaging youth involved in ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 54 the justice system as well as the challenges that communities and services might face and how we could overcome those challenges. Guest speakers shared information on programs that are working to collaborate with First Nations communities to reduce crime (e.g. the WITS program; and the Write to Read program). This event was helpful to gain a better understanding of the services that exist in Prince George for youth, as well as the struggles to engage youth in communities, schools, and other programs. I was also able to act as a co-guest speaker for staff training at Camp Trapping. Along with my supervisor, we presented to Camp Trapping staff on stress and anxiety and ways that staff can assist to regulate and ground youth who come to the program. It was really beneficial to hear first-hand challenges staff that live and work with the youth face that do not exist in an office setting. It brought to light the different work that takes place in residential settings. Another activity that I was able to participate in was acting as a guest facilitator for two weeks at the Mind Fit program. Mind Fit is run through the YMCA and is a program for youth to talk about mental and physical health. I acted as a guest speaker for the weeks on motivation, anxiety and depression. I was able to bring information and assist the YMCA facilitator to educate and support youth during the group. This highlighted the way in which YFPS works with other youth serving agencies to provide education, resources, and collaboration. During my practicum, I also had the opportunity to be certified in Naloxone training. Through a nurse at the youth custody centre, I learned about the signs and symptoms of opioid overdose as well as how to administer Naloxone. In our society right now, when drug use appears to be increasing, and more drugs are laced with opioids, ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 55 overdoses are on the rise (Cimino et al., 2017; Yoder et al., 2014). I am happy I learned about Naloxone and am now trained in how to administer it. Conclusion Overall, my practicum was extremely rewarding and allowed me to fulfill and exceed the learning goal and objectives I had made going into it. I have learned a lot of new information and developed new skills as well as solidified the skills I already had as a social worker. I have made great connections and met colleagues who affirmed my hope for continuing good social work. The practicum experience, however, did not come without some difficulties that are worth discussing as well. Starting in a new field always has its transition period of learning new policies, legalities, acronyms, and a feel for the intricacies of that field. YFPS was extremely helpful and patient in assisting me to start to become more entrenched in their information and language. One situation that arose that impacted my learning experience - not necessarily positively or negatively- was that I started my practicum within a week of a new employee starting at YFPS. There were aspects of this that were extremely helpful. For example, we attended some training together, and were able to discuss various things we were learning. On the other hand, some learning and experiences were prioritized to the new staff as case numbers were low and they wanted to ensure she was adequately trained for her paid position. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 56 CHAPTER 5: IMPLICATIONS FOR SOCIAL WORK PRACTICE My experience at YFPS, while providing new skills and knowledge, also assisted me to recognize some areas that I need to continue my growth and be cognizant of in my future social work practice. The areas that I discuss here are important for me to continue to be mindful of and include the specific intricacies of working with youth, social work practice and increasing use of technology, practice within interprofessional teams, social work in rural and remote communities, and the ongoing need for self-care. Working with youth brings its own unique challenges. Youth, developmentally, are immature and continuing to grow their brain both biologically and experientially. Youth are more compulsive, self-centred, and trying to balance their yearning for independence with still being dependent on adults for some things (Drinkard et al., 2017). Working with youth requires a skill set that includes patience, consistency, connection, and creativity. Social workers have worked with youth effectively for a long time, but the conditions youth live in are also changing as became evident in my practicum experience, and noteworthy in terms of social work practice moving forward. My experience at YFPS has reminded me of the need to practice flexibility and patience with my clients and to carry that forward to my work with youth and any other client population. I want to continue to reflect on how I can use experiential models of therapy and remember to think outside of the box when it comes to clinical support. Technology and access to information has greatly increased in recent years. This has impacted social work generally in the way that we can communicate with and serve our clients. Many youth, in particular, apparently rely on technology and are entrenched in its use. Social workers, therefore, must be aware of various social media platforms and ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 57 the access that exists for youth. Hopefully social work will adapt services to be more accessible for our client population. Technology has far reaching impacts and, specifically in the youth justice field, clinicians assessing risk and reducing risk must take into account how this is impacted by technology. Risks may be exacerbated by social media and the virtual or online world. For my practice in particular, I want to continue to be mindful of appropriate use of technology with the client population I am working with, and to not ignore the impact it has on people’s communication, how they create community, and their sense of self. This may mean implementing new technology into my practice, or advocating in my agency for reassessing how we communicate with clients. Another theme from my practicum experience that has implications for social work practice is the use of interdisciplinary teams. YFPS is a close-knit team of social workers, psychiatric nurses, psychologists, and psychiatrists who work very well together on an ongoing basis to ensure clinical and safety needs are met for each youth. In many complex cases that social workers are involved in, it is inevitable that various professionals will be involved. Good communication, respect, and willingness to work with other professionals ultimately best serves the client. When professionals understand each other’s perspectives and work together, clients receive the best wrap-around, holistic services. The YFPS model of interdisciplinary service sets a good example of how social workers can be an extremely valued and an integral part of a client’s support team. My experience at YFPS has taught me how to know and hold my role within an interprofessional team which is a skill that I will take forward. Social work is inherently a ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 58 job that communicates and collaborates with others, so the skill of being able to work effectively within an interdisciplinary team will be extremely useful. Furthermore, I will use my experience at YFPS as a model to introduce better interdisciplinary work in future workplaces if need be. Rural and remote locations add another layer of complexity for social workers supporting clients (Cheers, Darracott, & Lonne, 2005). My experience at the Prince George outpatient centre, the hub for YFPS northern region, was also complicated by the reality of living and working in the north of British Columbia. Our clients had access to some YPFS services in smaller communities through contract workers, but ultimately many services were located in Prince George. This highlighted the various difficulties that arise for clients trying to access supports and services in the north (e.g. travel difficulties, financial difficulties, and change in environment). Clients who are ordered for assessments from communities like Prince Rupert, Fort Nelson, etc., must travel to Prince George for their psychological assessment, psychological testing, and psychiatric assessment. Travel in the north is not quick nor simple; many families have to take various flights, drive long distances, arrange accommodations, and incur related costs in accessing YFPS services. Additionally, once a youth has been sentenced, they may need to access services not available in their home community. If a youth is returning to live at home while on probation, some more rural and remote communities have contract clinicians but there are many smaller communities who do not have the appropriate resources. Sometimes a youth is forced to leave their community, leave behind family and friends and natural resources, and relocate to access support that the court has required (e.g. and FTAP or ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 59 other specific treatment program). These few examples start to expand on some situations that arise in rural and remote places that are not considered in more urban settings. As a social worker who plans to continue to work in Prince George, a hub for many more remote communities, I will take what I have learned from my experiences at YFPS to remind myself the complexities that people living more remotely can face in terms of accessing services. From a TIP and AOP lens I will work within my agency to advocate to break down the oppressive barriers and support clients to access services. The final implication that I will carry forward is the need for self-care and reflection of how the work social workers are doing impacts them. In my own practice, I want to continue to track and be aware of the ways I am taking care of myself to make it a priority as well as consistently reflect on whether it is working. I also want to work to create an atmosphere similar to what I experienced at YFPS where self-care is openly talked about, and people are held accountable to it. I want to try to support my team at my workplaces to take simple acts that can support their own self-care in a profession that is consistently overworked and under-resourced, such as taking lunch and coffee breaks, or getting outside for a walk at lunch, I hope that I can bring that as a priority to my workplace in the same way that I saw it being prioritized in my time at YFPS. Conclusion Overall, my practicum experience has greatly broadened my knowledge. It has expanded my understanding of the youth justice system and the realm of justice in general. I had the opportunity to learn about and practice formal assessment writing skills, offence specific clinical skills, as well as the opportunity to work with the youth population. I was also challenged in my understanding and implementation of TIP and ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 60 AOP. My experience has solidified for me the need to continue to be cognizant of theories central to my practice as a social worker, as well as to constantly reflect on how I use those theories in practice. I met professionals who supported my learning and growth as a social worker, and who have taught me about working with youth in the criminal justice system. I will forever remember my time at YFPS and am a more varied practitioner because of it. ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 61 References Adorjan, M., & Ricciardelli, R. (2018). The last bastion of rehabilitation: Contextualizing youth correctionalism in Canada. 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Youth Criminal Justice Act, SC 2002. c. 1. Youth Justice Act, SBC 2003, c 85. 66 ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM 67 APPENDICIES Appendix A: Learning Contract LEARNING GOALS TASKS, ACTIVITIES AND STRATEGIES To assist in achieving goal - Increase knowledge of Youth Justice System - - - Increase knowledge of youth forensic assessments - PERFORMANCE INDICATORS Observable indicators of achievement Reading Youth - Completed planned Criminal Justice Act readings - Engaged in regular (YCJA) legislation Reading Youth workplace discussions - Meeting / exposure Forensic Psychiatric with youth probation Services (YFPS) - Meeting / exposure policies and with police systems, procedures, YF Core Urban Aboriginal Competency Justice Society, Camp Document, risk Trapping and other assessment tools, related agencies that treatment related books, are community articles and manuals partners with PG Entrenchment in the YFPS youth justice system through exposure working daily at YFPS Learning through others within the system including youth probation, Urban Aboriginal Justice Society, Camp Trapping, STRIDE/AXIS, Youth Custody Centre and other related agencies Review and familiarize - Read assessments for youth attending myself with completed treatment assessments Observe supervisor or - Sit in on at least one assessment / collateral other staff conducting and writing assessments gathering session Receive instruction - Observe the about the report writing assessment writing process including being process at least once involved in collateral ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM Increase skills in writing youth forensic psychiatric and Treatment Needs assessments - - Increase knowledge in youth forensic psychiatric treatment - - Increase skills in implementing youth forensic psychiatric treatment - information gathering and interviewing - Conduct tasks needed to prepare assessments such as gathering collateral information and interviews Work with supervisor to write a Social History Assessment using proper formatting and language Present completed Treatment Needs Assessments/Social History Reports in Team meeting - Learn about various types of treatments from policies/procedures, treatment manuals Observe staff using treatment modalities with clients Attend weekly team case reviews to gather information and observe how goal setting and tracking takes place Observe other staff creating treatment plans with clients Use observed and learned skills to implement treatment on my own Create treatment plans by using assessment report recommendations, - - - 68 Sit in for at least one multi-disciplinary team assessment case conference Complete or assist with at least one formal forensic assessment Observe at least 4 sessions of any staff conducting a treatment session with a client and/or family Attend all team meetings possible Observe and/or review treatment plans Facilitate individual sessions as available (based on case load etc) Involved in all aspects of treatment preparation, planning, session presentation, ASSESSMENT AND TREATMENT WITH YOUTH IN THE JUSTICE SYSTEM - - - Evaluate and change self- care strategies as needed - Reflect on central theories of TIP and AOP and how they exist while working with the youth justice system - supervision and multidisciplinary team input Meet with supervisor regularly to plan and discuss treatment, and debrief Complete all appropriate documentation as required Involved in as many aspects of case transition planning, case discharge and transfer as possible Track current self- care Evaluate weekly where my emotional and mental states are at Increase self-care if needed Discuss self-care approaches with YF staff Keep journal with thoughts and reflections about implementing TIP and AOP at YFPS Discuss same topics at ongoing supervision and debriefing Discussion of social work ethics within a forensic setting to be part of the above discussions as situations arise - - - - - 69 reviews and supervision. Involved in weekly case reviews, including monthly updates of Case Plans, writing Monthly Clinical Case Review notes, presenting the review notes to the multi disciplinary team Use supervision as ongoing support for planning and debriefing Journal to track initial self-care plan Journal to track if current self-care plan is working Implement further self-care if need exists Discuss self-care thoughts, concerns or issues with YF personnel or UNBC supervisor if needed At least weekly journal to reflect specifically on integration of TIP and AOP in practicum experience Use journal as needed for thoughts, questions, etc Bring reflections to regular, ongoing supervision