Workshop Goals Participants will:

1. Changing How We Do Business: System Integration for Youth Involved in Both the Child Welfare and Juvenile Justice SystemsOUTAGAMIE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICESMark Mertens & Melissa Blom

2. Workshop Goals Participants will: • Have knowledge of the most up to date research on dual status youth (youth who have come into contact with both the child welfare and juvenile justice systems) prevalence, characteristics, and outcomes • Become familiar with the RFK National Resource Center framework for system coordination and integration to improve outcomes for dual status youth and its application on site • Identify possible areas in which your jurisdiction could improve its approach to handling dual status youth, potential barriers to reform that may arise, and recommended approaches for overcoming challenges • Receive guidance on how to use current tools and resources to assist in dual status work

3. Today’s Workshop Community • Name and Profession • Interest or Experience with Dual Status Youth • Particular Issues in Your Jurisdiction or Practice

4. “We recognize also that many young offenders may be redirected toward constructive activities through successful treatment efforts. However, these programs deal with the end results of delinquency – not the sources. We must broaden our attack and focus as much energy in the future on prevention as we have on control and treatment in the past.” Robert F. Kennedy, National Committee for Children & Youth Conference on Unemployed, Out-of-School Youth in Urban Areas. Washington, D.C. May 24, 1961. Page 59. Quoted in Make Gentle the Life of this World, The Vision of Robert F. Kennedy, Edited and with and Introduction by Maxwell Taylor Kennedy, 1998.

5. Dual Status Youth Youth who have come into contact with both the child welfare and juvenile justice systems occupy various statuses in terms of their relationship to the two systems. For purposes of discussion and development of approaches and resources to address dual status youth, the following definitions have been created to distinguish the various statuses: • Dually-Identified Youth: Youth who are currently involved with the juvenile justice system and have a history in the child welfare system but no current involvement. • Dually-Involved Youth: Youth who have concurrent involvement (diversionary, formal, or a combination of the two) with both the child welfare and juvenile justice systems. • Dually-Adjudicated Youth: Youth who are concurrently adjudicated in both the child welfare and juvenile justice systems (i.e. both dependent and delinquent).

6. The Research: Is There a Compelling Case to be Made? General delinquency research shows that childhood abuse (physical and sexual) is often associated with delinquency and that the early onset of maltreatment may increase the variety, seriousness, and duration of problems.¹ Additionally, there is an increased risk for mental health problems (suicide attempts and post-traumatic stress disorder), educational problems (extremely low IQ scores and reading ability), poor occupational outcomes (lack of work, high rates of unemployment, and employment in low-level service jobs), and public health and safety issues (prostitution in males and females and alcohol problems in females).² ¹ National Institute of Justice, Research in Brief: An Update on the Cycle of Violence (Widom, C.S. and Maxfield, M.G. February 2001). ² Ibid.

7. Research & Characteristics of Dual Status Youth • At least seven studies have examined dual status youth characteristics (Herz & Ryan 2008b; Widom & Maxfield 2001; Halemba, Siegel, Lord, & Zawacki 2004; Kelley, Thornberry, & Smith 1997; Saeturn & Swain, 2009; Halemba & Siegel 2011; and Dannerback & Yan 2011). • Although these studies are not identical in their methodology, they all examine characteristics of crossover youth and report a tremendous amount of similarity. • All provide evidence that childhood abuse and neglect are associated with an increased risk of crime and violence; it is important to highlight though that this relationship is neither inevitable nor deterministic 7

8. Evidence that childhood abuse and neglect are associated with an increased risk of crime and violence; it is important to highlight though that this relationship is neither inevitable nor deterministic. Approximately 1/3 of crossover youth are female (over-represented). African-American youth are overrepresented in the crossover numbers in child welfare referrals and juvenile justice referrals (this finding was specific to Herz & Ryan, 2008b and Saeturn & Swain, 2009). A high prevalence of a family history of criminal behavior, mental health, and/or substance abuse problems (Widom & Maxfield 2001). Are exposed to domestic violence (70% in Halemba et al). Experience numerous placements, often resulting in one or more placements in congregate care (Herz & Ryan, 2008b). Enter the system when they are young children & remain in the system into (and sometimes through) adolescence (Halemba & Siegel 2011). Inconsistent pre-adjudication identification and are more likely to be detained (Conger & Ross, 2010). Characteristics of Dual Status Youth 8

9. Updating the Research: Characteristics of Dual Status Youth http://www.journalofjuvjustice.org/JOJJ0101/JOJJ0101.pdf www.ncjj.orgor http://www.modelsforchange.net/publications/304

10. Outcomes for Dual Status Youth • Hilton Foundation Study: Young Adult Outcomes of Youth Exiting Dependent or Delinquent Care in Los Angeles County, 2011 • In comparison to foster youth with no involvement in probation, youth involved in both the child welfare and juvenile justice systems were: • – Three times as likely to experience a jail stay. • – One and one-half times more likely to receive welfare. • – 50 percent less likely to be consistently employed. • Nearly one-quarter of youth involved in both systems received treatment for a serious mental illness during the first four years of adulthood. • – This is more than double the rates for foster care only youth or probation only youth

11. Dual Status Youth Initiative: Development • Initial Grant - Raised awareness of the relationship and trajectory (2000) • Created a framework for multi-system coordination; Guidebook in 2004 • Supported site based practice reform beginning in 2003 (2003 - King County, WA; 2004 - Los Angeles County, CA) • Revised Guidebook (2008) • MfC - OJJDP 4-site Project launched (2011) • Revised Guidebook;Dual Status Youth -Technical Assistance Workbook (2013) 11 11/4/2014

12. Initial data that sparked interest at our local level! A snapshot of youth open to Juvenile Justice revealed that 64 % had child maltreatment history!

13. A Blended Perspective Historically child welfare focus is on safety and can be incident based. This work forced us to examine youth outcomes beyond safety.

14. Technical assistance project Sponsored jointly by the John D. and Catherine T MacArthur Foundation Models for Change and the Office of Juvenile Justice and Delinquency Prevention Four sites chosen for the project: • Outagamie Co., WI • Hampden Co., MA • Newton Co., GA • Santa Clara Co., CA

15. A RESOURCE TO GET US STARTED March 2012 Addressing the Needs of Multi-System Youth: Strengthening the Connection between Child Welfare and Juvenile Justice http://www.rfkchildren.org/our-work/national-partnerships/models-for-change or http://cjjr.georgetown.edu/resources.html 15

16. DUAL STATUS YOUTH INITIATIVE: Framework FOUR PHASE PROCESS: I. MOBILIZATION / ADVOCACY II. STUDY & ANALYSIS - Data Collection, Mgmt., & Performance Measurement - Resource Inventory & Assessment - Legal & Policy Analysis III. ACTION STRATEGY IV. IMPLEMENTATION Guidebook for Juvenile Justice & Child Welfare Systems Coordination & Integration: A Framework for Improved Outcomes (2004. Revised 2008) http://www.modelsforchange.net/publications/195 16

17. Goals: • Improved collaboration/integration between Child Welfare/Child Protection and Juvenile Justice services • Improved outcomes beyond safety & permanence: increased protective factors, increased community support, decreased risk of delinquency • Decrease in subsequent referrals for abuse & neglect • Decrease in out of home placements

18. I. MOBILIZATION / ADVOCACYCrucial Conversations Between Managers 1. Common sticky decision points between systems: • Screening decisions • Custody • Court • Case closure • Sacred Cows: The “untouchable” issues that preserve the status quo Important to form a strong alliance with agreement on how to go forward!

19. Organizational Culture Change • How do you pursue it? • What are you moving toward? • How do you take others along with you? • How do you communicate the vision of change? • What are the costs? • How fast should you move?

20. Culture Change: Step 1 Leadership • Role model how to have difficult discussions • Understand how expectations and limitations collide • Don’t assume, ask • Honor each other’s expertise • We do this to promote good outcomes for youth!!

21. Messages with Resonance • Fit the mission of the agency • Outline a course of action that is fundamentally logical & achievable • Connect staff with their core values (why they do this work) • Compel action from an ethical perspective • Offer opportunities for inclusion and input

22. Culture Change: Step 2 Vision of Change From To I

23. The work…. I. MOBILIZATION/ ADVOCACY

24. II. STUDY & ANALYSISOutagamie County Target Population Youth of any age (under 17 for delinquency) who are referred to Juvenile Intake for Delinquency or JIPS for the first time and who have had some Child Protective/Child Welfare involvement in Wisconsin that includes a “screened in” case. CPS/CW involvement is not limited to cases involving a substantiation of abuse or neglect.

25. II. STUDY & ANALYSISMapping

26. Critical Conversations Revisited with supervisors & staff Culture Change: Step 3 Common sticky decision points between systems • Screening decisions • Custody • Court • Case closure

27. III. ACTION STRATEGYPractice Improvements • Guiding Principle: Trauma-Informed Care • Two New Practice Protocols: • Coordinated Response to Intra-familial Sexual Abuse • Coordinated Case Planning

28. Practice Improvements

29. The Trauma Story Discuss here the questions and fears: “how do we identify and what do we do then???”

30. IV. IMPLEMENTATION Wisconsin Trauma Project

31. Wisconsin Trauma Project • Tier 1 - 30 clinicians trained in TF-CBT and participating in learning collaborative • Tier 2 - Three sessions of the NCTSN curriculum “Caring for Children who have experienced Trauma” to foster parents, biological parents and case workers • Tier 3 - Training offered agency based and to include community stakeholders

32. What is TF-CBT? An evidence-basedtrauma treatment proven to decrease symptoms of PTSD, anxiety, depression, and other child behavior problems…also proven to decrease shame, improveparenting skills, and strengthen the child-caregiver relationship. A sequencedtreatment with coping skills and gradual exposure preceding exposure.

33. Child Traumatic Stress & Foster Care • A national study of adult "foster care alumni" found higher rates of PTSD (21.5%) compared with the general population (4.5%) • Compare with rates in American war veterans: • 15% in Vietnam • 6% in Afghanistan • and 12-13% in Iraq • Foster care alumni have higher rates of major depression, social phobia, panic disorder, generalized anxiety, addiction, and bulimia (Pecora, et al., 2003)

34. Child Traumatic Stress & Foster Care • A study of children in foster care revealed PTSD: • 60% of sexually abused children • 42% of the physically abused children • 18% of foster children who had not experienced either type of abuse had PTSD(Dubner & Motta, 1999), possibly as a result of exposure to domestic or community violence (Marsenich, 2002) • 1 out of 3 children entering foster care, ages 6 to 8, met criteria for PTSD(Dale et al. 1999)

35. Neurobiology and Trauma Early trauma, prolonged separation and insecure attachment produce permanent changes in the neurochemistry of children that continue into adulthood: • a neurobiological sensitivity to loss • fear of abandonment • hyperarousal • sensitivity to environmental threat (Van der Kolk, 1987) Together, insecure attachment and early trauma produce extreme affective dysregulation with concomitant difficulty in modulating aggression in adults (Lawson, 2001, p. 505)

36. IV. IMPLEMENTATION The Data is compelling…. • Initial data was drawn manually • Our RFK project allowed for an expert to examine our data and compare it across sites • Commitment to collecting the data to continue to inform our practice • Intent to automate as much of the data as possible

37. Gender N = 92 8/31/14

38. Ethnicity

39. Age at First Referral

40. Average # of JJ Referrals

41. Desired Outcomes • Improved Educational Performance - (School attendance) • Reduced Recidivism - (Referrals to YFS in last 9 months) • Increase in Pro-social connections - (Youth connected to one or more programs) • Strengthening Families - (Reduce subsequent CPS referrals)

42. IV. IMPLEMENTATIONData Boot Camp Developing internal data systems that inter-connect can be a challenge: • eWiSACWIS • TCM • YASI Case Works Bringing the right people to the table to understand the options

43. Dual Status Youth Initiative: Framework Guidebook for Juvenile Justice and Child Welfare System Coordination and Integration: Framework for Improved Outcomes (Wiig, Janet K. and Tuell, John A. with Heldman, Jessica K., 3rd ed., 2013, Robert F. Kennedy Action Corps and Child Welfare League of America) www.rfknrcjj.org Dual Status Youth – Technical Assistance Workbook (Tuell, John A., Heldman, Jessica, and Wiig, Janet K., 2013, Robert F. Kennedy Action Corps)www.rfknrcjj.org Understanding Child Maltreatment and Juvenile Delinquency: From Research to Effective Program, Practice, and Systemic Solutions Child Welfare League of America,2003, Janet K. Wiig, C. S. Widom, with John A. Tuell http://modelsforchange.net/publications/207

44. Dual Status Youth Initiative: Activities Practice Network – Site-based personnel convening to highlight advances in reform, identify innovations, engage new sites, and explore legislative opportunities Technical Assistance / Consultation – Provide support for local & state jurisdictions using proven frameworks, tools, and resources Innovation Briefs: Effective Approaches to Secure Education / Schools as our Multi-System Reform Partner; Mentoring for Juvenile Justice System Involved Youth; Creating Cross-system Culture Change White Paper: Effective Use of Trauma Screening to Inform Care (released at the Symposium) Webinar / Webcast – RFK NRC for JJ Practice Networks featuring models or examples of innovative and successful approaches in the field Symposium – Recognizing Best Practices for Dual Status Youth

45. Opportunities • Application to be one of the next four sites nationally to do this work http://www.rfknrcjj.org/initiatives/

46. Next Steps • Continue to promote collaborative culture between YFS & CYF • Encourage & coach supervisors to practice cross-system consultation & problem solving • Review & improve existing protocols • Research & develop new protocols: information sharing, “one family, one judge”, etc.

47. Next Steps (cont’d) • Integrate what we are learning from the WI Trauma Project into our work with Dual-System youth • Begin participation with the RFK National Resource Center to bring our lessons learned to other jurisdictions

48. Resources • Doorways to Delinquency (Halemba & Siegel, 2011): http://www.ncjj.org/pdf/MFC/Doorways_to_Delinquency_2011.pdf • WWCFWisKids Policy Brief: “We Can Do Better”: http://www.wccf.org/publication/can-better-sharing-responsibility-better-meet-needs-dual-status-youth/ • RFK national Resource Center for Juvenile Justice: www.rfknrcjj.org • Center for Juvenile Justice Reform, Georgetown University: http://cjjr.georgetown.edu/ • Models for Change: www.modelsforchange.net

49. Discussion/Questions