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Making a Case for Why Trauma Isn't Fading Away

Kelly Decker, PhD, Clinical Psychologist, National Center for Child Traumatic Stress

Summary: Dr. Decker sets forth a blueprint for creating a trauma-informed court.

Child trauma [1] is endemic in the juvenile justice system. At least 75% of youth involved in the juvenile delinquency system have experienced traumatic victimization and 11–50% have developed posttraumatic stress disorder (PTSD). [2] Most court-involved youth have been repeatedly exposed to multiple types of traumas, also known as polyvictimization, before they even reach the juvenile justice system. [3] Therefore, it unfortunately appears that many youth are in the family court system due to a history of complex victimization.

The term complex trauma [4] describes both exposure to multiple traumatic events—often of an invasive, interpersonal nature—and the wide-ranging, long-term impactof this exposure (See Table). These events, such as physical and sexual abuse, profound neglect, witnessing domestic and community violence, separation from family members, and revictimization by others, are severe and pervasive. Since they frequently occur in the context of the child’s relationship with a caregiver, these events typically interfere with the child’s ability to form a secure attachment: a primary source of safety and stability that is essential for healthy physical and emotional development.

What's a Judge to Do?

Create a Trauma-Informed Court. Given that courts are often stressful environments that serve individuals with mental health needs, reducing undue physiological and psychological arousal and increasing safety is critical for developing a trauma-informed court. [5] Train staff across the entire spectrum of the court, from CASA volunteers to judicial officers, on how complex trauma impacts the court environment, its practices and policies.

Screen and Assess. Evidence-based trauma-informed assessment [6] involves evaluating the ways in which a youth’s functioning might have been affected by the experience of trauma. There are three dimensions on which a trauma-informed assessment might focus: a) whether a youth has been exposed to a life-threatening event; b) whether a youth displays symptoms associated with posttraumatic stress; and c) whether a youth meets the criteria for a formal diagnosis of PTSD. [7]

Although assessment is a term generally reserved for an evaluation that is performed by a trained mental health practitioner, we can also include screening under this heading, a procedure that can be carried out by anyone in the juvenile justice system (e.g., judges, probation officers, detention staff), with no specialized training or licensure required. Screening is appropriate for an evaluation of the extent to which a youth has been exposed to traumatic events or exhibits symptoms of posttraumatic stress, and thus warrants referral for a comprehensive assessment. In contrast, a qualified mental health professional is needed to determine a youth’s diagnostic status as well as to cast a wider net in assessing not only for trauma exposure and PTSD but also for related disorders. Screening generally takes place through the administration of a brief questionnaire, self-report or interview format, whereas the “gold standard” for diagnosis is the administration of a structured diagnostic interview protocol. [8]

Refer to Trauma-Informed Care. [9] Trauma-focused cognitive behavioral therapy (, is the most robustly investigated and empirically supported intervention for the treatment of trauma among youth. In addition, there are trauma-informed interventions designed to increase the awareness and responsiveness of juvenile justice staff and youth across various settings, such as the NCTSN Think Trauma Training, [10] Trauma Affective Regulation Guidelines for Education and Therapy of Adolescents (TARGET-A) [11] and Trauma and Grief Component Therapy for Adolescents (TGCT-A). [12]

Develop Trust. Being abused or neglected, separated from family members, placed in the homes of strangers, or incarcerated may lead some youth to distrust authority figures and make them reluctant to disclose personal information. As issues related to safety and trust are paramount for youth, they are likely to test judges and court staff to determine if they are honest and reliable, and it may take some time for staff to gain the trust and respect of these young people. Judges and court staff can acknowledge past experiences of loss and betrayal, let youth know that they have the right to choose what information that they want to share, and give youth the time and space they need to develop a trusting relationship with staff.

Be Mindful. Trauma impacts many important court decisions. [13] Consider how these decisions—especially removing a youth from their home and facing dependency court—can be, in themselves, traumatic events. Frequently, the court setting and/or legal process will trigger feelings of helplessness or loss of control in youth and parents, which can serve as reminders of previous trauma. Judges and court staff may observe youth and parents’ posttraumatic stress reactions in response to such reminders when in court. Experiences of trauma can affect a parent’s [14] confidence and ability to keep children safe, work effectively with judges and court staff, and respond to court expectations.

Take care. Judges are people too! All court staff, including judges, are susceptible to the emotional impact that results from repeatedly listening to the traumatic experiences of the youth and families that you serve. Implementation of both preventive and intervention strategies targeting vicarious or secondary traumatic stress [15] is paramount to creating and sustaining a trauma-informed court.


Author biography:

Kelly Decker, PhD, is a clinical psychologist at the National Center for Child Traumatic Stress at University of California, Los Angeles. The National Center is the coordinating agency for over 75 sites nationwide dedicated to improving access and increasing the standard of care for traumatized children and families. She specializes in evidence-based treatment of children, adults and families and her research interests include understanding the developmental consequences of childhood trauma and maltreatment with respect to mental illness, suicide and self-injury. Currently, she is serving as a member of the NCJFCJ Juvenile Drug Court Treatment Taskforce and consultant on their trauma audit pilot program for juvenile and family courts.



[1] The NCTSN defines trauma as events outside the typical range of human experience—that is, events involving actual or threatened risk to the life or physical integrity of individuals or someone close to them. Traumatic experiences may include, for example: unexpected death of a loved one, abuse and neglect, serious accidents, experiencing or witnessing interpersonal violence, house fires, combat injuries, natural disasters, acts of terrorism, and community violence.

[2] Teplin, LA, Abram, KM, McClelland, GM, Dulcan, MK, Mericle, AA (2002). Psychiatric Disorders in Youth in Juvenile Detention. Archives of General Psychiatry, 59, 1133-1143.

[3] Abram, KM, Teplin, LA, Charles, DR, Longworth, SL, McClelland, GM, & Dulcan, MK (2004). Posttraumatic stress disorder and trauma in youth in juvenile detention. Archives of General Psychiatry, 61, 403-410

[4] Cook, A., Blaustein, M., Spinazzola, J., & van der Kolk, B. (Eds.) (2003). Complex trauma in children and adolescents. National Child Traumatic Stress Network.

[5] See NCJFCJ's Trauma-Informed Court Audit Program at 

[6] Kerig, P.K. (2013). Trauma-Informed Assessment and Intervention. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.

[7] Per the American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing and World Health Organization (1993). ICD-10, the ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva: World Health Organization

[8] For information on specific screening and assessment measures of trauma, trauma reactions and related mental health symptoms/disorders See the NCTSN Measures Review Database.

[9] See NCTSN Empirically Supported Treatments and Promising Practices

[10] Marrow, M., Benamati, J., Decker, K., Griffin, D., and Lott, D. A. (2012). Think trauma: A training for staff in juvenile justice residential settings. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.

[11] Ford, J. D., & Hawke, J. (2012). Trauma affect regulation psychoeducation group and milieu intervention outcomes in juvenile detention facilities. Journal of Aggression, Maltreatment & Trauma, 21(4), 365-384. Marrow, M. T., Knudsen, K., Olafson, E., & Bucher, S. E. (2012). The value of implementing TARGET within a trauma-informed juvenile justice setting. Journal of Child and Adolescent Trauma, 5, 257-270.

[12] See Layne, Saltzman, Pynoos, Olafson and Boat (2015) Cambridge University Press.

[13] For example: temporary placement or custody, detention or hospitalization, residential or community based treatment, treatment and referrals to health and behavioral health services, transfers to adult criminal court, termination of parental rights and adoption, restoration and treatment for child victims, and visitation with maltreating adults or jail/prison visitation.

[14] National Child Traumatic Stress Network, Child Welfare Committee. (2013). Birth parents with trauma histories and the child welfare system: A guide for court-based child advocates. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.

[15] National Child Traumatic Stress Network, Secondary Traumatic Stress Committee. (2011). Secondary traumatic stress: A fact sheet for child-serving professionals. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress.

Common Traumatic Stress Reactions (By Age Group)

Young children (Birth–5 years)

  • Withdrawal and passivity
  • Exaggerated startle response
  • Aggressive outbursts
  • Sleep difficulties (including night terrors)
  • Separation anxiety
  • Fear of new situations
  • Difficulty assessing threats and finding protection (especially in cases where a parent or caretaker was aggressor)
  • Regression to previous behaviors (e.g., baby talk, bed-wetting, crying)

School-age children (6–12 years)

  • Abrupt and unpredictable shifts between withdrawn and aggressive behaviors
  • Social isolation and withdrawal (may be an attempt to avoid further trauma or reminders of past trauma)
  • Sleep disturbances that interfere with daytime concentration and attention
  • Preoccupation with the traumatic experience(s)
  • Intense, specific fears related to the traumatic event(s)

Adolescents (13–18 years) 

  • Increased risk taking (substance abuse, truancy, risky sexual behaviors)
  • Heightened sensitivity to perceived threats (may respond to seemingly neutral stimuli with aggression or hostility)
  • Social isolation (belief that they are unique and alone in their pain)
  • Withdrawal and emotional numbing
  • Low self esteem (may manifest as a sense of helplessness or hopelessness)

National Child Traumatic Stress Network, Justice System Consortium. (2009). Helping Traumatized Children: Tips for Judges. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress

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