1

Dawn Sias

Developing an Integrative Treatment Model Incorporating Rap Therapy and Selected

Components of Trauma-Focused Cognitive Behavior Therapy to Reduce Recidivism
Among Juvenile Delinquents

Date Approved: December 9, 2107

APPROVAL GRANTED BY:

Study Committee
Dr. Amy Vlach
Dr. Dawn Ellison
Dr. Jessica Cole

Oral Comprehensive Examination Committee

Dr. Amy Vlach
Dr. Dawn Ellison
Dr. Jessica Cole

Director of the Study

Dr. Amy Vlach

Dean of the Graduate School

Dr. Debbie C. Norris

 2

MISSISSIPPI COLLEGE

DEVELOPING AN INTEGRATIVE TREATMENT MODEL INCORPORATING RAP

THERAPY AND SELECTED COMPONENTS OF TRAUMA-FOCUSED COGNITIVE

BEHAVIOR THERAPY TO REDUCE RECIDIVISM AMONG JUVENILE DELINQUENTS

A PROJECT DEMONSTRATING EXCELLENCE

SUBMITTED TO THE

GRADUATE SCHOOL OF MISSISSIPPI COLLEGE

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS

FOR THE DEGREE OF

DOCTOR OF PROFESSIONAL COUNSELING

DEPARTMENT OF PSYCHOLOGY AND COUNSELING

BY

DAWN R. SIAS

CLINTON, MISSISSIPPI

DECEMBER 2017




ProQuest Number: 10687279




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 3

ACKNOWLEDGMENTS

First, and foremost, I would like to give honor and praises to God for giving me the strength and

elasticity to endure this powerful journey. I would also like to thank my parents, Donald &

Mildred Sias for their unconditional love and support. I dedicate this journey and achievement to

my late grandparents, Leo & Helen Sias, & Foster & Annie Norwood. I know I stood on the

shoulders of giants and know you all would be so proud!!!!!

 4

Developing an Integrative Treatment Model Incorporating Rap Therapy and Selected

Components of Trauma-Focused Cognitive Behavior Therapy to Address Recidivism in Juvenile

Delinquents

Dawn Sias

Mississippi College
 5

Abstract

Research has shown that throughout the juvenile justice system trauma and recidivism have been

common dominators among delinquent adolescents. The resulting psychological impact of

exposure to trauma may not always be addressed when a juvenile is incarcerated at a detention

center or jail. Juvenile delinquency remains a concern for communities around the nation

because offenders who repeat crimes are responsible for a large number of all severe crimes

where violence is involved. Because of the impact of Rap music influencing youth, it has

become a tool to help reach those who may have been deemed unreachable. This paper proposes

utilizing the Developmental Research Utilization Model (DRU) to create an integrative model

using selected components of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and

Rap Therapy to address the psychological impacts of trauma to help reduce recidivism in

delinquent adolescents.

Keywords: recidivism, delinquent, acute trauma, chronic trauma, complex trauma

Developmental Research and Utilization Model, emotional numbing

 6

TABLE OF CONTENT

CHAPTER 1: INTRODUCTION…..................................................................................11

Post-Traumatic Stress Disorder………………………………………………………… 12

Emotional Numbing……………………………………………………………………. 12

TF-CBT………………………………………..………………………………………...12

Rap Therapy……...……………………………..……………………………………….12

Recidivism……………………………………………………………………………….14

Statement of the Problem……………………………………………………………….. 15

Significance of the Study………………………………………………………………...15

Research Questions………………………………………………………………………16

Method…………………………………………………………………………………... 16

Definition of Terms……………………………………………………………………… 20

Organization of Remainder of Study………………………………………………….…..21

CHAPTER 2: REVIEW OF THE LITERATURE………………………………………..22

Adolescence……………………………………………………………………………….22

Trauma…………………………………………………………………………… 24

Types of Trauma………………………………………………………………… ..24

Impact of Trauma…………………………………………………………………..25

Statistics……………………………………………………………..……………..26

Effects of Trauma on the Brain…………………………………………………….26

Jurisdiction……………………………………………………………….………....28
 7

Law Enforcement………………………………………………………………..28

Punitive Juvenile Laws………………………………………………………….29

Post-Traumatic Stress Disorder…………………………………………………………29

PTSD in Adolescents……………………………………………………………29

Diagnostic Criteria………………………………………………………………30

Emotional Avoidance……………………………………………………………31

Intrusion………………………………………………………………………….31

Hyperarousal……………………………………………………………………..32

PTSD in the Juvenile Justice Population…………………………………………32

Comorbidity………………………………………………………………………32

Assessing Trauma in Adolescents………………………………………………..33

Emotional Numbness…………………………………………………………………….34

Callous-Unemotional Traits……………………………………………………...35

Secondary Psychopathy………………………………………………………….35

Betrayal Trauma Theory…………………………………………………………36

Juvenile Detention………………………………………………………………..37

Conduct Disorder…………………………………………………………………………38

Diagnostic Criteria………………………………………………………………..38

Onset……………………………………………………………………………...38

Specifying Classification…………………………………………………………39

Impacts…………………………………………………………………………....39

Risk Factors……………………………………………………………………….40

Recidivism………………………………………………………………………………...40
 8

Risk Factors………………………………………………………………………42

Family…………………………………………………………………………….42

Substance Abuse………………………………………………………………….43

Protective Factors…………………………………………………………………44

Individual Characteristics…………………………………………………………44

Social Characteristics…………………………………………………………..…44

Gender…………………………………………………………………………......45

Existing Treatments & Methods in Juvenile Justice System to Prevent Recidivism………46

TF-CBT……………………………………………………………………………..47

Parenting…………………………………………………………………………….48

Selective Active Ignoring……………………………………………………………49

Timeout………………………………………………………………………………49

Behavior Charting……………………………………………………………………49

Relaxation…………………………………………………………………………….50

Affective Modulation…………………………………………………………………50

Positive Self-Talk……………………………………………………………………..51

Thought Interruption………………………………………………………………….51

Cognitive Triangle……………………………………………………………………51

Trauma Narrative……………………………………………………………………..52

Cognitive Coping……………………………………………………………………..53

In Vivo Exposure & Mastery…………………………………………………………54

Conjoint Session………………………………………………………………………54
 9

Enhancing Safety……………………………………………………………………..55

Music Therapy………………………………………………………………………………..56

The History & Benefits of Rap Music………………………………………………..57

Stages…………………………………………………………………………………58

Assessment……………………………………………………………………………59

Alliance……………………………………………………………………………….59

Reframing……………………………………………………………………………..59

Role Play………………………………………………………………………………59

Action and Maintenance……………………………………………………………….60

Group Rap Therapy……………………………………………………………………60

CHAPTER 3: METHODOLOGY………………………………………………………….… 65

Developmental Research……………………………………………………………..………...65

Design-Based Research………………………………………………………………………...66

History of the Developmental & Research Utilization Model…………………………………67

Research Stage………………………………………………………………………….68

Analysis Phase…………………………………………………..……….……………..68

Developmental Phase…………………………………………………...........................69

Evaluation Phase………………………………………………………………………..69

Utilization Phase………………………………………………………………………..70

Diffusion Phase…………………………………………………………………………70

Adoption Phase…………………………………………………………………………70

CHAPTER 4: RESULTS……………………………………………………………………….73

Development of Powerful Minds Integrated Model……………………………………………74

 10

Analysis……………………………………………………………………………..…………74

Problematic Human Condtion………………………………………………………………….76

Statement of Problem…………………………………………………………………………..78

Product Preparation…………………………………………………………………….96

Product Realization…………………………………………………………………….96

Conclusion……………………………………………………………………………...96

CHAPTER 5: DISCUSSION…………………………………………………………………...97

Limitations………………………………………………………………………….…………..99

Implications and Recommendations………………………………………………..…………..99

Conclusion………………………………………………………………………….………….100

REFERENCES…………………………………………………………………………….…...101
 11

CHAPTER I: INTRODUCTION

According to the National Center for Mental Health (2006), trauma is a common

experience among youth in the juvenile justice system. The Diagnostic and Statistical Manual of

Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association [APA], 2013)

described trauma as “exposure to actual or threatened death, serious injury, or sexual violence”

(p. 143). Exposure to a traumatic event is an experience a majority of individuals will face at

some point during their lifetime. Trauma can be a result of mental and verbal abuse, neglect,

being a witness to violence, school violence, being bullied, grief, or separation. Research has

shown that many youth involved in the juvenile justice system have experienced traumatic

events in their lifetime and are suffering from Post-Traumatic Stress Disorder (PTSD)(National

Center for Mental Health, 2006).

Emotional numbing is a specific symptom included in the revised criteria for the

diagnosis of PTSD in the DSM-5 (APA, 2013). It established numbing as separate from the

symptoms of avoidance which was combined in the DSM-IV-TR (APA, 2000). Also, emotional

numbing has come to play a vital role in theoretical models attempting to explain the association

between exposure to childhood trauma and maladaptive outcomes in adolescence, particularly in

delinquent behavior and criminal justice system involvement. The numbing of emotions when

dealing with the aftermath of trauma may cause a dampening of youths’ awareness of distressing

emotions and increase the likelihood that youth will externalize that distress and act out against

others (Ford, Chapman, Connor, & Cruise, 2012; Lansford et al., 2006).
 12

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is a result of one experiencing or witnessing

severe injury or death. The DSM-5(APA, 2013) explained this disorder could also be a result of

learning that something traumatic happened to a close friend or member of one family. Intrusion

symptoms include distressing memories, dreams and flashbacks; also, persistent avoidance to

memories, thoughts, and feelings about the event. There also may be changes in the mood

because of the traumatic event, distorted thoughts, and feelings of detachment concerning

hobbies and people.

Up to 90% of justice-involved youth report exposure to some traumatic event. On

average, 70% of youth meet criteria for a mental health disorder with approximately 30%

of youth meeting criteria for post-traumatic stress disorder (PTSD). Justice-involved

youth are also at risk for substance use and academic problems, and child welfare

involvement (Dierkhising et al., 2013, p.1).

Emotional Numbing

The DSM-5 (APA, 2013) added emotional numbing as a part of PTSD criteria. Emotional

numbing as a specific symptom helped to inform the revised criteria for the diagnosis of

Posttraumatic Stress Disorder (The National Center for PTSD, 2016). It is viewed as a symptom

separate from avoidance symptoms when describing symptoms of PTSD (avoidance and

numbing were combined in the DSM-IV-TR). Also, emotional numbing is the common

denominator between trauma and disturbed and unbalanced youth.

Trauma-Focused Cognitive Behavior Therapy (TF-CBT)

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a form of Cognitive

Behavioral Therapy (CBT) that integrates families of children and adolescents who are
 13

experiencing significant emotional and behavioral difficulties related to traumatic life events into

the therapeutic process. It is a components-based treatment model that incorporates trauma-

sensitive interventions with cognitive-behavioral, family, and humanistic principles and

techniques (Cohen et al., 2006).Children and parents learn new skills to (a) help process thoughts

and feelings related to traumatic life events, (b) manage and resolve distressing thoughts,

feelings, and behaviors related traumatic life events, and (c) enhance safety, growth, parenting

skills, and family communication.

TF-CBT is “the most well-supported and effective treatment for children who have been

abused and traumatized” (Saunders et al., 2003, p.1). Research has shown over 80% of

traumatized children who receive TF-CBT experience significant improvement after 12 to 16

weeks of treatment (Cohen et al., 2006). Multiple clinical research studies have consistently

found it beneficial to children and adolescents with PTSD and other trauma-related problems.

TF-CBT is currently being used in community service agencies across the country (Cohen et al.,

2006). It has been shown to be effective in addressing PTSD, depression, anxiety, externalizing

behaviors, sexualized behaviors, feelings of shame, and mistrust (Cohen et al., 2006).

Rap Therapy

Rap music discusses an array of topics that speak to everyday life struggles and how to

overcome those struggles. The youth that created this genre of music had experienced extreme

adversities and used rap to excel and move past the negative aspects of their lives toward feelings

of resilience (Rose, 2008). Despite the negative connotations that coincide, rap music empowers

individuals and brings about feelings of resilience. It also has shown to positively change one’s

mood, decrease negative emotions, and bring about a mental place of peace (Gold, 2011).
 14

In 2000, Don Elligan introduced Rap Therapy as an intervention to work with at-risk

youth. This therapy resounded with that population due to its ability to help youth efficiently

identify and ventilate their feelings. This therapy is conducted in five stages (components): (a)

Assessment, (b) Alliance, (c) Reframing, (d) Role Play, and (e) Actions and Maintenance.

Through hip-hop and music, rap therapy helped to make the relationship between the counselor

and the juvenile cohesive. For at-risk youth, the awareness aids in their ability to be reflective

and allows them to effectively problem solve (Elligan, 2000). The ability to achieve goals while

facing trials is a compelling story that gives one hope. Being able to use this form of storytelling

is extremely relevant to those youths who feel that they have been deemed incorrigible by

society.

Recidivism

Research has illustrated that juvenile delinquency tends to occur when youth are exposed

to risk factors such as negative parenting strategies and negative emotionality. Exposure to risk

factors increases the chances to offend and cause juveniles to recidivate, especially when a

juvenile’s childhood experiences are filled with adversity (Baglivio et al., 2015). Previous work

has also implied that traumatic experiences during childhood—such as emotional, physical, and

sexual abuse, and being raised in a poverty-stricken environment—are a catalyst that may cause

difficulty with the expression of emotions, anger, impulsive and erratic conduct among

institutionalized juvenile offenders (DeLisi et al., 2011). These individuals have been found to

re-offend and to re-offend in a shorter amount of time than those who have completed a

community-based program that focuses on ceasing delinquency (Wolff et al., 2017). These

realities help one to understand the difference between what initially causes a juvenile to offend

from what causes the juvenile to re-offend (Wolff & Baglivio, 2016).
 15

Researchers are devoted to uncovering the relationship between delinquency and

reducing recidivism. It is the identification of these factors that will increase the understanding of

how maltreatment during childhood contributes to delinquency and yield insights into what can

interrupt the cycle among youth who have exposure to traumatic events.

Statement of the Problem

The problem of this study was developing an integrative treatment model integrating Rap

Therapy and selected components of TF-CBT to address recidivism among juvenile delinquents.

Significance of the Study

The incidence of PTSD among youth in the juvenile justice system is similar to youth in

the mental health and substance abuse systems, but up to eight times higher than comparably

aged youth in the general, community population (National Center for Mental Health, 2006).

Emotional numbing provides some insight as to why recidivism occurs among juvenile

offenders. When one suffers trauma, they may experience PTSD; that is when the possibility of

emotional numbing begins to take place. If there is lack of empathy for others, there will be no

problem with causing distress or acting out against another person.

Integrating TF-CBT and rap therapy may help at-risk youth better understand the need to

express their feelings, cope with possible trauma and obstacles, and could help decrease the

emotional numbing while awakening their sensitivity concerning themselves and others. The

importance of integrating rap therapy with a cognitive behavioral model is that the clients

become aware of the association between personal lyric interpretation, their emotions, and at-risk

behaviors. This awareness aids in their ability to be reflective and allows them to efficiently

problem solve.
 16

Research Questions

The research questions addressed in this study are as follows:

1. What are the core components of Rap Therapy for addressing recidivism in juvenile

delinquents?

2. What selected components of TF-CBT address recidivism in juvenile delinquents?

3. How can the core components of Rap Therapy be integrated with selected components of

TF-CBT to develop a treatment model for addressing recidivism in juvenile delinquents?

Methodology

Evidence-based practice (EBP) is “the integration of the best available research with

clinical expertise in the context of patient characteristics, culture, and preferences” (APA, 2006,

p.273). EBP is considered extremely important in counseling and psychotherapy; but the ability

to translate research into practice is often overlooked (Ohmer & Korr, 2006). Researchers use

several terms to describe their best effort to implement a scientific result in practice: diffusion,

dissemination, utilization, exchange interaction, mobilization, and knowledge transfer (Jansson

et al., 2010).

Developmental research is a critical element of many organizations that, when well-

planned and used, helps support treatments used to build programs and services throughout many

clinical arenas. Developmental research “involves the development, testing, evaluation, and

modification of new models of practice” (Gilgun& Sands, 2012, p. 349). Developmental research

pays attention to a particular product for the learner or the organization, and gears towards a

general examination of the design of the product as a whole or as components.

 17

Developmental and Research Utilization (DRU) Model

The Developmental and Research Utilization (DRU) Model (see Table 1) originated at

the Institute for Social Research at the University of Michigan(Southern, 2007). It has been a

guide in community psychology and education for over 40 years (Gomez, 2007). It was adopted

by Southern (2007) at Texas A & M University, to use in program development, evaluation, and

consultation. The model has two stages (Research and Utilization) divided into five phases that

address activities, concerns, and operations at each level.

Phase I (analysis) and Phase II (development) will guide the process of integrating

components of TF-CBT and Rap Therapy. Development includes the following: extensive

literature review, descriptions of the views of service providers who currently work with the

population / problem under study, examination of risks and protective factors, novel assembly or

the addition of novel components, and construction of a prototype, product, or manual (Gilgun &

Sands, 2012; Southern, 2007).

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Table 1.

Developmental Research and Utilization Model

________________________________________________________________

Phase Concerns Operations Activities

Research
I. Analysis A. Problematic 1. Problem statement Problem analysis and identification;

Human Condition State-of-the-art review

B. Basic Information 2. Information selection Selection of basic or applied research,

Source technology, or practice experience;

Selection of product language, goals,

and objectives

II. Development C. Relevant Data 3. Information gathering Literature review, site visitation, or

assessment

D. Product Design 4. Product innovation Novel assembly, application, or

invention

E. Product Preparation 5. Product realization Construction of prototype, product, or

statement of procedures

III. Evaluation F. Field Trial 6. Trial application Pilot implementation or demonstration

7. Data collection Collection of relevant data from trial

G. Outcome Analysis 8. Product evaluation Empirical research study, program

evaluation, process review, or policy

analysis

Utilization
IV. Diffusion H. Diffusion Media 9. Diffusion media Preparation of guides, manuals, or

preparation training materials

10. Information Demonstration, professional

dissemination presentation, or publication

V. Adoption I. Product Acceptance 11. Implementation by Systematic use by practitioners;

Users Monitoring of adherence or

compliance;
 19

Administrative support

J. Product Renewal 12. Institutionalization Maintenance of community, staff, and

administrative support for product;

Follow-up, periodic review, and quality

control;

Revision or expansion of product;

Ongoing participation in planned change

________________________________________________________________

Note. This developmental research model was supplied by Southern (2007).

Research Stage

The research stage addresses concerns through activities defining the details involved

which are consistent with other methods of research. The research stage is broken into three

phases: analysis, development, and evaluation. Analysis helps the researcher narrow down what

was once a broad scope, so that the specialization can be more defined and specific. It also helps

bring forth the possibility of new procedures and programs. The analysis should identify an issue

or opportunity, explore its history or background, and provide a convincing and persuasive

argument that this problem is significant and worth research (Herrington et al., 2007).

In the development phase, the researcher decides how to move forward with the area of

specialization. Also, the framework for the theory becomes evident and may provide a

foundation for the proposed solution. Once made clear what the problem is, reviewing the data

begins. The final phase of the research stage of the DRU is evaluation. It is the systematic

process of determining the equality and effectiveness of the program (Hur & Suh, 2010, p.4).It

involves implementation, data collection, and evaluation of the information that has researched

and possibly been a part of a field trial. At times, some pilot testing may be done to see if the

product or activity is sufficient.

 20

Utilization Stage

The utilization stage consists of two phases: diffusion and adoption. Along with analysis,

development, and evaluation phases of the DRU model, dissemination and adoption work

together to help further inform the researcher on whether a particular study may be implemented.

In the diffusion phase, the research looks at possible breakthroughs that may be found

and could be tested for possible implementation. Researchers engage in exercises to support

information dissemination and diffusion media preparation (Southern, 2007). Activities include

product demonstration, research findings publication, and product presentation. Construction of

product material for testing and circulation may be accomplished if not previously realized

within the development phase. There are two concerns addressed: product, acceptance and

product renewal (Southern, 2007). Product acceptance involves ensuring compliance, monitoring

and implementing product use. Product renewal involves system product review and support.

Definitions of Terms

Trauma is defined as “exposure to actual or threatened death, serious injury, or sexual

violence” (APA, 2013, p.143).

Acute trauma is defined as a single traumatic experience that is limited in time. An

earthquake, dog bite, or motor vehicle accident are all examples of acute traumas (Child Welfare

Committee, 2008).

Chronic trauma is multiple and varied (traumatic) events such as a child who is exposed

to domestic violence at home, is involved in a car accident, and then becomes a victim of

community violence (Child Welfare Committee, 2008).

Complex trauma is a term used by some experts to describe both exposure to chronic

trauma-usually caused by adults entrusted with the child’s care, such as parents or caregivers and
 21

the immediate and long-term impact of such exposure on the child (Child Welfare Committee,

2008).

Emotional numbing is defined as dampening of a one’s awareness of distressing emotions

(Ford, Chapman, Connor, & Cruise, 2012; Lansford et al., 2006).

Developmental research “involves the development, testing, evaluation, and modification

of new models of practice” (Gilgun & Sands, 2012, p. 349).

Juvenile delinquency is “a status determined both by age (less than the legal age

ofmajority) and behavior (actions that violate the law) and a separate legal system that include

juvenile courts and reformatories” (Burfiend & Bartusch, 2015, p. 17).

Recidivismi s “most commonly measured regarding rearrests, referrals to court,

reconvictions, or confinement” (Snyder&Sickmund, 2006, p. 234).

Organization of Remainder of Study

This chapter provides an introduction to trauma and how it has affected juveniles in the

justice system, statement of the problem, research questions, the significance of the study, a

description of the method, and definition of terms. Chapter 2 offers an extensive review of the

literature related to (a) the impact of trauma, (b) risk factors that increase chances of juvenile

delinquency, (c) benefits of TF-CBT, and (d) influence of music/rap. The research methodology

is discussed in Chapter 3. Chapter 4 will provide the results of the research. Chapter 5 includes a

discussion of the results, implications of findings, and recommendations for future program

implementation.
 22

CHAPTER II: LITERATURE REVIEW

Research has shown that many youths involved in the juvenile justice system have been

victims of trauma and suffered from PTSD (National Center for Mental Health, 2006).

According to the National Center for Mental Health Promotion and Youth Violence Prevention

(2012), 60% of adults report experiencing abuse or other difficult family circumstances during

childhood. While trauma plagues juveniles in the youth court system, so do mental health issues.

The incidence of PTSD among youth in the juvenile justice system is similar to youth in the

mental health and substance abuse systems, but up to eight times higher than comparably aged

youth in the general, community population (National Center for Mental Health, 2006, p.6).

Systems that are trauma-informed understand how the impact of traumatic stress may

take a toll on individuals mentally and emotionally-- crippling their ability to develop nurturing

relationships with family and friends. Many youths have experienced some form of trauma in the

juvenile justice system. Traumatic events and how they may influence a youth’s actions may be

overlooked. It is essential that juvenile courts work to understand how the implementation of

therapy that focuses on trauma would possibly help decrease the number of repeat offenders and

decrease the percentage of recidivism.

Adolescence

Erik Erikson’s psychosocial theory of development examined the significance of external

elements, parents, and society on personality maturation from childhood to adulthood. According

to Erikson’s theory, every individual must progress through the following sequence of eight

interconnected stages over one’s entire lifespan: (a) Trust versus Mistrust; (b) Autonomy versus

Shame and Doubt; (c) Initiative versus Guilt; (d) Industry versus Inferiority; (e) Identity versus
 23

Role Confusion; (f) Intimacy versus Isolation; (g) Generativity versus Stagnation; and (h) Ego

Integrity versus Despair (Davey, 2014).

Ego Identity versus Role Confusion is the fifth stage, defined as the adolescent stage

(ages 12 to 18). Erickson stated that if a child can merge their identities and roles from the past

stages, they will accomplish this stage (Turns & Kimmes, 2014). If they were not able to

integrate, they would facediffusion of their identity. He explained that in a complicated society,

adolescents experience identity crisis--where children pore over characteristics that define who

they are from past stages and incorporate them into the emerging identity. If a child’s choices are

limited and he does not receive encouragement from parents, he may lose a sense of direction

and will be unequipped to be prepared for challenges faced in adulthood (Erickson, 1959).

During the Ego Identity versus Role Confusion stage, identity becomes extremely

important. Adolescents begin to seek more independence, begin to think about the decisions they

make concerning their future, and become more serious about relationships (Eriksonmuch,1959).

Also, physical, social, and cognitive development occurs (American Academy of Child and

Adolescents Facts for Families, 2008). The body and voice begin to change, and identity

becomes a struggle. There is a desire for increased privacy, and concern about one’s appearance.

Children began to see the world and their parents differently; they began to understand

that their parents and people are not perfect. There is an increased influence of peer groups, a

struggle to fit in to gain approval. Research has shown that a strong sense of identity stems from

positive thoughts of self, which coincides with the better mental health of adolescents. Positive

relationships with their peer group are also associated with an adolescent’s inner and

psychological wellness (American Academy of Child and Adolescents Facts for Families, 2008).
 24

Resolution of the Ego Identity versus Role Confusion stage will lead to fidelity (McLeod,

2013). Fidelity involves one being able to believe in one’s self while accepting others, even

though they may have different views. During this stage, adolescents search for practicality and

may base some of their identity on the results of their experiences. Failed attempts to create a

strong sense of self within society may lead to role confusion. As a result, the adolescent may

become rebellious, and form a negative identity (McLeod, 2013).

Due to an adverse identity, deviance may become an issue because the child wants to be

accepted by his/her peers. When this occurs, deviant adolescents began to associate with other

deviant adolescents. Lack of stability in the home, traumatic events, and family dynamics all

play a role in the child’s susceptibility to deviant behavior. Gangs and cliques may begin to form

and the discussion around breaking the rules and law become action (Dodge et al., 2006).

Trauma

Trauma is an emotional response to a terrible event like an accident, rape, or natural

disaster immediately after the event; shock and denial are typical (APA, 2013). No matter what

form of trauma has taken place, the symptoms of PTSD may still be displayed including

flashbacks, nausea, headaches, unpredictable emotions, and difficulty building and maintaining

relationships. The type of trauma is then specified.

Types of Trauma

If someone ends up bitten by a dog or is in a car accident that would be defined as acute

trauma, due to those incidents being a single traumatic experience in a short time span (Child

Welfare Committee, 2008). When trauma has been experienced multiple times, it then is defined

as chronic trauma. Chronic trauma does not have to be at a specific time or on particular days of

the week. Rather, it is being exposed to the same negative and stressful event repeatedly (Child
 25

Welfare Committee, 2008). When chronic trauma and intense trauma such as sexual and physical

abuse are fused together, that is referred to as complex trauma, due to the two forms of trauma

being present simultaneously (Child Welfare Committee, 2008).

Impact of Trauma in Adolescence

When a child experiences trauma, the way he/she views the world, processes thoughts, and

views others may change. These changes play a role in how a child may embark on a negative

path. A traumatized child may grow into becoming hyper-vigilant and pay more attention to

hostile cues and may assume what the other person may be thinking or feeling without observing

the other person’s behavior. They tend to perceive others as aggressive and not feel that they are

or can be overly aggressive. This pattern of thinking may help them justify their level of

aggression (Baer & Maschi, 2003).

The youth also struggles to solve problems effectively, typically using aggression to

make decisions rather than calmly rationalizing situations. The shortfall, as it relates to

displaying the ability to problem-solve, is evident in traumatized youth by their criminal activity

and acting out (Janoff-Bulman, 1992). Distorted thoughts tend to occur in traumatized aggressive

children due to their cognitive rules for predicting, interpreting, responding to, and controlling

other aspects of the earlier trauma including emotionality, and specifically the idea that others

are hostile towards them (Baer &Maschi, 2003). They may engage in self-destructive behavior,

and view justified consequences they receive as unfair-- due to having developed the notion that

they are unworthy of happiness. Substance abuse, self-injurious behavior, and incarceration may

be a form of self-inflicted punishment (Janoff-Bulman, 1992). There may even be an inflated

self-esteem.
 26

Statistics

While physical and sexual assault continues to be the most reported traumatic events to

occur, there are issues surrounding maltreatment by a parent/legal guardian, bullying, or being a

witness to some form of violence in the home or the community. Within the past ten years,

research has moved outside of just studying specific traumatic events that only surround sexual

and physical abuse to studying many forms of victimization that plague our nation’s youth

(Turner, Finkelhor, & Ormrod, 2006). According to the U.S. Administration for Children and

Families, Child Maltreatment (2015), there were an estimated 683,000 children who were

neglect and abuse victims in 2015. Approximately 8.4% suffered sexual abuse and 17.2%

suffered physical abuse. Of the substantiated cases of child maltreatment, 78.1% of those

children’s parents were the perpetrators. About 20.8% (more than 1 out of 5) children report

being bullied (National Center for Educational Statistics, 2016). In 2015, of students who were

the 9th-12th grade, 2.9% reported being a victim of an assault which resulted in the individual

having to receive medical care (National Center for Injury Prevention and Control Division of

Violence Prevention, 2016).

Effects of Trauma on the Developing Brain of Adolescents

Traumatizing experiences in the early stages of life may expose individuals to emotional,

cognitive, and somatic problems later in life. These experiences also are compelling predictors of

psychiatric illness. The effects of psychological trauma on the developing human brain are less

known, and a challenging question is whether the effects can be reversed or even prevented

(Thomason & Marusak, 2017). However, there has been a growing increase of research that is

now highlighting the observable change in the neurological structure and function of the brain

due to trauma (Thomason & Marusak, 2017). “Data from studies show childhood adversity can
 27

have a long-lasting impact on brain structure and functioning...Structural MRI studies in

traumatized children and adolescents have found abnormalities in some brain regions” (Rinne-

Albers et al., p.745).

Children and adolescents who endured psychological trauma had structural abnormalities

to the corpus callosum (Thomas & Marusak, 2017). The corpus callosum connects the two

hemispheres of the brain. Research explained that children and adolescents who have been

traumatized show reduction in connectivity of the corpus callosum. Findings also clarify there

are gender-specific structural abnormalities according to the stage in development that the

neglect and abuse occurred (Jackowski et al., 2009). Findings of reduced volume in some of the

studies in children and adolescents “showed an association between maltreatment and a

reduction in predominantly left dorsal medial prefrontal cortex volume in a study with adults

reporting childhood emotional maltreatment” (van Harmelen. et al., 2010, p. 834).

When the total brain was closely examined, it displayed diminishing volume within the

cerebral area along with other findings for those youth who suffered constant psychological

trauma and PTSD (Mehta et al., 2009). The sensory cortex engages perception processing. A

study showed that this area of the brain might be affected by extreme traumatic exposure in early

childhood (Mehta et al., 2009). Thismakes the case that “differences in structure and functioning

of the sensory cortex influence the vulnerability to traumatization due to a history of

psychological trauma” (Mehta. et al., 2009, p. 944).

The cerebellum assists with motor and emotional action. Carrion et al. (2009) reported

that the volume of the cerebellum decreased in youth who experienced mistreatment related to

trauma more than in youth with generalized anxiety disorder. Marsh et al. (2008) studied the

amygdala, the integrative section of the brain. This part of the brain plays a role in one’s
 28

motivation and emotions and how one processes the severity and possibility of being harmed and

fear conditioning. Their results showed deformity with affective disorders.

Cultural Differences

African-Americans, Hispanics, Asians, Pacific Islanders, and Native Americans comprise

a combined one-third of the nation’s youth population. Yet, they account for over two-thirds of

the youth in juvenile facilities (Armour & Hammond, 2009). Many explanations have come forth

as to why minority delinquents tend to have more involvement in the juvenile justice system.

They range from specific interaction from the police, jurisdictional issues, and detected racial

bias.

Jurisdiction

Harsher consequences tend to be more likely for cases adjudicated in urban areas than

adjudicated cases in non-urban areas. Due to minority juveniles living in those urban areas, a

geographic effect influences the representation of minorities. Another factor related to

urbanization is the visibility and location of minority youth committing crimes. According to

Armour and Hammond (2009), the Office of Juvenile Justice and Delinquency Prevention

(OJJDP) reported that Caucasian youth tend to sell and use drugs within the home, whereas

minority youth are more likely to stand on the street corners or a familiar neighborhood where

they may gather. Approximately 76% of African-American boys have chances of being involved

in the juvenile justice system. Compared to Caucasian youth, African American youth were more

likely to be arrested and placed in a juvenile detention facility (Yampolskaya, 2012).

Law enforcement

Armour and Hammond (2009) stated the OJJDP report arrest rate statistics showed

African-American youth were arrested at higher rates than Caucasian youth. This situation is due
 29

to low-income urban neighborhoods being targeted. Police use group arrest strategies that may

be out of proportion. Even though Caucasian youth are just as likely to be involved with the

selling and use of illegal drugs, African-American youth are arrested for drug crimes at twice the

rate; minority youth commit more crimes.

Punitive juvenile laws

Some states put the automatic transfer law into place due to the increase in juvenile

homicides with firearm use. This law made it easier for the youth to be tried and sentenced as

adults. With this automatic transfer, Armour and Hammond (2009) stated that the OJJDP data

reported that African-American and Native American Youth were convicted of gun and drug-

related crimes.

Posttraumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is described as “exposure to actual or threatened

death, serious injury, or sexual violence” (APA, 2013, p. 143). The National Center for PTSD

(2012) explained that, while PTSD may occur within the first few days or weeks after the

traumatic event, sometimes the symptoms may not manifest until some years later.

PTSD in Adolescents

Adolescents may develop PTSD as a result of living through an event where someone

they knew was significantly injured or was even killed. Also, events such as floods, school

shootings, car accidents, fires, a friend’s suicide, learning of a diagnosis that could affect a loved

one’s health, or seeing violence in the area that they live may cause PTSD. Guilt for having

survived an event where a friend or a family member may have died may also contribute to

PTSD.
 30

There are factors influencing chances a child may get PTSD including the severity of the

trauma, the parent’s reaction to the trauma, and how far away from or close to the trauma the

child was. Also, the chances of developing PTSD and how severe it is vary based on family and

social support, family history, personality, childhood experience, the current level of stress, and

the nature of the traumatic event (The National Center for PTSD, 2016).

The National Center for PTSD (2016) also explained that adolescents might not have

flashbacks or have problems remembering the details of the trauma as adults do. They may,

however, change the order of the event or begin to think about possible signs that gave a hint the

event was going to occur and may start to look for those same signs again in hopes they can

avoid future trauma. For children, they may keep repeating a particular part of the trauma while

playing or take pieces of the trauma and make it a part of their daily lives. For example, a child

may have witnessed a school shooting. The child may want to play games where a gun is

involved or even want to take a gun to school. A significant difference between adolescents and

children is that adolescents may become more impulsive and agitated. They may also become

withdrawn, do self-harm, and abuse drugs or alcohol (Burfeind, J., & Bartusch, D. J., 2015).

Diagnostic Criteria

The DSM-5 (APA, 2013) described PTSD symptoms as witnessing or directly

experiencing including flashbacks traumatic event(s). PTSD may also occur due to learning that

a close family member or friend has endured the traumatic event(s). The individual may feel that

there is some threat to their or their loved one’s well-being through injury, harm, or death. The

individual may also feel helpless. When these types of incidents occur, one may develop an array

of symptoms that will affect their views surrounding the event and themselves. PTSD symptoms

are described in three categories: emotional avoidance, intrusion, and hyperarousal.

 31

Emotional Avoidance

The DSM-5 (APA, 2013) explained that avoidance is a symptom related to PTSD and

emotional numbing. There is a loss of interest in once positive and pleasurable activities. Where

there was once closeness to others, that feeling has diminished. The individual may also have

difficulty expressing feelings. They will take extra precaution to ensure that they can prevent

feelings of shame, fear, and sadness.

Due to children’s inability to efficiently describe how they feel, their behavior may

negatively shift, becoming aggressive and irritable. These adolescents may not be able to identify

when the traumatic experience occurred. They may also lose the anticipation of participating in

activities with their peers and feel that they are viewed as awkward (APA, 2013).

Intrusion

This particular symptom is involuntary and undesirable to a trauma victim. The DSM-5

(APA, 2013) explains that with intrusive symptoms, people may feel as though they are reliving

the traumatic experience again. Intrusion typically occurs during distressing memories or

thoughts surrounding the event(s). Unwanted flashbacks and painful images may also plague the

victim due to the intensity of trauma.The victim may experience psychological and physiological

(rapid heartbeat and dizziness) stress when the mind and body are triggered to think about the

trauma.

Children may reenact the event during play, perform acts that are symbolically related to

the event, and report having bad dreams. They may not have a fearful reaction as an adult, but

the parent may report a change in the child’s emotions and behaviors (APA, 2013).
 32

Hyperarousal

Agitation, difficulty sleeping, difficulty concentrating, hypervigilance, becoming angered

easily, and being irritated all describe hyperarousal (APA, 2013). These symptoms might occur

due to the trauma victim’s physiology being in high gear. Due to the psychological damage that

happened during the event, the victim may display an inability to reset and center their emotions.

During hyperarousal, the DSM-5 (APA, 2013) explained the individual may have

recurrent feelings of being detached from the outside world. They may feel as if they are in a

dream and have lost touch with reality. The world around them may seem unreal and distant.

PTSD in the Juvenile Justice Population

PTSD is rampant among adolescents involved in the juvenile justice system (Ford et al.,

2008). At least 90% of youth who have justice court involvement have voiced being exposed to

some form of trauma, with at least 30% of them meeting PTSD criteria (Dierkhising et al., 2013).

Within the past 10 years, there is a sustained increase in recognition that trauma experience(s) is

a commonality among juveniles involved in the justice system, therefore bringing about an

increased effort to implement programs that focus on addressing trauma(National Center for

Mental Health and Juvenile Justice, 2016).

Comorbidity

Research has shown that PTSD and comorbid disorders coincide among detained youth

(Emanuel, 2007). In the juvenile detention centers, about two-thirds of males and three-quarters

of females suffer from one or more psychiatric disorders (Teplin et al., 2002). Males and females

with PTSD were more likely to have a substance use disorder, alcohol use disorder, or both

alcohol and drug use disorder than those who were not diagnosed with PTSD (Emanuel, 2007).

Typically, PTSD is the disorder that is co-occurring with the other psychiatric disorders
 33

(Giaconia et al., 2000). Over 90% of detained youth had least one form of comorbid psychiatric

disorder and had experienced at least one traumatic event, while over 50% had two or more

(Abram et al., 2013).

Comorbid disorders have an unfortunate impact on the treatment and outcome of the

individual with PTSD. Youth with comorbid disorders and PTSD have significantly more health

problems, behavior issues, and strained interpersonal relationships in comparison to those with

no comorbid disorders with only a PTSD diagnosis (Giaconia et al., 2000).

Comorbidity and continuance of care within the juvenile delinquent population is needed

for several reasons. First, individuals with comorbid disorders are less likely to positively

respond to traditional treatments than those who have only been diagnosed with one disorder and

more difficult to find placement due to the complexity of their needs being met (US Department

of Health and Human Services, 2010). Secondly, due to the secondary diagnostic predictors not

being identified at the onset of assessment will result in ramifications for prevention and

treatment--meaning that the juvenile may only receive inpatient, acute treatment for just 14 days

as opposed to long-term care (Copeland et al., 2009). Third, studies from the correctional

population show data proving females have associated trauma issues that need addressing due to

the increase of female justice court involvement by 30% (US Department of Health and Human

Services,2009).

Assessing Trauma in Adolescents

Many tools assess trauma in adolescents that can be used to evaluate traumatic stress

among youth in the juvenile justice system. The Massachusetts Youth Screening Instrument,

Traumatic Events Screening Inventory (TESI), Trauma Symptoms Checklist for Children

(TSCC) and PTSD Checklist for Children/Parent Report (PCIC/PR) are all tools that have been
 34

used to assess trauma and stress in adolescents within the juvenile justice system (Wevodau,

2016). Due to trauma symptoms possibly being interpreted as some form of anxiety or other

disorder, these assessments make it possible to specify what type of traumatic experience the

child may have had. They help identify what possible mental health concerns the adolescent may

have and how they are related to PTSD.

Assessing the child helps to assess the family within the domains of their lives. What

tends to be exposed during some of the tests is that the child’s caregiver may have had some of

the same trauma exposure when they were children themselves and may need some resolving of

their distress about their child’s recent exposure. Most parents do not want their child to

experience or be witness to any form of trauma. Unfortunately, due to the parent(s) not receiving

any form of psychological help when they were children and lacking the knowledge about

coping strategies, the possibility of the vicious cycle of exposure continues (Williamson et al.,

2016).

Emotional Numbing

Emotional numbing helped to inform the revised criteria for the diagnosis of PTSD in the

DSM-5(APA, 2013) by establishing that numbing should be considered separately from the

symptoms of avoidance with which was combined in the DSM-IV-TR (APA, 2000). Also,

emotional numbing has become a significant factor in theoretical models that attempt to explain

the association between childhood trauma exposure and maladaptive outcomes in adolescence as

it relates to justice system involvement and delinquent behavior. It explained emotional

numbness tends to occur as a defense strategy after enduring trauma. Even though numbing may

decrease the youth’s awareness of the event, it may increase the likelihood the adolescent will

display the distress outwardly and react irrationally to others (Kerig et al., 2010).
 35

Feeling emotionally numb can be a possible symptom when having different medical

issues or side effects stemming from the medication (Maciejewski & Prigerson, 2013). Anxiety

and depression are the common causes as to why numbing may occur--which may cause the

depletion of both physical and emotional energy (Gotter, 2107). It can cause emotional

disconnect or isolation from others. When stress occurs, the body may become physically and

emotionally fatigued. It is, at times, described as despondency where one may feel that they have

no definite future (Gotter, 2017).

Callous-Unemotional Traits

Research confirmed that there is a link between juvenile delinquency and trauma (Kerig

et al., 2012). Further research stated that, in this regard, delinquent youth exhibit symptoms of

PTSD and callous-unemotional traits (CU). The term CU is used to describe a lack of remorse,

understanding, or empathy for others (Frick et al., 2014). It is also described as “having a lack of

response to punishment, and deficits in emotional processing particularly related to anxiety”

(Frick & Marsee, 2006, p. 353). CU is associated with the most troublesome and uncontrollable

youth who offend and are resistant to, versus being a product of, social experience (Blair, 1999).

CU is believed to be the reason behind those who constantly violate laws and rights of others,

due to diminished sensitivity to others’ anguish and suffering (Blair, 1999). Among youth

involved with the juvenile justice system, those high in CU traits are thought to have a stable,

severe, and aggressive trajectory (Frick & White, 2008).

Secondary psychopathy

In contrast, there is secondary psychopathy- referred to as acquired callousness- which

suggests that youth who have experienced trauma exposure might intentionally develop

emotional detachment as a defense mechanism to shield them from enormous stress (Kerig &
 36

Becker, 2010). It was proposed that secondary psychopathy may stem from environmental

factors such as family dysfunction and peer rejection (Krishcher & Sevecke, 2008). Ford,

Chapman, Mack, and Pearson (2006) explained youth that had been chronically victimized may

create a facade of callousness, aggression, and participation in risk-taking acts as a means of

survival coping.

A juvenile with secondary psychopathy traits may participate in antisocial acts as an

escape from emotionally driven situations that they feel are too difficult for them to handle.

Krischer and Sevecke (2008) explainedin earlier research that callousness was not associated

with unfortunate childhood experiences; recent research, however, has shown that there is a link

between early childhood trauma and CU traits. Bennett and Kerig’s (2014) study of 417 detained

adolescents was consistent with the findings in Porter’s research done in 1996 which showed

youth who have acquired CU traits still displayed an ability to recognize other’s disgusts and

were able to identify one’s emotions based on facial expressions. However, these youth had

difficulty expressing their own emotions; instead, they displayed toughness and avoided

discussing feelings of vulnerability felt after suffering trauma themselves (Ford et al., 2006).

Betrayal Trauma Theory

Goldsmith, Freyd, and DePrince (2012) stated that CU, emotional numbing, trauma

exposure, and betrayal trauma theory were all intertwined. Betrayal trauma theory proposed that

emotional detachment may stem from interpersonal traumas committed by someone with whom

the youth may have had a close relationship. A betrayal of trust can be extremely damaging. If

the youth acknowledges the trauma and hurt, there may be a threat to the relationship the child

hasemotionally. Although research on betrayal trauma has looked carefully at the victim’s

refusal to acknowledge awareness regarding the traumatic event, Freyd, DePrince,and Gleaves
 37

(2007) explained it is possible that what is removed is the awareness of the emotion linked to the

betrayal. It is possible that emotional blocking helps one to distance themselves and decrease

disappointment that may be caused by others’ rejection or inconsiderate actions (Freyd et al.,

2007).

A study involving 276 boys and girls from two juvenile detention centers investigated the

correlation between emotion numbing, callous-unemotional traits, and trauma exposure (Kerig et

al., 2012). Findings were consistent with the theory that there is a definite correlation between

callous-unemotional traits and trauma exposure that was linked to general emotional numbing.

Gender does not play a role in these moderate effects (Kerig et al., 2012, p. 272).

Juvenile Detention

Understanding the role that emotional numbing plays in posttraumatic stress reactionis

needed to understand further how this particular symptom has affected the justice-involved youth

and the youth’s ability have a genuine concern for their own and others well-being (Kerig et al.,

2016). Ford et al’s(2008) study of youth in juvenile detention found that 40% reported

witnessing domestic violence, and these youths had more severe problems with traumatic stress,

substance abuse, and suicidal ideation than other detained youths.

Witnessing community violence has been associated with emotional numbing symptoms

– this means that numbing can provide short-term relief, avoidance of trauma, or traumatic

reactions related to stress. Over time, however, numbing is associated with substance abuse,

depression, aggression, fear and social withdrawal, leading to isolation, and problems managing

fear and anger (Litz & Gray, 2002). These findings underscore the need to help violence-exposed

youths in juvenile justice settings learn strategies to regulate their emotions, to deal with

numbing, and prevent risky behavior.

 38

Conduct Disorder (CD)

Youth exposed to trauma often display symptoms consistent with Conduct Disorder

(CD).The DSM-5 (APA, 2013) stated that CD “is a repetitive and persistent pattern of behavior

in which the basic rights of others or major age-appropriate societal norms or rules are violated”

(p. 221).

Diagnostic Criteria

The DSM-5 (APA, 2013) explained youth diagnosed with CD will deliberately destroy

people’s belongings without any regard. They may also intentionally start fires knowing the fire

will cause severe damage or harm. These youths display aggressive behavior and may cause

unjustified harm to others or animals. This can be done through intimidation, bullying, and

initiating verbal or physical fights. They possess little to no regard for people’s property and

often damage or lose others’ property. These juveniles may act impulsively, tend to run away

from home, stay out all night without parental consent and be truant from school. Lying to others

or being deceitful to obtain goods from others is also a part of the diagnostic criteria – there is no

intention of gaining possession of things genuinely or through hard work.

Onset

Conduct Disorder can be broken down into three types: Childhood onset, Adolescent

onset, and Unspecified onset. Childhood-onset occurs when symptoms begin to appear before the

child is 10 years old; Adolescent-onset will happen when the child is between 12-17 years old.

Unspecified onset means the age at which CD criteria began to appear is unknown (APA, 2013).

Colins (2016) explained that youth with CD may display difficulty expressing concern,

feelings, and remorse for their actions. These youths tend to misinterpret others motives and

actions. Instead of de-escalating conflict, they will respond by intensifying the conflict.
 39

Substance use and risk-taking may be precipitating factors. These children also may have parents

who exhibited those same behaviors as children themselves (Colins, 2016).

Specifying Classification

CD can be specified as mild, moderate, or severe (APA, 2013). If the child has mild

symptoms, he/she has displayed little to no behavior issues more than those to make the

diagnosis (APA, 2013). Common problems include truancy, lying, and staying out past curfew

or without parental permission (Colins, 2016). Moderate symptoms mean the child has had

numerous incidents where their behavior was a problem and this behavior has had an impact on

others (APA, 2013). Those issues may include stealing and vandalism (Colins, 2016). If the child

has displayed severe symptoms, they have demonstrated CD symptoms excessively and may

have caused considerable harm to others (APA, 2013). Those problems have included the use of

a weapon, breaking, or rape (Colins, 2016).

Impacts

Youth in the adolescent-onset subgroup participate in anti-social and delinquent

behaviors as a misguided attempt to obtain a subjective sense of maturity and adult status in a

way that is maladaptive but encouraged by an antisocial peer group (Moffitt, 2003). Research

stated if preventive measures are not taken to address this, children and adolescents with CD will

cease attending school, battle substance abuse, possibly go to prison, experience increased

chances of physical health deterioration due to injury, and may experience a violent death

(Hektner, 2014). Among all examined mental health disorders, CD was the strongest predictor of

juvenile justice involvement (Yampolskaya, 2012).

 40

Risk Factors

Moffit, Moffitt, and Caspi (2001) suggested CD manifested in children due to inadequate

parental supervision, family dysfunction, parents modeling antisocial conduct, and poor

schooling. The following were also indicated: erratic and unstable parental discipline, lack of

parental involvement, lack of caring emotions and warmth, and familial rejection directly related

to the detrimental externalized conduct of children and adolescents (Moffit et al., 2001). Other

factors that contributed to the influence of negative behavior include the number of parents who

are actively present, family size and conflict, socioeconomic status, parent’s criminal history and

psychiatric issues, and child abuse (Frick et al., 1992).

Recidivism

Recidivism, defined as the repetition of criminal behavior, is usually measured as the

occurrence or frequency of a rearrests or incarcerations in a specific period (Aalsma et al., 2015).

Recidivism occurs as a person re-offends (relapses into criminal behavior) often after the person

receives sanctions or undergoes intervention for a previous crime (National Institute of Justice

[NJJ], 2014). According to the Office of Juvenile Justice and Delinquency Preventions (OJJDP)

Juvenile Offenders and Victims: 2014 National Report (2014), “The juvenile justice system

differs for each state. The administration, organization, and data capacity also vary. Therefore,

there is no recidivism rate that is nationally known for juveniles” (OJJDP, 2014). The Indiana

Department of Corrections (IDOC) studied juvenile offenders released in 2012 and followed the

offender until 2015 to determine if the offender would have trouble with the law and return to

incarceration as a juvenile or an adult. Results showed that of 1,013 releases, there were 358

returns (169 as juveniles and 189 as adults);37.9 % were males and 21.1 % were females. About

43.9% were African American juvenile offenders (the highest rate--met more than any other
 41

ethnicity or race); almost 87% of juveniles who recidivated returned to IDOC for new crimes

(Juvenile Recidivism Rates, 2015). Even though the study was done in Indiana, recidivism rates

tend to be higher among males, racial/ethnic minority youths, youths who are younger when first

having trouble with the juvenile justice system, and adolescents with a history of early childhood

misbehavior or conduct problems (Marczyk et al., 2003).

Evidence indicated that justice court-involved juveniles have significant behavioral

health issues that need to be addressed, and interventions that target these problems have the

potential to reduce recidivism. However, few studies have adequately examined the relationship

between behavioral health needs, detention-based behavioral health services, and recurrence

(Hoeve et al., 2014). While therapy and counseling services are offered at most juvenile

residential facilities, research has shown that these facilities were not prepared to address the

needs of the youth. Therefore, the core issues the youth may have tend not to be evaluated—

which, in turn, may increase the chances of the youth recidivating (Ford & Hawke, 2014).

Once a juvenile is sentenced to a detention center, the assumption is that while there, the

youth will receive some form of help that will deter them from future crime. However,

McPherson and Sedlacks’ (2010) study found 45% of youth were incarcerated in facilities where

screening did not take place on every new juvenile that was placed in the service. Fifty-three

percent of youth were incarcerated in facilities that did not provide mental health evaluations

and, among youth with a documented mental health issue imprisoned in these facilities, 47%

percent did not meet with a counselor.

While research has shown that treating juveniles with substance use can lower recidivism

rates, facilities lack adequate screening materials and mental health professionals to do the

screening (McPherson & Sedlack, 2010). Though there is an awareness that a relationship
 42

between juvenile delinquency, ethanol, and drugs exists, there are still facilities that do not

screen youth for alcohol and drug use (McPherson &Sedlack, 2010).

Risk Factors

One way to examine the causes of delinquency is to observe the child’s environment,

mental health and maltreatment history. Another would be to evaluate the number of times the

child has had trouble with the law. Typically, the strongest and most consistent predictor of

recidivism is prior criminal history, measured in the number of arrests in the pre-detention

period.

Having an understanding of certain characteristics and possible risk as predictors of

repeat offenders may assist with possible interventions and preventions that may help deter the

juvenile from re-offending (Sharpe et al., 2004). Characteristics examined as possible predictors

of re-offenses include: age at the time of the offense, gender, race, legal custodian of the youth,

type of original offense committed, and prior charges. The risk factors that should be studied are:

the family that has already been in the justice system, the type of behavior the child displays in

school, the parents’ history of substance use, and the child's friends circle. When studying those

characteristics, some understanding is given when examining the different dynamics of the child.

Family

When a child is born, it is the parents that give the child exposure to the world. Children

act as they are taught and by what they observe. A parental influence is seen in a child’s behavior

in other domains of their lives when interacting with their peers and authority figures. Whether

their attitude is positive or negative, it is all a result of the foundation that was laid in the home

by the parents. If the family is stable, communicates effectively, spends quality time, and

provides structure, the child will most likely have a positive outlook on life and possess self-
 43

confidence. A lack of structure, lack of consistency with rules, and displays of deviance and

violence within the home may provoke an attitude towards deviance and violence within the

child (Sharpe & Litzelfelner, 2004).

The disorganization and decline of the family increases the likelihood that the children

will not be given consistency with rules, be unsupervised, and allowed to make decisions on their

own without any positive influence from their caregiver(s). Therefore, many children and

adolescents will look for order, acceptance, and supervision on the streets. An additional risk is

incurred by individuals whose parents have a criminal history.

The deterioration of the family structure has placed socialization responsibilities on the

schools and communities due to the lack of parental support; eventually these entities will

deteriorate (Chassin et al., 2009). Schools have difficulty helping the child understand the need

to become motivated concerning their future. Therefore, the child displays apathy concerning

their education. The family does not emphasize education or appropriate behavior. This results in

misbehavior at school and possible antisocial behavior in the community.

Substance abuse

Due to the lack of supervision, the child may develop a substance use problem (Chassin

et al., 2009). In some situations, alcohol and drugs may be normalized in a household, giving the

impression to the child that substances should be used. They may use at an early age and develop

a substance abuse problem as an adult. Substance abuse treatments help reduce substance use

and criminal offending when treatment has lasted 90 days or more (Chassin et al., 2009).

Age

The National Institute of Justice (2014) reported that offending typically begins between

at 13 years old, will peak in the teenage years (15 to 19), and then decrease when the individual
 44

is in his/her early 20s. However, the risk to continue to offend well into theadult years is higher

for those who began offending at an early age. Those individuals were chronic delinquents and

violent offenders (National Institute of Justice, 2014).

These findings are needed to help clinicians who work with juvenile offenders be better

able to intensely discuss with youth the risk factors that they face to help them better understand

how their environment may affect them. By doing this, the clinician can help the youth become

aware of the risk factors and characteristics they face as they relate to repeat offending.

Protective Factors

Some research purported that protective factors help to safeguard against the risks for

juvenile delinquency whereas other researchers concluded that protective factors have a precise

impact in decreasing problematic behavior, even where no risk factors are present (van der Put,

2015). Protective factors for offending behavior consist of individual characteristics and social

characteristics found in the domains of family, peers, school, and neighborhood (van der Put,

2015).

Individual characteristics

It is crucial a child has a firm footing as he relates to himself as an individual. Self-

confidence triggers positive self-image in a child. Protective factors such as intelligence, positive

social skills, a willingness to be respectful to authority figures, and extracurricular activity

involvement all are incentives in the individual domain (Loeber et al., 2008).

Social characteristics

Being able to participate in family activities help a child develop a sense of love and

support. Also, being able to candidly discuss problems with parents who are positive and
 45

understanding and having the resources to help the child have multiple experiences can

strengthen the family domain of protective factors (Loeber et al., 2008).

Adolescents want to have relationships with their peers, but for the peer domain to be

successful, their peers must be positive influences who have similar views. Peers understand that

if they are going to be involved in leisure activities, they must be safe and healthy (Loeber et al.,

2008). The neighborhood in which the child is raised plays an important role in a child’s life, as

does the school he or she attends. The community and school need to foster growth and provide

a safe environment. A concern for academics and emotional support will encourage learning

(Loeber et al., 2008).

Gender

Girls have always been a small percentage of the juvenile offender population. However,

the number of girls is increasing as it relates to non-violent crimes since the 1980s (Cauffman &

Grisso, 2008). Boys were four times more likely to be arrested for a violent crime (Cauffman &

Grisso, 2008). Studies showed that within the last 30 years, the number of girls involved in

delinquency cases had a 92% increase (Cauffman & Grisso, 2008). In the past, the judge may

have been more lenient with girls, but now they are receiving the same consequences as boys

even though girls continue to be less likely to be formally charged than boys.

While girls and boys start offending around the same age, girls start offending at a

younger age than boys in violent and serious crimes (Cauffman & Grisso, 2008). While boys

account for the majority of arrests, it is girls that account for over 59% of arrest for offenses such

as running away, and 69% of arrests for prostitution and commercialized vice (Cauffman &

Grisso, 2008). Girls will more likely receive placement to help reduce recidivism or receive
 46

inpatient treatment to address mental health and possible substance use problems

(Cauffman&Grisso, 2008).

Cauffman and Grisso (2008) explained that when adolescent males become adults,

marriage and responsibility may have a positive influence to help decrease criminal behavior. On

the other hand, girls more likely to marry someone who has antisocial characteristics. Males may

cease their delinquent behavior, but women who have a delinquent history may replace

delinquency with violence towards others. The female may also tend to have children at a

younger age without an active paternal influence, passing on an antisocial behavior from one

generation to the next--a domino effect.

Existing Treatments and Methods in Juvenile Justice System to Prevent Recidivism

Behavioral Parent Training, Multisystemic Therapy (MST), Functional Family Therapy

(FFT), Treatment Foster Care, and Brief Family (Bourdin et al., 2000; Chamberlain and Moore,

2002; Ford et al., 2003; Kashani et al., 1999) have been widely used to address behavioral health

problems of youth in the juvenile justice system. These interventions are critical as they all

involve parental engagement. Each one of these therapies is geared towards helping parents

improve their relationships with their children. By doing this, the child may display the ability to

listen and gain respect for authority figures and follow the rules. The objective is to help parents

set perimeters within the home that will help the child refrain from trouble in the community and

surrounding himself with negative peers.

The caregivers gain an understanding of the importance of developing the ability to

effectively communicate, possessing self-control, and implementing of a consistently positive

and negative reinforcement pattern. Therapy could be as intensive as seven days a week, twenty-

four hours a day to as short-term as thirty hours. All of these therapies are aimed to help decrease
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the domino effect of negative and dysfunctional patterns of behavior in hopes of drastically

decreasing the possibility of recidivism.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based

treatment that was created to help children and adolescents recover from trauma. It was

developed by Judith Cohen, Anthony Mannarino, and Esther Deblinger (2006) and emphasizes

both gradual exposure to traumatic memories and cognitive restructuring. This treatment has

been shown to decrease symptoms of anxiety, depression, and PTSD. It also helps children and

adolescents gain the ability to rebuild confidence and strengthen the relationship they have with

their parents.

TF-CBT is designed to be a relatively short-term treatment, typically lasting 12 to 16

sessions. It may be longer depending on the child’s and parent’s needs and their willingness to

adhere to the process of this model. TF-CBT therapists must be nationally certified before

providing this form of therapy. This is a components-based treatment model that incorporates

trauma-sensitive interventions with cognitive-behavioral, humanistic, and family principles and

techniques (Cohen, Mannarino, & Deblinger, 2006). In TF-CBT the child and the parent

/caregiver are educated on improved strategies that help process the distressing thoughts,

behaviors, and feelings associated with the traumatic life event. It is vital that the

parent/caregiver be supportive, because research suggests that parents can contribute to the

resilience of their child, helping modify symptoms and responses related to trauma and allowing

the child to better process the difficult experience (Godbout et al., 2014). Studies revealed when

a parent/caregiver has difficulty processing their thoughts surrounding the child’s trauma--

whether it be due to avoidance or blame--the likelihood of the child externalizing and

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internalizing symptoms increased. By doing this, the child may feel unbalanced and possibly

develop imbalanced beliefs surrounding the event (Deblinger et al., 2016).

The components of TF-CBT are: (a) Psychoeducation/Parenting;(b) Relaxation;(c)

Affective Modulation;(d) Cognitive Coping; (e) Trauma Narrative;(f) Cognitive Processing;(g)

In Vivo Exposure; (h) Conjoint Session; and (i) Enhancing Safety. Every component involves

desensitization/gradual exposure to help the individual better cope with past trauma (Cohen,

Mannarino, &Deblinger, 2006).

Psychoeducation

Psychoeducation is the initial component when beginning TF-CBT (Cohen et al., 2006).

In this component, the initial assessment is done with questions surrounding the trauma. PTSD

symptoms are described to the caregiver and child, and the process of TF-CBT is explained.

During this time, it is the therapist’s responsibility to answer any questions surrounding this

process by explaining the prevalence of trauma. This is also when the therapist explains what

behavioral and emotional symptoms may look like. Pamphlets, books, and other sources of

information are given and reviewed. Most importantly, this is when hope and the possibility of

resilience take place. It is the therapist’s responsibility to build that positive rapport and trust

during this time so that the client and their caregiver will be able to look forward to ending

success.

Parenting

This component can be the most taxing for even the most sensible and consistent parent.

Parenting skills are typically introduced in the first few sessions (Cohen et al., 2006). The

therapist questions the caregiver about how often the child is praised; then the therapist stresses

the importance of praising the child for their display of positive behavior. Within this
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component, the therapist and caregiver may role-play different ways how and exactly how to

praise the child. This is also the time when the caregiver may learn about techniques such as

selective active ignoring, time out, and behavior charting (Cohen et al., 2006).

Selective Active Ignoring

The caregiver learns the child’s display of negative behavior may be due to the trauma

(Cohen et al., 2006). Caregivers learn how to ignore negative conduct that does not involve harm

to the child or someone else. That may mean the caregiver walking away or just simply not

acknowledging the child’s attempt to get a negative reaction from the caregiver. Eventually, this

strategy may decrease unwarranted conduct (Cohen et al., 2006).

Timeout

Timeout is when the caregiver interrupts the negative behavior and deprives the child of

getting attention from the caregiver (Cohen et al., 2006). If the child does not stop, the caregiver

escorts the child to a designated place in the home where the child has to stay for a timed number

of minutes. Once that time is up, the child is removed from the time-out designated space.

Behavior charting

Behavior charts help the child see what they have earned based on their conduct (Cohen

et al., 2006). This parenting technique involves the parent discussing the behavior (one at a time)

that is the target for change (Cohen et al., 2006). The caregiver explains the child must do to earn

a star or a certain color on the chart per day to signify actual conduct. With this strategy, the

child helps to decide on the reward if they obtain that a certain number of stars or colors that they

were to receive within seven days (Cohen et al., 2006).

If done with consistency, the caregiver will be able to see a reduction in negative

symptoms exhibited by their child (Cohen et al., 2006). At this time, the therapist monitors and
 50

assesses how the parent is handling their caregiver homework concerning these behavior

modification techniques with the child.

Relaxation

During this component, triggers to the manifestation of PTSD symptoms and stress are

discussed (Cohen et al., 2006). This discussion is needed due to symptoms that may occur during

the narrative component of TF-CBT (Cohen et al., 2006). Techniques such as focused breathing

and meditation are taught and are encouraged when symptoms occur (startled responses,

hypervigilance, anger, irritability, increased breathing and heart rate).

Focused breathing allows the individual to focus solely on their breathing and body by

inhaling and exhaling slowly (Cohen et al., 2006). This helps to redirect mental focus.

Meditation allows the individual to focus on a particular mantra or word that helps them calmly

focus on the present. They attempt not to allow their thoughts to be interrupted by any negative

feelings or thoughts.

It is important that the caregivers be also taught relaxation strategies because they have

their response related to their child’s trauma exposure (Cohen et al., 2006). It is vital that they

practice these techniques in the home so that the child can see an example of how to respond

when trauma symptoms flare.

Affective Modulation

This component helps children learn how to ventilate their feelings effectively (Cohen et

al. 2006). At this time, the therapist assists the child with voicing different feelings. This can be

done through merely talking in during the session, drawing or writing. Affective modulation is

used to help the child become better able to express negative emotions surrounding the trauma

without attempting to divert from the discussion or use defense mechanisms (Cohen et al., 2006).
 51

Children also are educated on how to enhance the positive about themselves and learn how to

problem solve through new cognitive coping skills such as positive self-talk and thought to stop.

Positive Self-Talk

Positive self-talk allows the child to focus on the positive characteristics of themselves.

They also learn positive statements to say or think when feeling they are in a negative place

mentally. This technique helps to encourage optimism within the child (Cohen et al., 2006).

Thought Interruption

Thought interruption is a strategy that helps to divert the child’s attention from a negative

traumatic thought to a non-traumatic replaced thought. This teaches the child that they have

control over what they think, and that they can choose what they think about, and when they

think about it, interruption gives a sense of control (Cohen et al., 2006).

It is necessary for the caregiver to assist the child within this component to help reinforce

in the home. Their reinforcement may also help improve the child’s ability to function better

socially, because confidence has helped to decrease skewed thoughts about what others may feel

or think about them (Cohen et al., 2006).

Cognitive Triangle

The difference between thoughts, feelings, and behavior are taught within this

component. This is called the cognitive triangle. First, the child is to identify feelings. This was

initially done within affective modulation but is reiterated here. The therapist then explains what

the cognitive triangle is and gives different scenarios to help the child better grasp the

understanding of the difference between the three. Once the child gains understanding, the

therapist encourages the child to identify the more truthful and helpful aspects of his thoughts so

that he may feel differently. Lastly, the therapist stresses how the cognitive triangle helps the
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child gain the ability to interact better with people and how the relationship with our behaviors

influence thoughts; this also helps with healthier coping with PTSD symptoms.

The caregivers are also educated on the cognitive triangle and practice learning the

difference between thoughts, feelings, and behaviors by having to discuss different scenarios that

break down the three dimensions just as the child had to do (Cohen et al., 2006). Cognitive

coping teaches the distinction between thoughts, feelings, and behaviors and helps to explain

common cognitive distortion that may occur due to the trauma or other stressful life events

(Cohen et al., 2006). This effort attempts to change the automatic thoughts that may occur. It also

helps to identify positive and negative coping strategies.

Trauma Narrative

The reason that creating a trauma narrative is extremely important is that this component

helps to dramatically decrease the feelings of shame, helplessness, and other overwhelming

negative emotions that are associated with the traumatic experience (Cohen et al., 2006). During

this time, the child may become reticent about the details of the trauma and not want to discuss

them. It is the therapist’s responsibility to encourage the child to share their feelings surrounding

the event so that the therapist can begin to correct distorted and dysfunctional thoughts that may

cause the child to have continued behavioral and emotional difficulties. The descriptive narrative

may take a few sessions because the therapist must gradually expose the child to the event where

they can ultimately discuss the trauma in explicit detail in writing as though it is a story in a book

(Cohen et al., 2006). Once the narrative is complete, the therapist has the child to read the story

aloud, while explaining the feelings described in the narrative. This entails discussing the worst

moments and memories that surround the turmoil of the trauma.

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The caregiver is also prepared for the narrative. It is important that the parent not have

exaggerated responses or try to change the narrative of the story because the child may not tell

the entire story or avoid telling the story at all (Cohen et al., 2006). The therapist encourages the

parent not to discuss the event in the presence of the child while in emotional distress, but to be a

support regardless of how upsetting the details are because there needs to be a comfort level

established. When feelings of inadequacy and worry take place within the child, the caregiver is

the child’s source of comfort. That is why joint sessions are important so that the child may

begin to trust that the caregiver is not disgruntled with them surrounding the trauma (Cohen et

al., 2006). The objective of this component is not to describe the exact reality of the trauma, but

to help the child describe and gain mastery over the intrusive thoughts and memories.

Cognitive Coping

At this stage, the therapist begins to help the child correct the inaccurate cognitions

surrounding the trauma once the narrative has been completed. Once the distortion is identified,

it is the therapist’s responsibility to explore and correct those thoughts with more rational and

correct thoughts. By doing this, the therapist asks questions that require critical thinking; these

questions challenge the child to understand why the thought is inaccurate (Cohen et al., 2006).

The caregiver also goes through the same cognitive coping process, because the parents

often blame themselves by voicing that they should have known that the event may occur (Cohen

et al., 2006). The therapist discusses the distorted thoughts and will give homework for the

parent to do to track the amount of unhelpful or inaccurate thoughts between the sessions so that

the thoughts can move to the accurate and helpful ones.

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In Vivo Exposure and Mastery

It is an individual’s natural reaction to attempt to avoid any situation where they can

avoid being faced with triggers that bring forth memories of trauma. With In Vivo Exposure, the

therapist must be willing to find out as much information about the most feared situations and

help the child to overcome the fear by gradually facing the very thing that causes the fear. The

child can face the feared situation to the point where the feared consequences and anxieties begin

to diminish (Cohen et al., 2006).

The caregiver is encouraged to participate in this process because if the parent begins to

make their feelings the priority by giving in to the child’s fears concerning the situation, the

parent is preventing the child from moving forward, even though the parent’s intentions are

good. Cohen et al. (2006) explained the importance of the parent showing the child that the

traumatic event cannot be the dark cloud that looms over their lives indefinitely. The parent

inspires and gives hope to help the child to understand that life goes on and can be beautiful.

Conjoint Session

With this component, the caregiver and child come together. Cohen et al. (2006)

explained that, before this session, the therapist has met with caregiver and child individually.

The therapist should have read the trauma narrative to the caregiver during their sessions before

the conjoint so that it would not be overwhelming for them to hear when the child reads it during

this particular session. Also, before the conjoint session, the therapist has assisted the child with

formulating clear questions that they may want to ask their caregiver surrounding the caregiver’s

feelings about them, a possible perpetrator, the trauma itself, and other questions that the child

may feel are pertinent. Just because this session is at the end of the TF-CBT model does not

insinuate that this session is easy due to the sensitive nature of the topics that may arise (Cohen
 55

et al., 2006). It is helpful that the therapist ends the joint sessions on a positive note by helping

the caregiver and child praise each other about something they did or said during the session or

over the week that they appreciated.

Enhancing Safety

Cohen et al., (2006) stated that this is the last component of TF-CBT entails the child

learning how to become more aware of what danger may look like--the difference between an

innocuous and actual trigger that signifies that notion of danger. They also learn to identify those

people and places that may provide safety. Basic facts surrounding abuse, violence, bullying and

other potential threats are discussed. Due to the child experiencing past trauma, it is vital that the

therapist role-play situations with the child to assess how they react. This is because children

who have experienced some form of violence and suffered from PTSD symptoms may lack

sensitivity to danger cues, so it is important to see what they will do if a placed in a dangerous

situation (Cohen et al., 2006). They learn effective communication concerning their feelings,

how to be attentive to their gut feelings about a person or situation, understanding of body

ownership in terms of when someone touches and where they touch, learn the difference between

secrets versus surprises, and how to ask for assistance from others and not attempt to handle the

situation alone (Cohen et al., 2006).

TF-CBT is the most well-supported and effective treatment for children who have been

abused and traumatized (Saunders et al., 2003). TF-CBT was also selected as a Best Practice in

the Kaufman Best Practices Task Force Final Report sponsored by the National Traumatic Stress

Network (Child Welfare Committee, 2008).

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Music Therapy

Music is fundamental in the lives of many adolescents, playing a role in social-emotional,

interpersonal, and intellectual-artistic development, and is an outlet for self-expression and

emotional release (Campbell, Connell, & Beegle, 2007). Research on popular music and its

effects have been explored in various fields and proven itself to have effects on one’s ability to

do schoolwork, socially interact with others, their mood and affect, and overall behavior

(Council on Communications Media, 2009). Although music consumption varies with age,

reports estimate youth listen to an average of 1.5-6.8 hours of music daily. Furthermore, youth

report spending an additional two hours watching music videos (Council on Communications

and Media, 2009).

When traveling music groups played their instruments for veterans who had been

hospitalized during and after both World Wars, medical professionals and clinicians began to

understand the positive effects that music has on the mental health and healing (American Music

Therapy Association, 2015). The American Music Therapy Association explained that music

had been used for centuries to improve mental health. No matter if it is writing music, playing an

instrument, singing, or improvisation, music has been shown to be a voice for those who may not

be able to effectively communicate their feelings (American Music Therapy Association, 2015).

Not all patients with PTSD respond to cognitive behavioral therapy (Carr et al., 2012). In

treating PTSD, group music therapy might be beneficial. Research has been done concerning

group music therapy for patients with persistent PTSD. The study showed that the patients had a

significant reduction in the severity of their PTSD symptoms, as well as a reduction in depressive

symptoms (Carr et al., 2012).

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Davis (2010) explained that studies have also shown that music has helped children who

have experienced being a part of natural disaster (tornado) express how they felt to help them

transition back into school after experiencing trauma. Music was used to help them regain a

sense of normalcy and security and to validate their feelings of frustration, fear, and anger.

Furthermore, researching and affirming such feelings and experiences through the creative use of

music supported the humanistic approach of valuing one’s creative power as a crucial force in

change and healing (Davis, 2010).

The History and Benefit of Rap Music

Rap is a genre of music that involves the speaking or chanting of lyrics that are often to a

continuous beat. Before this genre made its way to the United States, West Africans were already

telling stories rhythmically to the beat of a drum. It was not until the 1970s that rap first gained

popularity in the United States starting out in Bronx, New York. Since then, the influence of rap

on the urban culture has gone beyond music. It has influenced dance, art, and dress. Rap has also

influenced the way people view their environment and the way they speak and act. Rap music

has given counselors the ability to bridge the gap with cultural differences (Kobin & Tyson,

2006). Many Latino and African American youth have immersed rap culture into their identities.

Rap music seemed to be a voice of those who were impoverished, oppressed, and dealt

with hurt and pain due to the struggles of everyday life, as well as socio-political concerns. Rap

also addressed subjects such as violence, drugs, and sex. For some, rap music is a genre of music

that disrespects women and gives youth the wrong interpretation concerning life and love. For

others, rap music is an art form that describes the population that people may describe as

incorrigible (Kobin & Tyson, 2006). It gives hope in times of trouble.

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In 1979, a group called the Sugarhill Gang burst onto the music scene with a rap song

entitled, Rappers Delight. With the song being such a major hit across the nation, music

producers began to take notice of this new style of music (Ellis, 2014).

In 2000, Don Elligan introduced Rap Therapy as a psychotherapeutic intervention for

working with at-risk youth (Elligan, 2000). Elligan found that rap music engaged a population of

at-risk youth who had received counseling apprehensively. Elligan understood that using

narrative themes in rap music would help increase client reflection on their value system and

become in tune with their emotions that connect with personal interpretations heard through

music lyrics. By the therapist and clients working together, the therapist helps to bring about

awareness, expose problematic behavioral patterns, and empower positive changes.

The importance of integrating Rap Therapy with a cognitive behavioral model is that the

clients become aware of the association between personal lyric interpretation, their emotions, and

at-risk behaviors. This awareness aids in their ability to be reflective and allows them to

effectively problem solve (Gonzalez & Hayes, 2009).

Stages

Rap therapy is conducted in five stages: (a) Assessment, (b) Alliance, (c) Reframing, (d)

Role Play, and (e) Actions and Maintenance (Elligan, 2000). The questions asked in Rap therapy

are non-situational specific questions. Examples of those questions are: How long have you been

dealing with difficulties in managing the unwanted behavior? How many times a week do you

behave this way? How does this behavior affect your interactions with other people? For youth

who exhibit aggressive behaviors, Elligan (2000) suggested the following questions: What do

you do when getting angry? Have you hurt anyone while angry? How many fights do you get

into each week?

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Assessment

During the assessment stage, the counselor attempts to determine if the youth has a strong

interest in rap music by discussing the youth’s favorite rap songs, artists, and groups. The

counselor then determines if the music influences the youth’s identity. Questions may go as

follows: Which rap artists do you listen to? Why do you enjoy these styles of rap? What is your

favorite rap song? Which rap artists do you like the least?

Alliance

In the alliance stage, the counselor and the youth begin to build a positive rapport and

listen to the rap music that the adolescent stated that he liked. By doing this, the counselor is

engaging, listening and interpreting lyrics. Elligan (2000) explained that it is essential that the

counselor be non-judgmental so that the counselor can display that they are open to what the

youth’s choice of music.

Reframing

During the reframing stage, the counselor attempts to enlighten the adolescent on other

forms of rap music to help him gain a better appreciation for rap. In this stage, the counselor

helps the adolescent interrupt other lyrics and the meaning behind the words. By doing this, the

counselor attempts to promote further cognitive restructuring (Elligan, 2000, p.31) of the

meaning of rap music for clients.

Role play

In the role play stage, the counselor and the adolescent write their rap lyrics. According

to Elligan (2000), modeling and reinforcement for a particular type of rap is often congruent with

the style the client prefers. In this stage, the rap lyrics are then called poetry and the counselor

determines if the reframing stage was successful.

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Action and maintenance

Over time, the counselor encourages the adolescent to write about specific issues that

directly affect their lives. This activity happens in the fifth and final stage, action and

maintenance. The counselor encourages the youth to put his lyrics into action.

Group Rap Therapy (GRT)

Within the past ten years, Group Rap Therapy (GRT) has become an intervention that

some psychotherapists have begun to use to reach youth. This model was created by Alonzo

DeCarlo (2013). GRT was designed just like other major models to help the clients and those

providing counseling--specifically in the prison setting for lethally violent offenders (DeCarlo,

2013). Even though GRT is still very new to the mental health field, it has been shown effective

in building rapport between young African American males and non-African American

counselors (DeCarlo, 2013). This model helps to increase self-disclosure and comfort ability

without the youth having just a dialogue with the counselor.

T. Thomas Alverez III also saw the need to have a form of communication outside of

traditional talk therapy that would reach at-risk youth. He became the founder and executive

director of Beats, Rhymes, and Life (BRL), a clinically-based community organization for youth

and young adults aiming to promote mental health by utilizing Hip Hop and other forms of

popular culture (Hadley & Yancy, 2012). BRL is also a model he created to help youth engage in

positive peer interaction, life struggles, and receive advice from other youth in the program.

Alverez III realized that youth do not look at rap as destructive and harmful. He understood that

it was an outlet for expression and gave possibilities (Hadley & Yancy, 2012).

Hadley and Yancy (2012) explained that Rap Therapy is a way of meeting the youth

where they are regarding their culture--by embracing the fact that youth may view life
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differently. By listening, the counselor gives the youth a chance to be heard where they may have

felt, in the past, that their thoughts and feelings did not matter; where they no longer felt a need

to verbalize their emotions. The counselor now gives them the voice to share their personal

experiences. By doing this, the opportunity provides the youth a conducive environment to be

heard and feel empowered (Rine, 2013). Hadley and Yancy (2012) explained that giving the

youth an opportunity to perform, create and improvise their story helped them to accept their

story for how it was and currently is.It also allowed them to gain strength and understanding

concerning their story, develop a sense of who they are, and take a closer look at their

personality characteristics--how they hinder and help.

Disciplinary Alternative Education Programs (DAEP)

Disciplinary alternative education programs (DAEP) were established in the 1960’s to

help provide education and support to students who had difficulty functioning in their original

school (Foley & Pang, 2006). These schools also attempted to correct behavioral problems.

Studies showed that at least 61% of students referred to these programs had issues with

substance abuse and possession, truancy, constant academic failure, disruptive behaviors,

physical aggression, interpersonal conflict, weapons possession, and mental health needs (Foley

& Pang, 2006). It was later discovered that Rap Therapy demonstrated positive impact

effectiveness in this population. Armstrong and Ricard’s (2016) study was done to see how

receptive the students in DAEP were to Rap Therapy. They found approximately 17% of the

girls and 25% of the boys enjoyed the therapy only because their favorite song was involve, and

they enjoyed the lyrics.

Counselors in DAEP used a rap therapy-based intervention and gave the student an

option to express himself--giving the student a feeling of empowerment within the counseling
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process (Carver & Lewis, 2010). The counselor had several different exercises where Rap Music

was involved in helping create a narrative that described thoughts and feelings.

Catching Feelings and Expressing Emotions

This exercise helped to identify practical strategies to help better handle stress (Carver &

Lewis, 2010). In this activity, the counselor played a rap song that was directly related to the

interpersonal conflict. The counselor played it three times. The first time was so the student

could listen to the lyrics carefully. The second and third time, the counselor has the students to

write down the words that they heard that stood out the most to them. The counselor then helped

the student make a connection between the song lyrics and the student’s therapeutic needs.

Dollars and Dreams

This exercise helped students identify their goals and values (Carver & Lewis, 2010).

Due to rap having a constant message of rags-to-riches stories about how the rapper started out

poor and now has money; it gives a tone of resilience themes. The counselor has the student

listen to a song surrounding a theme and then helps the student describe their wants and dreams.

The counselor has them discuss having money and what they would need to do with it if they had

it and explain how they, too, can become resilient and not a statistic by using the SMART goal

structure: specific, measurable, achievable, realistic and time-bound. This helps the student

understand that their goals are attainable.

Rap Therapy has innovated the mental health field and should be validated due to its

ability to bridge a gap and outcomes for youth of color (Elligan, 2000). By acknowledging how

important music is to today’s youth, it helps the counselor gain access to the youth. It has

become apparent to clinicians how dominant this genre of music is. Although rap does have
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somewhat of a negative connotation, counselors realize the strength of its therapeutic usage

(Elligan, 2000).

Substance Abuse and Adolescents

Caldwell et al., (2010) explained the patterns of substance use by juvenile delinquents are

concerning. There are higher recidivism rates and poor outcomes associated with law violations

involving drug and alcohol use. Belenko and Logan (2003) states that reports have shown that

juvenile delinquents who have substance related offenses have more than doubled within the past

15 years‚ an increase by 148% over a 10-year span.

Research has consistently shown that substance use among adolescents is linked to severe

juvenile offending. The adolescent offenders profiled in Mulvey’s (2011) study reported very

high levels of substance use and substance use problems. The presence of a drug or alcohol

disorder and the level of substance abuse were both shown to be strongly and independently

related to the level of self-reported offending and the number of arrests. This relationship held

even when drug-related offenses and behaviors were removed from the offending measures, and

characteristics including socioeconomic status, gender, and ethnicity were controlled statistically

(Mulvey et al., 2010).

The National Institute on Drug Abuse (2014) explained that a lot of juvenile offenders

who have substance use problems have risk factors such as family difficulties, educational

issues, lacking social skills, medical issues and infectious disease that increase the possibility of

drug relapse, and recidivism if problems are left unaddressed. It is incredibly stressful for a

juvenile to refrain from alcohol and drugs when they have to re-enter the same environment they

were in before incarceration (The National Institute on Drug Abuse, 2014). Substance abusers

may come into contact with people from their lives that continue to have drug problems and
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crime involvement. This may trigger the individual to return substance use and criminal activity

(The National Institute on Drug Abuse, 2014).

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Chapter III: Methodology

Within this chapter, the unexpressed concept and advancement of developmental research

and the all-encompassing of design research are examined. Examination of the analysis and

development phase pertaining to the research stage to the Development Research and Utilization

Model (DRU; Southern, 2007) will be given.

Developmental Research

The advancement of developmental research, as explained by Gilgun and Sands (2012),

reinforce the headway of research as being more open to current findings and display processes

that are more polished evaluations and tests. Development gives suggestions that constant

modifying may take place in order to create a solid intervention or solution. Richey and Klein

(2005) state developmental research is the “systematic study of designing, developing and

evaluating instructional programs, processes, and products that must meet the criteria of internal

consistency and effectiveness” (p. 24); meaning developmental research’s goal is to promote

knowledge rooted in findings that are systematically attained through practice (Richey & Klein,

2005).

Development and research are critical elements of many organizations, and when well-

planned and used, can help support treatments that can help build programs and services

throughout many clinical arenas. Developmental research involves the development, testing,

evaluation, and modification of new models of practice (Gilgun& Sands, 2012, p. 349). There is

also involvement with situations in which the product-development process is analyzed and

described and the final product evaluated. The developmental research focused more on the

impact of a particular product‚ the learner or the organization and oriented toward a general

analysis of design development or evaluation processes as a whole rather than as components.

 66

Gilgun and Sands (2102) stressed the importance of approaches that were qualitative to

developmental research by observing and examining the initial works and practices of carefully

chosen intellectuals. By doing this, what has been understood is through experience and

relationships between those two factors would stimulate innovative thinking in others. It is the

constant interaction during the design and development stage that increases the comprehension

of each step or component while helping develop other steps or components.

A fundamental distinction should be made between reports of actual developmental

research (practice) and descriptions of design and development procedural models (theory).

Developmental research has contributed much to the growth of the psychological field, often

serving as a basis for model construction and theorizing. The Developmental Research and

Utilization (DRU; Southern, 2007) model is essential due to its ability to guide the present study.

Through its meticulous stages, it will help inform and improve practice.

Evidence-based practice (EBP) is the integration of the best available research with

clinical expertise in the context of patient characteristics, culture, and preferences (APA, 2006,

p.273). EBP is considered extremely important in counseling and psychotherapy, but the ability

to translate research into practice is often an overlooked (Ohmer & Korr, 2006). Researchers

attempt to use several terms to describe their best effort to implement scientific result in practice:

diffusion, dissemination, utilization, exchange interaction, mobilization, and knowledge transfer

(Jansson, Benoit, Casey, Philips & Burns, 2010).

Design-Based Research

According to Barab and Squire (2004), design-based research is defined as “a series of

approaches, with the intent of producing new theories, artifacts, and practices that account for

and potentially impact learning and teaching in naturalistic settings” (p.2). Barab and Squire
 67

(2004) foresaw progress that would be made in the future through the use of technology which

would improve teaching and learning. This could be understood through design-based research.

Herrington, McKinney, Reeves & Oliver (2007) state there are 4 phases of design-based

research. Each phase can be still be used just as the usual requirements that are essential for

research proposals. While there are differences between institutions and requirements, a general

proposal would still require having objectives, a rationale for the study, research questions,

significance of study, literature review, method, data, and proposed results.

The results of studies and research are geared towards helping provide a link between

practical applications and theoretical comprehension. The analysis of the research help those

interested in learning how to link the interests of the design with research that can be used by a

broader audience making design-based research a favorable alternative.

While analyzing the content of research, two limitations were noticed. First, the design-

based research requires constant input between the practitioners and researchers. Second, design-

based research can be more difficult to clearly work through as opposed to other types of

research. The design-based research model is a piece of a series of research methods, and the

Developmental and Research Utilization Model is one of its components.

History of the Developmental and Research Utilization Model

The DRU is deemed a design-based research model; it was developed to combine

research and practice. Originating at the Institute for Social Research at the University of

Michigan, it has been a guide in community psychology and education for over 40 years

(Gomez, 2007). It was then adopted by Southern (2007) at Texas A&M University to be used in

program development, evaluation and consultation. Research and development are the two stages
 68

that helped guide researchers through transformation of the product (Ellison, 2014). Phases,

concerns, operations, and activities are within each level.

Research Stage

The Research stage of the DRU is broken into three phases: Analysis, Development, and

Evaluation. They address concerns through activities that define the details involved that are

consistent with other methods of research.

Analysis phase

This phase is the first within the research stage of the DRU. It helps the researcher

narrow down what was once a broad scope so that the specialization can be more defined and

specific. It also helps bring forth the possibility of new procedures and programs. Within the

Analysis phase, the type of information gathered with this phase are comments and observations

by the clients and professionals, information gathered from attending workshops and

conferences, and several literature reviews. This phase should identify an issue or opportunity,

explore its history or background, and provide convincing and persuasive argument that this

problem is significant and worth researching (Herrington et al., 2007). This information helps the

researcher define parameters and find possible answers to questions asked about the research

performed.

Secondly, the Analysis phase involves the identification of key terms, selection of

research, goals and objectives. In this phase, the researchers are able to state the specific

databases and other data bases and sources that will assist with the gathering of information. This

information is then accumulated and structured in a structured manner (Southern, 2007).

 69

Development phase

Within the development phase, the researcher decides how to move forward with the area

of specialization once the information gathered. The researcher creates a theoretical framework

that provides reason to analyze the condition and give meaning to the possible solution proposal.

Within this stage, important data product design and preparation has been selected. This is

mastered by formally assessing pertinent literature about existing interventions or models that

confront current concerns (Southern, 2007). All of the findings combined to create a literature

review that builds throughout the DRU process. Also, the framework for the theory becomes

evident and may provide a foundation for the proposed solution. Once made clear what the

problem is, reviewing the data is next.

Evaluation phase

The evaluation phase is the final stage of the Research stage of the DRU. It is the

systematic process of determining the equality and effectiveness of the program (Hur& Suh,

2010). It involves implementation, data collection, and evaluation of the information that has

researched and possibly been a part of a field trial. At times, some pilot testing may be done to

see if the product or activity is sufficient.

The Evaluation phase of the DRU gathers and processes accountability reports that aid in

assessing the effectiveness or quality associated with a given program or product (Dozois,

Langlois, & Blanchet-Cohen, 2010; Patton, 1999). This process is on-going due to possible

modification of the model due to changing conditions, new findings, and knowledge. With

developmental evaluation, the importance of developmental evaluation allows the organization,

researcher, or consultant the chance to adapt the intricate environments in which clinical

transformation happens.
 70

Utilization Stage

The Utilization stage consists of two phases: Diffusion and Adoption. Along with

analysis, development, and evaluation phases of the DRU model, diffusion and adoption created

to working together to help further inform the researcher on whether a specific study

implemented.

Diffusion phase

The researcher looks at possible breakthroughs that may be found and could test for

possible implementation. According to Southern (2007), these exercises support information

dissemination and diffusion media preparation and can comprise product demonstration, research

findings publication, and product presentation. Construction of product material for testing and

circulation may accomplish if not previously realized within the development phase.

Adoption phase

This is the second phase of the Utilization Stage of the DRU. At this point, there are two

concerns that are addressed: product acceptance and product renewal (Southern, 2007). This

phase helps determine if theory or product will be accepted by consistent use and monitoring by

practitioners. Implementation may be allowed or denied. Within the DRU model as presented by

Southern (2007), product acceptance and product renewal are two components addressed in this

phase. Product acceptance involves ensuring compliance, monitoring and implementing product

use. Product renewal requires system product review and support. The details of the DRU are

listed in Table 1 below:

 71

Table 1.

Developmental Research and Utilization Model

________________________________________________________________

Phase Concerns Operations Activities

Research
I. Analysis A. Problematic 1. Problem statement Problem analysis and identification;

Human Condition State-of-the-art review

B. Basic Information 2. Information selection Selection of basic or applied research,

Source technology, or practice experience;

Selection of product language, goals,

and objectives

II. Development C. Relevant Data 3. Information gathering Literature review, site visitation, or

assessment

D. Product Design 4. Product innovation Novel assembly, application, or

invention

E. Product Preparation 5. Product realization Construction of prototype, product, or

statement of procedures

III. Evaluation F. Field Trial 6. Trial application Pilot implementation or demonstration

7. Data collection Collection of relevant data from trial

G. Outcome Analysis 8. Product evaluation Empirical research study, program

evaluation, process review, or policy

analysis

Utilization
IV. Diffusion H. Diffusion Media 9. Diffusion media Preparation of guides, manuals, or

preparation training materials

10. Information Demonstration, professional

dissemination presentation, or publication

V. Adoption I. Product Acceptance 11. Implementation by Systematic use by practitioners;

Users Monitoring of adherence or

compliance;
 72

Administrative support

J. Product Renewal 12. Institutionalization Maintenance of community, staff, and

administrative support for product;

Follow-up, periodic review, and quality

control;

Revision or expansion of product;

Ongoing participation in planned change

________________________________________________________________

Note. This developmental research model was supplied by Southern (2007).

 73

CHAPTER IV: RESULTS

Phase I (Analysis) and Phase II (Development) of the Research Stage of the DRU Model

guided the process of integrating Rap Therapy and selected components of Trauma-Focused

Cognitive Behavior Therapy (TF-CBT) to develop the model--Powerful Minds. Influential Minds

can help a juvenile participate in therapy that is unconventional to traditional Cognitive Behavioral

Therapies and will help them become aware of the importance of caring for themselves and others

to reduce the possibility of further juvenile court involvement.

Development of Powerful Minds Integrated Model

The DRU Model was the structured approach that was used to guide the development of

the product (Powerful Minds). The author went through the step-by-step process of the analysis

and development stages to build a model that would address the need for trauma treatment for

adolescents in the juvenile justice system. Issues addressed, and required revisions were made to

construct Powerful Mind’s integrated treatment model.

Phase I: Analysis

Identification of the problem came from the researcher’s interest: juveniles involved in the

justice court system, the impact of trauma, trauma treatment, music, and its ability to evoke human

emotions. The initial examination of the researcher’s interests also included reading peer reviewed

articles to help gain an understanding of juvenile delinquency and how trauma plays a role in

misconduct (See Table 1).

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Table 1

Past Paper Analysis

Paper/Presentation Title Topics/Areas Examined Conclusions

Cauffman, E. (2008). Girls and boys Looks at comparisons and the Boys and girls may share risk

inthe juvenile justice system: Are differences of male and female factors, but it is explained that the

there differences that warrant offenders: Characteristics of risk factors affect the genders

policychanges in the juvenile justice female offenders, risk factors for differently due to the way they

system?Understanding the female offending, assessment and cope with the stress of being

offender. The future of children, treatment, and long-term abused

18(2),119-142. consequences.

Yampolskaya, S Chaung.(October Child demographics, maltreatment Children with any juvenile justice

2012).Effects of mental health history, and the presence of mental involvement, having a mental

risorders on the risk juvenile Justice health disorders were examined. health diagnosis, significantly

system involvement and recidivism increased children’s odds of

among children placed in out-of- criminal recidivism.

home care. American Journal of

Orthopsychiatry, 82(4), 585-593.

Sharpe, E.G. &Litzelfelner, P. Understanding the causes of The presence of these case

(2004). Juvenile case characteristics juvenile delinquency is to focus on characteristics and risk factors for

and risk factors as predictors of re- the characteristics of the individual repeat offenders further validates

offenses. Journal for Juvenile and their environment. Another why juveniles find it difficult to

Justice Services, 19, 73-84. approach has been to study repeat refrain from crime.

offenders as a way of gaining a

 75

total scope as it relates of juvenile

delinquency.

Clinkinbeard, S. S. (2014). What Investigates how adolescents view A positive relationship between

lies ahead: an exploration of future their future, as it relates to self- low self-control and delinquency

orientation, self-control, and control and delinquent behavior. such that higher levels of low self-

delinquency.Criminal Justice control are related to higher levels

Review,39(1), 19-36. of delinquency. However, the

results showed that if an adolescent

has positive expectations for the

future, there are lower reports of

delinquency.

Mulvey, E. P. (2011). Highlights Monthly data about institutional Findings also showed that

from pathways to desistance: A placement, probation, collects community-based supervision was

longitudinal study of serious monthly data about institutional effective for youth who were

adolescent offenders. Office of placement, probation, and offenders. Increasing the duration

Juvenile Justice and Delinquency involvement in community-based of community supervision reduced

Prevention. 1-4. services; investigators were able to reported reoffending.

examine the effects of aftercare

services for 6 months after a court-

ordered placement.

National Center for Mental Health Statistics concerning children and There were no significant

and Juvenile Justice (2016). trauma exposure associations between types of

Childhood trauma and its effect on maltreatment and the time of

health development. Retrieved from involvement with the juvenile

https://www.ncmhjj.com/wp- justice system

 76

content/uploads/2016/09/Trauma-

Among-Youth-in-the-Juvenile-

Justice-System-for-WEBSITE.pdf

Kerig, P. K., Bennett, D. C., Chaplo, Discusses emotional numbing as a The numbing of general rather

S. D., Modrowski, C. A., & McGee, specific posttraumatic symptom than positive emotions may play a

A. B. (2016). Numbing of Positive, helped to inform the revised criteria more salient role in posttraumatic

Negative and General Emotions: for the diagnosis of posttraumatic stress.

Associations with Trauma Exposure, stress disorder

Posttraumatic Stress, and Depressive

Symptoms Among Justice-Involved

Youth.Journal of Traumatic Stress,

29(2), 111-119.

Table 1 offers the literature reviews that provide insight as to how trauma connects to

juvenile delinquency and recidivism.

Problematic Human Condition

The analysis involved researching articles focused on the following: how trauma and

juvenile delinquency are connected, risk factors and characteristics surrounding juvenile

delinquency and recidivism, how music therapy has helped those who have PTSD, the impact of

rap music on today’s youth, and how rap used in a therapeutic setting. There was a massive amount

of research that was done that adequately addressed juveniles involved with the justice system,

PTSD, recidivism, and trauma.

Recidivism is the term that refers to when an individual continually repeats criminal

behavior where the result may be repeated arrests or re-incarceration for set periods of time

(Aalsma et al., 2015). Juveniles who are younger when first encountering the juvenile justice
 77

system, are of a racial/ethnic minority, and have a history of behavior problems are those

individuals who are more prone to have trouble with the law and recidivate (Marczyk et al., 2003).

Also, their environment, history of maltreatment, and mental health are key areas to examine as to

why a juvenile may have continuous justice court involvement. Recidivism rates tend to be higher

among males, racial/ethnic minority youths, youths who are younger when first having trouble

with the juvenile justice system, and teens with a history of early childhood misbehavior or conduct

problems (Marczyk et al., 2003).

Table 2

Risk Factors Identified for Juvenile Delinquency and Recidivism.

Risk Factors Domain Affected Protective Factors

*Early behavioral problems & INDIVIDUAL *Willingness to respect

antisocial behavior being authority figures

exhibited *Ability to positively

*Impulsivity/Hyperactivity socialize

*Poor cognitive maturation *High IQ

*Club and religious

fellowship

*Insufficient and inconsistent FAMILY *The presence of a positive

parenting with child family member

*Lack of positive parental *Economic resources that

involvement could give the youth

*Constant Parent/Child exposure to positive

conflict experiences
 78

*Chaotic home life *Family activity

*Family violence exposure participation

*Abuse and maltreatment *A nurturing environment

*Large family that fosters communication

*Poverty between parent and child

*Teenage Parenthood

*Family history of mental

illness

*Large family size

*Gang involvement PEER *Positive and safe activity

*Lack of positive activity involvement during leisure

exposure time

*Being with juveniles who are *Positive peer friendships

involved in delinquent

behavior

*Poor academic performance SCHOOL/COMMUNITY *Enrollment in a school that

*Lack of motivation social and emotional

*Suspensions/Cutting School- concerns along with

losing commitment to academics

education *School is in a safe area

*Academic and social needs *Involvement in school

not met when social and extracurricular activities

emotional problems occur

 79

*Living in a poor and crime

infested neighborhood

Though there is not much literature that discusses Rap Therapy, there was research

explaining how Rap music has an overwhelming influence on youth and its ability to awaken one’s

emotions. The analysis resulted in the identification of two factors: 1) the commonality between

trauma and juvenile justice involvement 2) the influence of Rap Music on the juvenile population.

Factor one. Research has shown how trauma is universal among juveniles involved in the

juvenile justice system. It explains how with injury, Post-Traumatic Stress Disorder (PTSD)

symptoms will occur (National Center for Mental Health, 2006).

Emotional numbing is one of the avoidance symptoms associated with PTSD. It has

become a significant factor in theoretical models that attempt to explain the association between

childhood trauma exposure and maladaptive outcomes in adolescence as it relates to justice system

involvement and delinquent behavior. It explained that emotional numbness tends to occur as a

defense strategy after enduring trauma. Even though numbing may decrease the youth’s awareness

of the event, it may increase the likelihood the adolescent will display the distress outwardly and

react irrationally to others (Kerig et al., 2010). With emotional numbing now being specified as

one of its main symptoms, literature explains how numbing will cause one not to feel emotionally

connected to themselves or others concerning safety and well-being, which may tell why the

juvenile may not display concern for the law (Ford et al., 2008).

Callous-Unemotional traits (CU) & Secondary Psychopathy coincide with emotional

numbing. These two characteristics help explain what happens when numbing takes place within
 80

an individual and what exactly happens to emotions once they dissolve. Research has shown there

is a link between trauma and delinquency (Kerig et al., 2012). CU is described as a response deficit

to punishment and processing of emotions for others and themselves. It is also defined as a

decreased understanding of others’ emotional pain. Youth who have juvenile justice involvement

have been found to have an aggressive outlook on life and disregard for the law or others’ personal

space or property (Frick & White, 2008).

Secondary Psychopathy-acquired callousness is suggested to occur as a means of survival

for the youth when they have suffered trauma. They intentionally will detach from their emotions

to prevent them from having to deal with stressful situations (Kerig & Becker, 2010). Family

dysfunction and constant bullying can cause secondary psychopathy (Krishcher & Sevecke, 2008).

Even though the juvenile may handle situations aggressively without regard for themselves or

others, research states the minor still recognize when someone is experiencing sadness and anguish

(Bennett & Kerig, 2014). However, they display difficulty expressing their hurt and pain to avoid

the possibility of appearing vulnerable (Ford et al., 2006).

Emotional numbing, CU, trauma exposure is all a part of the Betrayal Trauma Theory

(Goldsmith et al., 2012). This theory explains that due to trauma experienced by someone the youth

had a close relationship with, it causes damaging effects. Due to the nature of the relationship, the

child may not acknowledge the hurt surrounding the trauma because, if confronted, they fear it

may damage their relationship (Freyd et al., 2007). It is possible emotional blocking and numbing

helps one to distance themselves and decrease disappointment that may be caused by others’

rejection or inconsiderate actions (Freyd et al., 2007).

Literature also strongly supports TF-CBT as being effective evidence-based therapies to

address PTSD in children and youth (Cohen, Mannarino& Deblinger. 2006). Research states there
 81

is a possibility a juvenile may not recidivate if his emotions awakened as his conscience begins to

develop. This situation causes the youth to think about the outcome of their future and decrease

the possibility of committing a crime or harming another person (Clinkinbeard, 2014).

Factor two. Literature strongly supports the use of Rap Therapy to reach youth; especially

those who have difficulty communicating in talk therapy (See Table 3).

Table 3

Literature Support for Rap Therapy

Paper/Presentation Title Topics/Areas Examined Conclusions

Elligan, D. (2000). Rap therapy: A Integrating Rap Therapy into Being able to write lyrics about

culturally sensitive approach to traditional Cognitive Behavioral what has affected your life and

psychotherapy with young African Therapy being able to put positive lyrics

American men. Journal of African into action.

American Studies, 5(3), 27-36.

Alverez III, T.T (2006). Beats, Provides a culturally responsive, Youth did not perceive Rap Music

rhymes and life in an urban setting. strength-based therapeutic services as destructive and negative; but as

SmithCollege School for Social to at-risk youth of color through an outlet for expression

Work, Northampton, Massachusetts. Hip Hop

American Music Therapy Music’s influence on different Music has an ability to be a voice

Association (2015). What is music cultures through the use of writing for those who may not be able to

therapy? Retrieved from music, playing instruments, effectively communicate their

www.Musictherapy.org/faq singing, or improvisation of music feelings

 82

Carr, C., d’Ardenne, P., Sloboda, A., How beneficial patients with PTSD Group Music Therapy was viewed

Scott, C., Wang, D., &Priebe, respond to CBT and Music Therapy as a resourceful tool for those who

S.(2012). Group music therapy for in a group setting did not respond effectively to CBT.

patients with persistent post-

traumatic stress disorder-An

exploratory randomized controlled

trial with mixed methods

evaluations. Psycho Psychotherapy.

85(2).

Davis, Keith M. (2010). Music and Using “feelings ensemble” and Creativity and expression with the

the expressive arts with children “feelings symphony” as musical use of music with children and

experiencing trauma. Journal of exercises to help children transition adolescents who have experienced

Creativity in Mental Health.5(2), back to school following a tornado. trauma proved to be beneficial

125-133.

DeCarlo, Alonzo. (2013). The Rise The use of Group Rap Therapy GRT helps build rapport between

and all of group rap therapy: A (GRT)counseling in order to reach young African American males and

critical analysis from its creator. clients specifically in the prison non African American counselors.

Sage Journals,46(2), 225-238. setting for lethally violent offenders This model also helps to increase

self-disclosure and give comfort

ability without to the youth without

having to just have dialogue with

the counselor

Galant, W., &Holosko, M. (2001). Incorporating clients who suffer GCM displayed efficacy showing

Music intervention in grief work from loss and depression with that music intervention can be

with clients experiencing loss and effectively used with grieving

 83

bereavement. Guidance & music intervention through the clients, who voluntarily embrace

Counseling, 16, 115-121. Grief Continuum Model (GCM) this approach to working through

grief.

Gonzalez, T., & Hayes, B. G. Rap Therapy’s introduction as School Counselors see how

(2009). Rap music in school psychotherapeutic intervention for reframing the way the youth

counseling based on Don Elligan's working with at-risk youth experience Rap Music in order to

rap therapy. Journal of creativity in build rapport and the youth’s

mental health, 4(2), 161-172. resilience.

Hadley, S., & Yancy, G. (Eds.). Rap Music is examined to see Social Workers understand that

(2012). Therapeutic uses of rap and people’s personal and professional Rap Therapy and Hip-Hop help

hip-hop. Routledge. perceiption of Rap Music and Hip- them meet the

Hop, and its benefits across a disenfranchised, at-risk populations

diverse therapeutic setting. “where they are.”

This genre of music identifies with the daily struggles juveniles have, especially those who

have troubled home lives, and helps them to find hope and resilience concerning themselves and

their future. Rap Music discusses topics such as poverty, strained family relationships, crime, drug

use, and violence. Many youth witness these things in their everyday lives. Because of this,

literature explains, they actively listen to Rap Music and feel as if those rap artists understand,

because they too have experienced these issues; they know the daily “struggles” that impede

success (See Table 4). They feel as though the artists genuinely understand their plight because of

having to overcome similar obstacles. There is a story of rags-to-riches (See Table 5) and a story

of resilience (See Table 6).

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Table 4

Songs discussing daily struggles, poverties, and crimes

Song Title Rap Artist Lyrical Content

“The Ghetto” Too Short “The story I tell is so incomplete,

Shaw, T (1989). The ghetto [Too five kid in the house and no food to

Short]. On short dog’s in the house eat, Don’t look at me and don’t ask

[CD]. New York, NY: Jive me why, Mama’s next door getting

Records. high, Even though she’s got five

mouths to feed, She’d rather spend

her money on a H-I-T”

“Say Hello” Jay-Z “We ain’t thugs for the sake of just

Carter, S., Davis, A. & Brocker, T. being thugs, Nobody do that where

(2007). Say hello [Jay-Z]. On we grew at, nigga, DUH!

American gangster [CD]. New The poverty line, we not above

York, NY; Rock-A-Fella Records. So outcome the mask and glove

cause we ain’t feelin’ the love

We ain’t doing crime for the sake of

doing crime, We movin’ dimes

cause we ain’t doin’ fine”

“Changes” Tupac “I see no changes, wake up in the

Shakur, T.Evans, D. & Hornsby, B., morning and I ask myself:

(1998). Changes [Recorded by ‘Is life worth living? Should I blast

Tupac Shakur]. On Greatest hits myself?’I’m tired of being poor

[CD]. Santa Monica, CA: and, even worse, I’m black my

Interscope Records (1992). stomach hurts so I’m looking for a

purse to snatch
 85

Table 5

Songs discussing Rags-to-Riches

Song Title Rap Artist Lyrical Content

“Started From The Bottom” Drake “Working all night, traffic on the

Graham, A., Shebib, N & Coleman, way home, And my uncle calling

M (2012). Started from the bottom me like, “Where ya at? I gave you

[Recorded by Drake]. On Nothing the keys told ya bring it right back.”

was the same [Digital download]. I just think it’s funny how it goes,

New Orleans, LA: Young Money. Now I’m on the road, half a million

for a show and we started from the

bottom now we’re here. Started

from the bottom now my whole

team here.”

Juicy Biggie Smalls “Super Nintendo, Sega Genesis,

Wallace, C., McIntosh, H., Combs, When I was dead broke, Man I

S., Rock, P., Olivier, Jean-Claude couldn’t picture this, 50 inch

&, Barnes, S (1994). Juicy screen, money green leather sofa,

[Recorded by Biggie Smalls]. On Got two rides, limousine and a

Ready to die [CD]. New York, NY: chauffeur, Phone bill about 2 G’s

Arista Records, Inc. flat, No need to worry, my

accountant handles that

And my whole crew is loungin'

Celebratin' every day, no more

public housin', Thinkin' back on my

one-room shack

Now my mom pimps a Ac' with

minks on her back.”

 86

“On Top Of The World” T.I. “No way should reflection be

Harris Jr., Clifford, Joseph (2008). mistaken for glorification

On top of the world [Recorded by Now I remember so vivid, me and

T.I.]. On Paper trail [CD]. Atlanta. my niggaz was livin, Sub-standard

GA: Grand Hustle Records. condition, still handlin’ business,

I'm rappin not reminiscin, and

goddamn it we did it, Cause I work

for myself and no one else cause

I'm too smart to, Put one of my

partners right through culinary art

school, Now he my personal chef so

that bread he get it, Put 'em all in

houses, cleaned up all of my

friends' credit, And now they

witnessed all the glitz and the

glamour, Catch us eatin at Straits

Atlanta with women with table

manners.”

Table 6

Songs discussing resilience

Song Title Rap Artist Lyrical Content

“I Can” Nas “If the truth is told, the youth can

Jones, N & Remi, S (2009). I can grow, They learn to survive until

[Recorded by Nas]. On God’s son they gain control, Nobody says you

have to be gangstas, hoes, Read

 87

[CD]. New York City, NY: Ill Will, more, learn more, change the globe.

Columbia Records. You can be anything in the world, in

God we trust, an architect, doctor, or

maybe an actress.”

“Be” Common I want to be as free as the spirits of

Lynn Jr., L.R., West, K, & Poyser, those who left, I'm talking Malcom,

James (2005) Be [Recorded by Coltrane, my man Yusef

Common]. On Be [CD]. New York Through death-grew conception

City, NY: GOOD, Geffen Records. New breath and resurrection

For moms, new steps in her

direction

In the right way, Told inside is

where the fight lay

“Self Destruction” Boogie Down Productions “This is all about, no doubt, to stop

KRS-One, D Nice, MC Lyte, LL violence, But first let's have a

Stetsasonic, Kool Moe Dee.
Cool J, Kool Moe Dee, Heavy D, moment of silence…Things been
MC Lyte, Doug E. Fresh,
Chuck D, Flavor Flav, Doug E. stated re-educated, evaluated
Just-Ice, Heavy D, & Public
Fresh, Just-Ice, Daddy-O, Frukwan, Thoughts of the past have faded

Enemy The only thing left is the memories

Wise, MC Delite & Ms. Melodie

(1988). Self destruction. On The of our belated, and I hate it, when

stop the violence movement [12- Someone dies and gets all hurt up

inch single]. Jive Records, New For a silly gold chain by a chump;

York, NY word up, It doesn't make you a big

man, and to want to go out and dis

your brother man, and you don't

know that's part of the plan”

 88

Based on the research, the author created the statement of the problem for this study. It was

developed to design a strategy to combine components of TF-CBT and Rap Therapy to craft an

integrative model to help reduce recidivism among juvenile delinquents possibly. Three questions

were submitted to help formulate the development of the model. The research questions were as

follows:

1. What are the core components of Rap Therapy for addressing recidivism in juvenile

delinquents?

2. What selected elements of TF-CBT address recidivism in juvenile delinquents?

3. How can the core components of Rap Therapy be integrated with selected parts of TF-

CBT

to develop a treatment model for reducing recidivism in juvenile delinquents?

Statement of the problem

The problem of this study was developing an integrative treatment model using Rap

Therapy and selected components of TF-CBT to reduce recidivism among juvenile delinquents.

What are the core components of Rap Therapy for addressing recidivism in juvenile delinquents?

The selected elements are a review of the literature on the history of Rap Therapy were done. The

core components identified are: (a)Assessment, (b)Alliance, (c)Reframing, (d)Role Play,

(e)Action and (f)Maintenance (See Table 7).

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Rap Therapy Components

Component Component Explanation Component Goal

Assessment The counselor and the youth *The counselor determines if

discuss music by discussing the youth has a strong interest

the youth’s favorite rap in Rap Music

songs, artists, and groups

Alliance The counselor and the youth *The counselor and the youth

listen to the rap music that build a positive rapport

the adolescent stated that he *The counselor is able to gain

liked an understanding of what

specific type of Rap Music

the youth likes (trap music,

gangsta rap,etc)

Reframing The counselor helps the *The counselor begins to

adolescent interrupt other encourage thought

lyrics and the meaning reconstruction.

behind the words

Role Play The counselor and adolescent *The counselor assesses

begin to write their own rap lyrics to help continue

thought reconstruction.
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Action and Maintenance The counselor motivates the *The counselor determines

youth to put his restructured whether or not thought

lyrics into action. reconstruction was successful

*The youth has learned how

to restructure negative

thoughts to prevent negative

actions

What selected components of TF-CBT address recidivism in juvenile delinquents? The

selected elements are the following: (a)Psychoeducation, (b)Affective Modulation, (c)Trauma

Narrative, (d)In Vivo Exposure and Mastery, and (e)Cognitive Coping (See Table 8). While all

components of TF-CBT are essential in helping a client heal from the traumatic experience(s),

only five elements of TF-CBT used to coincide with the five parts of Rap Therapy.

Table 8

Selected TF-CBT Components

Component Component Explanation Component Goal

Psychoeducation The initial assessment is done • Describe selected

surrounding the trauma and components of TF-CBT

(structure, expectations)
PTSD is explained. This is

when hope and the possibility • Normalized trauma

of resilience takes place exposure

• Explain how treatment

works
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Affective Modulation The individual learns how to • Identification of feelings

ventilate feelings effectively associated with traumatic

event
and learns about the cognitive

triangle • Learn the relationship

thoughts between thoughts,

feelings, and behaviors

• Normalizing feelings of

conflict

feelings behaviors
• Identification of calming

strategies

Trauma Narrative The individual begins to share • Talking about the

their feelings surrounding the traumatic experience in

depth
traumatic experience

• Identify inaccurate

cognitions related to the

traumatic event

• Identify accurate strategies

to think about the

traumatic exposure,

family, self, and the future

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• Develop an understanding

of the experiences and

gain the understanding the

trauma does not define the

individual

In Vivo Exposure & The individual divulges as • Reduction of avoidance

Mastery much information about their that interrupts normalcy in

daily life functioning

most fear situation so that

they may learn how to • Separate innocuous

overcome the fear gradually conditioned fear responses

over time

Cognitive Coping Inaccurate cognitions • Learning the identity of

negative unhelpful or
surrounding the trauma are
inaccurate thoughts that
addressed
the individual may not be

aware

• Gaining the understanding

that thoughts drive

feelings and that thoughts

can change

How can the core components of Rap Therapy be integrated with selected elements of TF-

CBT to develop a treatment model for reducing recidivism in juvenile delinquents? Rap Therapy

and TF-CBT incorporated into the core components of Rap Therapy due to both therapies’ ability
 93

to help juveniles overcome traumatic events, even though they both address these events

differently (See Table 8).

Table 9

Rap Therapy /TF-CBT Comparison

Rap Therapy Addresses: TF-CBT Addresses:

Culture Trauma

Sense of community Trauma symptoms

Musical ability to express feelings Depression

Rags to riches inspiration Improving parenting practices

Table 10 displays risk factors addressed within Rap & TF-CBT Therapy Integration to create the

Powerful Mind Model.

Table 10

Powerful Minds
Risk Factors/Targets of Rap Therapy Component TF-CBT Component Used

Treatment Used

Family violence exposure Reframing Psychoeducation, Trauma

Abuse & maltreatment
Narrative, Affective
Modulation
Reframing Psychoeducation, Trauma
Narrative ,Cognitive
Coping, Affective
Modulation, In Vivo
Exposure & Mastery
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Lack of positive activity Assessment Not Applicable

exposure

Impact of living in poverty Alliance, Role Play, Cognitive Coping, In Vivo

Reframing, Action and
Maintenance
Gang involvement Alliance, Role Play,
Reframing, Action and
Maintenance
Impact of living in a poor & Alliance, Role Play,
Reframing, Action and
crime infested neighborhood Maintenance
Exposure & Mastery
Not Applicable
Trauma Narrative, In Vivo
Exposure, Cognitive
Coping

Lack of motivation for Reframing, Role Play, Action Cognitive Coping

and Maintenance
positive future

Figure 1identifies the issues addressed and combined therapies used to help youth achieve

success within the Powerful Minds Integrated Model.

 95

Figure 1

Powerful Minds Model

Powerful
Minds

TF-CBT Rap

Product Preparation

In preparation for constructing the model, the author of the project reviewed research

concerning TF-CBT and the entrance of Rap Therapy into traditional cognitive behavioral therapy.

This study helped to formalize the Powerful Minds Integrated Treatment Model. The order of the

components, as it relates to activity sessions set at attempting to achieve maximum success with

helping the youth find self-worth and gain a positive outlook concerning their future by awakening

those emotions dampened due to trauma.

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Product Realization

Like TF-CBT, this integrative treatment model is designed to be short-term lasting 12 to

16 sessions (Cohan, Mannarino, and Deblinger, 2006). However, the number is approximate

depending upon the juvenile’s progression. The primary focus of the model is to help reduce

juvenile delinquency in the community, to help juveniles understand it is very realistic to have

goals and to be able to accomplish them, and to break vicious cycles that have possibly plagued

their family for generations.

The Powerful Minds Integrated Model aims at fostering resilience, possibly helping youth

become more aware of self-preservation; which, in turn, may decrease recidivism. Each session

will always be focused Rap Therapy components, TF-CBT component, or both therapies fused

together. The juvenile may stay in one element longer than another due to the difficulty

comprehending or discussing matters involving the traumatic experience and recidivism with the

goal being to decrease or cease emotional numbing and increase emotional awakening,

consciousness concerning self, and reduction of juvenile crime. The model is designed to uplift

youth through an unconventional technique that helps one to communicate feelings effectively.

This program is to remind the juvenile of the consequences of breaking the law, as a means to

motivate positive change; to increase the awareness surround self-care; and to motivate students

to refrain from peer pressure or succumb to negative family culture.

Conclusion

Chapter 4 explains the process used to develop the Powerful Minds Integrated Model

utilizing the DRU model for its research method. With further research was done using this

product, it is possible there will be a significant percentage of court-ordered youth who will enjoy

the different approach Powerful Minds gives to traditional therapy.

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CHAPTER V: DISCUSSION

The purpose of this project was to create an integrative model incorporating Rap Therapy

and selected components of TF-CBT to help reduce recidivism among juvenile delinquents by

treating the client’s underlying trauma. The model was designed by the Developmental and

Utilization Model (Southern, 2007), a systematic approach to product development. The previous

chapters written have described how the treatment model was established. The research questions

addressed within this process were the following:

1. What are the components of Rap Therapy for treating recidivism in juvenile

delinquents?

2. What selected elements of TF-CBT address recidivism in juvenile delinquents?

3. How can the core components of Rap Therapy be integrated with selected parts of TF-

CBT

to develop a treatment model for reducing recidivism in juvenile delinquents?

The inspiration surrounding this product was discerned by integrating Rap Therapy and

selected core components of Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) to build a

treatment model to address trauma as it relates to emotional dampening, juvenile delinquency, and

recidivism. Rap Therapy & TF-CBT have both been successful in their right to help youth gain a

sense of resilience, possibly help cease negative family cultures and promote normal mental health

by awakening the dampened feelings of the child due to trauma. By addressing these issues and

others surrounding the dynamics of the juvenile, this model could help reduce the amount of

criminal activity that plagues this population.

Rap Therapy has embraced in several programs target troubled youth who have a plethora

of issues that prevented them from being able to express their feelings healthily and efficiently.
 98

However, this particular therapy has not been implemented into juvenile detention programs that

draw attention to traumatic experiences. The treatment model was formulated to engage the youth

in a program that is designed to address trauma, family issues, self-esteem, and many more

concerns that have caused juveniles to lose sight of developing into productive, law-abiding

citizens.

The Analysis Phase explained the extent of how trauma affects human psyche which

resulted in recognizing an area of research needed to be addressed. The majority of research

discussed in detail, the growing population lacked the services focused on the healing of PTSD

due to trauma in juvenile detention centers. The undersupply of research displayed a need for

examination of how rap music largely influences the youth of today and could have such an impact

if infiltrated into the juvenile justice programs.

The examination of written works pertinent to juvenile crimes, recidivism, and different

treatment methods used to address delinquency among this population justifies the expressed need

for the problem statement to be sent. These problems can be solved by developing an integrative

model using Rap Therapy and selected components of TF-CBT to reduce recidivism among

juvenile delinquents; how to assist and aid youth who have suffered trauma; and how emotional

dampening could lead to constant justice court involvement could be deterred from committing

crimes in the future if they become aware of their purpose, as well as the concern they should have

for others. The Analysis Phase led the selection of specific research and provided direction for the

development of the product.

The structure of the Development Phase steered the preparing of the product (model).

Within this phase, the core components of Post-Traumatic Stress Disorder (PTSD), TF-CBT, &

Rap Therapy and recidivism were reviewed.

 99

Limitations

An apparent restriction of the product (model) built in this project is that model

effectiveness could not be tested. The product advanced through the first two phases of the DRU

model (Analysis and Development). The product did not develop through the third stage

(Evaluation).

The researcher has identified limitations of this study. The author’s training in TF-CBT

and extensive musical background lends to the belief that any counselor/therapist can use the

model with confidence and exactness. However, if the counselor/therapist lacks competence and

interest in TF-CBT and Rap Therapy, the success of the model could minimize positive outcomes

and potentially harm the client if trauma has been exposed and not adequately dealt with during

the use of the model. A limitation concerning this model is that TF-CBT can only be used by those

who are nationally certified. Also, those who created TF-CBT do not desire for the model to be

amended in any form. Another limitation is there is a lack of research done on Rap Therapy and

different Rap Therapy techniques that could be implemented to “meet” the juvenile emotionally

and mentally “where they are.” Lastly, the model nis limited due to the lack of focus on specific

criminal acts conducted when juveniles recidivate.

Implications and Recommendations

Therapies such as Cognitive Behavioral Therapy(CBT), Multisystemic Therapy(MST),

Functional Family Therapy(FFT), Treatment Foster Care, and Brief Family Therapy are used in

juvenile detention and community mental health centers. These centers are used to address one’s

life’s issues, how to build positive caregiver/child relationships. Therefore, to some degree, all

information provided is not new.

 100

Despite the overwhelmingly positive response to TF-CBT and the favorable impact of

Rap Therapy, there is still a lack of programs that possess activities that are relevant to African-

American and Hispanic--those who are mostly the majority who have consistent involvement with

the justice system. The limited lack of prevention programs that focus on trauma within the justice

system demonstrates a need for this model that could be of use to help benefit the youth while

being detained instead of their stay being merely a holding place for juveniles until their court-

given time done.

Conclusion

This project integrated Rap Therapy and selected components of TF-CBT to help reduce

recidivism among juvenile delinquents to construct a model that outlines a prevention strategy for

this population. Past research has shown the effectiveness of both therapies; which all the more

explains why the treatments would be extremely conducive to help prevent youth from repeating

criminal acts.

The procedures of Developmental Research and the Utilization Model have been

significant to the development of the construction of Rap and TF-CBT integrated model (Powerful

Minds Integrated Model). The objective of the Project Demonstrating Excellence (PDE) achieved

the intended goal of addressing pertinent questions, research issue investigation, and created an

integrative model that will be beneficial to all youth. The author is optimistic about this PDE; that

it will compel more research and treatment professionals to carefully examine the potency that

Rap Therapy offers to implement new and innovative strategies through the use of this genre of

music.
 101

References:

Abram, K. M., Teplin, L. A., King, D. C., Longworth, S. L., Emanuel, K. M., Romero, E. G., &

Olson, N. D. (2013). PTSD, trauma, and comorbid psychiatric disorders in detained

youth. Washington, DC: US Department of Justice, Office of Justice Programs, Office of

Juvenile Justice and Delinquency Prevention.

Alverez III, T.T (2006). Beats, Rhymes and Life:Rap Therapy in an Urban Setting.

SmithCollege School for Social Work, Northampton, Massachusetts.

American Music Therapy Association (2015). What is music therapy? Retrieved from

www.Musictherapy.org/faq

American Psychiatric Association (2013). American Psychiatric Association: Desk Reference

from the Diagnostic Criteria from DSM-5. Arlington, VA: American Psychiatric

Association.

Armour, J. & Hammond, S. (2009). Minority Youth in the Juvenile Justice System Minority

Youth in the Juvenile Justice System Disproportionate Minority Contact. National

Conference of State Legislature. Retrieved from

https://www.ncsl.org/print/cj/minoritiesinjj.pdf.

Baer, J., & Maschi, T. (2003). Random acts of delinquency: Trauma and self-destructiveness in

juvenile offenders. Child and Adolescent Social Work Journal, 20(2), 85-98.

Barab, S., & Squire, K. (2004). Design-based research: Putting a stake in the ground. The

Journal of the Learning Sciences, 13(1), 1-14.

Baglivio, M. T., Wolff, K. T., Piquero, A. R., & Epps, N. (2015). The relationship between

adverse childhood experiences (ACE) and juvenile offending trajectories in a juvenile

offender sample. Journal of Criminal Justice, 43(3), 229-241.

 102

Belenko, S. &Logan,T.K. (2003). Delivering more effective treatment to adolescents: Improving

the juvenile drug court model. Journal of Substance Abuse Treatment. Volume 25, p.

189-211.

Bennett, D. C., & Kerig, P. K. (2014). Investigating the construct of trauma‐related acquired

callousness among delinquent youth: Differences in emotion processing. Journal of

Traumatic Stress, 27(4), 415-422.

Blair, R.J.R. (1999). Responsiveness to distress cues in the child with psychopathic tendencies.

Personality and Individual differences, 27(1), 135-145.

Blueprints for Healthy Youth Development (2016). Functional Family Therapy(FFT).

Retrievedfromhttp://www.blueprintsprograms.com/factsheet/functional-family-therapy-

fft

Blueprints for Healthy Youth Development (2016). Multisystem Therapy (MST).

Retrievedfromhttp://www.blueprintsprograms.com/factsheet/multisystemic-therapy-mst

Bouduin, C.M., Heiblum, N., Jones, M.R., and Grabe, S.A. (2000). Community-based

treatmentof serious antisocial behavior in adolescents. In W.E. Martin (Ed.). Person-

EnvironmentPsychology and Mental Health: Assessment and Intervention. Mahwah, NJ:

Lawrence Erlbaum Associates Publishers.

Boyd, Laura W. (2013). Therapeutic Foster Care: Exceptional Care for Complex, Trauma-

Impacted Youth in Foster Care (pdf). Retrieved from

https://childwelfaresparc.files.word.Press.com/2013/07/therapeutic-foster-care-

exceptional-care-for-complex-trauma-impacted- Youth-in-foster-care.

Burfeind, J., & Bartusch, D. J. (2015). Juvenile delinquency: An integrated approach. Routledge.
 103

Caldwell, R. M., Silver, N. C., & Strada, M. (2010). Substance abuse, familial factors, and

mental health: Exploring racial and ethnic group differences among African American,

Caucasian, and Hispanic juvenile offenders. The American Journal of Family Therapy,

38(4), 310-321.

Carr, C., d’Ardenne, P., Sloboda, A., Scott, C., Wang, D.&Priebe, S.(2012). Group music

therapy for patients with persistent post-traumatic stress disorder-an exploratory

randomized controlled trial with mixed methods evaluation. Psycho Psychotherapy,

85(2).

Carter, S., Davis, A. & Brocker, T. (2007). Say hello [Jay-Z]. On American gangster [CD]. New

York, NY; Rock-A-Fella Records.

Cauffman, E. (2008). Understanding the female offender. The Future of Children, 18(2), 119-

142.

Child Welfare Committee, National Child Traumatic Stress Network. (2008). Child welfare

trauma training tool kit: Comprehensive guide (2nded). Los Angeles, CA& Durham:

National Center for Child Traumatic Stress.

Clinkinbeard, S.S. (2014). What Lies Ahead: An Exploration of Future Orientation, Self-

Control, and Delinquency. Criminal Justice Review, 39(1), 19-36.

Cohen, Judith.A., Mannario, Anthony P., &Deblinger, Esther (2006). Treating trauma and

traumatic grief in children and adolescents. Journal of Psychological Trauma, 7(1), 63-

65.

Colins, O. F. (2016). The clinical usefulness of the DSM–5 specifier for conduct disorder outside

of a research context. Law and Human Behavior, 40(3), 310.

 104

Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A. (2009). Childhood and adolescent

psychiatric disorders as predictors of young adult disorders. Archives of

General Psychiatry, 66(7), 764-772.

Davis, Keith M. (2010). Music and the expressive arts with children experiencing trauma.

Journal of Creativity in Mental Health, 5(2), p.125-133.

Deblinger, E., Yasinki, C., Hayes, A.M., Cummings, J.A., Mc.Cauley, T., Ready, C.B., Berman,

I.S., Webb, C. In-session caregiver behavior predicts symptom change in youth receiving

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Journal of Consulting and

ClinicalPsychology, 84(12), 1066-1077.

Deblinger, Esther, Pollio, Elisabeth, Runyon, Melissa K., Steer, Robert A. Improvements in

Personal resiliency among youth who have completed trauma-focused cognitive

behavioral Therapy: A preliminary examination (2017).

DeCarlo, Alonzo (2013). The rise and call of Group Rap Therapy: A critical analysis from its

creator. Sage Journals, 46(2), 225-238.

DeLisi, M., Trulson, C. R., Marquart, J. W., Drury, A. J., & Kosloski, A. E. (2011). Inside the

prison black box: Toward a life course importation model of inmate behavior.

International journal of offender therapy and comparative criminology, 55(8), 1186-

1207.

Dierkhising, C.B., Ko, Susan J., Wood-Jaeger, B., Briggs, E. C., Lee, R., Pynoos, R.S. (2013).

Trauma histories among justice-involved youth: findings from the National Child

Traumatic Stress Network. European Journal of Psychotraumatology.4(1), 1-12.

 105

Durose, M. R., Cooper, A. D., Synder, H. D. (2014). Recidivism of Prisoners Released in 30

States in 2005: Patterns from 2005 to 2010. Bureau of Justice Statistics. Retrieved from

http://www.bjs.gov/content/pub/pdf/rprts05p0510.pdf

Elligan, D. (2000). Rap therapy: A culturally sensitive approach to psychotherapy with young

African American men. Journal of African American Studies, 5(3), 27-36.

Ellis, C. (2014). Landmark Hip Hop Hits. Simon and Schuster.

Ellison, D. M. (2014). Incorporating self-defense training with feminist group therapy to

facilitate trauma resolution in adult female survivors of sexual abuse(Doctoral

dissertation, Mississippi College).

Emanuel, K.M., Romero, E.G., and McClelland, G.M. (2007). Posttraumatic stress disorder and

psychiatric comorbidity among detained youth. Psychiatric Services.58(10), 1311-1316.

Falck, Suzanne (2017). Understanding emotional numbness. Retrieved from

https://www.healthline.com/health/feeling-numb#overview1.

Finkelhor, D., Turner, H., Ormond, R., & Hamby. S. (2009). Violence, abuse, and crime

exposure in a national sample of children and youth. Pediatrics, 124(5), 1411-1423.

Foley, R. M., & Pang, L. S. (2006). Alternative education programs: Program and student

characteristics. The High School Journal, 89(3), 10-21.

Ford, J. D., Chapman, J., Mack, J. M., & Pearson, G. (2006). Pathways from traumatic child

victimization to delinquency: Implications for juvenile and permanency court

proceedings and decisions. Juvenile and Family Court Journal, 57(1), 13-26.

Ford, J.D., Hartman, J.K, Hawke, J., Chapman, J.F. (2008). Trauma Victimization, Posttraumatic

Stress Disorder, Suicidal Ideation, and Substance Abuse Risk Among Juvenile Justice-

Involved Youth. Journal of Child and Adolescent Trauma,1(1), 75-92.

 106

Freyd, J. J., DePrince, A. P., & Gleaves, D. H. (2007). The state of betrayal trauma theory: Reply

to McNally—Conceptual issues, and future directions. Memory, 15(3), 295-311.

Frick, P. J., Marsee, M. A., & Patrick, C. (2006). Psychopathy and developmental pathways to

antisocial behavior in youth. Handbook of psychopathy, 353-374.

Frick, P. J., Ray, J. V., Thornton, L. C., & Kahn, R. E. (2014). Can callous-unemotional traits

enhance the understanding, diagnosis, and treatment of serious conduct problems in

children and adolescents? A comprehensive review. Psychological Bulletin, 140(1), 1.

Frick, P. J., & White, S. F. (2008). Research review: The importance of callous‐unemotional

traits for developmental models of aggressive and antisocial behavior. Journal of Child

Psychology and Psychiatry, 49(4), 359-375.

Galant, W., &Holosko, M. (2001). Music intervention in grief work with clients experiencing

loss and bereavement. Guidance & Counseling, 16(4), 115-121.

Giaconia, R. M., Reinherz, H. Z., Hauf, A. C., Paradis, A. D., Wasserman, M. S.,

&Langhammer, D. M. (2000). Comorbidity of substance use and post-traumatic stress

disorders in a community sample of adolescents. American Journal of Orthopsychiatry,

70(2), 253.

Glfun, J.F., & Sands, R.G. (2012). The contribution of qualitative approaches to developmental

Intervention research. Qualitative Social Work, 349-361.

Godbout, N., Briere, J., Sabourin, S., & Lussier, Y. (2014). Child sexual abuse and subsequent

Relational and personal functioning: The role of parental support. Child Abuse

&Neglect.38(2), 317-325.

Gold, C., Saarikallio, S. H., & McFerran, K. (2011). Music therapy. In Encyclopedia of

adolescence 1826-1834.
 107

Goldsmith, R. E., Freyd, J. J., &DePrince, A. P. (2012). Betrayal trauma: Associations with

psychological and physical symptoms in young adults. Journal of interpersonal violence,

27(3), 547-567.

Gonzalez, T. & Hayes, Grant B. (2009). Rap Music in School Counseling based on

DonElligan’s rap therapy. Journal of Creativity in Mental Health,4(2), 161-172.

Gottfredson, M.R., & Hirschi, T. (1990). A general theory of crime. Standford, CA:

StanfordUniversity Press.

Graham, A., Shebib, N & Coleman, M (2012). Started from the bottom [Recorded by Drake]. On

Nothing was the same [Digital download]. New Orleans, LA: Young Money.

Hadley, S., & Yancy, G. (Eds.). (2012). Therapeutic uses of rap and hip-hop. Routledge.

Harris Jr., Clifford, Joseph (2008). On top of the world [Recorded by T.I.]. On Paper trail [CD].

Atlanta. GA: Grand Hustle Records.

Havelock, R. G. (1969). A Comparative Study of the Literature on the Dissemination and

Utilization of Scientific Knowledge.

Herrington, J., McKenney, S., Reeves, T., & Oliver, R. (2007). Design-based research and

doctoral students: Guidelines for preparing a dissertation proposal.

Jackowski, A. P., De Araújo, C. M., De Lacerda, A. L. T., de Jesus Mari, J., & Kaufman, J.

(2009). Neurostructural imaging findings in children with post‐traumatic stress disorder:

Brief review. Psychiatry and Clinical Neurosciences, 63(1), 1-8.

Jones, N & Remi, S (2009). I can [Recorded by Nas]. On God’s son [CD]. New York City, NY:

Ill Will, Columbia Records.

Kerig, P. K., Bennett, D. C., Chaplo, S. D., Modrowski, C. A., & McGee, A. B. (2016).

Numbing of Positive, Negative, and General Emotions: Associations with Trauma

 108

Exposure, Posttraumatic Stress, and Depressive Symptoms among Justice‐Involved

Youth. Journal of Traumatic Stress, 29 (2), 111-119.

Kerig, P. K., Bennett, D. C., Thompson, M., & Becker, S. P. (2012). “Nothing really matters”:

Emotional numbing as a link between trauma exposure and callousness in delinquent

youth. Journal of traumatic stress, 25(3), 272-279.

Kerig, P. K., Becker, S. P., & Egan, S. (2010). From internalizing to externalizing: Theoretical

models of the processes linking PTSD to juvenile delinquency. Posttraumatic stress

disorder (PTSD): Causes, symptoms and treatment, 33-78.

Kobin, C., & Tyson, E. (2006). Thematic analysis of hip-hop music: Can hip-hop in therapy

facilitate empathic connections when working with clients in urban settings? The arts in

psychotherapy, 33(4), 343-356.

KRS-One, D Nice, MC Lyte, LL Cool J, Kool Moe Dee, Heavy D, Chuck D, Flavor Flav, Doug

E. Fresh, Just-Ice, Daddy-O, Frukwan, Wise, MC Delite & Ms. Melodie (1988). Self

destruction. On The stop the violence movement [12-inch single]. Jive Records, New

York, NY

Lynn Jr., L.R., West, K, & Poyser, James (2005) Be [Recorded by Common]. On Be [CD]. New

York City, NY: GOOD, Geffen Records.

Maciejewski, P. K., & Prigerson, H. G. (2013). Emotional numbness modifies the effect of end-

of-life discussions on end-of-life care. Journal of pain and symptom management, 45(5),

841-847.

Marsh, A. A., Finger, E. C., Mitchell, D. G., Reid, M. E., Sims, C., Kosson, Pine, D. S., & Blair,

R. J. R. (2008). Reduced amygdala response to fearful expressions in children and

 109

adolescents with callous-unemotional traits and disruptive behavior disorders. American

Journal of Psychiatry, 165(6), 712-720.

Mulvey, E.P. (2011). Highlights from Pathways to Desistance: A Longitudinal Study of

SeriousAdolescent Offenders. Office of Juvenile Justice and Delinquency Prevention. 1-

4.

National Center for Educational Statistics. (2016). Retrieved from

https://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2017015

National Center for Injury Prevention and Control Division of Violence Prevention (2016).

Retrieved from https://www.cdc.gov/violenceprevention/pdf/yv-datasheet.pdf

National Center for Mental Health and Juvenile Justice (2016). Retrieved from

https://www.ncmhjj.com/wp-content/uploads/2016/09/Trauma-Among-Youth-in-the-

Juvenile-Justice-System-for-WEBSITE.pdf

National Institute of Drug Abuse, “Principles of Drug Abuse Treatment for Criminal Justice

Populations – a Research-Based Guide.” (2014). Retrieved from

https://www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-

justice-populations/why-should-drug-abuse-treatment-be-provided-to-offe

National Institute of Justice, “Recidivism,” (2014). Retrieved from

https://www.nij.gov/topics/corrections/recidivism/Pages/welcome.aspx

Richey, R. C., & Klein, J. D. (2005). Developmental research methods: Creating knowledge

from instructional design and development practice. Journal of Computing in higher

Education, 16(2), 23-38.

Rine, Christine M. (2013). Therapeutic uses of rap and hip-hip. Health & Social Work.38(1), 59-

62.
 110

Rose, T. (2008). The hip hop wars: What we talk about when we talk about hip hop--and why it

matters.Civitas Books.

Saunders, B. E. (2003). Child physical and sexual abuse: Guidelines for treatment.

Shakur, T., Evans, D.,& Hornsby, B., (1998). Changes [Recorded by Tupac Shakur]. On

Greatest hits [CD]. Santa Monica, CA: Interscope Records (1992).

Sharpe, E.G. &Litzelfelner P. (2004). Juvenile Case Characteristics And Risk Factors As

Predictors Of Re-Offenses. Journal for Juvenile Justice Services, 19(1/2), 73-84.

Shirk, S.R., DePrince, A., Crisostomo, P. S., Labus, J. (2014). Cognitive Behavioral Therapy for

Depressed Adolescents Exposed to Interpersonal Trauma: An Initial Effectiveness Trial.

Psychotherapy 2014. 51(1), 167-179. Retrieved from

http://sshs.promoteprevent.org/sites/defaut/files/trauma_brief_in_final.pdf\

Stoolmiller, M., &Blechman, E. A. (2005). Substance use as a robust predictor of adolescent

Recidivism. Criminal Justie and Behavior, 32(3), 302-328.

Southern, S. (2007). The developmental research and utilization model. Unpublished manuscript,

Texas A&M, University-Corpus Christi.

Synder, Howard N., Sickmund, Monica (2006). Juvenile offenders and victims: 2006national

report. Washington, D.C.: Office of Juvenile Justice and Delinquency Prevention.

Teplin, L.A., Charles D.R., Longwork, S.L., McClelland, G.M, and Dulcan, M.K., Abram, K.M.,

Washburn, J.J. (2004). Posttraumatic stress disorder and trauma in youth in juvenile

detention. Archives of General Psychiatry. 61(4), 403-410.

The Indiana Department of Corrections (2014). Retrieved from

http://www.in.gov/idoc/files/2015JuvRecidivismRpt.pdf
 111

The National Center for PTSD (2016). PTSD in children and teens. Retrieved from

https://www.ptsd.va.gov/public/family/ptsd-children-adolescents.asp

The National Institute of Justice (2014). Retrieved from

https://www.nij.gov/topics/crime/Pages/delinquency-to-adult-offending.aspx

Turner, H.A., Finkelhor, D., &Ormrod, R. (2006). The effect of lifetime victimization on the

mental health of children adolescents. Social Science & Medicine, 62(1),13-27.

U.S. Administration for Children & Families, Child Maltreatment. (2015). Retrieved from

https://www.acf.hhs.gov/cb/resource/child-maltreatment-2015

US Department of Health and Human Services. (2010). Comorbidity: Addiction and Other

Mental Illnesses. Retrieved

fromhttps://www.hhs.gov/sites/default/files/ash/initiatives/mcc/mcc-inventory-

20111018.pdf

US Department of Health and Human Services. Healthy People 2020. (2010). Retrieved from

http://www.healthypeople.gov.

Wallace, C., McIntosh, H., Combs, S., Rock, P., Olivier, Jean-Claude &, Barnes, S. (1994). Juicy

[Recorded by Biggie Smalls]. On Ready to die [CD]. New York, NY: Arista Records,

Inc.

Welty, Leah J., Olson, Nichole, D. (2013). PTSD, Trauma, and Comorbid PsychiatricDisorders

in Detained Youth. (2013). Adapted from Abrahm, K.M., Washburn.

Wevodau, Amy. Review of Trauma Screening Tools for Children and Adolescents. (2016).

Retrieved from

http://www.nysap.us/Review%20of%20Trauma%20Screening%20Tools%20for%20Chil

dren%20&%20Adolescents.pdf
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Williamson, V., Creswell, C., Butler, I., Christie, H., & Halligan, S. L. (2016). Parental

responses to child experiences of trauma following presentation at emergency

departments: a qualitative study. BMJ open, 6(11), e012944.

Wolff, K. T., Baglivio, M. T., & Piquero, A. R. (2017). The relationship between adverse

childhood experiences and recidivism in a sample of juvenile offenders in community-

based treatment. International Journal of Offender Therapy and Comparative

Criminology,61(11), 1210-1242.

Wolff, K. T., & Baglivio, M. T. (2016). Adverse childhood experiences, negative emotionality,

and pathways to juvenile recidivism. Crime & Delinquency, 0011128715627469.

Yampolskaya, S. Chaung, E., (2012). Effects of mental disorders on the risk of juvenile justice

system involvement and recidivism among children placed in out-of-home care.

American Journal of Orthopsychiatry. 82(4), 585-593.

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Appendix A

THE INTRODUCTION AND PURPOSE OF THE TREATMENT MANUAL AND THE

CONFIDENTIALITY FORM
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INTRODUCTION
The Powerful Minds treatment manual represents a finished product designed to promote the

decrease of recidivism among juvenile offenders by integrating Rap Therapy and selected

components of Trauma Focused Cognitive Behavioral Therapy (TF-CBT). This manual was

created to increase awareness that there is a need for an increase of trauma focused interventions

in juvenile detention centers. Research stated that up to 90% of justice-involved youth report

exposure to some type of traumatic event. On average, 70% of youth meet criteria for a mental

health disorder with approximately 30% of youth meeting criteria for post-traumatic stress

disorder (PTSD). “Justice-involved youth are also at risk for substance use and academic

problems, and child welfare involvement” (Dierkhising et. al, 2013, p.1).

This manual serves as a workbook to treat juvenile offenders between 12-17 years old. It

involves 5 components of Rap Therapy and TF-CBT infused activities that, with committed

participation of the juvenile with the juvenile’s counselor, could help improve trauma- related

issues within 8-25 sessions that last from 60 minutes to 80 minutes.

Powerful Minds was developed after the realization that most programs that service the

youth use some form of traditional talk therapy. There was a lack of research and interventions

that focused on Rap Therapy and its ability to reach troubled youth who have had involvement

with the law; especially the African American and Hispanic population. The realization, along

with the assessment of accessible research, helped to give birth to the Powerful Minds model.
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Rights of Individuals Receiving Services

I,______________________________, entered Powerful Minds on ________________ and

have been informed of the following:
1. My options within the program and other services available.
2. The programs rules and regulations.
3. The responsibility of the program to refer me to another agency, if this program becomes
unable to serve me or meet my needs.
4. My right to refuse treatment and withdraw from this program at any time.
5. My right to not be subjected to corporal punishment or unethical treatment which
includes my right to be free from all forms of abuse or harassment and my right to be free
from restraints of any form that are not medically necessary or are used as a means of
coercion, discipline, convenience or retaliation from staff.
6. My right to voice my opinion, recommendations, and a written grievance to result in
program review and response without retribution.
7. My right to privacy in respect to facilities and visitors.
8. My right regarding the program’s nondiscrimination policies related to HIV infection and
AIDS.
9. My right to be treated with consideration, respect and full recognition of my dignity and
individual worth.
10. My right to review my records, except when restricted by law.
11. My right to fully participate in and receive a copy of my comprehensive treatment plan
and have access to my records.
12. My right to retain all Constitutional rights, except when restricted by due process and
resulting court order.
13. My right to have a family member or representative of my choice notified should I be
admitted into a hospital.
14. My right to receive care in a safe setting.
15. My right to confidentiality regarding my personal information involving receiving
services as well as the compilation, storage and dissemination of my individual case
records
16. My right to be provided means of communicating with persons outside the program
17. My right to have visitation by close relatives and/or significant others during reasonable
hours unless clinically contraindicated and documented in my case record.
18. My right to be permitted to send/receive mail without hindrance unless clinically
contraindicated and documented in my case record.
19. My right to conduct private telephone conversations with family and friends, unless
clinically contraindicated and documented in my case record.

Release of Information Without Consent: This service provider/program may, without

consent, divulge information and/or contact a third party(ies) regarding the individual
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services if there is indication, by word or action, that he/she (1) is, or recently has been,
abusing a child, or has been abused (2) intends to physically harm another person (3)
intends to physically harm themselves (4) is unable to provide for his/her own physically
safety, including but not limited to, a medical emergency: or (5) if I understand that my
healthcare information may be disclosed to Medicaid, and/or other third party payers for
the purpose of insurance eligibility determination, coverage, and payment for services.

Court Order Policy: Written information/materials regarding the individual receiving

services are subject to Court Order. Should a Court Order all, or any portion of, the case
records of the individual receiving services, this service provider will submit them to
court.

Third Parties: Essential information will be released for insurance purposes and to
other necessary third parties including labs for testing for substance use.

CONSENT ORDER POLICY

I am requesting services from this service provider. The information I have provided as a
condition of my request is true and complete to the best of my knowledge. I apply for and
consent to such psychiatric consultation

_______________________ ___________________________
Individual’s Signature Parent/Guardian Signature

________________________
Counselor’s Signature
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Appendix B
INTIAL INTAKE ASSESSMENT
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General Information
Name:
Informant(s):
Age: Date of Birth: Gender: Race:

Guardianship Information

Does the individual have a court appointed legal guardian?

Guardianship documentation verified:

Name of Guardian/Custodian:

Address of Guardian/Custodian:

Phone No. of Guardian/Custodian:

Does the individual seeking services have an outpatient commitment order?

**If so, what court issued the order?**

Is the individual or family of the individual involved with (i.e. have an active case) the

Department of Human Services?

If yes, has consent to release information been obtained?

If yes and applicable, please explain and indicate the name of the assigned case worker:

Confidentiality

Were the limits of confidentiality reviewed with individual and/or legal guardian?

Referral Source

Who referred the individual?

Participants in this initial assessment?

Description of Need
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What is your reason for seeking services today?

Is the reason for seeking services related to any traumatic experiences?

Is the reason for seeking services related to substance use?

Trauma History

Have you ever seen or been in a really bad accident?

Has someone close to you ever been in a really bad accident?

Has someone close to you ever been so badly injured or sick that she/he almost died?

Has someone close to you ever died?

Have you ever been so sick that you or the doctor thought you might die?

Have you ever been unexpectedly separated from someone you depend on for love or security

for more than a few days?

Has someone close to you ever tried to kill or hurt him/herself?

Has someone ever physically hurt you or threatened to hurt you?

Has anyone ever kidnapped you?

Have you ever been attacked by a dog or another animal?

Have you ever seen or heard people physically fighting or threatening to hurt each other (In or

outside of family?

Have you ever witnessed a family member who was arrested or in jail?

Have you ever had a time in your life when you did not have a place to live or enough food?

Has someone ever made you see or do something sexual? Or have you seen or heard someone

else being forced to do sex acts?

Have you ever watched people using drugs, like smoking drugs or using needles?
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What positive steps or coping skills have been helpful to you in the past?

Thoughts of suicide?

Attempts of suicide?

Thoughts of homicide?

Acts of self-harm?

Social/Cultural Information

Identification of support system:

What activities do you participate in that are meaningful to you?

Cultural/Ethnic/Spiritual interests/supports do you have?

Who do you currently live with?

What are your views concerning your current living situation?

Developmental History

During pregnancy, did mother use alcohol or drugs?

Describe any problems with the pregnancy or birth:

Were developmental milestones met?

Was the individual’s first year of life difficult, easy or other?

Describe any childhood accidents or injuries:

School Functioning

Name of school currently attending: Current grace placement:

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Does the individual receive Special Education Services?

Comments on Educational Classification/Placement:

Grades:

School Attendance issues:

Previous Grade Retentions:

Suspensions/Expulsions:

Other Academic/School Concerns:

Parent History (Educational/Occupational)

Mother’s Age:

Father’s Age:

Mother’s highest level of education:

Father’s highest level of education:

Mother’s current employment:

Father’s current employment:

Current Legal Status

Has the individual been involved with the legal system within the past twelve months?

Any history of arrests? If yes, number and type of arrest(s):

Number of arrests in the past 90 days:

Any legal charges pending? If yes, number and type of pending charge(s):

Describe any substance use related legal issues:

Is the individual currently on parole and/or probation?

If yes, indicate if any reports should be submitted and to whom:

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Parent Legal Status

Has the mother/father been involved with the legal system within the past twelve months?

Any history of arrests? If yes, number and type of arrest(s):

Number of arrests in the past 90 days:

Any legal charges pending? If yes, number and type of pending charge(s):

Describe any substance use related legal issues:

Is the mother/father currently on parole and/or probation?

Medical History

Allergies:

Appetite issues or problems:

Sleep issues or problems:

Current or chronic diseases:

Are you pregnant?

If yes, any complications?

Individual Mental Health History

Previous or Current Diagnosis:

Family History of psychiatric or substance use disorders?

Outpatient Mental Health Treatment

Treatment Agency:

Dates of Service: Type of Service:

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Psychiatric Hospitalizations/Residential Treatment

Treatment/Facility:

Reason for placement (suicidal, depressed, etc.):

Dates of Service:

Substance Abuse/Use History

Drugs/Substances of Choice:

Age of first use:

How often used:

How much used:

Last Used:

Method:

Resulting circumstances:

Has individual received substance abuse treatment in the past?

Parent(s) Substance Abuse/Use History

Parent(s) drugs/substances of choice:

Parent(s) age of first use:

How often used:

How much used:

Last used:

Method:

Resulting circumstances:

Has/Have the parent(s) received substance abuse treatment in the past?

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Musical Interest
Which rap artists do you listen to?

Why do you enjoy these particular styles of rap?

What is your favorite rap song?

Which rap artists do you like the least?

Why do you not like that/those particular rap artist(s)?

What rap song gives you a feeling of happiness when you hear it?

What rap song gets you excited i.e. “crunk?”

What rap song gives you feelings of aggression?

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Appendix C
Pre & Post Self-Assessment
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The Self-Assessment will be given to the juvenile to take home to complete once the

Initial Assessment has been completed. He/She is to bring the assessment back to the next

session with counselor to discuss. It will also be given for the juvenile to complete and discussed

in the last session to assess if there has been any reframing of thoughts about themselves and

their outlook on their future.

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“My Thoughts about Me” Assessment

*I know I will graduate from high school

_____________________________________________________________________________

_____________________________________________________________________________

*I possess a lot of positive qualities

_____________________________________________________________________________

_____________________________________________________________________________

*I love me

______________________________________________________________________________

______________________________________________________________________________

*I feel positive about myself when I look in the mirror

______________________________________________________________________________

______________________________________________________________________________

*I care about people & their feelings

______________________________________________________________________________

______________________________________________________________________________

*I am an awesome person

______________________________________________________________________________

______________________________________________________________________________

*I know I am going to end up in jail

______________________________________________________________________________

______________________________________________________________________________
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*I will never succeed in life

______________________________________________________________________________

______________________________________________________________________________

*I have high self esteem

______________________________________________________________________________

______________________________________________________________________________

*All the negative stuff in my life define me as a person

______________________________________________________________________________

______________________________________________________________________________

*I will always be a trouble maker

______________________________________________________________________________

______________________________________________________________________________
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Table of Contents

INTRODUCTION 18

WELCOME TO POWERFUL MINDS 20

IT’S ALL ABOUT WHO? YOU!!! 22

ABOUT YOUR FAMILY 23

YOUR INTENSITY LEVEL 24

COPING WITH FEELINGS 25

WHAT DO YOU FEEL 27

TELLING YOUR SIDE OF THE STORY-PART I 50

TELLING YOUR SIDE OF THE STORY-PART II 51

FIGHTING TRAUMA PROMPTS 53

PEELING BACK THE LAYERS-PART I 55

PEELING BACK THE LAYERS-PART II 57

BE AWARE! 58

ACTION AND MAINTENANCE 59

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Session 1
Introduction, Assessment, and Forms
The first initial session will include the completing of all intake assessment

paperwork in Appendix A & B. There is an initial assessment completed on the child that

may last 45 minutes to 1 hour. The questions asked are surrounding different domains of

the juvenile’s life (educational, family, social and cultural, developmental history, legal

status, medical history, individual mental health history, individual mental health history,

trauma history, and musical interests) so that the counselor will gain an understanding of

the dynamic of the individual. The juvenile is also educated on PTSD symptoms. He/She is

allowed to discuss the experiences of past and present. The counselor then assesses how

strong the juvenile’s interest is in Rap Music so that the counselor can gain an

understanding of what particular type of Rap the individual likes to begin to understand

how the music connects to the individual’s spirit.

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Session 2
Session 2 starts the Alliance/Affective Modulation phase. This session’s goal is to

help the therapist begin to build a positive rapport with the juvenile. The counselor and

juvenile will discuss the “My Thoughts about Me” assessment the juvenile was to complete

prior to coming to therapy. He/She discusses fusic that helps calm them when finding

himself becoming upset when thinking about the trauma. They slowly begin to learn new

cognitive coping strategies through listening to the Rap Music. He also learns about the

meaning of different feelings by discussing songs that give him that particular feeling. The

goal of this phase is to learn the relationship between thoughts, feelings, and behaviors,

normalize feelings of conflict, and identify calming strategies.

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Welcome to Powerful Minds!!!

Therapy is a haven of safety to assist you to feel better about events that have left you with

feelings of being upset and confused. Those types of feelings really can destroy how you view

yourself, as well as others. They can really “mess with your mind.” You will be educated on

many things that surround your thoughts and feelings through music. You will also learn a lot

about who you are as an individual: your strengths, feelings, actions, thoughts and dreams!!!!!

With commitment to yourself, as you go on this musical journey, you will learn the tools needed

to regain control of your thoughts and your POWERFUL MIND because YOU DO MATTER!!!

Please write a short rap that explains how you feel about being here today:

Do you have any questions about therapy?

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Session 3
This session is a continuation of the Alliance/Affective Modulation phase. This

session questions in juvenile about the extracurricular activity involvement and their views

about family. This session helps the counselor begin to understand risk factors that may

influence recidivism.
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IT’S ALL ABOUT WHO? YOU!!!

You are a very special person!! There are many things about you that you are sooooo awesome

at doing!!! What are some things you like do for fun?

Please write a short rap about that explains the enjoyment you feel when doing things you
like to do:

ABOUT YOUR FAMILY

What are some things you like about your family? Do you and your family do things together?

Please write a short rap about the things that you enjoy doing with them:
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Session 4
Continuing in the Alliance/Affective Modulation phase, the counselor and individual

begin to discuss emotions and particular songs that provoke those emotions. This session is

also an attempt to help the juvenile develop calming musical mantras to listen to when

negative feelings are present.

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YOUR INTENSITY LEVEL

At times, we may feel a certain way only a little, and then there are other times we feel a feeling

that overwhelms us with emotion. You can rate or measure your feelings based on the numbers

and color of the box (10 highest-0 lowest). The number tells how strongly the feeling is.

What feelings are you having right now? How would you rate those feelings?

Very Strong A Lot Medium

10-9 8-6 5-3

A Little Not at all

2-1 0
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COPING WITH FEELINGS

When we experience feelings of being scared, angry, anxious, or sad, we tend to get upset, so we

can listen to music that will lessen the intensity of that feeling. For example, if your frustration

and anger is at a 10 (The red box on the previous page, you can find a song that may bring it

down to a 1 or 2 (The blue box on the previous page. What are some lyrics in Rap songs that you

like that can help decrease your intensity level from being “in the red” to calmly “getting in the

blue?” Please make a list of inspirational “blue” songs below with some of the lyrics you find

uplifting.

1. _______________________________________

2. _______________________________________

3. _______________________________________

4. _______________________________________

5. _______________________________________

Alrighty then!!! You have just made your own list of calming lyric mantras for your SURVIVAL

OF THE FITTEST KIT!! You can take that list of lyrics and carry it in your pocket or put them

in a special place such as a bag or special box. Take the lyrics with you so that the next time you

feel very upset, you will have the lyrics that you wrote to encourage you to get out of the red and

into the blue!!!!!!!!

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Session 5 & 6
The counselor and individual begin to delve into music that discuss risk factors such

as poverty, abuse, living in a poor & crime infested neighborhood, lack of motivation for a

positive future. The juvenile discuss their feelings and how he/she relates to them.
 139

WHAT DO YOU FEEL?

Music can provoke all types of emotions within us. Music, at times, can describe exactly what

we feel when we cannot just simply verbalize our feelings. Below are lyrics to different songs.

You will hear the song played three times. The first time is so that you can listen to the lyrics

carefully. The second and third time, you will write down the lyrics that you heard that stood out

the most (The counselor then helps the student make a connection between the song lyrics and

the student’s therapeutic needs).

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Who We Be By DMX

Uh, yeah

Another one of those

Down to earth joints

They don't know who we be

They don't know who we be

What they don't know is

(Verse 1)

The bulls**t, the drama (uh), the guns, the armor (what!)

The city, the farmer, the babies, the mama (what!)

The projects, the drugs (uh!), the children, the thugs (Uh!)

The tears, the hugs, the love, the slugs (c'mon!)

The funerals, the wakes, the churches, the coffins (uh!)

The heartbroken mothers - it happens too often (why?)

The problems, the things we use to solve 'em (what!)

Yonkers, the Bronx (uh!), Brooklyn, Harlem (c'mon!)

The hurt, the pain, the dirt, the rain (uh!)

The jerk, the fame, the work, the game (uh!)

The friends, the foes, the Benz, the hos (what!)

The studios, the shows, comes and it goes (c'mon!)

The jealousy, the envy, the phony, the friendly (uh-huh!)

The one that gave 'em the slugs, the one that put 'em in me (woo!)

The snakes, the grass too long to see (uh, uh!)

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The lawnmower sittin' right next to the tree (c'mon!)

(Chorus)

They don't know who we be

They don't know who we be

What we seeing is

The streets, the cops, the system, harassment (uh-huh)

The options, get shot, go to jail, or getcha a** kicked (a'ight)

The lawyers, the part they are of the puzzle (uh-huh)

The release, the warning, "Try not, to get in trouble." (Damn!)

The snitches, the odds (uh), probation, parole (what!)

The new charge, the bail, the warrant, the hole (damn!)

The cell, the bus, the ride up North (uh-huh)

The greens, the boots, the yard, the court (uh!)

The fightin', the stabbin', the pullin', the grabbin' (what!)

The riot squad with the captain, nobody knows what happened (what!)

The two years in a box, revenge, the plots (uh!)

The twenty-three hours that's locked, the one hour that's not (uh!)

The silence, the dark, the mind so fragile (a'ight!)

The wish that the streets would have took you when they had you (damn!)

The days, the months, the years, despair

One night on my knees, here it comes: the prayer

They don't know who we be

They don't know who we be

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This here is all about

My wife, my kids (uh-huh), the life that I live (uh-huh)

Through the night I was his (uh-huh), it was right what I did (uh-huh)

My ups and downs (uh), my slips, my falls (uh)

My trials and tribulations (uh), my heart, my balls (uh)

My mother, my father - I love 'em, I hate 'em (uh!)

Wish God, I didn't have 'em, but I'm glad that he made 'em (uh!)

The roaches, the rats, the strays, the cats (what, what!)

The guns, knives and bats, every time we scrap

The hustlin', the dealin', the robbin', the stealin' (uh!)

The shit hit the ceilin', little boy with no feelin's (damn)

The frustration, rage, trapped inside a cage

The beatings till the age I carried a twelve gauge (a'ight!)

Somebody stop me (please!), somebody come and get me (what!)

Little did I know that the Lord was ridin' with me

The dark, the light (uh), my heart (uh), the fight (uh)

The wrong (uh!), the right (uh!), it's gone (uh!), a'ight!

They don't know who we be

They don't know who we be

 143

"Things'll Never Change" By E-40

Ah yeah..(ah yeah)..it's real.

gonna put it down. all these little crime thangs,

homeless, the world is crazy boy

it's like this

it's the way it is

Heavy out there..it's heavy.

(Verse 1)

Was I really such a bad child that I deserved to get hit with boards

and whooped with extension cords?

did you forget that I was your creation,

and all I wanted from you all was love, hope, and motivation?

son, you're disrespectful and you're talking back,

get out my face, kicked me out the house

and wouldn't even let me plead my case.

now I'm homeless and I'm freezing like the morgue,

the only thing keepin me alive is the Lord

needless to say it's times like this I'd rather be locked up then

drinkin water out my hands and eatin out of garbage cans

can I come back home, huh could I?

Son, you're on your own, why should I?

(Chorus)

Things'll never change, that's just the way it is

 144

Nobody's even concerned

Some things'll never change, that's just the way it is

when will we ever learn?

(Verse 2)

Huh. three years from now, I think I'm gon be straight, (straight)

I put my name on the list for section 8

tried out for the army but I was flat footed,

didn't do no harm to me, cuz I was used to it

if I apply for some work, let's make a bet,

I'll get the nine

cuz I don't know about the internet

What do you think we need to do to change about this nation?

need to provide more jobs and better education

nuclear weapons (puh) should be stopping crimes,

already got enough to blow the world up

a thousand times

the birds and the bees, deadly disease,

teenage pregnancies, STD’s

(Verse 3)

A-wuh a wait a minute, I hear sirens

Oh that's the couple down the street

domestic violence

either them or the little girl in 306

 145

she's always telling everyone that she gon slice her wrists

I guess that's the way it is in the life of sin

where you'll prolly end up dead, or in the pen

but my family ain't no better than the next

my auntie brenda turned her own sister in

for writing bad checks

and save folks try to hit you where it hurts

knowin they the biggest hypocrites in the church

we need to give our minds a bath and

do some scrubbin'

stop the hate and start the lovin'

Things'll never change, that's just the way it is

Nobody's even concerned

Some things'll never change, that's just the way it is

when will we ever learn?

(Chorus)

Things'll never change, that's just the way it is

Nobody's even concerned

Some things'll never change, that's just the way it is

when will we ever learn?

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Session 7 & 8
In session 7, the counselor has the juvenile now listen to music that is focused on the

love a young man has for his mother. Session 8, the song heard and discussed will focus on

the relationship a father feels for his son. These songs are to provoke discussion concerning

the juvenile’s feelings about the relationship he/she has with his parents. This will help the

counselor understand possible feelings of negligence and rejection from their primary

caregiver. This will also help the counselor understand the possible root of where emotional

numbing and callousness may stem.

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Dear Mama by Tupac Shukar

Verse 1

When I was young, me and my mama had beef

17 years old, kicked out on the streets

Though back at the time I never thought I'd see her face

Ain't a woman alive that could take my mama's place

Suspended from school

And scared to go home, I was a fool

With the big boys breaking all the rules

I shed tears with my baby sister, over the years

We was poorer than the other little kids

And even though we had different daddies, the same drama

When things went wrong we'd blame mama

I reminisce on the stress I caused, it was hell

Huggin' on my mama from a jail cell

And who'd think in elementary, hey

I'd see the penitentiary one day?

And running from the police, that's right

Mama catch me, put a whoopin' to my backside

And even as a crack fiend, mama

You always was a black queen, mama

I finally understand

For a woman it ain't easy trying to raise a man

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You always was committed

A poor single mother on welfare, tell me how you did it

There's no way I can pay you back, but the plan

Is to show you that I understand; you are appreciated

Verse 2

Now, ain't nobody tell us it was fair

No love from my daddy, 'cause the coward wasn't there

He passed away and I didn't cry, 'cause my anger

wouldn't let me feel for a stranger

They say I'm wrong and I'm heartless, but all along

I was looking for a father he was gone

I hung around with the thugs

And even though they sold drugs

They showed a young brother love

I moved out and started really hangin'

I needed money of my own, so I started slangin'

I ain't guilty, 'cause even though I sell rocks

It feels good putting money in your mailbox

I love paying rent when the rent is due

I hope you got the diamond necklace that I sent to you

'Cause when I was low you was there for me

And never left me alone, because you cared for me

And I could see you coming home after work late

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You're in the kitchen, trying to fix us a hot plate

You just working with the scraps you was given

And Mama made miracles every Thanksgivin'

But now the road got rough, you're alone

You're trying to raise two bad kids on your own

And there's no way I can pay you back, but my plan

Is to show you that I understand; you are appreciated

Chorus

Lady, don't you know we love ya? (Dear Mama)

Sweet lady, place no one above ya (You are appreciated)

Sweet lady, don't you know we love ya?

Verse 3

Pour out some liquor and I reminisce

'Cause through the drama I can always depend on my mama

And when it seems that I'm hopeless

You say the words that can get me back in focus

When I was sick as a little kid

To keep me happy, there's no limit to the things you did

And all my childhood memories

Are full of all the sweet things you did for me

And even though I act crazy

I gotta thank the Lord that you made me

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There are no words that can express how I feel

You never kept a secret, always stayed real

And I appreciate how you raised me

And all the extra love that you gave me

I wish I could take the pain away

If you can make it through the night, there's a brighter day

Everything will be alright if you hold on

It's a struggle everyday, gotta roll on

And there's no way I can pay you back, but my plan

Is to show you that I understand; you are appreciated

Chorus

Lady, don't you know we love ya? (Dear Mama)

Sweet lady, place no one above ya (You are appreciated)

Sweet lady, don't you know we love ya? (Dear Mama)

Sweet lady
 151

Just The Two Of Us by Will Smith

(Verse 1)

From the first time the doctor placed you in my arms

I knew I'd meet death before I'd let you meet harm

Although questions arose in my mind, would I be man enough?

Against wrong, choose right and be standin up

From the hospital that first night

Took a hour just ta get the carseat in right

People drivin all fast, got me kinda upset

Got you home safe, placed you in your basonette

That night I don't think one wink I slept

As I slipped out my bed, to your crib I crept

Touched your head gently, felt my heart melt

Cause I know I loved you more than life itself

Then to my knees, and I begged the Lord please

Let me be a good daddy, all he needs

Love, knowledge, discipline too

I pledge my life to you

[Chorus:]

Just the two of us, we can make it if we try

Just the two of us, (Just the two of us)

Just the two of us, building castles in the sky

Just the two of us, you and I

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(Verse 2)

Five years old, bringin comedy

Everytime I look at you I think man, a little me

Just like me

Wait an see gonna be tall

Makes me laugh cause you got your dads ears an all

Sometimes I wonder, what you gonna be

A General, a Doctor, maybe a MC

Haha, I wanna kiss you all the time

But I will test that butt when you cut outta line, trudat

Uh-uh-uh why you do dat?

I try to be a tough dad, but you be makin me laugh

Crazy joy, when I see the eyes of my baby boy

I pledge to you, I will always do

Everything I can

Show you how to be a man

Dignity, integrity, honor an

An I don't mind if you lose, long as you came with it

An you can cry, ain't no shame it it

It didn't work out with me an your mom

But yo, push come to shove

You was conceived in love

So if the world attacks, and you slide off track

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Remember one fact, I got your back

[Chorus]

Just the two of us, we can make it if we try

Just the two of us, (Just the two of us)

Just the two of us, building castles in the sky

Just the two of us, you and I

It's a full-time job to be a good dad

You got so much more stuff than I had

I gotta study just to keep with the changin times

101 Dalmations on your CD-ROM

See me-I'm

Tryin to pretend I know

On my PC where that CD go

But yo, ain'tnuthin promised, one day I'll be gone

Feel the strife, but trust life does go wrong

But just in case

It's my place

To impart

One day some girl's gonna break your heart

And ooh ain'tno pain like from the opposite sex

Gonna hurt bad, but don't take it out on the next, son

Throughout life people will make you mad

 154

Disrespect you and treat you bad

Let God deal with the things they do

Cause hate in your heart will consume you too

Always tell the truth, say your prayers

Hold doors, pull out chairs, easy on the swears

You're living proof that dreams do come true

I love you and I'm here for you

Just the two of us, we can make it if we try

Just the two of us, (Just the two of us)

Just the two of us, building castles in the sky

Just the two of us, you and I

 155

Session 9 & 10
Songs about love & the juvenile’s views about relationships are listened to and

discussed in session 9 & 10. These sessions are to help the juvenile gain insight concerning

his/her thoughts about how they view having to “share” and be “giving” of themselves with

someone else. During these sessions, emotional numbing and callousness are also discussed

so that the juvenile can further understand the negative influence emotional numbing can

have on one’s ability to give and receive love and support from a significant other.
 156

Love of My Life by Erykah Badu featuring Common

(Verse 1: Erykah Badu)

I met him when I was a

A little girl, he gave me

He gave me poetry

He was my first

But in my heart I knew I

Wasn't the only one

'Cause when the tables turned

He had to break, but...

Whenever I got lonely

Or needed some advice

He gave me his shoulder

His words were very nice

But that is all behind me

'Cause now there is no other

My love is his and his is mine

A friend became the

(Chorus)

Love of my life

You are my friend

Love of my life

I can depend
 157

Love of my life

Without you, baby

It feels like a simple true love

Hope this s*** ain't clear

(Common)

A freak-freak, y'all, and ya don't stop

To the beat y'all and ya don't stop

A freak-freak

(Erkykah Badu)

Or could it be that it was

All just so simple then

A teenage lover who said

He's just a friend

He moved around and we kept

In touch through his friend Mike

The world was young and he knew

We couldn't rush but

Whenever I got lonely

Or needed some advice

He gave me his shoulder

His words were very nice

But that is all behind me

 158

'Cause now there is no other

My love is his and his is mine

A friend became the

(Chorus)

Love of my life

You are my friend

Love of my life

A dude I can depend, yeah, yeah

Love of my life

Feels like a simple true love, yeah

Hope this s*** ain't clear

(Common)

Y'all know how I met her

We broke up and got back together

To get her back I had to sweat her

Thought she roll with bad boys forever in many ways

Them boys may be better, to I had to let her (Never)

She needed cheddar and I understood that

Lookin' for cheese, that don't make her a hood rat (Rat)

In fact she's a queen to me, her light beams on me

I love it when she sings to me

It's like that now

(Chorus)
 159

Love of my life

Ooh, you know you rock my world and

Love of my life

You be boy and I'll be girl and

Love of my life

We don't stop until the break of dawn, ooh...

 160

21 Questions by 50 Cent

New York City!

You are now rapping, with 50 Cent

(Verse 1)

You gotta love it,

I just wanna chill and twist a lot

Catch suns in my 7-45

You drive me crazy shorty I

Need to see you and feel you next to me

I provide everything you need and I

Like your smile I don't wanna see you cry

Got some questions that I got to ask and I

Hope you can come up with the answers babe

(Chorus)

Girl, It's easy to love me now

Would you love me if I was down and out?

Would you still have love for me?

Girl, It's easy to love me now

Would you love me if I was down and out?

Would you still have love for me girl?

(Verse 2)

If I fell off tomorrow would you still love me?

If I didn't smell so good would you still hug me?

 161

If I got locked up and sentenced to a quarter century,

Could I count on you to be there to support me mentally?

If I went back to a hoopty from a Benz, would you poof and disappear like

Some of my friends?

If I was hit and I was hurt would you be by my side?

If it was time to put in work would you be down to ride?

I'd get out and peel a ni**a cap and chill and drive

I'm asking questions to find out how you feel inside

If I ain't rap 'cause I flipped burgers at Burger King

Would you be ashamed to tell your friends you feelin' me?

If I didn’t pressure you to bed would you like that?

If I wrote you a love letter would you write back?

And we could sip and drink a soda like a nightcap

And we could go do what you like, I know you like that

(Chorus)

Girl, It's easy to love me now

Would you love me if I was down and out?

Would you still have love for me?

Girl, It's easy to love me now

Would you love me if I was down and out?

Would you still have love for me girl?

(Verse 3)

Now would you leave me if you're father found out I was thuggin'?
 162

Do you believe me when I tell you, you the one I'm loving?

Are you mad 'cause I'm asking you 21 questions?

Are you my soul mate? 'Cause if so, girl you a blessing

Do you trust me enough, to tell me your dreams?

I'm staring at ya' trying to figure how you got in them jeans

If I was down would you say things to make me smile?

I treat you how you want to be treated just teach me how

If I was with some other chick and someone happened to see?

And when you asked me about it I said it wasn't me

Would you believe me? Or up and leave me?

How deep is our bond if that's all it takes for you to be gone?

We only humans girl we make mistakes, to make it up I do whatever it take

I love you like a fat kid love cake

You know my style I say anything to make you smile

(Chorus)

Girl, It's easy to love me now

Would you love me if I was down and out?

Would you still have love for me?

Girl, It's easy to love me now

Would you love me if I was down and out?

Would you still have love for me girl?

Could you love me in a Bentley?

 163

Could you love me on a bus?

I'll ask 21 questions, and they all about us

Could you love me in a Bentley?

Could you love me on a bus?

I'll ask 21 questions, and they all about us

 164

Session 11 & 12
Session 11 is the beginning of the Role Play/Trauma Narrative phase. The juvenile

begins to write lyrics concerning the trauma. The counselor begins to help him/her find the

rhythm flow (fast, medium, slow) that the juvenile would like to use in order for the

narrative to become a song and to give meaning to the juvenile’s feelings concerning the

event. The goal of this phase is to identify inaccurate cognitions related to the event and

develop an understanding of the experiences and gain the understanding that the trauma

does not define the individual.

 165

TELLING YOUR SIDE OF THE STORY-PART I

You’ve learned about events that have been upsetting, and at time, confusing to you. It is

awesome that you have successfully been able to discuss and gain an understanding of the

different feelings you experience. These are all extremely essential things that will assist you as

you begin to tell YOUR side of the story concerning the disturbing and confusing event(s) that

you faced. You get to decide at what point you would like to begin, and how musically, you

would like for your story to be told. As you are telling about the event(s), your counselor will

help you do the color intensity level check that you did in Component #2 to help “keep check” of

your feelings (Are you feeling red, green, purple, blue, or orange). If you begin to feel strongly

disgruntled, you can stop, and your counselor will help remind you of calming strategies to help

handle your feelings. You are the head of your own ship!!!! Please begin to write your Rap song

below to describe how you feel about having to start to tell your side of the story.
 166

TELLING YOUR SIDE OF THE STORY-PART II

Now it is time for you to decide what rhythm and type of musical track you would like to use as

your background (Country, Rock ‘n’ Roll, Techno, Classical, Hip Hop, etc.) while rapping about

your side of the story. You and your counselor can discuss what music, in depth, you feel would

be best that would help you create the poetic movement or style you would like for your song to

have that would best express your story. YOU decide what form you want your side of the story

to have. Again, you and your counselor can use the color intensity level check from (PUT PAGE

NUMBER, NOT THE COMPONENT if you needed to for this activity.)

The title of my song is:

This is how I will create MY SIDE OF THE STORY:

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Session 12 & 13
In the Reframing/InVivo Exposure & Mastery & Cognitive Coping phase, the

therapist finds out the juvenile’s most feared situations and gradually exposes them to

overcome the fear so that anxiety can begin to disappear. The counselor continues to

discuss emotional numbing & callousness with the juvenile to help the individual continue

“peel back the layers” of hurt, guilt, etc. The counselor is simultaneously enlightening the

juvenile on other forms of Rap Music to help correct inaccurate thoughts surrounding the

trauma. The counselor and juvenile collaborate to interrupt inaccurate lyrics (thoughts)

and their meaning so that the process of cognitive restructuring may begin. The goal of this

phase is to reduce avoidance that interrupts normalcy in daily life functioning, identify

inaccurate thoughts that the juvenile maybe unaware of, and gain and understanding how

thoughts drive feelings; and how those thoughts can change.

 168

Fighting Trauma Prompts

Now that you have told your story…Your truth….and discussed your feelings and thoughts, let’s

talk about trauma prompts. Trauma prompts will remind you of many things: people, places,

things, smells, sounds, etc. When experiencing these prompts, you may feel uneasy or unsafe or

may feel like you are reliving the event(s) again. But you can use your favorite rap song, whether

by a rap artist or a rap song you have created to help you calm down (remember those musical

mantras on page…..) and relax so that you may gain control over those irritating prompts! YOU

CAN DO THIS!!!!!!!!!!

Please write some of your trauma prompts below:

Now your counselor and you will come up with a brilliant, musical play list of songs that will

help to defeat each prompt individually. Then you can practice in session with your counselor to

help gain control of these prompts. Again, YOU CAN DO THIS!!!!!!

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Session 14-16
In Session 14-16, the counselor is in the Cognitive Coping phase with the juvenile,

while re-visiting the Alliance/Affective Modulation phase to discuss the cognitive triangle:

thoughts, feelings and behaviors. The revisiting of this phase is to further discuss emotional

numbing, callousness, recidivism and how they negatively impact one’s life. The goal is for

the juvenile to learn the identity of negative unhelpful or inaccurate thoughts and gain an

understanding of how thoughts drive feelings; but learning that those thoughts and actions

can change.
 170

Peeling back the layers-Part I

In life, we can experience or witness so many negative things until we can almost become numb.

We may forget that IT DOES MATTER what our thoughts are! IT DOES MATTER how we

feel! IT DOES MATTER how we act towards others, as well as ourselves! We have got to

“peel back the layers” of numbness to understand that….I MATTER! YOU MATTER!!! WHAT

WE FEEL ABOUT OURSELVES AND OTHERS MATTERS!!

What do you think? What do you feel? How do you act?

Match the definition of the word by placing the letter beside the word.

_____Thoughts A. Things we do with our bodies! For example,

Laugh, cry, walk, and talk

_____ Feelings B. Ideas we have when we think

_____ Actions C. Our emotions and sensations we have in our

Bodies and hearts
 171

What do you think? What do you feel? How do you act?

This activity is to help you learn the difference between a thought, a feeling, or an action. Work

with your counselor to understand which words are thoughts, feelings and actions, then relate the

words to your life.

Excitement Stealing from a store

Running It’s all my Fault!

I’m intelligent! Scared

They hate me He is happy for me!

Sadness Anxious

Anger Drinking Alcohol

Playing Rapping a song

Crying Talking to a friend

Skipping school Robbing someone

 172

Peeling back the layers-Part II

Sometimes due to the negative experiences we have had to handle, we begin to have thoughts

that do not help us improve how we feel about ourselves or others. Those thoughts hinder us

from being able to effectively solve problems. Those thoughts can also be false. We get stuck in

a negative pattern of thinking that only hurts us or mentally restrains us from progressing as an

individual. Please write a rap that explains some of the problem ways of thinking you have

had recently.

How did those thoughts make you feel?

 173

BE AWARE!!
When you feel sad, what are you saying to yourself in your head? What are you thinking? When

you feel bad, what are you saying to yourself in your head? What are you thinking? Has it

occurred to you that the reason you may feel bad is because of how you are thinking? The good

news is that, with practice, you can change the way you think! Try doing this below. Write a

thought in the form of a rap that gives you a feeling a being sad and write down the feeling it

gives you. Then, write a different thought that would improve your mood and write down the

new feeling. LET’S TRY!

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Session 17-until final session

Action and Maintenance

In the final phase, Action and Maintenance, the counselor motivates the youth to put their

restructured lyrics into action. The therapist also has the juvenile complete the “Thoughts about

Me” assessment and then compares his/her answers to the first time the assessment was

completed during the first initial session. The purpose of revisiting the assessment is to help the

individual see how their thoughts about self, the future, words and actions may have positively

changed. The counselor and the juvenile re-discuss risk factors, musical mantras, and the

development of protective factors that will help prevent recidivism.

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“My Thoughts about Me” Assessment

*I know I will graduate from high school

_____________________________________________________________________________

_____________________________________________________________________________

*I possess a lot of positive qualities

_____________________________________________________________________________

_____________________________________________________________________________

*I love me

______________________________________________________________________________

______________________________________________________________________________

*I feel positive about myself when I look in the mirror

______________________________________________________________________________

______________________________________________________________________________

*I care about people & their feelings

______________________________________________________________________________

______________________________________________________________________________

*I am an awesome person

______________________________________________________________________________

______________________________________________________________________________

*I know I am going to end up in jail

______________________________________________________________________________

______________________________________________________________________________
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*I will never succeed in life

______________________________________________________________________________

______________________________________________________________________________

*I have high self esteem

______________________________________________________________________________

______________________________________________________________________________

*All the negative stuff in my life define me as a person

______________________________________________________________________________

______________________________________________________________________________

*I will always be a trouble maker

______________________________________________________________________________

______________________________________________________________________________
 177

References

Badu, E., Lynn, L.R., Chinwah, M., Ozuma, R., Poyser, J., Saadiq, R., Standridge, G. (2002).

Love of my life [Erykah Badu featuring Common] on Brown Sugar [CD]. New York, NY

MCA Records.

Jackson, C., Risto, K., Cameron, J., Cameron, V.M., (2003). 21 Questions [50 Cent] on Get Rich

Or Die Tryin’ [CD]. Santa Monica, CA; Interscope Records.

Malik, A., Banks, A., E-40, Ojetunde, F., Gardner, Mosley, Redwine, Rick Rock, Studio Ton,

Tone Capone (1996) Things’ll never change [E-40] on The Hall of Game [CD]. New

York, NY; Jive Records.

Shakur, T. (1996). Dear mama [Tupac Shakur] on Me Against the World [CD]. Santa Monica,

CA; Interscope Records.

Simmons, E., Mickey. D., R, (2001). Who we be [DMX] on The Great Depression [CD]. New

York, NY; Def Jam Records.

Smith, W, Washington Jr., Grover, Withers, B., MacDonald, R, Salter, W. (1998). Just the two of

Us [Will Smith] on Big Willie Style [CD] New York, NY; Columbia Records.