Introduction to the Special Theme Issue on Health Disparities, Trauma, Disruptive and Criminal Behaviors and the Adolescent Brain: Conference Collaborators, Major Developments in Conference Planning, and Overview of the Articles

ABSTRACT

The November 21, 2015, conference Health Disparities, Trauma, Disruptive and Criminal Behaviors and the Adolescent Brain, examined the national problem of youth incarceration by exploring research on the adolescent brain, trauma, poverty, racism, health disparities and mental health treatment. This special theme issue of the Journal of Infant, Child and Adolescent Psychotherapy provides an opportunity for selected authors to contribute original articles that capture their contributions to the conference event. The purpose of this article is to provide an introduction to this special theme issue. This article provides an overview of the following: the roots of the conference, including the role of numerous collaborators; specific major developments that contributed to the evolution of the conference focus; and a brief overview of the actual articles that have been selected for inclusion in the theme issue.

Introduction

While law and neuroscience conferences have been held in different venues across the country (MacArthur Research Network on Law and Neuroscience, 2016), the November 21, 2015, conference Health Disparities, Trauma, Disruptive and Criminal Behaviors and the Adolescent Brain examined the national problem of youth incarceration by exploring research on the adolescent brain, trauma, poverty, racism, health disparities, and mental health treatment. Cosponsored by the Division of Neuropsychology, New York State Psychological Association (NYSPA) and Teachers College, Columbia University, the conference event convened speakers across multiple disciplines to offer continuing education to lawyers, psychologists, social workers, health educators, students, and other stakeholders. The conference event gave rise to this special theme issue of the Journal of Infant, Child and Adolescent Psychotherapy as an important contribution to the literature.

The purpose of this article is to provide an introduction to this special theme issue. This article provides an overview of the roots of the conference, including the role of numerous collaborators, as well as specific major developments that contributed to the evolution of the conference focus. In addition, the article provides an overview of the actual articles that have been selected for inclusion in the theme issue.

The conference collaborators

The roots of the conference may be located in a collaborative effort, including valued partners and co-sponsors. From its inception, this conference was a reflection of the fulfillment of several needs of the emerging Division of Neuropsychology within the New York State Psychological Association (NYSPA). Founder and then President of the division, Dr. Gabrielle Stutman, was responsive to the call from membership for more emphasis on issues pertaining to children and adolescents. Dr. Stutman supported the formation of a Pediatric Committee within the Division of Neuropsychology.

Further, Dr. Stutman embraced the vision of the Founding Chair of the Pediatric Committee, Dr. Bonnee Price-Linden. Dr. Price-Linden generated the original idea for the Division of Neuropsychology’s fall 2015 conference. In addition, she initiated the formation of the fall 2015 conference structure and collaborations with some key partners, laying the groundwork for an exciting conference focused on the application of developmental neuroscience in the courts. At the same time, Dr. Stutman embraced the request made early on by this article’s first author and conference co-producer, Dr. Carla Beckford, for the conference event to also attend to the crisis of children and adolescents in underserved areas. As Dr. Stutman conceptualized the emergent broad conference focus, she responded that such an event “had never been done before in terms of complexity, size and scope;” with this encouragement, next steps involved intensive outreach to potential speakers and panelists. Thus, a dynamic synergy allowed the conference leadership to facilitate the realization of the goals of the burgeoning Division of Neuropsychology to educate its membership, NYSPA at large, others in the mental health community, as well as the public with regard to some of the latest developments in neuropsychology. Other members of the Division of Neuropsychology also provided assistance in conference planning, including Dr. Hannah Geller, Dr. Paul Gunser, Dr. Margaret Alvarez, Nazia Fyazi, and Anny Reyes.

As explained later in this article, there were major developments that led to a conference focus that was inclusive of health disparities. This led to a collaboration with Dr. Barbara Wallace, Founding Director of the Annual Health Disparities Conference at Teachers College, Columbia University—while also a Professor of Health Education, Department of Health Studies; and, Director of Health Equity within the Center for Health Equity and Urban Science Education (CHEUSE), as well as Director of the Research Group on Health Equity (RGHE) at Teachers College, Columbia University. Thus, Teachers College, Columbia University became the main conference co-sponsor, through the leadership of Dr. Wallace, while the college also hosted the event at their Cowin Conference Center.

Other conference co-sponsors within NYSPA included the Division of Psychoanalysis, the Forensic Division, and the Independent Practice Division. Support for the conference was also expressed by then NYSPA President Dr. Lenny Davidman, who worked behind the scenes to ensure the success of the conference event. Also vital was the role played by NYSPA Executive Director Tom Cote, who effectively negotiated the official partnership between NYSPA and Teachers College, Columbia University, and who also supervised the provision of continuing education credits for psychologists—as a major draw for professional participation in the conference event.

Especially important was the collaboration with Honorable Judge Jane Pearl, who facilitated co-sponsorship with the Association of Family and Conciliation Courts, ensuring inclusion of the legal community in the conference event. Furthermore, Judge Pearl provided assistance in shaping the conference structure. During the conference Judge Pearl contributed a powerful voice that provided a keen focus on the legal issues, while she also provided leadership by moderating the panel on treatment.

Helping to ensure the participation of attorneys in the conference, The New York Women’s Bar Association provided continuing legal education credits. Assisting in further broadening the conference audience, the Columbia School of Social Work provided continuing education units for social workers. Also, continuing education credits for certified health education specialists were made possible through the Programs in Health Education and Community Health Education, Department of Health and Behavior Studies, Teachers College, Columbia University.

Another key ingredient in the conference success involved the receipt of technical assistance and guidance from both the MacArthur Foundation and the Vera Institute of Justice. This included assistance in helping to secure some speakers and panelists.

Finally, the most essential collaboration making this special theme issue possible was with Dr. Susan Warshaw as editor-in-chief of the Journal of Infant, Child and Adolescent Psychotherapy. Dr. Warshaw provided enthusiastic and consistent support for the conference. From the earliest stages of conference planning, she encouraged the Pediatric Committee to consider publishing the conference proceedings—in order to ensure that the information presented at the November 21, 2015, conference event would enjoy wide dissemination.

Major developments in conference planning

Aside from the contributions of numerous collaborators, as reviewed above, the conference event evolved across the stages of planning. There were major developments that contributed to the evolution of the conference event.

Advances in adolescent brain research by developmental neuroscientists

The conference concept and framework reflects appreciation regarding how, over the last two decades, developmental neuroscientists have generated an impressive body of research on adolescent brain development (Casey & Caudle, 2013, 2014; Galvan et al., 2006; Steinberg, 2004; Steinberg & Monahan, 2007). Findings have clarified how adolescence is not only a period of development distinct from childhood and adulthood but also one especially noteworthy for increased risk due to neurobiological changes in self-regulation, peer influence, decision making, and adolescent orientation toward the future (Galvan et al., 2007; Pfeifer et al., 2011; Schriber & Guyer, 2016). Alongside this tendency toward risk, adolescence has also been shown to be ripe with possibilities for rehabilitation, and clinical and academic efforts increasingly have become aimed at applying developmental neuroscience to juvenile law (Farahany, 2016).

Intersection of developmental neuroscience and major juvenile justice legal decisions

The collaborative work of the legal scholar Elisabeth Scott and the psychologist Laurence Steinberg (Scott & Steinberg, 2010) provided the law and neuroscience framework for the conference’s structure. Research on the immaturity of the adolescent brain has had a profound impact in shaping major legal decisions (e.g., Graham v. Florida, 2010; Miller v. Alabama, 2012; Roper v. Simmons, 2005)). In Rethinking Juvenile Justice, Scott and Steinberg (2010)not only outlined how developmental neuroscience has shaped legal decision-making, but also laid a solid groundwork for prominent issues that needed deeper exploration.

For example, consider three landmark cases reviewed by Scott and Steinberg (2010) in which evidentiary material from neuroscience played a role: Roper v. Simmons (2005), which abolished the death penalty for juvenile offenders; Graham v. Florida (2010), which prohibited mandatory life-sentence without parole for juveniles convicted of a non-homicidal offense; and Miller v. Alabama(2012), which forbid life in prison without the possibility of parole for juvenile homicide offenders—as it violated the 8th amendment to the constitution. In Roper v. Simmons (2005), as well as in the other cases, key legal arguments acknowledged “the immaturity” of the adolescent, “adolescent propensity toward reckless behavior,” and the adolescent “increased tendency to be influenced by peer pressure” (p. 3); these factors not only distinguish adolescence as distinct from adulthood, but also affirm the nascent, yet critical role of developmental neuroscience in the courts. In addition, these landmark cases paved the way for increased legal consideration and academic examination of the role of the emerging science in law. In this regard, from 2005–2012, the period during which these 3 major cases were argued, the number of legal decisions citing evidence from neuroscience increased more than twofold (Farahany, 2016). Further, the number of neurolaw conferences, at least as listed on the MacArthur website, increased as well from 1 in 2003 to approximately 22 in 2015 (MacArthur Foundation, 2016).

In this manner, the MacArthur Foundation Research Network on Law and Neuroscience has been at the forefront, bringing together groups of scholars in law and neuroscience to advance neuroscientific understanding of adolescence in the justice systems (Wolf, 2011). The conference was fortunate to be able to include Dr. Laurence Steinberg as a morning keynote speaker, ensuring coverage of the advances in developmental neuroscience and scientific understanding of the adolescent brain, including the impact on landmark legal cases.

The necessity of expanding the focus to include the role of trauma

However, the present conference sought to both emulate and expand upon the conference tradition of the MacArthur Foundation Research Network on Law and Neuroscience. For example, we turned to the Vera Institute of Justice in New York City, another leading institution on the topic of the juvenile criminal justice system and needed reforms (Vera Institute of Justice, 2016), to help build the conference roster of potential speakers. Most importantly, the complexity and multifaceted nature of the problems embedded in the three landmark cases reinforced the necessity of including in the conference not only leading experts in law and neuroscience, but also experts on trauma and mental health.

This expanded conference focus was deemed important, given how others have discussed the limitations of developmental neuroscience, recommending that it play only a small role in juvenile justice (Maroney, 2009). More specifically, Maroney argues for consideration of numerous factors, including: individual variation; environmental factors such as the quality of schools, family variables, and socioeconomics; and access to mental health care and rehabilitative services—as factors upon which action can be taken and greater direct control exercised. What needs to be emphasized, according to Maroney (2009), is how “young people differ from adults in systematic ways directly relevant to their relative culpability, deterability, and potential for rehabilitation”—as an important message for advocates (p. 94). Thus, the conference focus expanded beyond neuroscience and the law to also consider other factors.

In this regard, Taylor-Thompson (2014) provided a review and analysis of the legal outcome in the case of 12 year-old Cristian Fernandez, citing both neuroscience as a basis for understanding Cristian’s criminal behaviors and the role of trauma in his childhood. Thus, Taylor-Thompson (2014) highlighted both brain immaturity and trauma as key factors to be considered in assessing culpability and responsibility, while relying on developmental neuroscience to argue for a mandate that would bar all children under 17 from being prosecuted in the adult system. As the morning keynote speaker, Dr. Laurence Steinberg would also be able to address the impact of trauma on the developing brain, ensuring some coverage of these issues.

The need to invite scholars in the area of trauma was discussed early on in conference planning, including well before Dr. Steinberg had accepted the invitation to serve as the morning keynote speaker. The work of Dr. Bessel van der Kolk of the Trauma Center at Justice Resource Institute drew attention. A colleague of Bessel van der Kolk, Dr. Wendy D’Andrea (e.g., D’Andrea et al., 2012; D’Andrea et al., 2013), was available for conference participation. D’Andrea’s work in the classification of the types and chronicity of trauma of childhood, subsequent psychiatric diagnoses, and on complex trauma was considered important.

The extensive work of neuroscientist Dr. Paul Eslinger (e.g., Eslinger & Biddle, 2000; Eslinger et al., 2011) was also acknowledged, especially with regard to the specific features of the social brain and impacts from traumatic brain injury, culminating in an invitation for Dr. Eslinger to participate in the conference event. The landmark cases revealed the impact of different types of trauma, and including a conference focus on trauma was deemed vital to highlight the range of problems for adjudicated youth.

The disproportionate impact on youth of color: A focus on race/ethnicity

Upon directly contacting Dr. Taylor-Thompson and discussing her work (Taylor-Thompson, 2014), she generously offered guidance regarding the conference focus, emphasizing that the court’s treatment of youth as adults has had a disproportionate impact on adolescents of color. This is a critical issue in need of attention, particularly in states such as New York. This need for a conference focus upon the disproportionate impact upon youth of color was not surprising. Indeed, all of the above mentioned court cases not only delineated issues of neurobiological immaturity and trauma, but also made visible the roles of poverty and race/ethnicity as perhaps insufficiently explored factors in need of consideration. The fact that so many youth in high profile cases had suffered early trauma, and were also described as coming from “troubled backgrounds” would require attention. The conference focus by necessity sought to include an examination of the multifaceted nature of the problems in the backgrounds of youth of color.

Dr. Steinberg would be able to provide partial coverage of these issues in his morning keynote, given a focus on the importance of considering early disadvantages (e.g., poverty, exposure to violence, exposure to stress, inferior schools, and dangerous neighborhoods) for children of color and implications for disparities; that is, children of color emerge as especially vulnerable for evidencing impaired decision-making and engaging in risky and reckless behavior due to the impact upon the brain from growing up under conditions of disadvantage. Hence, from the perspective of Dr. Steinberg, youth of color from backgrounds of disadvantage are more vulnerable for engagement in disruptive behavior that may lead to criminal justice system involvement.

Health disparities as capturing racial/ethnic disparities in disadvantage and disproportionate negative impacts

This focus on the early disadvantages that disproportionately impact youth of color—and the negative consequences for adolescent brain development, behavior, and risk for criminal justice system involvement—dovetailed with the recommendations of Dr. Taylor-Thompson, that is, to focus on the court’s treatment of youth as adults having a disproportionate impact on adolescents of color. The result was a focus on racial/ethnic disparities that have a history of being investigated within the United States under the rubric of health disparities (Walker, 2008; Wallace, 2008). Yet, attention to health disparities, as well as to disparities in access to health care delivery services also necessitates attention to factors in the social context, or upon social determinants operating as mechanisms in health disparities (Marmot et al., 2008). There are also calls for taking action on the social determinants of health in order to reduce and eliminate them (Marmot et al., 2008).

As conference planning continued, a number of events converged and confirmed the timely nature of this conference also focusing on factors falling under the broad umbrella of health disparities. This included attention being paid, more specifically, to mental health disparities and the core issue of disparities in access to treatment services (Constantine et al., 2008). In this regard, the wife of New York City Mayor William de Blasio (First Lady Chirlane McCray) has discussed the New York City mental health crisis, specifically the importance of youth receiving assistance in accessing the mental health services they need before they end up in court (McCray, 2016). She shared the case of a high school youth (and son of an immigrant mother) having an angry violent outburst in a school setting, which led to court involvement. Consistent with the contemporary focus on social determinants, McCray (2016) emphasized the goal of creating a more inclusive mental health system, such as one that meets the needs of immigrant families of color that are raising youth in New York City. First Lady McCray cited the manner in which Mayor de Blasio convened a task force in 2015 that focused on the urgency of reducing the large number of individuals cycling through both the criminal justice and health care systems due to their behavioral health needs being left unaddressed (McCray, 2016).

First Lady McCray and Mayor de Blasio called for the common objective of reducing and eliminating health disparities, specifically mental health disparities (Constantine et al., 2008; Wallace, 2008)—which are intimately linked to a vulnerability to entering the criminal justice system. The goal is to also ensure equity in access for all to opportunities to receive health care(Wallace, 2008) in an effort to reduce related risks for criminal justice system involvement.

As a key influential event impacting conference planning, the article by McCray (2016) was followed up by First Lady McCray hosting a forum, “Breaking Point: New York’s Mental Health Crisis,” held in March 2015 in Harlem in New York City. First Lady McCray proposed plans to address disparities in access to mental health care in New York City. Panelists at that forum highlighted the path into the justice systems for youth with a history of trauma and lack of access to mental health care.

An impact upon conference planning included an emphasis on access to mental health care, including the possibilities for rehabilitation and various treatment approaches with this population. In addition to including featured speakers and panelists who could address these issues, other presenters addressed policies and needed reforms in policy to improve access to mental health care and alternatives to incarceration.

Issues of health disparities, mental health disparities, and access to care led to discussions to include Dr. Barbara Wallace in the conference event. This followed from the legacy of seven prior annual health disparities conferences at Teachers College, Columbia University (spanning 2006 to 2015), for which Dr. Wallace served as founding conference director. Dr. Wallace was seen as providing expertise in the area of health disparities (e.g., Wallace, 2008), which is embodied in her contributions to this theme issue. What eventually solidified was the conference event title that included recognition of the important role of health disparities (i.e., Health Disparities, Trauma, Disruptive and Criminal Behaviors and the Adolescent Brain).

The role of media: Racial disparities in the disproportionate use of police violence and risks for entering the school-to-prison pipeline

Other key influential events impacting conference planning involved those highly publicized by media. Across the United States, the powerful roles played by incidents involving shootings by law enforcement of persons, particularly youth of color, were aired almost daily (Colarossi, 2015; Staggers-Hakim, 2016; Ohlheiser, 2014). Then came a widely publicized report of the suicide of a young man of color, arrested at age 17, and incarcerated for more than three years at a New York prison—including two years in solitary confinement—without ever being convicted of a crime (Gonnerman, 2015). This traumatic incarceration and widespread news reports of his case seemed to strengthen broad efforts to consider “Raise the Age” legislation in New York State (Justice Policy Institute, 2015).

During the same time period, a widely viewed video (Klein, 2015) of the violent arrest of a Black teenage girl texting in a South Carolina classroom, brought additional attention on the treatment of youth in educational settings and additional focus on what has been described as the School to Prison Pipeline (Wical, 2012). It was felt that an important aspect of the conference would be specifically a focus on the multitude of structural factors contributing to youth of color and Black males, in particular, being vulnerable to school push out and entrance into the criminal justice system (Edelman, 2014; Vaughans & Spielberg, 2014). In addition, the plan was to discuss strategies to disrupt the school-to-prison pipeline.

Taken together, these events reported in the media served to focus additional attention to critical issues. More specifically, media coverage thrust the issue of race into conversations at the national, state, and local levels and made it more possible to explore questions regarding the role of implicit and/or explicit racial bias in the differential treatment of adolescents at every point of contact with law.

In this regard, and making a major contribution to the conference, Dr. Kirkland Vaughans accepted the invitation to serve as the afternoon keynote speaker. He contextualized the relationship of police with youth of color, focusing initially on the historical relation of black boys to the police, as rooted in the history of the enslavement of Africans in the United States. He expanded that to include the lived experience of Hispanic youth, the second most overrepresented group in the criminal justice system. Delineating both explicit unconscious, or implicit factors and the lived experience of youth of color, Dr. Vaughans would provide a deeper understanding of the unprocessed aspects of experience, which may play a role in increasing risks facing Black and Latino males, in particular.

Other broad Issues addressed by the varied conference contributors

There were several other broad considerations—whether via the keynote speakers, featured speakers, panelists, or through dialogue with audience participants—that were included: the intersection of issues of the adolescent brain, trauma, poverty, racism, health disparities, and mental health treatment, as well as substance abuse and violence; the possibilities of expanding the conference conversation to include the impact and role of transgenerational trauma, particularly given the disproportionate involvement of Black males in the school-to-prison pipeline and the history of African enslavement; the challenge of an inadequately trained and overwhelmed workforce, including how those having the least training are serving those with the greatest need across multiple systems—and the realities of there being little time for information sharing in their daily work; the tendency to avoid discussions on implicit and/or explicit bias and the inseparable role of poverty and the need to find effective ways to discuss these biases and provide cultural competence training; and the goal of including more key stakeholders in the overall conference conversation, including formerly incarcerated youth, parents, social workers, wardens, mental health counselors, correction officers, psychologists, lawyers, judges, and neuroscience researchers.

As a result of active outreach and successful recruitment of diverse professionals as conference contributors by the conference co-producer, Dr. Carla Beckford, there was some discussion within the conference of these numerous broad issues. Specifically, this was made possible via the invaluable contributions of numerous professionals: our featured speakers (Dr. Akeem Marsh, Dr. Amelio D’Onofrio, Dr. Isaiah Pickens, Thomas Andriola, M.A.), our featured speaker session discussant (Honorable Jane Pearl), and the New York State Psychological Association (NYSPA) representatives who provided speaker introductions and commentary (e.g., Dr. Carla Beckford and Dr. Gabrielle Stutman).

Special invited guest Dr. Roy Aranda, Psy.D., J.D., president of New York State Psychological Association (NYSPA) in 2016 (president-elect for 2015), with a strong background in forensic psychology and neuropsychology, provided some background and insights about this important conference topic. In particular, Dr. Aranda was well-positioned to represent NYSPA, the largest psychological association in New York and affiliate of the American Psychological Association. He referenced recent legislative changes in Connecticut, specifically “Raise the Age,” which would decrease the numbers of youth entering the criminal justice system pursuant to research that shows that juveniles prosecuted as adults are more likely to reoffend and commit more serious crimes than juveniles prosecuted in juvenile court. He called for other states, including New York, to explore Connecticut’s approach to solving issues of overrepresentation of Black and Latino youth in the criminal and juvenile justice systems. Dr. Aranda spoke highly about the importance for students in the audience to study the interface of psychology and law and to maintain high standards of empirical research. He added that neuropsychology is well-suited to provide the legal system with solid scientific knowledge in forensic applications.

Our panel moderator and discussant (Attorney Kathleen DeCataldo), as well as panelists (e.g., Hernan Carvente, Lois Herrera, Lisa Salvatore, Esq, Dr. Paul Eslinger, Dr. Wendy D’Andrea) promoted a lively discussion with audience members about issues faced by those on the frontlines.

Overview of the theme issue

This theme issue captures the exceptional contributions made by an array of professionals to the conference focus on health disparities, trauma, disruptive and criminal behaviors, and the adolescent brain. In this manner, the theme issue constitutes proceedings of the conference, given the willingness of nearly all the keynote speakers and featured speakers to contribute an article to this issue. An additional contribution has been added to augment and enrich the theme issue.

The new brain science: Morning keynote of Dr. Laurence Steinberg—with commentary

The theme issue begins with an article by Wallace (2016), “The Conference Morning Keynote Address of Dr. Laurence Steinberg on the Age of Opportunity and Lessons from the New Science of Adolescence: With Introductory and Closing Commentary,” which serves to capture the contributions of the conference morning keynote speaker. This article is based on a careful transcription of the keynote remarks given by Dr. Laurence Steinberg, suggesting the thoroughness of what is presented. Most importantly, Dr. Steinberg had the opportunity to review the article and offer edits while providing written approval of the content. Of note, Dr. Laurence Steinberg was not able to accept the invitation to contribute a journal article, given he is in great demand, partly due to the success of his book Age of Opportunity: Lessons from the New Science of Adolescence (2014). Wallace (2016) highlights the elements of the keynote: how the prevailing conceptualization of adolescence as something to survive needs to be replaced and informed by brain science, including how adolescence should be viewed as a stage of opportunity for impacting the brain due to plasticity; the importance of self-control as a variable in research while highlighting other research on the interaction of sex hormones and the neurotransmitter dopamine during adolescence; how adolescent brain plasticity means adolescence is not only a stage of opportunity but also a period of great vulnerability to mental illness, substance dependence, and stress and trauma; the importance of lessons from brain science that translate into the imperative to change how we think about juvenile justice policy and practice; and key implications for overall criminal justice system policy and practice and the need for society re-thinking how adolescents are sanctioned. Of note, Dr. Steinberg acknowledged the portion of the conference theme on health disparities, discussing the role of early disadvantages for children of color and the implications for disparities. Perhaps most importantly, as per the comments offered by Wallace (2016), Dr. Steinberg put out a powerful call to action, essentially launching a revolution with regard to the types of interventions professionals—such as those in the conference audience and now the larger body of the journal audience readership—need to put in place as alternatives to what now exists, which is damaging adolescents. Further, this revolution includes viewing societal-wide crime prevention as involving the implementation of early prevention, intervention, and treatment of mental health issues.Wallace (2016) concludes her article by noting the manner in which Dr. Laurence Steinberg was honored as the morning keynote speaker with the presentation of a plaque.

A dangerous inability to mentalize: The afternoon keynote of Dr. Kirkland Vaughans

Also noted is how the afternoon keynote speaker, Dr. Kirkland Vaughans, was similarly honored with a plaque noting his outstanding contributions to the field, including through his recent volumes (i.e., the two volume set, The psychology of Black boys and adolescents; Vaughans & Spielberg, 2014). Hence, next, the theme issue presents the contributions made by Dr. Vaughans, as the afternoon keynote speaker, in collaboration with Dr. Lisa Harris, a Hispanic psychoanalyst, to assist with an elaboration of how Hispanic males are also impacted by implicit and explicit racism. Thus, Vaughans and Harris (2016) provide the entitled, “The Police, Black and Hispanic Boys: A Dangerous Inability to Mentalize.” Vaughans and Harris (2016) explore the volatile relationship between the nation’s police and Black males, its historical roots in slavery, and expand their exploration to include the lived experience of Hispanic youth. Casting a psychoanalytic lens upon the relations of youth of color with law enforcement, they explore the implicit, unconscious misperceptions and attributions towards these youth, which are a product of what they refer to as egregious failures of mentalization. They explain the key construct of mentalization, invoking self-reflective and interpersonal processes, including observing others and reflecting upon their mental states—thereby arriving at what others may be thinking, feeling or experiencing. Vaughans and Harris (2016) suggest that the failure of mentalization as it occurs in relation to Black boys and others of color may have dangerous results, suggesting these failures to truly see and recognize the personhood of these youth can lead to misperceptions and distortions that may underlie cases of police brutality and be one factor in the multitude of factors working to marginalize Black and Hispanic males.

Vaughans and Harris (2016) delve into the problem of police control while reflecting on contemporary accounts of police shootings and discuss the roots of violence and oppression (as the exercise and institutionalization of violence—citing a body of classic writings; e.g., Frantz Fanon). They also consider key historical factors, developmental issues, trauma, cultural trauma, and acculturation stress, particularly as they expand their discourse to include Hispanic youth. Vaughans and Harris (2016) provide a prescription for moving toward real change, that is, a comprehensive program that improves the education system, changes the penal system to rehabilitation (away from primitive retribution), provides real opportunities for employment, and effectively addresses the mental health needs of youth—“instead of blaming them for their condition.”

Spotlight on social brain maturation and the social brain network: Implications

Dr. Paul Eslinger, a featured conference speaker, presents the next article in the theme issue, joined by his colleague Dr. Melissa Long (“Biopsychosocial Influences that Promote and Impede Social Brain Maturation”). Within their article, Eslinger and Long (2016) explain how adolescence is a period during which the brain is undergoing great change, specifically with regard to social, emotional, and executive function systems. They explain that the course of maturation of brain networks has implications for key social executive functions such as empathy, social emotions, and self-monitoring. They discuss the social brain network, including how the “social brain” areas mediate behaviors associated with mentalizing, empathy, moral judgment, and interpersonal perception, for example. Of note, Eslinger and Long (2016) discuss mentalization as a key process, just as do Vaughans and Harris (2016). Here, Eslinger and Long (2016) note how mentalization involves social judgments and understanding the intentions of others (e.g., unintentional harm vs. planned action to harm) as processes that depend on the social brain network activation in social judgment tasks. They also discuss how the presence of a familiar individual “reduces or eliminates stress and fear responses” as social stress buffering. However, a lack of “stress buffering may occur in adolescence as well, and in fact become heightened with peer pressure, exposure to drugs and alcohol, as well as other mounting adversity, further disrupting maturation of the prefrontal cortex and the executive control systems.”Eslinger and Long (2016) alert readers to the many influences that can promote maturation of these social executor systems, as well as to those that can disrupt this maturation. Most importantly, they provide a framework that alerts the reader to the necessity and opportunity to create and foster environments that are conducive to promoting maturation of the social executor systems. Eslinger and Long (2016) also echoe the views expressed by Dr. Laurence Steinberg, as summarized by Wallace (2016): adolescence is both a “vulnerable period for external influence,” as well as “a window of opportunity for potentially untapped potential for growth and maturation.”

A case analysis: Executive function, neuropsychological and psychological impairment

In the next article, “Connecting the Dots through a Case Report: A Child’s Unmet Needs, Neuropsychological Impairment and Entrance into the Juvenile Justice System,” Dr. Carla Beckford shares the composite case of Trey to delineate a common youth profile: weaknesses in executive functions; impaired neuropsychological, and psychological skills rooted in trauma; and Attention-Deficit/Hyperactive Disorder and other learning difficulties/disabilities. Also operating are numerous social ecological factors: family poverty, parental health and chronic stress; underserved and low-performing schools with a punitive environment (e.g., suspensions); lack of access to learning and support services and treatment; and living in an underserved neighborhood. These factors combined in paving Trey’s way into the school-to-prison pipeline. Beckford (2016) draws attention to the need for researchers to study not only trauma but also resilience—as the vast majority of children “living in underserved areas do not end up in the criminal justice systems.” She also calls for dismantling zero tolerance policies, as unfair treatment for children with a history of trauma and learning difficulties/disabilities, raising the question as to whether such policies violate mandates of the Individuals with Disabilities Education Act. Further, Beckford (2016) offers a range of recommendations for research, policy and practice, while urging all education stakeholders to call for treatment, rehabilitation and remediation—in order to facilitate a larger societal shift away from punishment and toward clinical care.

Inappropriate responses to youth: The overuse of harsh punishment in schools

Next, Parks, Wallace, Emdin, and Levy’s (2016) article, “An Examination of Gendered Violence and School Push-Out Directed Against Urban Black Girls/Adolescents: Illustrative Data, Cases, and a Call to Action,” seeks to spur a societal shift. The article urges a nationwide movement to disrupt and end racial disparities in the exercise of harsh discipline directed against Black girls/adolescents compared with White girls/adolescents and to disrupt and end school push-out and the overall school-to-prison pipeline. The article reflects how the conference was also an online course through Teachers College, Columbia University for a small group of registered graduate students with Professor Barbara Wallace. Parks’ submission of her required online course paper spurred the collaboration that resulted in this article. Parks et al. (2016) analyze how structural inequality and gender-based violence operate in society, communities, and schools. A caution is given regarding the danger of blame-the-victim and deficit-oriented approaches, which locate the problem as being within Black girls/adolescents. Parks et al. (2016) emphasize the need to focus on both proximal individual-level and distal structural-level variables—as factors located in the social context. Three cases of African American adolescents are presented, while case discussion covers how disadvantages accrue for students, including stress reactions from exposure to harsh discipline in schools. Parks et al. (2016) conclude with a call to action to end school harsh disciplinary practices, school push out, and the school-to-prison pipeline.

Appropriate responses to youth in juvenile detention: A trauma-informed approach

Given the reality that many youth do end up incarcerated, the next article, “Laying the Groundwork: Conceptualizing a Trauma-Informed System of Care in Juvenile Detention,” by featured conference speaker Dr. Isaiah Pickens (2016) discusses a systems based trauma-informed approach for use within secure juvenile detention settings. Pickens (2016) considers how incarcerated youth bring a high prevalence of exposure to traumatic events prior to incarceration and may be readily triggered by aspects of the incarceration experience. Juvenile detention centers hold the potential for youth accessing resources to facilitate recovery from trauma via interventions not readily accessible in the community. When youth with trauma backgrounds are triggered by the incarceration experience, they may manifest behaviors (e.g., fights) that require staff intervention, sometimes prompting staff to experience secondary traumatic stress and vicarious traumatization as a challenge to staff professionalism. Implications include the need for strategies to manage staff stress via policies and practices (e.g., staff breaks, staff self-care techniques, staff support, weekly interdisciplinary team meeting) that ensure the physical and psychological safety of staff—and youth. For Pickens (2016), the results may be described as a trauma-informed system of care in juvenile detention. Also recommended is a closer collaboration between the juvenile detention system and multiple child-serving systems during the period of incarceration; this may assist youth in developing healthy alternatives to survival coping skills (e.g., gang involvement, weapon carrying) for deployment upon their return to community settings, and reduce recidivism. Ultimately, Pickens (2016) recommends a coalition of service providers engaged in the implementation of trauma-informed practices between systems—as a vitally needed cross-system collaboration.

A model for cross-system collaboration and partnerships to address psychiatric issues

Dr. Akeem Marsh (2016), as another featured conference speaker, describes an exemplary grant-funded collaboration across systems in the article “Psychiatric Issues Among Adjudicated Youth: Challenges, Failures, and Successes.” This cross-system collaboration, as described by Marsh (2016), was initially between New York City’s Administration for Children’s Services (ACS) and their Juvenile Detention Centers, the Bellevue Hospital Center, and New York University in order to provide Skills Training in Affective and Interpersonal Regulation (STAIR) to improve care of youth and eventually the cross-system collaboration expanded via a partnership agreement between ACS and the New York City Health and Hospitals Corporation (HHC) that permitted creation of the Bellevue Juvenile Justice Mental Health Team. In this manner, the Marsh (2016) article shifts focus to the more than two-thirds of youth in the juvenile justice system with psychiatric disorders. As context for discussion, Marsh (2016) acknowledges the challenges associated with mental health service delivery within the juvenile justice system in response to high rates of exposure to victimization, trauma, multiple trauma, and chronic exposure to traumatic stressors, including many suffering from complex trauma; there are associated problems of aggression, substance use, oppositional behavior, and delinquency. Also, there is a high prevalence of varied mental disorders, including substance use disorders and learning disabilities, as well as co-morbid conditions and multiple co-morbid conditions. Through provision of a clinical vignette, Marsh (2016) demonstrates the reality of multiple Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnoses in a female adolescent in detention and the delivery of treatment interventions. Looking toward the future,Marsh (2016) envisions care being delivered in a therapeutic milieu versus a punitive setting, which would align with best practices recommendations set forth by numerous organizations.

Translating brain science into action: Juvenile justice reform in New York State

The conference featured speaker, Thomas Andriola (2016), presents the article “Juvenile Justice Reform in New York State” to describe the work at the Division of Criminal Justice Services and with other state partners with regard to the essential task of knowledge translation. This has involved translating the latest developments in neuroscience and understanding of the adolescent brain into practical and well-informed changes to the juvenile justice system in New York State, according to Andriola (2016). Here, too, working closely and collaboratively—both locally and across disciplines—is emphasized as key to improving outcomes for youth. This process includes the launching in 2010 of a statewide collective impact planning process with cross-sector representatives focused on the common agenda of understanding the problem and envisioning change. The results were a major report that guided subsequent developments in New York State, such as the implementation of various screening and assessment tools “in an effort to reduce racial and ethnic disparities and impose the right interventions for the right youth at the right time,” according to Andriola (2016). Further, findings from screening and assessment permit the delivery of evidence-based practices; for example, the Neurosequential Model of Therapeutics (NMT) as a neurobiologically informed approach rooted in neurodevelopment and traumatology, and Collaborative Problem Solving (CPS) as a strengths-based and neurobiologically grounded approach, among others. Andriola (2016) also stresses the importance of Regional Youth Justice Teams in increasing “the capacity of agencies, organizations, and courts across the State to adopt both New York State based and national innovative research-driven and evidence-informed practices.” Finally, Andriola (2016) envisions ongoing and greater success in promoting youth success, while ensuring public safety.

Using trauma-sensitive design principles to inform sports programming for youth

Featured conference speaker Dr. Wendy D’Andrea is joined by Lou Bergholz and Erin Stafford in presenting her conference contribution on the work of The Trauma and Affective Psychophysiology Lab, New School for Social Research, via the article “Creating Trauma-informed Sports Programming for Traumatized Youth: Core Principles for an Adjunctive Therapeutic Approach.” Bergholz, Stafford, and D’Andrea (2016) draw upon gold-standard trauma informed psychotherapy approaches and adapt them to articulate principles of trauma-informed sports programming—as a response to the reality that youth engaging in sports may present the challenge of hyperarousal and aggression. The approach does not replace the need for formal clinical care. Building on research findings, they identify trauma-sensitive design principles as the foundation for designing and delivering sports programming while ensuring physical and emotional safety. Also key for Bergholz et al. (2016) are considerations of attachment, self-regulation, prosocial behavior, goal pursuit, supportive relationships, a supportive structure (e.g., clear program rules, a predictable schedule of activities), as well as integration of local cultural practices to increase feelings of familiarity and safety for youth. The authors also identify important trauma-sensitive elements for sports programing. These include clear program practices (e.g., coaching in pairs) and numerous vital skills for youth workers, for example, mindfulness to counteract trauma reactions in youth of dissociation and emotional numbing. Also vital for Bergholz et al. (2016) is how coaches speak to youth affected by trauma, emphasizing use of a calming voice and tone, among other elements. Through use of the trauma-sensitive design principles, youth with histories of trauma may receive the many benefits associated with pro-social involvement in sports.

Conclusion

This article has served to introduce the special theme issue of this journal, which serves as the proceedings of the November 21, 2015, conference Health Disparities, Trauma, Disruptive and Criminal Behaviors and the Adolescent Brain, while augmented with an article to enrich this journal issue. What has emerged is the manner in which the conference was made possible by numerous fruitful collaborations, an organic process through which the conference focus naturally evolved, and the acceptance of invitations to present at the conference by varied professionals who brought genuine expertise. Their expertise is reflected across the range of journal articles in this theme issue that allow the reader to gain knowledge on topics ranging from the new adolescent brain science, to the impact of societal policies, cases illustrating the challenges to which society and professionals may endeavor to respond, as well as examples of inappropriate, appropriate, and model pioneering responses to the challenges of youth who present health disparities from trauma along with disruptive and criminal behaviors. The remainder of this journal provides readers an opportunity to deepen their knowledge on all of these varied topics and to contemplate their potential responses to the calls to action that were put forth at the conference and embodied in this collection of articles.

Additional information

Notes on contributors

Carla Beckford

Carla A. Beckford, Ph.D., specializes in the assessment, remediation, research, and advocacy for children, adolescents, and families struggling with learning disabilities and related disorders. She works at Northside Center for Child Development and privately as a consultant. Representing the Pediatric Committee, Division of Neuropsychology, New York State Psychological Association, she served as co-producer of the Fall 2015 conference, on which this special themed issue is based.

Barbara C. Wallace

Barbara C. Wallace, Ph.D., is a New York State Licensed Psychologist, Professor of Health Education, Coordinator of the Programs in Health Education & Community Health Education, and Director of Health Equity at the Center for Health Equity and Urban Science Education at Teachers College, Columbia University.