Trauma-informed education could improve outcomes for justice-involved Black adolescents

Sexual and substance use education that incorporates knowledge about trauma could improve developmental outcomes among justice-involved Black youth, according to a Rutgers study published in the journal Children and Youth Services Review.

"For black adolescents in the justice system, childhood trauma greatly influences early life choices, particularly with sex, drugs and alcohol," said Abigail Williams-Butler, an assistant professor at the Rutgers School of Social Work. "Trauma-informed sexual health education, coupled with substance misuse awareness, can improve well-being and might even lower rates of incarceration for these youth."

To determine how adverse childhood experiences (ACEs) influenced the age of sexual debut (first intercourse), and substance use initiation (first experience with marijuana or alcohol) among incarcerated Black adolescents, Williams-Butler and Tyriesa Howard, an assistant professor of social work in the Brown School at Washington University in St. Louis, examined data from the Northwestern Juvenile Project (NJP).

Launched in 1995, the NJP was created at Northwestern University to assess the mental health needs and outcomes of youth after they entered the juvenile justice system.

A total of 368 Black adolescents (52.7 percent female) between ages 11 and 17 arrested in Cook County, Illinois, were surveyed as part of the NJP. Respondents self-reported history of sexual activity, substance use and adverse childhood experiences—traumas such as emotional, physical or sexual abuse; neglect; and household dysfunction (like an incarcerated relative).

Using this original data, Williams-Butler, Howard and colleagues conducted analyses to determine the effects of adverse childhood experiences on sexual debut, substance use initiation and engagement in sex under the influence.

What the researchers found was shocking: 97 percent of participants reported at least one adverse childhood experience and 82 percent reported a sexual debut before turning 15. More than 10 percent said they used alcohol or cannabis before they turned 11.

The researchers also found having a history of adverse childhood experiences influenced whether respondents had engaged in sex under the influence of drugs or alcohol, suggesting that childhood trauma influences substance use behaviors that contribute to risky sexual behaviors.

"What this data demonstrates is the need to include discussions about trauma in sexual health education," said Howard. "For this population, sexual health needs to emphasize what people's lived experiences look like and be intentional and direct about post-traumatic growth."

While sexuality education curriculum varies widely by state, most programs tend to avoid discussions related to trauma, Williams-Butler said. This oversight is problematic for justice-involved youth, especially those arrested for activities that "may be seen as traumatic within themselves, such as engaging in survival sex …or running away from physical violence in their home caused by childhood victimization," the researchers wrote.

Bringing a trauma-informed approach to sexuality education "honors their experiences—whether they are good, bad or really ugly—and acknowledges them in the rehabilitation process," said Howard.

Williams-Butler said she hopes this research will eventually help expand trauma-informed adolescent sexual health programming, which in turn could reduce sexual harm, unplanned and unwanted pregnancies and sexual disease.