Contents lists available at ScienceDirect Children and Youth Services Review journal homepage: www.elsevier.com/locate/childyouth Therapeutic transformation of juvenile corrections in Virginia: A mixed method analysis of benefits and challenges Hayley M.D. Cleary ⁎ , Sarah Jane Brubaker Virginia Commonwealth University, USA ABSTRACT Many juvenile correctional institutions have moved toward a punitive, adult-like management model that prioritizes security and control. In recent years, Virginia has reinstituted a rehabilitative approach in its juvenile facilities via the Community Treatment Model, a therapeutic model of youth corrections similar to the Missouri Model that emphasizes relationship building, community and family connections, and group- based treatment and accountability. Despite the tremendous investment involved, evaluations of therapeutic correctional programs are rare. This article reports findings from a mixed-method, mid-implementation assessment of perceived benefits and challenges with Virginia's model. We conducted 18 focus groups and 248 surveys with incarcerated youth and facility staff. Perceived program benefits included regular, structured activities; increased family engagement; and improved staff-youth relationships facilitated by consistent staffing and efforts to build rapport. Participants identified forced interactions; youth resistance to talking- focused activities; insufficient accountability mechanisms; implementation problems; and questions regarding universal applicability as challenges with the new model. More than 48,000 youth are incarcerated in juvenile residential facilities on any given day across the United States (Hockenberry, 2018). In 2018, Virginia reported more than 7500 pre- and post-ad- judication detainments of youth in local detention centers and state correctional facilities (Virginia Department of Juvenile Justice, 2018). Youth in secure confinement often have complex social histories, in- cluding trauma, mental illness, academic problems, poverty, commu- nity violence, or substance abuse (Pyle, Flower, Fall, & Williams, 2016; Sedlak & McPherson, 2010). For example, one recent large-scale study reported that 92% of juvenile detainees had experienced some sort of trauma, and detained youth experienced 15 traumatic events on average, including physical and sexual assault, being threatened with a weapon, and witnessing community violence (Abram et al., 2013). Prevalence rates for mental health disorders are as high as 70% among incarcerated youth (Colins et al., 2010; Fazel, Doll, & Langstrom, 2008), and comorbid disorders are common (Shufelt & Cocozza, 2006). Juvenile correctional facilities face the dual challenges of meeting youths' complex treatment needs while maintaining a safe, secure en- vironment. Creating, implementing, and evaluating youth treatment programs is a difficult task in general, and doing so within an institu- tional setting is even harder due to barriers to access, staff resistance to research, and limited opportunity for experimental control (Fox, Lane, & Turner, 2018; Jeffords, 2007). Nonetheless, some evidence-based programming is available for institutional settings (Lipsey, 2009). Successful youth correctional programs share certain commonalities, including emphases on individual youths' needs, dynamic (changeable) risk factors, mental health treatment instead of punishment, and service delivery by trained mental health professionals as opposed to security- trained correctional staff (Greenwood & Turner, 2009; Lowenkamp, Makarios, Latessa, Lemke, & Smith, 2010). Many of these rehabilitative ideals are encapsulated in the state of Missouri's reformed and now- popularized approach to juvenile secure confinement. 1. The Missouri Model Missouri is considered a trailblazer in juvenile justice reform among juvenile justice professionals as well as the popular press (e.g., Colorado Child Safety Coalition, 2017; Edelman, 2010; Mendel, 2010). As early as the 1960s, the state was experimenting with dormitory-style housing for youth in state custody (Huebner, 2013). In the 1970s, amid federal expansion of protections for youthful offenders, Missouri decentralized its juvenile justice administrative operations, establishing regional of- fices across the state, and also created a successful bipartisan panel to guide the expansion of juvenile treatment services administered pri- marily at the local level. Missouri's Division of Youth Services now operates as an independent agency within the state Department of So- cial Services and is responsible for Missouri's incarcerated youth po- pulation, currently comprising approximately 2800 youth (http:// missouriapproach.org). The “Missouri Model,” as the state's approach has come to be known, departs from traditional incarceration approaches in several key ways (Huebner, 2013; Mendel, 2010; http://missouriapproach. https://doi.org/10.1016/j.childyouth.2019.104444 Received 30 April 2019; Received in revised form 26 July 2019; Accepted 27 July 2019 ⁎ Corresponding author. E-mail address: hmcleary@vcu.edu (H.M.D. Cleary). Children and Youth Services Review 105 (2019) 104444 Available online 29 July 2019 0190-7409/ © 2019 Elsevier Ltd. All rights reserved. T