Troubled Youth: Psychosocial Development Behind Bars

Serious Teenage  Boy wearing headphonesA prison sentence is challenging for the physical development of adolescents; but it can be downright devastating for psychosocial development. Psychosocial development is in full-swing during middle (15-17 years old) and late (18-21 years old) adolescence, when youthful offenders are likely a part of our patient population. This is a time when detention and association with the prison social system can have far-reaching effects. A longitudinal study published a few years back found that youth, once admitted into the juvenile justice system, were 37 times more likely to be arrested as an adult than similar kids who were not put into the system. Psychosocial development during the vulnerable adolescent years provides some insight into why this might happen.

Erikson’s Stages of Psychosocial Development is a widely accepted model of progressive psychosocial human development. Using this model, we can see how the criminal justice system might negatively affect detained youth in middle and late adolescents

Industry vs. Inferiority

Pride in accomplishment, developed from childhood through puberty, can have good results for individual identify development and self-esteem. This process can go awry, however, when youth are mixing in a criminal culture where deceit, manipulation, and bullying are often rewarded; while honesty, transparency, and kindness are socially unacceptable. In interactions with youthful offenders (really with all patients!) correctional nurses can role model and encourage positive identity development to help counteract this negative influence.

Identity vs. Role Confusion

Your adolescent patients are exploring adulthood and looking for an identity that aligns with their gifts and ambitions. This is a period of discovering who they are and their place in the world. How easy it is to take on a criminal identity when surrounded by adults or peers who, by word and action, are advocating for it. Uninformed custody professionals and even healthcare staff can encourage this identity selection through labeling and assumption. Regularly check your attitude toward your patient. Consider how your words and actions encourage or discourage a criminal role identity in interactions with your youthful patients.

Intimacy vs. Isolation

Young adults are exploring relationships that lead to long-term commitments. Youth confined for long periods with felons can end up in destructive relationships. The need for intimacy and belonging can lead to gang involvement as this insider suggests in an editorial about youth in adult prisons. Are there ways to encourage youth in your patient population toward healthier relationships? Possibly. Consider resources available in your facility. There may be outside groups such as dog training opportunities, educational sessions, or opportunity to engage in youth-specific programs.

What Can I Do?

Unfortunately, correctional nurses do not have the authority to change the juvenile justice system, although we have an obligation to work toward social justice and a better society. It would be easy to merely acknowledge this troubling information and focus on our various medical tasks – isn’t that enough? Isn’t that all we can do in this situation? Maybe so, but consider how a brief conversation or action can make a difference. We have moments in our care provision to talk with our patients. A passing word or expression of concern may have an impact – one that you may not ever see to fruition – but one that may change a life.

Consider these 5 C’s of Positive Youth Development and take opportunity to encourage in one of these areas with every patient contact:

  • Competence
  • Confidence
  • Connection
  • Character
  • Caring/Compassion

Do you provide healthcare to troubled youth? Share your experiences in the comments section of this post.

To read more about the unique aspects of juvenile health care in the correctional setting see Chapter 11 in the Essentials of Correctional Nursing. The text can be ordered directly from the publisher and if you use Promo Code AF1402 the price is discounted by $15 and shipping is free.

Photo Credit: © soupstock –

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