cents with a wider range of charges but limited our participants to males (because of the higher rates of males in
detention), with the intent of further adapting the intervention for females at a future date. We also reconceptualized
the theoretical framework of the intervention as one that
could address mental health problems while still emphasizing aggressive behaviors as our distal target outcome.
Given the importance that the court-based psychologists
and detention staff placed on providing services to as many
adolescents as possible, we worked to find ways to uphold
this value while also maintaining rigor in the research
strategy. All members of the team agreed that it would be
best to deliver the intervention in an open-group format ( i.e.,
new members could enter at any session). This decision
improved our ability to recruit enough participants and
maximized services for adolescents in detention but also
prevented us from employing a random assignment strategy. The agreed-upon approach was to first recruit adolescents who wanted to participate in the intervention, and then
recruit adolescents willing to participate as age-matched
controls. At the request of our partners, we later changed
our control condition to a waitlist control, so those who
wanted to participate in the group had the opportunity to do
so when a space opened. Despite all of these changes, we
ended up with a more versatile and scalable intervention
that can more readily be adapted for diverse settings.
Although our multidisciplinary team attempted to prevent
as many issues as possible during the implementation phase,
unexpected challenges arose within the detention setting,
including basic logistics, recruitment, and group procedures.
Setting logistics. Unique considerations were required
to run an intervention in detention. These challenges required ongoing consultation and problem-solving among
team members. For example, the first version of our treatment manual comprised 10 sessions. However, detention
staff asked that group sessions be conducted only on weekends, so as not to interfere with adolescents’ schooling
during the week. Additionally, the typical length of stay in
detention at that time was less than 1 month. The team
worked together to determine the optimal number of sessions, balancing the intervention developers’ preferences
for preserving the integrity of the intervention with the court
professionals’ knowledge about typical lengths of stay.
Given our hope that group members could complete the
entire intervention, we revised our treatment manual and
reduced the number of sessions to six, so that it could be
offered over three weekends.
As with any other compromise, this change had downstream effects on other aspects of the intervention delivery.
For example, the restriction on number of sessions was
considered in the decision to deliver the intervention in an
“open” format, such that that adolescents would be able to
join at any session and terminate once they completed all six
sessions. We also modified the intervention protocol to
incorporate regular review of earlier material in all sessions.
Recruitment. The recruitment procedure initially in-
volved detention staff reading an institution review board
(IRB) approved script to potential participants. We quickly
learned that this protocol was not only inconvenient but also
uncomfortable for staff who did not feel that they had the
knowledge to answer questions from potential participants.
When we asked staff for feedback about the recruitment
procedure, we learned that it was preferable that our group
facilitators recruit participants by reading the IRB-approved
script and answering questions. This new procedure was a
small change that greatly increased feasibility and reduced
Even with this resolution, recruiting a sufficient number
of participants for the intervention and control conditions
was at times problematic. Part of this problem was related to
adolescents’ behavior problems in detention, as we were
only able to recruit those who were not on some form of
restriction. Thus, the pool from which we were permitted to
recruit varied each week. Recruitment procedures also varied according to the preferences of detention staff (e.g., if
group facilitators were allowed to talk to one youth at a time
or to a full group, or recruit from one living quarter vs.
multiple). Although at times not ideal, the group facilitators
understood that working well with the different staff members was important for maintaining rapport with the broader
multidisciplinary team. IRB approval was obtained for every variation implemented.
Group procedures. Consistent with ACT, group facilitators were expected to be nonjudgmental and to prioritize
experiential learning over didactic learning. This facilitator
approach occasionally led participants to engage in off-task
behaviors (e.g., side conversations) or behaviors that are
prohibited in juvenile detention (e.g., using curse words).
Whereas group facilitators viewed these behaviors as simply off-task, they were considered violations of detention
rules to staff. Thus, we sought to balance the interests and
goals of detention staff with those of the group facilitators.
For example, facilitators repeatedly reminded the adolescents that although the group therapy was voluntary and
confidential, they were expected to abide by detention rules.
Juvenile detention administration required that one staff
member be present during the group, which is unusual in a
therapeutic context. An unexpected challenge of this requirement was that staff would at times want to be more
helpful and in a different manner than the intervention was
designed, such as encouraging the adolescents to participate
or looking over their shoulders to assist during an activity.
Although very well-intentioned, the intervention is designed
to allow participants to engage at their own pace and with
337 MULTIDISCIPLINARY PARTNERSHIP JUVENILE DETENTION