How Treating Teens’ Trauma Is Stopping Violence in Chicago

Dan Gorenstein (DG): As we near the end of 2025, we’re looking back at stories we’ve done that highlight people working on solutions to some of health care’s biggest problems.

Violence is one of the biggest threats to the health of American children.

This summer, we profiled a program in Chicago that’s having success using therapy to prevent violence among kids who are most at risk.

Stick around to the end for some updates.

ORGINAL STORY:

DG: Millions of kids every year are victims of or witnesses to violence. Fights. Assaults. Shootings. Black children see the most.

Decades of research show growing up around lots of violence is harmful for kids. It can hurt their mental health and their physical health. It increases the risk that kids use drugs, get pregnant and drop out of school.

Charles Branas (CB): Violence and particularly gun violence, it’s the number one threat to their health and their lives.

DG: In recent years, several rigorous studies have shown that therapy — specifically cognitive behavioral therapy — can substantially lower the chance that kids exposed to lots of violence will go on to commit violent acts themselves. But delivering those services to some of the highest-risk kids is tough.

Today, how Chicago may be breaking this cycle of violence among some of its most at-risk young people, and whether this model can be a solution nationwide.

From the studio at the Leonard Davis Institute at the University of Pennsylvania, I’m Dan Gorenstein. This is Tradeoffs.

*****

DG: A quick note before we start: Much of this episode focuses on a 17-year-old who has an ongoing case in the juvenile justice system. To protect his privacy, we will refer to him by a nickname and not name his school or discuss the specifics of his arrest.

DG: May 10, 2024 was kind of a perfect day for T-Man.

T-Man: That day was just amazing to me. It’s just like, too good to be true. 

DG: It was a Friday afternoon. School was out, and the 16-year-old sophomore was going to see his cousin.

T-Man: That’s like my everyday cousin. Like I could call him for anything. He could call me for anything. It’s not a day I don’t go without talking to this man.

DG: The two teenagers were close. They looked out for each other, trying to stay safe in their neighborhood on Chicago’s West Side — a section of the city where a fight, a robbery, or a shooting are common. 

They had a lot of fun together, too. And this Friday afternoon was one of those. The pair went to the park, goofed around, talked to girls. That night, T-Man went to his cousin’s house. They stayed up talking until 3.

The very next day, T-Man’s life turned upside down.

T-Man: I was in the bed with my cousin. I woke up, and he wasn’t breathing.

DG: T-Man and his uncle rushed his cousin to the hospital.

T-Man: An hour later, we were sitting down. They told us that he’s gone. He died from an overdose.

DG: T-Man was in shock. Apparently, his cousin had taken some pills. T-Man says he didn’t know his cousin had done that.

T-Man: He was 16 years old like this a person I never thought I’d be closing the casket on or have to wake up to him, like, next to me, and he’s not alive no more. I never experienced that type of pain before.

DG: Closing the casket on people happens a lot on Chicago’s West Side. It’s the part of the city with the highest rates of overdose deaths and the highest rates of gun violence.

Research shows that kids who are exposed to high levels of trauma are more likely to struggle with depression, addiction and suicide — as well as perpetrate violence and end up incarcerated.

But over the last decade, evidence has mounted that there’s a reliable way to help kids break this cycle.

Julie Noobler (JN): Cognitive behavioral therapy charges us with slowing down and challenging the way that we are interpreting information.

DG: Julie Noobler is a social worker and the director of mental health at Brightpoint, a Chicago-based mental health provider.

Cognitive behavioral therapy, or CBT, is a kind of talk therapy that focuses less on past traumas and more on present behavior. At its most simple, the idea is to help people change patterns of how they think and how they act, to develop more effective ways to cope with life.

Julie explains when young people are repeatedly exposed to trauma, the emotional part of their brain takes over.

JN: Your thinking brain goes offline because your brain’s trying to keep you as safe as possible, as quick as possible.

DG: This can be helpful — necessary even — when kids are surrounded by violence. But when your emotional brain is on all the time, alert to these dangers, it can make it harder to respond in other situations.

JN: You’re faced with an argument at school, and your brain is ready to take that shortcut that this is a threat to my safety. 

DG: In other words, a disagreement with a teacher turns into a shouting match; a hard look turns into a shooting. Julie says cognitive behavioral therapy helps kids avoid those overreactions.

JN: What we’re trying to do is slow that train down, and engage the young person in evaluating what’s happening and staying in their thinking brain.

DG: CBT therapists help kids learn to see distortions in their own thinking, better understand the motivation of others, and gain confidence in their ability to problem solve.

Dozens of studies over the last 50 years have shown that CBT can reduce the number of people who return to prison. And over the last decade, a string of rigorous evaluations has found that CBT can cut in half the chance that high-risk kids are arrested for a violent crime.

Jennifer Doleac (JD): Kind of feels like magic, right? It’s like, so we just tell people to slow down their thinking and they stop shooting people like, are you kidding? It’s that easy?

DG: Jennifer Doleac is an economist who studies criminal justice at Arnold Ventures, a philanthropic group that also supports Tradeoffs.

Jennifer is excited by the recent CBT work. Alimitation, she says, has long been getting the idea to spread among people who often consider mental health a four-letter word.

JD: A lot of the research that’s been done on CBT has been in settings like schools or in juvenile detention facilities or in prisons where people are literally captive audiences. So figuring out how to get people to voluntarily engage with that kind of treatment is in some ways, the million dollar question.

DG: 10 years ago, Brightpoint — the mental health provider — and the nonprofit Youth Advocate Programs partnered to bring CBT to high-risk kids that other programs struggled to reach.

Brightpoint would run up to 16 weeks of group CBT sessions. Youth Advocate Programs, or YAP, would pair each young person with an adult mentor for 6 months — what they call an advocate.

Gary Ivory (GI): Advocates are on call 24/7. They’re there to provide whatever support a young person or family may need.

DG: That’s Gary Ivory, YAP’s president and CEO.

Advocates would spend at least 8 hours a week with the young person, doing everything from taking them out to sporting events and meals to helping them find jobs or open a bank account. The theory, says Gary, was that the advocate — a caring, capable adult with cultural credibility — would support the entire family, help them get more comfortable with the idea of CBT, and then embrace it.

GI: We helped them to make sure they showed up. And then make sure those learnings from those group sessions, we help them to apply it in their home and community settings.

DG: The final partner in this collaboration — named Choose to Change — was the University of Chicago Crime Lab. Researchers would evaluate Choose to Change to see if it would reduce violence among high-risk kids before they ended up in jail or juvenile detention.

T-Man started participating in Choose to Change a couple of months before his cousin died in May 2024. A school dean hoped the program would help T-Man who had a history of getting into fights, or as T-Man described it, struggling to keep small problems small. 

After his cousin’s death, it became even harder to control his anger.  

T-Man: I was just in a dark space. I was just like, I didn’t really know what to do, honestly. I was feeling like it was nothing no one could help me with. I couldn’t do nothing about it. So I was really just angry at myself and the world.

DG: About a month after his cousin died, T-Man’s anger got the best of him. Police arrested him in early June 2024, and he spent the next month in juvenile detention. Over those four weeks, T-Man realized that he wanted to do something differently.

T-Man: Every day I woke up I was thinking about what I could do to better myself to deal with the stress and stuff I’m going through, like the pain, like how I’m going to do better.

DG: T-Man had been skeptical of the CBT sessions in Choose to Change. But sitting in juvenile detention, his mind drifted back to the lessons he’d learned.

Jasper Guilabault (JI): It’s called the bottle about to burst.

DG: That’s Jasper Guilbault, T-Man’s Choose to Change therapist.

First, Jasper lines up three, two liter bottles of Sprite.

G: And I give the kids this analogy: The unopened bottle of Sprite is like your brain. And inside you’ve got all these emotions, and when you are stressed, it kind of shakes up everything inside of you, and it builds up pressure inside of your brain.

DG: Jasper tells the kids to shake up one Sprite bottle and open it quickly. Sitting alone in the detention center, T-Man recognized himself in the metaphor.

T-Man: I was like, that’s crazy, because if you do hold your emotions in, eventually they’re going to come out, and it ain’t going to be a positive way. It’s going to be negatively.

DG: T-Man could see that’s what had happened to him after his cousin overdosed. But there was another part of the Sprite lesson that stuck even more. 

JG: The last bottle, I have them shake it up, but I also tell them, they need to release the pressure little by little, by opening the cap a little bit and then closing it.

DG: When the kids open that bottle, no big explosion.

T-Man: I was like, that’s pretty cool because it relate to me, and I kept that in the back of my mind, like, well, maybe I do need to work on expressing myself and talking about how I feel more.

DG: T-Man — ready to make a plan — asked to talk to a therapist in detention. And he started making goals for after he got out: land a job, get his grades up — he’d been ranked number two in his class. 

T-Man: I also had a goal of like changing the way I think about stuff and think before I do things. That was one of the main goals I really wanted to focus on.

DG: A textbook CBT success: T-Man saw the distortion in his own thinking that anger would help him cope with his cousin’s death.

After 31 days, a judge released T-Man back home. The judge ordered T-Man could only go to school, go to work, or go out with his Choose to Change advocate Theresa Wright. The two spent a lot of time together going out to eat, walking through the park, practicing the lessons T-Man had learned.

Theresa Wright (TW): We’re talking about things to prevent history repeating itself. We’re going to focus on some goals and what we need to do. So we we start setting goals. And so when we start setting those goals, he became excited.

T-Man: We talked about things like, you can’t take stuff back, so if you do it, do it with a meaning so you won’t have to regret anything you do.

DG: T-Man started making connections between the lessons in Choose to Change and other parts of his life. Like one of his favorite songs.

T-Man: It’s called I Can’t Take That Back by NBA YoungBoy.

Song: Shit I said before, I can’t take that back.

DG: He’d always liked the song. Now, he told Theresa, it was a constant reminder of one of the core lessons of CBT.

T-Man: I told her the meaning of it really just when you do something, you can’t take it back. That’s why I told her, like, so you got to make the right decision before you do it.

DG: When T-Man went back to school in August, he felt different — someone capable of making better decisions. The best example, maybe, one day, he was upset that a teacher had posted a grade late. Back in the day that would’ve set T-Man off.

T-Man: I probably was going to get angry, walk out the classroom, slam the door or something.

DG: But this time, he slowed down and thought.

T-Man: If I do something that I don’t mean, I know I’m not going to be able to take it back. So I was trying to think and handle it a different way instead of being angry and erupting like the Sprite bottle.

DG: T-Man, again solving his own problems, tracked down one of the school’s deans. The dean suggested T-Man ask the teacher after class when she’d post the grades.

T-Man: It was like I took a big step forward into working on myself and working on my anger and how I deal with things. So I was definitely proud of myself and I definitely felt good about myself.

DG: When we come back, why some researchers say this program could be a game-changer, why scaling it nationwide could still be a long-shot, and what’s next for T-Man.

BREAK

DG: Welcome back.

There is no shortage of programs designed to reduce and prevent violence among young people. But experts say there is a shortage of strong evidence to tell policymakers which interventions are effective and replicable.

So when Brightpoint and YAP launched Choose to Change in 2015, they immediately partnered with researchers at the University of Chicago Crime Lab. Nour Abdul-Razzak co-led the randomized control trial to see if pairing cognitive behavioral therapy with intensive mentoring actually could make a difference.

Nour Abdul-Razzak (NAR): It is very rare that you actually get a program that has some numbers and effectiveness behind it, and not just someone’s gut that they want to happen. So I think it’s really important that they continue programs that actually have some evidence.

DG: Between 2015 and 2019, Nour and her colleagues followed 1,000 Chicago teens who were in Choose to Change — what’s sometimes called C2C. They compared those kids’ outcomes to 1,000 similar kids who were not offered C2C and only had access to other services like traditional counseling and after school programs.

Of the 2,000 kids, 35% had a prior arrest. Seventy percent had missed at least three weeks of school.

Nour’s team zeroed in on three questions.

NAR: Does C2C reduce contact with the criminal justice system? Can the program reduce kids’ engagement with violence? And does C2C increase school engagement?

DG: The researchers are still analyzing the education results. The violence and arrest findings, though, are striking.

Nour and her colleagues found that kids in Choose to Change were 31% less likely to be arrested in the two years after starting the program, and 39% less likely to be arrested for a violent crime.

NAR: We were very surprised to see the results of the program. The effectiveness, the numbers are quite large in terms of how it’s helping young people. And they are working with a higher risk population.

DG: Nour says this research adds to what we know about violence prevention in important ways.

One, it’s yet another rigorous study showing that cognitive behavioral therapy works. It also shows that CBT combined with intensive mentorship and support can help kids that other programs failed to reach. Finally, and this is a big one, the reductions in arrests lasts up to four years after teens enter the program. 

NAR: Many programs, especially for young people, you see fade out as soon as the program ends. So the fact that it is still effective into their adulthood, I think, is quite promising.

DG: What surprised Nour the most is that the CBT lessons seem to be so sticky. Her hunch is that pairing the counseling with mentoring is a potent one-two combo.

NAR: Because the mentors are attending the group CBT sessions, they’re learning those same tools and skills, and so they can practice them in the 8 hours a week that they spend with the kids outside in the community. 

DG: Nour is hitting on something. The American Psychological Association says part of what makes treatment effective is practicing the CBT lessons in everyday life — just like what T-Man did with his Choose to Change advocate, Theresa.

The long-lasting effects of C2C have caught the attention of other researchers. Charles Branas is an epidemiologist and gun violence expert at Columbia University who was not involved in the study.

CB: That’s a super impressive outcome. Particularly the long-term effect of this program and the fact that this is a randomized controlled trial of a substantial number of people leads me to believe that it could indeed be a very big deal.

DG: Charles does have one caveat, though. Before he can fully endorse the findings, he says, he’d like to see the paper peer-reviewed.

Jennifer Doleac at Arnold Ventures says when she looks at this paper, she thinks we’re getting closer to answering her million dollar question — yes, we can get CBT to hard-to-reach kids.

JD: In a context where most of our good ideas don’t work, it’s extremely exciting to see evidence like this that shows that this is the kind of intervention that pretty dramatically can transform young people’s lives.

DG: Jennifer says the next step is to replicate Choose to Change in other cities. YAP, the group that provides the Choose to Change advocates, is already on it. They have launched similar programs in Tennessee, California, Iowa, Texas, and New Jersey, where YAP’s CEO Gary Ivory says they’ve begun working with Rutgers University to evaluate that program.

GI: We want to make sure we have the same level of rigor, the same level of lessons learned, applied learning, real time, so that we can get this feedback on how the participants are doing and get the research and all that.

DG: Gary says scaling the program has come with real challenges. One issue is some cities want to offer Choose to Change to more kids than Gary thinks makes sense.

GI: You want to serve the young people that really need this type of intensive intervention. If you don’t, it’s going to skew the research and skew the outcomes, and it could possibly bring in more young people who really don’t need this high level, high dosage intervention.

DG: Up to 16 weeks of CBT plus 8 hours a week with mentors is designed for kids who are both at high-risk of committing violent acts AND are hard-to-reach. Expanding such an intensive service to kids less in need, Gary worries, could also burn money. 

GI: It’s not cheap. So that’s another reason we want to get it right and serve the right participants.

DG: Money is one of the biggest hurdles to wide scale adoption of this type of program. Choose to Change costs about $8,500 per student, totaling $11 million this year to run for 1,300 kids.

Toni Copeland (TC): It’s worth every penny.

DG: Toni Copeland directs student supports and violence prevention for Chicago Public Schools. Choose to Change is funded by a mix of philanthropy and public dollars from the mayor’s office and the school district.

But the district is facing a $500 million deficit. So Toni says the program has, for now, stopped accepting new teens while they try to drum up more money for next year.

TC: We’ve tried to be innovative in finding solutions to make up for whatever the gap is because the district believes in choose to change.

DG: While some will likely balk at the program’s price tag, researchers have found that Choose to Change saves taxpayers up to $20,000 per kid. That comes from less involvement with police, public defenders, courts and juvenile detention over time.

The other big challenge to this program going nationwide: staffing. YAP CEO Gary Ivory says finding adults who can show up 8-10 hours a week to support the kids and braid in the CBT work is one of the hardest things they do.

GI: We’re responding to gun violence and interpersonal violence and dealing with the research, the learnings and applying those learnings in real time. To me, that’s the biggest challenge. Being on call 24/7, you know, all of that is part of the model, and that’s challenging. It’s just challenging.

DG: At the end of the day, Gary understands it’s the mentors who build the rock-solid relationships. It’s the mentors who work with the teens to incorporate the CBT lessons into their everyday lives.

And the working theory is that bond is why Choose to Change students are less likely to get arrested even years after they leave the program, something other CBT programs have failed to accomplish.

That brings us back to T-Man. Nearly a year after he finished Choose to Change, he is in constant contact with his advocate Theresa Wright.

TW: He calls me about everything. “Miss Theresa, I’ve got my own job. I’m working with kids! I’m giving back. I’m helping these kids. Every milestone that’s happening in his life, he always call.

T-Man: I know I could talk to Miss Theresa about anything, and she won’t judge me. Like she’ll be there for me and try to help the situation before anything.

DG: Theresa says most of the kids she’s worked with in her four years still blow up her phone.

TW: They still feel like that they have somebody that they can connect with when they’re having some type of issues or they’re telling me, “I’m getting to school on time,” or, “Miss Theresa, can we still see each other on the weekends?” That’s when I know I’ve done a good job.

DG: T-Man sure thinks Theresa has done a good job with him. 

T-Man: She’s seen something that I didn’t see in myself at first. It helped me realize the strengths that I had, the talent I had, like how far I could go with it.

DG: These days, T-Man is working as a counselor for younger kids, and he’s stayed out of trouble since his arrest. He’s number three in his class — one spot from his goal.

He dreams of starting his own fashion company; or a real estate company; a construction business.

T-Man: I surrounded myself around the right people, having the right support team. I want to build me an empire.

DG: CBT treatment often involves facing your fears instead of avoiding them and developing more confidence in yourself. T-Man has done both.

He thinks often of that song, I Can’t Take It Back. It’s a reminder to slow down, to think before he acts. It also reminds him that these days, he does a better job of keeping the small things, small. Nobody can take that back either.

UPDATE:

Chicago Public Schools were able to come up with enough money to enroll new students in Choose to Change this year.

But only 625, several hundred fewer than in previous years.

The school district says it’s actively courting philanthropic support to help sustain the program.

Meanwhile, YAP launched another Choose to Change inspired program, this one in Oklahoma, and the group is in talks with a potential funder that could help them scale this model to more communities.

And T-Man? He’s doing great.

He shared his story as a panelist at YAP’s 50th anniversary summit in Philadelphia this fall and he’s moving closer to his dream of running a construction and real estate business.

He’s been accepted to several 4-year universities and trade schools.

T-Man still talks with his Advocate Miss Theresa every Friday and he says he uses the skills he learned from Choose to Change every single day.

I’m Dan Gorenstein, this is Tradeoffs.