BALTIMORE -- Raynold Smith beefed with another man for months and when they crossed paths in March 2021, both were armed.
The reason Smith didn’t pull the trigger? In a split-second moment, when life and death hung in the balance, he glimpsed a child’s car seat and suddenly realized everything his enemy stood to lose. Almost immediately, Smith felt a bullet rip through his leg, narrowly missing a major artery and immobilizing him for weeks.
That was the second time Smith, 26, of Baltimore, had been shot; a 2019 shooting left him with graze wounds. He knew something had to change.
Over the next several months, he found what he needed at Roca, a nonprofit anti-violence program in Baltimore. In addition to job training and life skills classes, the program helps teens and young men recover from trauma and forge a new path — by rewiring their brains.
For that, Roca uses what it calls cognitive behavioral therapy, which focuses on examining the relationship of thoughts, emotions and actions. The theory is relatively simple, but the results can be profound, according to program staff and participants.
Could expanding the use of CBT among vulnerable youth help decrease gun violence and create healthier, more resilient communities? Experts and officials are optimistic, and the Maryland Department of Juvenile Services, in partnership with Roca, plans to find out.
Earlier this year, department leaders announced that 300 staff members — including many who work with the roughly 1,000 young people on either juvenile probation or post-release supervision — would receive training from Roca on adolescent brain science, the psychology of trauma and CBT.
A nearly $1 million federal grant will pay for the training, which comes amid a widespread push for juvenile justice reform. The General Assembly passed a series of bills this year with that goal, including eliminating youth confinement for most first-time misdemeanors, setting minimum age requirements for criminal charges and limiting the length of juvenile probation terms.
“Baltimore has a lot of hurt and pain,” said Ronnetta Alexander, a juvenile services case manager supervisor who recently completed the training. “This better prepares us to go in and assist these families. It opens the door to show them there really is a different choice.”
Smith’s split-second decision foreshadowed the skills he’s since solidified. He thought about the potential consequences — a child caught in the crossfire — and didn’t shoot. Now, he understands it in the context of one of CBT’s tenets: “Act on your values.”
He recently applied it in another volatile situation. He suspected infidelity in a relationship, got angry and was inclined toward violence. Then he considered all he stood to lose: his freedom, his kids, his two jobs. With the language to articulate his decision and a support system, stepping away was easier this time: “Some stuff is really not worth it,” he said, shrugging.
Instead, he picked up more shifts, often working seven days a week between the shipping department of a graphics company in Timonium and as a food runner at the Baltimore Comedy Factory.
Smith said he believes either a police officer or social worker referred him to Roca after meeting with him in the hospital after he got shot last year.
Through CBT and his close relationship with Calvin Monroe, the Roca worker assigned to his case, Smith credited the program with keeping him calm and levelheaded. The stress of past trauma still puts him on edge, but Smith said labeling his emotions allows him to avoid impulsive actions he might regret.
Standing outside his apartment complex during a recent check-in with Monroe, Smith joked about becoming a homebody: doing chores and staying safe.
Monroe said a huge challenge is getting young men to leave the streets — where the promise of fast money often outweighs the threat of violence — and choose long-term stability, even if that means making minimum wage or having to take high school equivalency classes.
“There’s no retirement plan in the streets. It’s either death or jail,” Monroe said. “That’s what I keep telling them.”
Changes in the brain
The program that Roca developed focuses on identifying “Think-Feel-Do” cycles and disrupting them to avoid potential negative outcomes. From a neuroscience perspective, that often means forging new pathways in the brain and strengthening them over time.
Founded in Massachusetts more than 30 years ago, Roca opened its Baltimore office in 2018. It has a reputation for success with some of the city’s most troubled and potentially dangerous young men.
The program teaches seven skills to disrupt unhealthy cycles. The first is to “Be present,” instead of fixating on the past or future, staff members said. Others include “Label your feelings,” “Stick with it” and “Flex your thinking.”
Experts say this type of therapy can be beneficial for people recovering from trauma, because they spend more time in “fight or flight” mode.
When people experience frequent trauma — such as regularly seeing gun violence — their brain activity changes to reflect a heightened sense of danger. That creates more activity in the amygdala, the region associated with fear and stress responses, and less in the prefrontal cortex. That’s where reasoning helps regulate emotions and impulses, leading to slower, more careful decision-making. For most people, the prefrontal cortex takes the longest to develop, reaching maturity around age 25.
During a summit last month hosted by the University of Maryland School of Medicine in Baltimore, Democratic Mayor Brandon Scott said he was 7 the first time he saw someone get shot.
“Growing up young and Black in Park Heights, living with the trauma of gun violence — everyone I knew had the same experiences. We thought that was normal,” he said. “We have to really think about how that impacts someone’s brain.”
Dr. Kerry Ressler, a professor of psychiatry at Harvard Medical School, said rates of post-traumatic stress disorder are higher in some urban neighborhoods than among military veterans.
“From a psychiatric perspective, people really are living in war zones,” he said at the summit. “People are getting in trouble and contributing to cycles of violence in part because of untreated trauma.”
Treatments like CBT can result in measurable changes to brain activity that promote healthier outcomes, he said.
‘This gives them emotional equity’
In the Maryland Department of Juvenile Services, staff in Baltimore were the first to undergo Roca’s ReWire CBT training; eventually, it will extend statewide.
Some were skeptical at first, doubtful that an 11-week training program on psychological theory would translate to improved interactions with the children they supervise. But at some point, the light bulb went off for Justine Buckingham, a juvenile services case manager supervisor.
Now, she often pulls out a worksheet to help her clients explore interconnected thoughts, feelings and actions. For example, she pointed to a diagram by a young man who was having problems at school. Thinking he didn’t know enough to pass a test made him feel nervous and disappointed, which led him to skip school and get in trouble.
Identifying that cycle allowed him to envision another outcome, Buckingham said. What if he studied enough to pass his classes? Then he could be proud, stay in school and earn his diploma. The skill he chose to focus on: “Stick with it.”
Young people hold themselves accountable this way, she said, rather than just complying with a judge’s orders.
“These kids have been told so much about who they are, what they will become or not become. But they’ve never been given a road map,” said James “JT” Timpson, director of community partnerships at Roca Maryland. “This gives them emotional equity. It gives them control without taking away accountability.”
Jenny Egan, who oversees the Baltimore juvenile division for the Maryland Office of the Public Defender, said the initiative is overdue, though she disputed whether it should be labeled cognitive behavioral therapy, a clinical term referring to a type of psychological treatment. Nonetheless, she said the evidence-based approach is a first step toward improving outcomes for vulnerable youth.
“This system is supposed to be about offering kids support, guidance, coaching and help,” she said. “But there has long been a culture in the child-serving agencies in Maryland that disregards the autonomy, the dignity and the voices of youth.”
Egan said she hopes the training contributes to a culture shift inside the department from harsh, sometimes arbitrary punishment to true rehabilitation.
She questioned why the training isn’t being given to DJS staff in detention centers. A spokesman for the department cited limited resources and said those facilities have mental and behavioral health professionals.
Inside the Roca Baltimore office on a recent afternoon, about a dozen young men wrote down some of their deepest concerns and most pressing questions, then crumpled up the anonymous responses and threw them into a bucket.
Academic and life skills instructor Zoe Andrade picked some at random and read them aloud so the young men could offer advice. Their answers contained nuggets of CBT wisdom, profound statements interspersed with sometimes irreverent jokes.
One participant wrote he was “in a confusing place,” wondering whether he should “let my brother rest in peace or retaliate.”
Jonathan Holloway, 23, offered a response based on personal experience; his brother also had been shot.
“You’ve gotta start living your own life,” he said. “I still want to retaliate, but I’m trying to better myself. I feel like everything I’m doing at Roca would be for nothing.”
The group also considered two questions about whether to quit Roca’s job training program and go make more money in the streets.
“The block is doing numbers right now. Should I go back out?” one participant asked. Holloway spoke up again, challenging his peers to think about the risks of ending up dead or locked up.
A question about relationship drama — one young man said he found a woman slashing his car’s tires that morning — produced consensus on letting karma take care of it. A discussion about the importance of hard work and consistency included a metaphor about turning dirt into diamonds, the message being that hard-earned cash comes with a stronger sense of accomplishment.
“If you want something you never had, you’ve gotta do things you’ve never done,” said Louis Pearl, 21. “Manifest the things you want.”
Keon Vines described the satisfaction of proving people wrong. During a recent stint behind bars, he told a friend he planned to “come home and chill, get a job or something” upon his release. The friend didn’t believe him.
“But look at me now,” said Vines, breaking into a triumphant smile. It was the day before his 20th birthday, and Vines found himself finally feeling optimistic about his future and surrounded by people who wanted to help him succeed.
The room erupted in cheers; his joy was contagious.