Treatment Court Research Articles

THE ILLEGALITY DEFENCE AND SANCTION-SHIFTING: IN DEFENCE OF GRAY V THAMES TRAIN LTD

AbstractThis article considers the rule that a claimant who has been wronged will be denied recovery where the damage flowed from a sanction imposed as a result of their own illegal acts such that compensating the claimant would divert a sanction intended to be imposed on the claimant to the defendant. The article has two purposes. The first aim is to provide a counterweight to the overwhelming body of academic literature critical of Gray v Thames Trains Ltd. in which the House of Lords, in applying the illegality bar found it unnecessary to examine the purpose of the criminal sanction against the claimant, preferring to treat its existence as sufficient to lead to a denial of recovery. The article argues that academic support for adoption of an alternative test of “significant personal responsibility” rests on precarious grounds, depending, as it does, on the “unsatisfactory state of law” and “different policies” arguments. This article reconceptualises the rule in Gray and systematically examines the role played by the theme of consistency between the civil law and criminal law in judicial decision-making. The second aim is to evaluate Gray in light of Patel v Mirza. The article critiques the Supreme Court's inconsistent treatment of deterrence in Henderson v Dorset University NHS Foundation Trust and Stoffel v Grondona, and argues that the way the court in Henderson conceptualised the relationship between Gray and Patel discloses an approach which is more closely aligned with that adopted by the minority in Patel.

The development and pilot testing of a family treatment court best practices assessment: The model standards implementation scale

AbstractIn 2019, the family treatment court (FTC) best practice standards (the Standards) were published to clarify attributes of FTC programs associated with superior child, parent, and family outcomes. The Standards cover the breadth of FTC operations including program structure and leadership, substance use treatment and complementary services, and behavioral responses to participants. This study aimed to develop an instrument (the Model Standards Implementation Scale; “MSIS”) that stakeholders can use to assess implementation of the Standards by individual FTCs. The MSIS balances usability with scientific validity. Interrater reliability (IRR), internal consistency, and several types of validity were assessed. Results indicated moderate to strong IRR, high internal consistency, mixed known groups validity depending on Standard, and high convergent and divergent validity. Initial findings suggest good validity and usability of the MSIS for evaluating FTC Standards' implementation. Notably, the process of using the tool functioned to educate FTC team members on the Standards. Although implementation of the MSIS is a resource‐intensive process, the opportunity to receive constructive feedback proved to be an effective incentive for initial and subsequent participation in the evaluation among FTCs. Future research is needed to examine predictive validity, including association between Standards' implementation and family outcomes in FTCs.

Interprofessional Learning and Psychiatric Expertise in Mental Health Courts.

Interprofessional collaboration is crucial to reduce overincarceration of people with severe mental illness. Learning how to collaborate occurs in 2 complementary ways. One model emphasizes cognitive tasks: becoming familiar with the values and knowledge of other disciplines. Another model emphasizes practical interactive skills: calibrating one's preexisting expertise to the demands of the local workplace. This qualitative study assesses the 2 models in the case of psychiatrists in a multidisciplinary mental health court who learned to divert people with psychiatric disease from jail and hence advance the court's mission. Ethnographic research was conducted over 4 years with the staff of a US mental health court. Interviews with 3 psychiatrists and observations of 87 staff meetings and probation review hearings were recorded on handwritten notes. Notes were transcribed, entered into a qualitative database management program (NVivo 12), and coded using the grounded theory approach. A master codebook was developed to identify crosscutting themes. Psychiatrists did not need deep familiarity with the values or skills of legal professionals to divert people with psychiatric disease from incarceration. They successfully inserted their expertise through 3 strategies-teaching about pharmaceutics, suggesting concrete interventions based on details of diagnosis and behavior, and shifting the collective assessment of defendants from a punitive to a therapeutic framework-that depended on their acquiring new interactive skills. However, they failed in their efforts to refine the eligibility criteria for admitting new defendants to the court; their expertise was underutilized because of the makeup of this interprofessional team. Reducing the overincarceration of people with severe mental illness depends on interprofessional collaboration. This study shows that discerning opportunities for (and blockages to) applying one's preexisting expertise and learning the perspective of other disciplines are key complementary ingredients of interprofessional learning in this setting. Research in other treatment courts is needed to assess the generalizability of this single case study.

Delays in commitment and treatment court proceedings worsen psychiatric and other medical conditions.

Adversarial hearings in hospital commitment and de novo treatment proceedings, or court hearings, delay psychiatric treatment in many jurisdictions. In Massachusetts, the "treatment over objection" process requires a court petition. For state hospital patients, the delay to treatment is an initial 34day waiting period in addition to continuances of court hearings that extend treatment delays. This study examined the frequency of adverse medical events due to delayed court hearings within a forensic state hospital in the US. The study reviewed all (n=355) treatment petitions filed by a Massachusetts forensic hospital from 2015 and 2016. The incidence and nature of adverse events (e.g. patient/staff assaults, milieu disruptions) and acute medical symptoms (e.g. catatonia, acute psychosis), before and after the Court granted a petition for treatment, were analyzed by two raters. Adverse events included patient and staff assaults, acute psychiatric symptoms, and milieu problems. 82.6% of treatment petitions led to involuntary treatment, 16.6% were withdrawn by the medical petition filer, and only 0.8% petitions were denied by the judge. Adversarial hearings occasioned an average delay of 41days from treatment petition filing to receipt of standing treatment in addition to statute required delays. Once treatment was court-approved, all types of adverse events were significantly reduced. Results established that the court treatment hearing scheme exacerbates health and safety risks to patients with serious mental illness. Increasing physician and court personnel awareness of these risks is likely key to enhancing a patient-focused, rights-oriented approach to these matters. This and other recommendations is proposed for jurisdictions that deal with this problem around the world.

Final Report of the Cross-Site Evaluation of the Juvenile Drug Treatment Court (JDTC)Guidelines and Data ElementsSpecifications

Final Report of the Cross-Site Evaluation of the Juvenile Drug Treatment Court (JDTC)Guidelines and Data ElementsSpecifications

Strategic Adaptation in a Crisis: Treatment Court Responses to COVID-19

This article draws on a case study of how Massachusetts treatment courts responded to the COVID-19 pandemic to address two intersecting theoretical and policy questions: (1) How do actors who work within criminal legal organizations use the law to solve complex social and political problems? (2) How do organizations working within multiple, fragmented organizational fields respond to an exogenous shock? The findings draw on interviews with eighty-four treatment court judges and practitioners and build from neo-institutional approaches to the study of courts to show that legal actors and organizations pursue pragmatic approaches, strategically adapting to their external environments through buffering, which is protective, and innovation, which is transformative. Each strategy reflects the courts’ autonomy or dependence on other organizations in the criminal legal and social service fields. The findings also provide insight into the social process of legitimation as personnel aligned beliefs with adaptation strategies, shifting understandings of surveillance practices and the utility of sanctions to meet overall court goals.

Marijuana Policies in Drug Treatment Courts

Drug treatment courts are challenged by the ongoing trend of marijuana legalization. In states where it is legal for adult citizens to consume marijuana for medical and recreational purposes, treatment courts need to determine whether participants should be allowed to consume or possess marijuana. By analyzing the written policies of treatment courts in states that have legalized recreational and medical marijuana, this study explores how treatment courts address such challenges. The review shows a large percentage of drug treatment courts have yet to clearly communicate their marijuana policies with the participants in writing. However, among the drug treatment courts that have established marijuana-specific policies, the vast majority of courts continue to ban the use of marijuana while a few courts allow medical marijuana use on an individual basis.

Characteristics of substance-addicted mothers that predict graduation from the family treatment court.

In the United States, substance addiction is a major contributing factor to incarceration of mothers and separation of children from their families. Five hundred Family Treatment Courts (FTC) operate across the country to combat the growing problem of women addicted to drugs. The FTC model provides mothers with substance addiction treatment, intensive judicial monitoring, repeated drug testing, counseling, incentives or sanctions, and case management with the goal of reaching long-term sobriety and reunification with their children. This retrospective study examined the relationship between sociodemographic characteristics and substance use characteristics, in predicting participants' graduations from the FTC program. Data were gathered from 317 participants from five Family Treatment Courts in the southeastern United States and analyzed using logistic regression. Participants who completed the FTC program were more likely to be older, completed Cognitive Behavioral Training, completed high school, and Caucasian. Age and completion of Cognitive Behavioral Therapy were the greatest predictors of graduating from the Family Treatment Court. These results convey the need for development of interventions tailored to each participant's age to maximize the success of the FTC participants. In addition, Cognitive Behavioral Therapy should be integrated into all FTC programs. The findings from this study will offer research scholars a foundation for designing future studies, aid researchers in creating interventions to increase success in substance addiction treatment programs, and contribute to the framework for theory development. In addition, understanding characteristics that may influence graduation from the Family Treatment Court will provide valuable information on developing interventions to support participants' success.

Color in the Court: Using the Racial and Ethnic Disparities (RED) Program Assessment Tool to Promote Equitable and Inclusive Treatment Court Practice

ABSTRACT Treatment courts have been part of the criminal justice system for nearly three-and-a-half decades. The first treatment court, an adult drug court, began in 1989 in Florida, and due to the success of drug courts in reducing criminal recidivism rates, the intervention has evolved to address other problems and populations, such as veterans treatment courts (VTCs) and family treatment courts (FTCs). Treatment courts have been credited with promoting criminal justice reform, as they offer a rehabilitative approach to justice, as compared to historical punitive models. Research, however, has consistently shown that racial and ethnic minorities have lower completion rates in some treatment courts than their white counterparts. This study is the first statewide evaluation to use the Racial and Ethnic Disparities (RED) Program Assessment Tool to assess for racial and ethnic disparities in programming across several types of treatment courts (n = 30). Results showed that 64.9% of white participants completed treatment court, whereas all other races had completion rates less than 30.0%. Implications for treatment court practice are discussed in reference to staff training, the quality of treatment participants receive for substance use and mental health disorders, future research, and other key components of the treatment court model.

Trauma-Informed Training for Veterans Treatment Court Professionals: Program Development and Initial Feedback.

Justice-involved veterans demonstrate greater mental health and psychosocial needs relative to justice-involved nonveterans and veterans without a criminal history. Veterans treatment courts (VTCs) serve as an alternative to incarceration for veterans whose criminogenic risk is believed to be related to mental health symptoms. Despite observed improvements in functioning and recidivism risk following successful VTC completion, little is known about factors that impede engagement with VTCs. This paper describes a trauma-informed training program that included psychoeducation, skills training, and consultation and was developed for court professionals to facilitate veteran engagement in VTCs. Needs assessments and court observations informed program development. Based on identified needs, the training incorporated skills from dialectical behavior therapy, acceptance and commitment therapy, and motivational interviewing. Two VTCs in the Rocky Mountain region participated in the pilot trauma-informed training, each lasting about 90 to 120 minutes. Feedback from attendees indicated that the focus on skills training-specifically, managing intense emotions, addressing ambivalence, and approaching sanctions and rewards-was uniquely helpful. The function of posttraumatic stress disorder symptoms and structure of evidence-based treatments were identified as useful educational components. Veterans Health Administration mental health professionals can serve an important role in facilitating effective practices for professionals working within VTCs. This pilot program provided preliminary support for skills-based training to bolster communication, motivation, distress tolerance, and engagement among veterans court participants. Future directions of this program may include expanding the training into a full-day workshop, conducting comprehensive needs assessments, and examining program outcomes.

Treatment Court Family Nights: An Accessible and Adaptable Support for Families Engaging in Recovery.

While public health measures including physical distancing and stay-at-home orders have clear benefits in COVID-19 mitigation and prevention, they have provided unique challenges for individuals with substance use disorder (SUD), including Treatment Court (TC) participants. This study involved a qualitative evaluation of TC Family Nights; one series of Family Nights was conducted before the COVID-19 pandemic and the second series was adapted and held remotely due to COVID-19 distancing requirements. Several important themes emerged, including general positive experiences, accessible session logistics, naloxone training, attention to stigma, building recovery capital, group engagement, social interaction, and community action. These themes will help inform future SUD recovery education. Online recovery support events provide a new model for courts and recovery organizations that seek multiple ways to provide connection and support for their participants and families during times when accessibility is prioritized, in-person activities are discouraged, and in resource-sparse and geographically isolated communities.

Identifying strategies to advance equitable implementation of co-occurring mental health and substance use disorder treatment in drug treatment courts: A study protocol.

Behavioral health treatment disparities by race and ethnicity are well documented across the criminal legal system. Despite criminal legal settings such as drug treatment courts (DTCs) increasingly adopting evidence-based programs (EBPs) to improve care, there is a dearth of research identifying strategies to advance equitable implementation of EBPs and reduce racial/ethnic treatment disparities. This paper describes an innovative approach to identify community- and provider-generated strategies to support equitable implementation of an evidence-based co-occurring mental health and substance use disorder intervention, called Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking-Criminal Justice (MISSION-CJ), in DTCs. Guided by the Health Equity Implementation Framework, qualitative interviews and surveys will assess factors facilitating and hindering equitable implementation of MISSION-CJ in DTCs among 30 Black/African American and/or Hispanic/Latino persons served and providers. Concept mapping with sixty Black/African American and/or Hispanic/Latino persons served and providers will gather community- and provider-generated strategies to address identified barriers. Finally, an advisory board will offer iterative feedback on the data to guide toolkit development and inform equitable implementation of MISSION-CJ within DTCs. The paper illustrates a protocol of a study based in community-engaged research and implementation science to understand multilevel drivers of racial/ethnic disparities in co-occurring disorder treatment and identify opportunities for intervention and improvements within criminal legal settings.

Adult Drug Treatment Courts and Community-Level Drug Possession Arrests.

Though the literature largely recognizes adult drug treatment courts (ADCs) as beneficial to participants, with lower rates of recidivism and drug use, the question remains of how ADCs impact communities and how other institutions (e.g., law enforcement) react to their presence. This study extends previous work estimating higher arrests associated with ADCs, particularly for crimes involving higher degrees of law enforcement discretion. Results indicate lower drug possession arrest rates for White residents in rural communities, and higher in urban areas, generally, but especially for Black citizens. Though the exact source of these changes has yet to be determined, current analysis indicates larger effect sizes for arrests scaled per officer, as compared to per population, pointing toward changes in law enforcement behavior.

Justice-Involved Veterans & Social Work: A Resource Dependence Theory Perspective

The salience of justice-involved military veterans endures as a pervasive social problem in the United States of America (USA). Since the 1980’s the percentages of Justice-Involved Veterans (JIV) have varied from a reduction in Vietnam to increasing numbers of Global War on Terror (GWOT) veterans (Bureau of Justice Statistics Report, 2015). In response, there has been a proliferation of magistrate diversion, correctional specialty units, Veterans Treatment Courts (VTC) and programming for JIV. Much of the progress is due to concerted identification and organizational sharing of resources. The USA Department of Veterans Affairs (VA), courts, corrections and non-profit organizations (NPO) provide a valuable service to our military men and women to remediate the JIV needs. Social work plays at critical in practice areas at the penal, VA and NPO systems in the USA. The JIV population are examined through the lens of social work practice, resource dependence theory (RDT), case example and future direction. The examination highlights the importance of internal and external resources and partnerships to meet organizational goals and to remediate JIV psycho-social problems.

“I was a soccer mom—high or not”: The intersecting roles of parenting and recovery

AbstractObjectiveThe overarching goal of this study was to analyze qualitatively how parents in a state‐mandated family treatment court (FTC) intervention revised and performed their parental role while navigating a novel recovery role.BackgroundA large proportion of parents are involved with the child welfare system for reasons related to substance misuse. Prior literature makes clear that navigating child welfare interventions is incredibly challenging given the many requirements and expectations parents must meet to resume parenting without state oversight. No work to date has explored the role strain arguably inherent to the experience of being tasked with simultaneously revising the parental role and adopting and performing a new recovery role in the context of nonvoluntary state intervention.MethodData came from transcripts of in‐depth, semistructured interviews with 21 parents who were former participants in FTC. Interview questions were designed to elicit rich, personal narratives, with probes for concrete examples wherever possible.ResultsVariation in parents' role definitions and trajectories of both parental and recovery role performance were used to develop a typology of roles: role enactors, role revisors, and role rejectors. The three groups differed in how closely their views around substance misuse, parenting, and recovery aligned with the role expectations put forth by the state, leading to varying degrees of role strain and conflict across groups.ConclusionFindings shed light on the experiences of parents involuntarily participating in both child protective interventions and substance use treatment—a growing proportion of parents that have been largely ignored in prior literature.

From Referral to Treatment: Implementation Processes in Juvenile Drug Treatment Court Programs

Juvenile Drug Treatment Courts (JDTCs) provide a critical opportunity to identify and treat youth with substance use disorders (SUD). Structuring JTDCs to minimize process complexity and time to treatment is important. Results across eight JDTCs indicate the number of steps between referral and enrollment varied from 2 to 7, and the potential wait time varied from 1 to 58 days. The number of steps between referral and SUD treatment varied from 3 to 8, and the potential wait time varied from 2 to 118 days. Information regarding JTDC process can inform the field about JTDC practice, including barriers to treatment as well as areas for improvement.

Experiences of Trauma-Informed Care in a Family Drug Treatment Court

Social service fields have been revolutionized by the recognition of widespread exposure to trauma and its harmful consequences for the populations they serve. Organizations have responded by adopting trauma-informed care (TIC) practices. To date, most research on TIC has been conducted with providers, not clients. We build on existing research by studying the experiences of clients in a cross-system family drug treatment court (FDTC) that implemented substantial TIC reforms. Drawing on in-depth interviews with 21 clients and 9 staff, we found that the dual therapeutic and punitive mandates of the FDTC, along with the court’s related structures of power and control, posed inherent challenges to enacting TIC principles related to control and collaboration. However, TIC reforms did promote a greater sense of transparency, safety, and support from strengths-based resources. We consider lessons for TIC reforms more generally and how therapeutic and punitive functions can enable or constrain TIC in mandated interventions.

Veteran’s Treatment Courts: will More be Necessary Now that the 20-Year War on Terror has Concluded for US Soldiers?

Senator John Kerry noted that September 11th was the worst day that we, as a nation, had ever seen; however, it served to unite us. For the families of the 2,977 victims, it was a day of immeasurable and unimaginable loss. For first responders, it was a living nightmare they willingly chose to return to for days, weeks, and months following the attacks so that the families impacted could have some measure of closure. Many of these experienced subsequent physical and mental health illnesses due to what they were exposed to. For others, it was a call to arms. A call to action and to begin serving something bigger than themselves. It was a call to enlist in the US military. It is reported that immediately following the September 11th attacks, over 180,000 American citizens enlisted in active-duty military with some claiming the events of 9/11 were the driving force behind their decision. The military reported that 1 year after 9/11 there were just over 1.4 million active-duty military personnel in the Army, Navy, Marine Corps, and Air Force combined. Since the beginning of the American military involvement in the Iraq and Afghanistan wars in 2001, it is estimated that approximately 1.9 US military personnel were deployed in 3 million missions lasting at least 30 days. Over 7,000 servicemembers have been killed, in post-9/11 wars, with thousands more sustaining critical life-changing injuries, including loss of limbs, traumatic brain injuries and the invisible injuries of posttraumatic stress disorder. This work consists of a content analysis, specifically focusing on the establishment and ongoing need of Veteran’s Treatment Courts (VTC), a specialty court established in 2008, as a direct response to a growing number of veterans, appearing on court dockets, who were addicted to drugs, alcohol, or suffering from undiagnosed/untreated mental illness due to exposure to traumatic events while on military deployment. Today there are 400 VTC across the country, but more of these courts and significantly more funding and resources are needed to address the invisible wounds and impact of a 20-year war. This article examines the literature in existence related to VTCs, including their missions, strategies, and recidivism success rates. It also examines where these VTCs are in relation to US military installations that experienced deployments, and the resources that are available and accessible to those veterans who agree to enter these diversion programs. Finally, it discusses any noted gaps in where VTCs should be and currently are not as well as the potential for deleterious outcomes for veterans who have honorably served their country and have either fallen through the system’s cracks or live in an underserved area of the country. These are wounded warriors that, absent being exposed to traumatic events in a war zone, may never have entered the criminal justice system.

Client attitudes toward virtual treatment court

IntroductionAs a response to the COVID-19 pandemic, many treatment courts shifted to offering teleservices. We sought to examine the barriers that clients faced when transitioning to virtual court and treatment, and how this transition impacted their perceptions of the treatment court experience. MethodsThe National Center for State Courts administered an online survey between January 1, 2021, and July 31, 2021, deployed to state and local court administrators, which resulted in 1356 unique client responses from 121 courts. The survey measured attitudes about the treatment court process, including interactions with the judge, the behavioral health treatment staff, and treatment groups, as well as barriers to virtual and in-person court. We hypothesized that clients with fewer technological barriers to virtual service, who shifted to virtual court or treatment, would report more positive attitudes to this service delivery. ResultsClients felt more comfortable participating in virtual court sessions than in-person sessions but were less likely to feel like the judge was familiar with their case during virtual court sessions. From the treatment perspective, clients felt more connected with other group members and reported greater benefit from treatment staff when treatment services were delivered in-person, but clients felt less anxious when treatment groups were virtual. ConclusionsEven though virtual experiences were more comfortable than in-person experiences for clients, the results are nuanced and show preference for some in-person connections as they transitioned to virtual connections. Future research should examine how to improve client connections with staff/group members during virtual court or treatment sessions, particularly as courts and treatment providers are likely to continue some services virtually into the future.

The Impact of Juvenile Drug Treatment Courts on Substance Use, Mental Health, and Recidivism: Results from a Multisite Experimental Evaluation.

Juvenile Drug Treatment Courts (JDTC) emerged in the mid-1990s as a potential solution to concern about substance use among youth in the juvenile justice system (JJS). Despite substantial research, findings on the JDTC effectiveness for reducing recidivism and substance use remain inconsistent, hampered by methodological problems. In 2016, the Office of Juvenile Justice and Delinquency Prevention published research-based JDTC Guidelines for best practices, and funded technical assistance for implementation and a multisite national outcomes study among JDTCs implementing the Guidelines. Ten sites were originally selected for this study, with a JDTC and Traditional Juvenile Court (TJC) participating. In two sites, moderate- to high-risk youth were randomized to JDTC or TJC, and in eight sites, a regression discontinuity design assigned moderate- to high-risk youth to JDTC, and other youth to TJC. Findings from four sites with sufficient cases and follow-up rates indicated that JDTCs reduced cannabis use, increased access to mental health services, and reduced recidivism. However, the effects were small to moderate, with positive impacts mainly observed among high-risk youth. The impacts of JDTCs may have been attenuated because Guidelines implementation was inconsistent across courts, and some TJCs implemented elements of the Guidelines, blurring the distinction between JDTCs and TJCs.