Drug Court Intervention Research Articles

Overview of the innovative Family Treatment Drug Court model in Kentucky

AbstractFamily Treatment Drug Courts (FTDCs) have been implemented to assist families involved with the child welfare system due to substance use. This article describes an enhanced version of a Family Treatment Drug Court intervention which builds on the traditional FTDC model but includes adaptations that add theoretically driven components to the basic FTDC model that aim to strengthen not only permanency outcomes but also address child well‐being including several precursors to child well‐being: parent well‐being and family well‐being so that the additional child welfare outcome of child well‐being can be met. The enhanced FTDC model described in this paper offers three phases of treatment but also utilizes data gathered for evaluation purposes as continuous quality improvement information to inform providers regarding participant engagement so that targeted re‐engagement efforts can occur to reduce dropouts. Thus, this paper also describes the measures utilized in the comprehensive evaluation. Data include 33 standardized scales from multiple sources, including clients, therapists/treatment providers, court personnel, and child welfare workers, at multiple points ranging from weekly to quarterly. Implications are discussed regarding how this enhanced FTDC model and use of evaluation/CQI data impact client engagement and multiple outcomes.

The Impact of Traumatic Stress, Social Support, and Substance Problems on Graduation Among Female Offenders in a Prescription Drug Court Program.

Trauma exposure and comorbid substance use are highly prevalent among female drug court participants. Despite the pervasiveness of the issue, few studies have investigated the impact of posttraumatic stress symptoms (PTSS) and nonmedical prescription drug use among this specific population. The present study examined the impact of posttraumatic stress, social support, and nonmedical prescription drug use on graduation outcomes among female participants in a specialized drug court program (N = 210). Participants either received motivational enhancement therapy/cognitive behavioral therapy (MET-CBT; N = 210) or both MET-CBT and Seeking Safety through intensive outpatient treatment (n = 109). The findings indicated that graduation was negatively correlated with posttraumatic stress, r = -.19, p = .007, d = 0.40; past 90-day nonmedical prescription painkiller, opiate, and analgesic use, r = -.19, p = .001, d = 0.44; tangible social support, r = -.24, p = < .001, d = 0.51; and past-month substance use problems, r = -.25, p < .001, d = .50. In addition, past-month substance use problems, OR = 0.84, 95% CI [0.72, 0.97]; PTSS, OR = 0.90, 95 % CI [0.82, 0.99]; and tangible social support, OR = 0.94, 95% CI [0.89, 0.98], were significant negative predictors of graduation. These results speak to the importance of facilitating the development of specialized evidence-based drug court interventions that target and improve comorbid substance use and trauma outcomes among female drug court participants to reduce recidivism and set a precedent for future research to replicate and expand upon these findings.

Examining the Relationship between Psychological Functioning, Childhood Trauma, and Types of Perceived Coercion Among Drug Court Enrollees: Results from A Pilot Study.

Background:Drug court interventions produce positive results—especially among mandated populations. Many criminal justice-involved persons, including drug court enrollees, have cooccurring substance abuse and childhood trauma disorders associated with psychological dysfunction. Given the coercive nature of mandated drug court treatment, it is important to understand whether childhood trauma and psychological functioning influence perceived coercion to enter treatment.Objectives:The purpose of this study was to describe the degree to which adverse childhood trauma and psychological functioning were associated with six domains of perceived coercion— self, family, legal, financial, health, and work—among a population of drug court enrollees.Methods:Data from 54 enrollees in a drug court pilot study were used to examine the relationship between childhood trauma, psychological functioning, and perceived coercion.Results:The pilot study data showed that psychological dysfunction and traumatic experiences in childhood were associated with higher perceived coercion to treatment, explaining 29% of the variance in coercion, controlling for gender and pre-arrest alcohol and drug use. Results indicated that the associations between psychological dysfunction and trauma were driven by non-legal types of coercion. In particular, childhood trauma was correlated with family (r = .32), financial (r = .32), and health (r = .47) types of coercion.Conclusions:Based on these preliminary findings, drug court practitioners are urged to assess perceived coercion, in addition to the behavioral health and childhood trauma of their clients, and to utilize non-legal types of coercion such as family, health, and financial impact to enhance treatment engagement.

Evaluating the Effectiveness of a Juvenile Drug Court: Comparisons to Traditional Probation

AbstractJuvenile Drug Courts have been in operation in the United States for over 20 years, yet their effectiveness and design have been challenged throughout the literature. Using data collected from a Juvenile Drug Court (JDC) in Southeast Texas, this project sought to determine if the JDC intervention reduced recidivism compared to a comparison sample of juvenile offenders. Results indicate that the recidivism rates of participants in the JDC were lower than the comparison group, suggesting that the Drug Court intervention was successful. The program completion rates for JDC youths were also higher for those with fewer infractions. Although the JDC youths had statistically lower infractions, the intervention overall appears to need strengthening. A close inspection of program components could document which programmatic skills are tied to efficacy, leading to the achievement of better outcomes.

Predicting nonresponse to juvenile drug court interventions

Using data from a recent randomized clinical trial involving juvenile drug court (JDC), youth marijuana use trajectories and the predictors of treatment nonresponse were examined. Participants were 118 juvenile offenders meeting diagnostic criteria for substance use disorders assigned to JDC and their families. Urine drug screen results were gathered from weekly court visits for 6 months, and youth reported their marijuana use over 12 months. Semiparametric mixture modeling jointly estimated and classified trajectories of both marijuana use indices. Youth were classified into responder versus nonresponder trajectory groups based on both outcomes. Regression analyses examined pretreatment individual, family, and extrafamilial predictors of nonresponse. Results indicated that youth whose caregivers reported illegal drug use pretreatment were almost 10 times as likely to be classified into the nonresponder trajectory group. No other variable significantly distinguished drug use trajectory groups. Findings have implications for the design of interventions to improve JDC outcomes.

A randomized pilot study of the Engaging Moms Program for family drug court

In response to the need for effective drug court interventions, the effectiveness of the Engaging Moms Program (EMP) versus Intensive Case Management Services (ICMS) on multiple outcomes for mothers enrolled in family drug court was investigated. In this intent-to-treat study, mothers ( N = 62) were randomly assigned to either usual drug court care or the Engaging Moms drug court program. Mothers were assessed at intake and 3, 6, 12, and 18 months following intake. Results indicated that at 18 months post drug court enrollment, 77% of mothers assigned to EMP versus 55% of mothers assigned to ICMS had positive child welfare dispositions. There were statistically significant time effects for both intervention groups on multiple outcomes including substance use, mental health, parenting practices, and family functioning. EMP showed equal or better improvement than ICMS on all outcomes. The results suggest that EMP in family drug court is a viable and promising intervention approach to reduce maternal addiction and child maltreatment.

Increasing Family Reunification for Substance‐Abusing Mothers and Their Children: Comparing Two Drug Court Interventions in Miami

ABSTRACTThis study provides a quasi‐experimental test of 80 consecutive enrollments in the Miami‐Dade (Florida) Dependency Drug Court in order to examine the impact of a family‐based and gender specific intervention, Engaging Moms Program (EMP), on drug court graduation and family reunification. We compared EMP with case management services (CMS). Results indicated that 72% of mothers in the EMP graduated from drug court, and 70% were reunified with their children. In contrast, 38% of mothers receiving CMS graduated from drug court, and 40% were reunited with their children. EMP, then, appears to be a promising family drug court intervention.

Assessing the Effects of the Drug Court Intervention on Offender Criminal Trajectories

Using a combination of NCIC and local police data from Wyoming, this study focuses on the short-term effects of the drug court intervention on offender criminal trajectories. Wyoming's drug courts operate in a manner consistent with most drug courts around the nation by focusing on offender supervision, judicial oversight, frequent and random drug testing, and intensive substance abuse treatment. The results of this outcome analysis suggest dramatic reductions in criminal offending both during the drug court program and for the year immediately following the program participation.

The Match Between Family Needs and Services for High-Risk Neglecting Families

ABSTRACT Child neglect is characterized by a complexity of family problems and needs. Whether families' needs are actually matched to the appropriate services is a critical area for study, although little empirical work exists. In this study, we examine the match between needs and services for a sample of high-risk neglecting families, using cluster analysis to identify clusters of services and previously identified need clusters. We examine need–service match from two perspectives: 1) how well services are allocated to family need, and 2) how well family needs are covered by available services. Some service clusters are well allocated to corresponding needs, such as intensive drug court and family preservation services to substance-abusing families; however, other service patterns are much less coherent. With regard to how well needs are covered by available services, although approximately one-third of substance-abusing families receive the intensive drug court intervention, another one-third receive the low-service cluster of services. Poor match is particularly evident for the mental health/economic need/domestic violence group, in which more than half are represented in the low-service cluster, and only one-fourth in the high-service/economic/domestic violence service cluster. Attention to need–service matching is an important feature of evidence-based practice from both the perspective of case planning with families and the design of services for subgroups of families. Implications for practice and policy are discussed.

Systems Modeling for Drug Courts

This policy research note argues for a systems modeling approach to explain drug court processes. The conceptual model links participants' beliefs, behavioral intentions, and behavioral outcomes. Conceptualization of core constructs combines elements of planned behavior theory with those of routine activities theory and acknowledges the transtheoretical model and therapeutic jurisprudence. Systems modeling is offered in an effort to identify specific drug court interventions that work, more accurately select suitable offenders, and ultimately to promote public safety.

Drug court treatment for methamphetamine dependence: Treatment response and posttreatment outcomes

Relatively little is known about the impact of drug court treatment programs for methamphetamine (MA) dependence. This article examines treatment performance among a subsample of 287 MA-dependent adults who participated in the Methamphetamine Treatment Project from 1999 to 2001. To gain a preliminary indication of MA users' response to drug court intervention, we compared a group of 57 MA-dependent participants treated in outpatient treatment within the context of a drug court to a group of comparable MA-dependent individuals treated in outpatient treatment but not supervised by a drug court ( n = 230). Analyses reveal that drug court participation was associated with better rates of engagement, retention, completion, and abstinence, compared to outpatient treatment without drug court supervision. Six- and 12-month outcome analyses indicated that participants who were enrolled in drug court intervention used MA significantly less frequently. These findings suggest that drug court supervision coupled with treatment may improve the outcomes of MA-dependent offenders beyond that seen from treatment alone.

Treating Substance‐Abusing Parents: A Study of the Pima County Family Drug Court Approach

ABSTRACTA geographical comparison‐group design was used to examine the effectiveness of the Pima County (Arizona) Court Assisted Treatment Services (CATS) program and its drug court intervention. The study compared the summary statistics for the volunteers to the family drug court (n=33) with a treatment‐refusal group (n=42) and a treatment‐as‐usual group (n=45) from a matched geographical area. The findings of this study indicate that the family drug court group had higher engagement and completion rates of residential treatment than was true of the other comparison groups. In addition, the volunteers to the family drug court group had fewer parental rights severed, a higher percentage of permanency decisions reached within one year, earlier permanency decisions, and a higher percentage of children placed with their parents. The implications of this study's findings for future evaluations of the components of a family drug court intervention are discussed.

DATStats: results from 85 studies using the Drug Abuse Treatment Cost Analysis Program (DATCAP)

The Drug Abuse Treatment Cost Analysis Program (DATCAP) was developed and launched in the early 1990s to help addiction researchers and administrators estimate the economic costs of substance abuse interventions. This paper presents summary results from 85 DATCAPs completed over the past 10 years. After first grouping the DATCAPs into 9 treatment modalities, cost measures (normalized to 2001 dollars) are reported along with client caseload information. Additionally, the distribution of costs across 6 resource categories is presented for each of the treatment modalities. The average weekly economic cost per client ranged from $82 per week for outpatient drug court interventions to $1,138 per week for adolescent residential treatment. As expected, labor was overwhelmingly the most utilized resource across all modalities, ranging from 48% to 88% of total economic cost. Addiction researchers, program administrators, and policymakers now have cost estimates and resource distribution information for various treatment modalities serving diverse populations.