Participants’ views on the strengths and limitations of drug court: Recommendations to enhance assessment and treatment of mental illnesses

ABSTRACT

Since 1989, drug courts have provided an alternative to incarceration for arrestees who have a substance use disorder. Previous research has suggested that participants who graduate from the program are less likely to recidivate than those who are terminated from the program. The majority of research on drug courts is quantitative; therefore, the benefits of qualitative methods are not fully seen in the literature. This qualitative study developed an in-depth understanding of participants’ (n = 42) views on the strengths and limitations of a Midwestern drug court. Two themes emerged from the data. First, participants felt that the drug court promoted camaraderie, which enhanced their motivation for change and supported them in graduating from the program. Second, participants felt that the drug court did not adequately treat their mental illnesses, which for some resulted in relapse and was perceived as a barrier to graduating from the program. Recommendations for drug court practice are discussed.     

What Do Social Workers Need to Know About Mental Health Courts?

Abstract

Mental health courts are an emerging strategy to engage mentally ill offenders in treatment and to avoid unnecessary incarceration. These courts began in 1997 based upon the drug court model; there are currently over 70 courts nationwide. These courts are heterogeneous in structure, work with interdisciplinary teams, and seek to engage the consumer in treatment rather than use judicial sanctions. Social workers are integral members of these teams; yet, no research has been published in social work journals on mental health courts. This article explains the background and context of the courts, describes their features, discusses what social workers need to know about mental health courts, and concludes with ideas for how social workers may work effectively with mental health courts.     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

Adult Drug Treatment Courts: A Review

Drug treatment courts (DTCs), an alternative to traditional criminal courts, provide an innovative way to legally process some drug offenders. The origin and recent growth of the drug court system in the USA can be explained as an unintended consequence of a failing 'war on drugs'. In this article, we discuss the spread of adult DTCs throughout the USA, the main components of drug courts, controversies surrounding DTCs, and some criticisms of drug courts. We summarize the recent evaluations of adult DTCs, and highlight various DTC factors that have been found to reduce individual drug use and criminal activity. We also offer suggestions for future research on DTCs and conclude with policy recommendations.     

Promoting Drug Court Education in Schools of Social Work: Ideas in Action

Drug courts have provided an alternative to incarceration for arrestees with substance use disorders since 1989 in the USA, and the first drug court outside of the USA began in 1998 in Canada. As drug courts continue to increase throughout the world, it is important for social work students to learn about the role of drug courts in their communities, as they may interact with these programs directly or indirectly, whether it is being a member of a task force that begins a drug court or providing substance abuse treatment to participants. This Ideas in Action article conceptualizes drug courts and discusses their relevance for social work education. The article also proposes several direct service-learning techniques, such as completing practicums and course projects, which can be used within schools of social work to educate students about drug courts and promote civic engagement, reflection, and reciprocity.     

COURT STRUCTURE, DEFENSE ATTORNEY USE, AND JUVENILE COURT DECISIONS

A typology of metropolitan juvenile courts suggests important variations in court structure and procedure. Data describing case characteristics and disposition decisions were drawn from two courts selected to represent "types" ("traditional" and "due process") that are different in structure and procedure. Analyses reveal important differences in the uses of defense attorneys, in case outcomes, and in the variables that influence case decisions. Defense attorney use is more consequential and case decision making is more patterned and regular in the "due process" type court. The study suggests an explanation for contradictions of previous research on the determinants of juvenile court decisions and an interpretation for confusing findings on the consequences of using defense attorneys in juvenile court proceedings.     

Juvenile Courts and Competency to Stand Trial

This article reviews the recent development of juvenile competency to stand trial (CST) policies across the United States in light of the inherent contradiction of this due process procedure in a separate juvenile court that is premised on the incompetence of youth. The article draws on existing CST legal doctrine and psycho‐legal research to demonstrate the need for sociolegal research to better understand who gains access to the CST process, CST decisions, and how CST may influence subsequent case processing decisions. Utilizing CST as an adopted formal policy from criminal court and an exploratory case study, I demonstrate the difficulties facing how court actors manage the role of youthfulness and culpability for CST decision‐making in contemporary juvenile courts. Overall, both quantitative and qualitative research is needed to examine whether court actors’ practice of CST serves to further deconstruct or reinforce the juvenile court’s rehabilitative ideal.     

Problem‐Solving Courts: Theory and Practice

Problem‐solving courts (PSCs) are a popular and fast‐growing alternative to the usual way of handling criminal cases. In place of the adversarial process, they provide court‐supervised treatment to certain groups of offenders by addressing the underlying causes of criminal behavior. They take on a variety of forms including drug courts, mental health courts, domestic violence courts, veterans’ courts, and homeless courts. PSCs, as relatively new innovations in the criminal justice system, are still evolving in scope and in practice. This article then attempts to synthesize what we know about these specialty dockets. To do so, this article (1) explores the origins and developments of PSCs as well as highlights their defining characteristics; (2) examines the theoretical approaches and empirical findings of contemporary research on problem‐solving courts; (3) critically discusses whether this new approach to old problems compromises core judicial principles; and (4) suggests directions for further research to better understand the cautionary promise of problem‐solving justice.     

The Evolution of Substance Abuse Treatment in Juvenile Justice

ABSTRACT

This paper discusses the scope of substance abuse and related problems among juvenile offenders, and describes three models of addressing the problem based on a review of current approaches, ranging from Treatment Alternatives to Street Crimes programs (TASC), to juvenile drug courts, to an integrated treatment network model. The relevant strengths and weaknesses of each in supporting lasting change in substance-abusing juvenile offenders and their families are presented, and a call to action is offered for communities wishing to aim their interventions innovatively and precisely in the direction of substance abuse among their delinquent youth.     

Sentencing Male Sex Offenders Under the Age of 14: A Law Reform Advocacy Journey in Hong Kong

The common law presumption that a boy under the age of 14 is incapable of sexual intercourse has provoked controversial debates in Hong Kong. This article describes a 6-step advocacy journey to examine how community efforts have helped modify this law so that juvenile male sexual offenders under the age of 14 who have committed the crime of having sexual intercourse with underage females can be sentenced to receive appropriate treatment. Seven court cases provided by the magistrates’ courts in Hong Kong were used in this advocacy effort for the removal of the presumption in July 2012. Although this effort has yet to reveal signs of effectiveness, it represents greater public awareness about providing rehabilitation appropriate for juvenile sex offenders through a formal sentence. Restorative justice, as opposed to retributive or punitive justice, places an emphasis on rehabilitation of the offender and restoration of victims to a place of wholeness.     

Drug Courts and the Logic of Coerced Treatment1

This article examines the social and historical significance of coerced drug treatment within the criminal justice system. Drug courts, the most prominent example of this approach, serve as a case study to explore how seemingly contradictory perspectives on substance use—therapeutic and punitive—are merged to justify increased criminal justice oversight of defendants in the name of facilitating recovery. Drawing on an analysis of drug court organizational documents and interviews with key advocates, this article (1) examines the punitive, therapeutic, and medical knowledge drug court advocates draw on and construct to justify an increased role for the courts in solving the problem of addiction, and (2) links these theories historically to broader discussions about the causes of crime and the courts’ role in solving social problems. Overall, this article considers how scientific theories are fused with moral considerations in the name of an “enlightened” criminal justice approach to complex social problems.     

The house of refuge movement: Humanitarian gesture or simple exploitation?

The 1800s marked the early development of a new approach to child welfare in the United States. Beginning with the house of refuge movement (1820s) and culminating with the creation of the juvenile court (1899), this developmental period has been traditionally praised as an age of humanitarian reform. Sociological research has suggested, however, that the creation of the juvenile court served mainly as a new form of social control designed to protect the power and privilege of the middle and upper classes while furthering the exploitation of the lower class. Unfortunately this research has treated only the reforms of the middle to late 1800s. The present study seeks to contribute to this literature by illuminating the early reforms. More specifically, an examination of the New York, Boston, and Philadelphia houses of refuge reveals that the exploitation thesis provides a more complete explanation of the emergence of these houses than does the humanitarian position.     

Discontinuity and/in the Early Twentieth Century Ontario Juvenile Court

Abstract  Canada's juvenile court has become axiomatic. As such, it demands critical and historical questioning of its hegemony. It is in this spirit of critique that I highlight its arbitrariness. Two ruptures in the ostensibly smooth telos of Ontario's juvenile courts are discussed in this paper. First, I examine the precarious and uncertain inauguration of the Juvenile Delinquents Act. Second, I explore the Act's implementation in Toronto; particularly as it relates to the adversity juvenile court judge E.W. Boyd experienced. This examination provides a convenient backdrop against which to highlight the juvenile court's foible. I conclude with a call for a socio-historic strategy of open ended practico-critique of law and juvenile courts; informed by the emancipatory logic of "justice" to come.     

Abusers gaining custody in family courts: A case series of over turned decisions

Abstract

This article presents findings and recommendations based on an in-depth examination of records from 27 custody cases from across the United States. The goal of this case series was to determine why family courts may place children with a parent that the child alleges abused them rather than with the nonoffending parent. We focused on “turned around cases” involving allegations of child abuse that were at first viewed as false and later judged to be valid. The average time a child spent in the court ordered custody of an abusive parent was 3.2?years. In all cases we uncovered the father was the abusive parent and the mother sought to protect their child. Results revealed that initially courts were highly suspicious of mothers' motives for being concerned with abuse. These mothers were often treated poorly and two-thirds of the mothers were pathologized by the court for advocating for the safety of their children. Judges who initially ordered children into custody or visitation with abusive parents relied mainly on reports by custody evaluators and guardians ad litem who mistakenly accused mothers of attempting to alienate their children from the father or having coached the child to falsely report abuse. As a result, 59% of perpetrators were given sole custody and the rest were given joint custody or unsupervised visitation. After failing to be protected in the first custody determination, 88% of children reported new incidents of abuse. The abuse often became increasingly severe and the children's mental and physical health frequently deteriorated. The main reason that cases turned around was because protective parents were able to present compelling evidence of the abuse and back the evidence up with reports by mental health professionals who had specific expertise in child abuse rather than merely custody assessment.     

Racial Disparities in Drug Court Graduation Rates: The Role of Recovery Support Groups and Environments

There are more than 3,000 drug courts in the United States, and research has demonstrated that, in some drug courts, African American participants are less likely to graduate than their White counterparts. Quantitative studies have documented the problem, but qualitative studies are needed to develop an in-depth understanding of this phenomenon through participants’ experiences. This qualitative study asked African American participants (n = 31) about their lived experiences in drug court to develop insight into the factors that might contribute to racial disparities in drug court outcomes. African Americans had favorable views toward both mandated and natural recovery support groups, and they felt that participating in these support groups increased their likelihood of graduating drug court. Conversely, African Americans felt that a barrier to graduating drug court was their environments, mainly risk factors posed by family, neighborhoods, and peers. Implications for drug court practice are discussed.     

Tackling Problem Drug Use

SUMMARY

Successful 'recovery' from long-term problem drug use has depended largely upon understanding and tackling the physiological and psychological nature of drug dependence; however, drawing upon research and practice in Liverpool, England, the author questions whether this discourse is sufficient given the changing nature, context and attitudes towards drug consumption in the twenty-first century. This article emphasises the importance of incorporating structural and social factors. Drawing upon qualitative data from three separate studies, the author illustrates how stigmatisation, marginalisation, and social exclusion are significant debilitating components that have tended to be overlooked. This paper contributes new insights into the damaging impact of political rhetoric and structural discrimination that has placed many long-term drug users vulnerable to relapse. In response to these findings the author offers a new conceptual framework for practice that incorporates and promotes an understanding of the social nature and context of long-term drug dependence.     

War and Peace: Social Work and the State of Chemical Dependency Treatment in the United States

SUMMARY

In recent decades, treatment for alcohol and drug problems in the United States has been influenced by a number of factors. This article discusses several of these factors, including the “War on Drugs,” with its emphasis on law enforcement and interdiction, and managed health care, which has compromised access to treatment. In spite of these factors, the U.S. invests a goodly amount in alcohol and drug prevention and treatment services and research. Efforts are being made to ensure that research findings are being translated into improved clinical practice. Among the controversial issues in the treatment arena are recent efforts by the Bush administration to promote public funding of faith- or religious-based groups in delivering chemical dependency services. Social workers commonly see people with alcohol and drug problems in their practices, but only a small number of social workers are well prepared to treat this group of clients.     

Examining Mental Health Court Completion: A Focal Concerns Perspective

Sociologists have long‐raised concern about disparate treatment in the justice system. Focal concerns have become the dominant perspective in explaining these disparities in legal processing decisions. Despite the growth of problem‐solving courts, little research has examined how this perspective operates in nontraditional court settings. This article used a mixed‐method approach to examine focal concerns in a mental health court (MHC). Observational findings indicate that gender and length of time in court influence the court's contextualization of noncompliance. While discussions of race were absent in observational data, competing‐risk survival analysis finds that gender and race interact to predict MHC termination.     

An Integrated Experiential Approach to Treating Young People Who Sexually Abuse

SUMMARY

This article promotes the use of an integrated (holistic) approach to treating juvenile sexual offenders. An integrated model takes into account the fact that: (a) youth are resilient, (b) youth progress through various stages of development, (c) these stages are often arrested as a result of trauma, child abuse and neglect, and attachment disorders, (d) humanistic approaches and the therapeutic relationship are essential to the healing and recovery process, (e) youth learn and work with a variety of learning styles and multiple intelligences, (f) many traditional assessment and treatment approaches can be modified and blended with an integrated approach, and (g) the use of experiential treatments can have a positive and profound impact in treating youth with sexual behavior problems.     

Labelling and Juvenile Court Dispositions: Official Responses to a Cohort of Violent Juveniles*

This research tests three hypotheses implicit in the societal reaction perspective, with data on approximately 3,300 juvenile court dispositions involving the members of a birth cohort of 1,100 violent juveniles. The results indicate, contrary to the implications of the labelling perspective, that defendants' social attributes play little role in this court's decisions. Two findings, however, provide some support for labellers' contentions. First, offense information predicts outcomes only moderately well. The discriminant analysis performed on the data indicates that the variables used in this and other models predict the imposition of extremely severe outcomes much better than they predict outcomes of lesser severity. Second, this court's previous responses to a youth play an important role in any subsequent disposition decisions. The importance of prior court responses in later decisions supports labellers' characterizations of courts as vortices.