A Qualitative Examination of the Juvenile Drug Court Treatment Process

ABSTRACT

Drug treatment courts have proliferated at a remarkable rate, to over 1,000 drug court programs by May 2001. Literature has developed which shows drug courts to be generally effective for reducing recidivism and drug use. However, research on juvenile drug court treatment has lagged behind its adult predecessor. Recent research efforts emphasize the need to understand the process components of drug court so this treatment model can be described and modified to improve effectiveness. The current paper has three related objectives: (1) to describe how focus groups can be effectively used to study juvenile drug court treatment processes; (2) to present findings from a juvenile drug court in which this method was used; and (3) to interpret these findings through an empirically validated conceptual model that has been used to examine the treatment process components of community-based drug abuse treatment. Implications for evaluation and treatment professionals are discussed.     

Treatment of incarcerated, sexually-abused adolescent females: an outcome study

This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to gender-specific, CBT-based intervention.     

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.     

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.     

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.     

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.     

Illuminating the Black Box From Within: Stakeholder Perspectives on Family Drug Court Best Practices

This article describes a mixed-methods, concept mapping study in an urban family drug court (FDC) designed to identify keys to FDC success from stakeholders’ perspectives. Participating FDC team members and clients developed a set of items they deemed integral to an FDC, thematically clustered the items, and then rated their relative importance. Using these data, cluster analysis and multidimensional scaling generated 6 themes perceived as contributing to positive outcomes. Resultant concept maps revealed that, compared to team members, clients view relational aspects of the FDC as more important. The findings point to implications for future research and social work practice.     

Families in Crisis: The Family Court Perspective

The Chief Justice, Family Court of Australia, explores the changing and challenged concept of family’ and the range of critical external pressures which impinge on families and inhibit their functioning. He then considers Family Court responses to issues of partner and child abuse, and recent legislative changes especially as they impinge on children.     

The National Elder Mistreatment Study: An 8-year longitudinal study of outcomes

Objectives: To conduct an 8-year follow-up of the National Elder Mistreatment Study (NEMS) and specify risk ratios for negative outcomes of elder abuse, including DSM-5 defined depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and poor self-reported health.

Methods: Attempts were made to re-contact, via Computer Assisted Telephone Interview, all 752 NEMS participants who reported mistreatment since age 60 at Wave I, as well as a randomly selected sample of non-mistreated NEMS participants

Results: 183 NEMS Wave I elder abuse victims and 591 non-victims provided data. In bivariate analyses, elder mistreatment 8 years earlier increased risk of negative outcomes by 200–700%. However, multivariate analyses revealed that Current (Wave II) social support was highly protective against most negative outcomes (excepting PTSD), and even appeared to nullify effects of mistreatment on GAD and poor self-reported health.

Conclusions: Outcomes of elder mistreatment have not been studied prospectively in a national sample. The NEMS 8-year follow-up findings indicate a strong relationship between elder mistreatment at Wave I and negative emotional and physical health 8 years later. Fortunately, current (Wave II) social support appears to be both consistently and powerfully protective against most negative outcomes.     

Methadone and Menopause: Midlife Women in Drug Treatment

ABSTRACT

As a rising number of midlife women receive methadone treatment, issues related to the menopausal transition take on increased importance. The similarity between many of the symptoms associated with opiate withdrawal, methadone and menopause (hot and cold flashes, sweats, fatigue, decreased libido, menstrual irregularity and insomnia), make it plausible these women and clinical staff attribute menopausal symptoms to other conditions of greater familiarity. The paucity of research, multiplicity of health problems and typically poor access to health care, further complicate the picture and underscore the importance of better integration of health care and social work intervention.     

The Effect of Drug Use on Social Work Students' Treatment Attitudes

Sixty first-year social work students were studied regarding their drug experiences and attitudes. A minority had experimented with drugs other than marijuana, and over half had tried marijuana. Older age was found to be associated with less drug use and more negative attitudes. Experience with drugs was also related to less negative attitudes toward users and more positive views about treatment effectiveness. Since social work is a profession concerned with helping those in trouble, particularly substance abusers, drug experiences and attitudes of social workers need to be explored further concerning their relationship to treatment outcome.     

The New Zealand Family Court: its structure and process

SUMMARY. During the last decade the New Zealand Family Court has been central to the transformation of key aspects of Family Law. It has provided a forum for conciliation, thus enabling the resolution of family conflict without recourse to the formal adjudicative process. Conciliation, coupled with a diminution in the use of adversarial techniques by lawyers., have combined to take the bitterness and recrimination out of family breakdown. The Family Court has therefore succeeded in enhancing the welfare of children. These two articles are based on papers given to the Family Courts Campaign Conference, May 1989     

Identifying Children's Needs When Parents Access Drug Treatment: The Utility of a Brief Screening Measure

SUMMARY

This study evaluated whether a brief screening measure of child psychosocial functioning completed by parents could assist drug and alcohol workers to identify which of their client's children needed follow-up support. As part of a broader research and intervention program for 4–13 year old children with substance dependent parents, the Strengths and Difficulties Questionnaire (SDQ) and a broader clinical assessment were completed with the families of 48 children. Validating its usefulness in this population, significant and moderate correlations were found between SDQ scores and workers' assessments of children's social, emotional, and cognitive development and schooling.     

Evolve Therapeutic Services: A 5-year outcome study of children and young people in out-of-home care with complex and extreme behavioural and mental health problems

BackgroundLittle evaluation research has been conducted on the effectiveness of services and intervention provided to children in out-of-home care. This study evaluated an innovative Queensland, Australia program employing a collaborative wrap-round model of care in combination with a flexible intervention approach, individually tailored to children and young people in out-of-home care presenting with complex and extreme behavioural and mental health problems.MethodThe sample consisted of 664 children and young people. Two clinician-rated measures, the CGAS and HoNOSCA, were used to assess young people's functioning via a pre-post-treatment design.ResultsResults revealed significant improvements across a range of problems areas: general functioning and adjustment; disruptive, antisocial and aggressive behaviour; overactivity, poor attention and concentration; non-accidental self-injury; problems with scholastic and language skills; non-organic somatic symptoms; emotional symptoms; peer and family relationships; self-care and independence; and school attendance.ConclusionFindings provide good evidence for the effectiveness of the therapeutic intervention program. Implications for future research are explored.     

Family preservation and child protection: The reality of Children's Court decision-making

Abstract

Ainsworth and Maluccio (Australian Social Work, December 1998) drew attention to the increased use of kinship care for children who need care away from their parents. This paper discusses the aim of family preservation, on which kinship care is predicated, and the challenges for legal decision-makers to meet this aim when children are before the courts in need of care and protection. It draws from findings of a study of magistrates' decision-making in child protection cases (Sheehan 1999). The paper provides examples of family situations that typically confront the Children's Court in Victoria and the court's response to them as it attempts to balance the importance of family ties and the reality of risk for a child; a reality that challenges valued beliefs about families and their ability to always care for their children.