The Fundamentals

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The Fundamentals of Family Drug Court
Presented by Meghan M. Wheeler, Project
Director National Drug Court Institute (NDCI)
2007 Drug and DUI Court Conference Wyndham
Peachtree Conference Center Peachtree, GA
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The Family Disease of Drug and Alcohol Dependence
Fetus/InfantFetal factors Intrauterine
toxicityNeonatal toxicity / withdrawalIncreased
muscle toneNeglect/abuse
ChildrenCOA RolesFamily Norms Neglect and
abuseBiologic vulnerability
MotherDrug/alcohol dependence and
codependenceCOA issuesPregnancy complications
Grandma/Extended FamilyDrug/alcohol dependence
and codependence
FatherDrug/alcohol dependence and codependence
COA issues
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No Safe Haven
A devastating tornado of substance abuse and
addiction is tearing through the nations child
welfare and family court systems leaving a path
of abused and neglected children, turning social
welfare agencies and courts on their heads and
uprooting the traditional disposition to keep
children with their natural parents.From No
Safe Haven Report, 1999Joseph A. Califano, Jr.,
Chair and PresidentThe National Center on
Addiction and Substance Abuse at Columbia
University
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Substance Abuse and Addiction and Child
Maltreatment

• National Statistics
• 5 Million Children - 3 Million Reports 1
  Million Victims
• 63 neglect 19 physically abused 10 sexually
  abused and 5 emotionally or psychologically
  maltreated
• 0-4
• 542 K children in foster care 126 K children
  awaiting adoption.
• 33 months
• 44 months
• Poor School Performance / Behavior Problems /
  Delinquency
• 30 of 12th graders, 26 of 10th graders and
  14.1 of 8th graders binge drinking in the past
  month.

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Substance Abuse and Addiction and Child
Maltreatment

• Children Whose Parents Abuse Drugs Alcohol
  Have
• 2.7 greater chance of abuse
• 4.2 greater chance of neglect
• Lack of Essential Food
• Lack of Hygienic Home Care
• Inappropriate Sleeping Conditions
• Lack of Medical / Dental Treatment
• Lack of Supervision

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Children Under Stress and Exposed to Violence

• Exposure to and involvement with socially
  unacceptable and illegal - practices
• Appearances of standards of normality that
  differ from community norm tribal identity
  issues
• Coercive belonging

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Future Implications for Child Victims

• Short Term
• Re-occurrence of Victimization (2X)
• Out of Home Placements
• Poor School Performance / Behavior Problems
• 30 of 12th graders, 26 of 10th graders and
  14.1 of 8th graders binge drinking in the past
  month.
• Long Term
• Re-occurrence of Victimization
• Emotional and Behavioral Problems
• Acute and Chronic Disease / Organ Damage
• Homelessness 30
• Delinquency, Crime, Prison (Violent Crimes)

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The Impact of Child NeglectChild Trauma Academy
(www.ChildTrauma.org) led by Bruce D. Perry,
M.D., Ph.D.
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The Connection

• 70 percent of the child abuse cases during 2001
  were methamphetamine-related. Children whose
  parents or guardians produce or abuse
  methamphetamine typically lack proper
  immunizations, medical care, dental care, and
  necessities such as food, water, and shelter
• Riverside and San Bernardino Counties,
  California
• ASFA mandates the safety, permanency and
  well-being of children within shorter timeframes
  and an approach to address the needs of children
  and families affected by substance abuse.

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DRUG ADDICTION IS A COMPLEX ILLNESSBiologicalP
sychologicalSociologicalAddiction Is No Longer
Just a Moral Problem
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Co-Occurring Issues of Parents

• Medical
• Psychological
• Legal
• Social

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Your Brain After Drugs
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• Does Treatment Work
• in Combating Substance Abuse?
• YESbut
• Not if the addict or alcoholic
• Isnt there!

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Perceived Need Effort Made to Receive Specialty
Treatment 2004 National Survey on Drug Use and
Health National Findings
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Coercion

• Social Contracting
• Exerting leverage
• From Loss of children, threat of job loss, being
  divorced, and being kicked out of the house to
  risk of jail all provide powerful incentives to
  start and stay in treatment.
• Intervention
• The choice of one contingency over another
• Keeping a patient engaged in treatment

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Coercion in the Justice System

• Institute of Medicine (1990)
• contrary to earlier fears among clinicians,
  justice pressure does not threaten treatment
  effectiveness, and it probably improves outcomes.
• Coerced patients tended to stay longer.
• This was in light of the finding that most of the
  legally coerced addicts had more crime and gang
  involvement, more drug use, and worse employment
  records than their non-coerced counterparts.

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Expedites the time interval to get
individuals into treatment and provide
accountability measures before losing them to
their addictions. Keeps the addict engaged in
treatment long enough to receive treatment
benefits.
DRUG COURT
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Over 1,600 drug courts
Drug Court Activity 1989-2004
12 drug courts
1 drug court Miami, FL
1989
1994
2005
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Drug Court Best Practices Publications Adult
Criminal Drug Courts www.ojp.usdoj.gov/BJA/grant/D
rugCourts/DefiningDC.pdf Juvenile Delinquency
Drug Courts www.ncjrs.org/pdffiles1/bja/197866.pdf
DUI Drug Courts Family Dependency Treatment
Courts www.ojp.usdoj.gov/BJA/pubs/FamDepMono.pdf
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The Evolution of FDTC Lessons Learned from the
Adult Criminal Drug Court Model To create an
opportunity for children to be safe and nurtured
by a parent free from substances. To expedite
the time interval to get parents into treatment
before losing them to their addictions. To keep
the family engaged in treatment long enough to
receive treatment benefits.
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Unlike These Judges
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Drug Court Judges Find the Good in Those Who
Cant See it in Themselves
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FDTC Characteristics

• Focus on the permanency, safety and welfare of
  abused and neglected children as well as the
  needs of the parents.
•    
• Early intervention, assessment and facilitated
  access to services for parents and children in a
  holistic approach to strengthen family function.
• Develop comprehensive service plans that address
  the needs of the entire family system.

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FDTC Characteristics

• Provide enhanced case management services to
  monitor progress facilitate access to services.
• Regularly scheduled staffings facilitate the
  exchange of information coordinate services for
  the family.
• Increased judicial supervision of children and
  families.

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FDTC Characteristics

• Individual systems accountability.
• Ensuring legal rights, advocacy and
  confidentiality for parents and children
• Operate within the Federal mandates of the
  Adoption and Safe Families Act and Indian Child
  Welfare Act

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FDTC Characteristics

• Judicial leadership for both the planning and
  implementation of the court
• Commitment to measuring outcomes of the FDTC
  program and plan for program sustainability
•  
• Working as a collaborative, non-adversarial team
  supported by cross-training

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Benefits of Drug Court

• National, Statewide, and Local Evaluations
• Process and Outcomes

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Participant Response

• To the Judge and the Court Hearings
• The Judge is always respectful, it is my fault
  when I am in trouble, but I always feel
  respected.
• You get to speak if you need to.
• I believe I am respected and my opinion is heard.
• It is not intimidating
• Coming in and seeing other people making movement
  and having their kids with them.
• I am treated as a human rather than an addict
• To CPS
• Got to know her and ending up liking her
• She is honest and trustworthy
• She is courteous, positive, respectful,
  encouraging, friendly
• She's easy to contact, and is available if I have
  any questions
• I feel that she works with me

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National Cross Site Evaluation

• The relationship between drug court factors and
  outcomes
• Parents who entered drug court more quickly
  following their petition also tended to enter
  treatment faster, achieve permanency faster, and
  have a shorter time to case closure than parents
  with longer time to drug court entry.
• The relationship between treatment factors and
  outcomes
• Parents who entered treatment services more
  quickly after their petition tended to have
  longer stays in treatment, more treatment
  completions, faster times to permanent placement,
  and shorter cases than parents with longer time
  to treatment entry.
• NPC Research
  Green, Worcel, Finigan, 2006

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National Cross Site Evaluation Relationship of
Treatment Experience to CW Outcomes

• Parents entering TX faster
• Stay longer in treatment
• More likely to complete treatment
• Enter permanent placement more quickly reach
  case closure more quickly
• Parents remaining in TX longer
• More likely to complete treatment
• Take longer to reach case closure.
• Parent completing TX
• More likely to graduate from FTDC
• Take longer to reach permanency,
• Have longer cases, BUT
• Children are more likely to be reunified with
  parents.

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Retrospective FDTC Evaluation
Young, N.K., 2003. Findings from the FDTC
National Cross-Site Evaluation Retrospective Phase

• Parent/Child Outcomes
• FDTC parents have significantly less criminal
  recidivism
• FDTC parents have significantly less CPS
  recidivism
• Treatment Outcomes
• Significantly more FDTC parents enter treatment
• FDTC parents remain in treatment longer
• Child Welfare Outcomes
• FDTC Children are reunified in significantly
  fewer days
• FDTC Children Reach Permanent Placement 3 Months
  Faster
• FDTC Children Have Permanent Plan Ordered 5
  Months Earlier

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FDTC Children Reach Permanent Placement3 Months
SoonerHave Permanent Plan Ordered 5 Months
Earlier and CPS Case Closed 4 Months Sooner
Number of Months
Young, N.K., 2003. Findings from the FDTC
National Cross-Site Evaluation Retrospective Phase
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On Average, More FDTC Children Reunified/Remained
with a Parent
of Children
Young, N.K., 2003. Findings from the FDTC
National Cross-Site Evaluation Retrospective Phase
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Significantly Less Criminal CPS Recidivism
Among FDTC Parents
of Parents
Young, N.K., 2003. Findings from the FDTC
National Cross-Site Evaluation Retrospective Phase
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San Diego County, Ca
NPC Research Green, Worcel, Finigan, 2006
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Yellowstone County, MT

• Children spent 1,002 days less in out-of-home
  care than the children in the comparison group.
• 71.5 of children achieved permanency compared
  64 in the comparison group.
• 49 of comparison group cases achieved permanency
  by having the parental rights terminated,
  compared to only 4.4 of the YCFDTC cases going
  to parental termination.
• 30.8 of the cases in YCFDTC the parents
  relinquished their parental rights compared to 0
  of the comparison group doing so.

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B.K. Roche, Ph.D. Yellowstone Family Treatment
Court Program Evaluation. June 2005
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B.K. Roche, Ph.D. Yellowstone Family Treatment
Court Program Evaluation. June 2005
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B.K. Roche, Ph.D. Yellowstone Family Treatment
Court Program Evaluation. June 2005
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B.K. Roche, Ph.D. Yellowstone Family Treatment
Court Program Evaluation. June 2005
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B.K. Roche, Ph.D. Yellowstone Family Treatment
Court Program Evaluation. June 2005
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B.K. Roche, Ph.D. Yellowstone Family Treatment
Court Program Evaluation. June 2005
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Drug Courts Save Money

• A state taxpayers return on the upfront
  investment in drug courts
• is substantial.
• a countys investment in drug
• court pays off.

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Cost Benefit of Drug CourtAnalysis of Foster
Care Cost
B.K. Roche, Ph.D. Yellowstone Family Treatment
Court Program Evaluation. June 2005

Yellowstone County, MT 1,280,100 saved in
foster care costs alone
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Cost Benefit of Drug CourtAnalysis of Foster
Care Cost
NPC Research, 2004. Findings from the FDTC
National Cross-Site Evaluation Retrospective Study
San Diego, Ca 1.8 million saved in foster
care costs alone

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844 drug free babies in 2004!
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The Promise of Drug Court

• We can capitalize on the consequences of a
  petition / charge to intervene earlier in child
  maltreatment and the parents career of
  substance abuse.
• More substance abusers will enter treatment
  sooner and stay longer.
• Highest level of accountability for the parent
  while ensuring the safety and well-being of
  children.
• Increased reunification rates and shorter time to
  permanency.
• Comprehensive and Unified Case Planning to
  address a familys presenting problems and
  capitalize on their strengths.

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For More Information
National Drug Court Institute (NDCI)
703-575-9400 or www.ndci.org Mwheeler_at_ndci.org