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

This 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.     

Race,Neighborhood, and Drug Court Graduation

This research examines the possibility that racial disparities in drug court graduation are attributable to individual-level employment or education or to neighborhood-level disadvantage. Individual-level data on 455 drug court clients and neighborhood-level census and police incident data are joined geographically. Drug court graduation is modeled using multilevel logistic regression. In a model with no neighborhood-level indicators, client race, employment, and education all predicted drug court graduation. When neighborhood-level variables are introduced, client-level race drops from significance but employment and education remain significant predictors of graduation. Client race, then, appears to be an indirect indicator of neighborhood disadvantage, while client employment and education remain important individual-level predictors of drug court graduation. These results support further analysis of neighborhood-based barriers to drug court graduation and the development of drug court programming that can address neighborhood-based challenges.     

Drug treatment court opens in British Columbia

British Columbia has launched its first drug treatment court. Designed as a mandated addiction treatment alternative to incarceration, the court will attempt to steer drug users charged with drug-related offences away from jail and into rigorous supervised addiction treatment. While some have applauded this recent development, local experts have criticized the move, citing the lack of evidence supporting the efficacy of drug courts and the need for more voluntary treatment programs.     

Matching Judicial Supervision to Clients' Risk Status in Drug Court

This article reports outcomes from a program of experimental research evaluating the risk principle in drug courts. Prior studies revealed that participants who were high risk and had (a) antisocial personality disorder or (b) a prior history of drug abuse treatment performed better in drug court when scheduled to attend biweekly judicial status hearings in court. In contrast, participants who were low risk performed equivalently regardless of the court hearings schedule. This study prospectively matches drug court clients to the optimal schedule of court hearings based on an assessment of their risk status and compares outcomes to clients randomly assigned to the standard hearings schedule. Results confirmed that participants who were high risk and matched to biweekly hearings had better during-treatment outcomes than participants assigned to status hearings as usual. These findings provide confirmation of the risk principle in drug courts and yield practical information for enhancing the efficacy and cost-efficiency of drug courts.     

Decision Making in a Hybrid Organization: A Case Study of a Southwestern Drug Court Treatment Program

This article presents a case study of decision making in a drug court located the southwestern United States. This study seeks to fill a gap in research on decision making by attending to the ways that drug court officials navigate the demands of a court that is dedicated to both therapy and criminal justice. This analysis differs from previous research by viewing the drug court as a “hybrid organization” and asking how the staff members interact in the decision‐making process. Additionally, this research provides an opportunity to investigate the concerns over collaborative decision making raised by critics. The data from this case study reveal that as a hybrid organization, the drug court staff often divides along institutional lines by allowing the counseling staff to manage treatment and the judge to manage punishment. When tensions arise, they are resolved by the structure of the court, which is hierarchical rather than collaborative.     

Judges as therapists and therapists as judges: the collision of judicial and therapeutic roles in drug treatment courts

This paper explores the implications of the expansion of judicial and therapeutic roles in a drug treatment court (DTC) in Canada. Issues that are raised are: how the courtroom is framed as a therapeutic space where public appearances by participants are part of the therapeutic process; how judges have taken on therapeutic practices, effectively compromising their traditional role as neutral arbiter; how certain women resisted therapeutic interventions by judges and felt they received harsher punishments than men; and how treatment counselors in DTCs are given powers of enforcement over their clients. The collision of judicial and therapeutic roles in the DTC results in negative consequences for individuals in the specialized courts. Specifically, DTC participants are expected to engage in a therapeutic relationship with their treatment counselors and the court; however, their right to confidentiality is withheld, and their treatment counselors act as agents for the court.     

EFFECTIVENESS OF DRUG TREATMENT COURTS: EVIDENCE FROM A RANDOMIZED TRIAL*

Research Summary: Study randomly assigned 235 offenders to drug treatment court (DTC) or “treatment as usual.” Analyses of official records collected over a two‐year follow‐up period show that DTC is reducing crime in a population of drug‐addicted offenders. DTC subjects who participated in treatment were significantly less likely to recidivate than were both untreated drug court subjects and control subjects. Policy Implications: Continued enthusiasm for DTCs is warranted. Both sanctions and treatment are important elements of the DTC model. However, DTCs will not necessarily result in cost reductions because DTC and control cases are incarcerated for approximately equal numbers of days. Implementation fidelity is important, and DTCs can be strengthened if they engage a higher percentage of their clients in drug treatment.     

Methamphetamine use in nonurban and urban drug court clients

Population-based surveys suggest that methamphetamine use and abuse may be rising in the United States. However, little is known about methamphetamine use in eastern sections of the United States, particularly nonurban areas. The purpose of the present study was (a) to explore reported methamphetamine use and its correlates among Kentucky drug court clients and(b) to determine whether differences exist between methamphetamine users by drug court location. Of the 500 drug court clients surveyed, approximately 32% n=161) reported lifetime methamphetamine use. Methamphetamine users and nonusers differed in their drug-use profiles, self-reported criminal history, and number of criminal offenses. Nonurban and urban methamphetamine users differed in their drug-use profiles, psychological functioning, self-reported criminal history, and number of criminal offenses. These results suggest that differences exist between these populations and clinicians, and criminal justice officials may need to consider these differences when planning treatment and rehabilitation strategies.     

Long-term effects of participation in the Baltimore City drug treatment court: Results from an experimental study

This study uses an experimental design comparing 235 offenders assigned either to drug treatment court or treatment as usual. It extends prior analyses of this study sample to examine whether differences observed between drug treatment court subjects and control subjects at one and two years after the start of the program persist after three years, when many of the subjects had ceased active treatment. Further, it extends earlier analyses that showed that the quantity of drug treatment court services received was related to lower recidivism rates by using an instrumental variables approach to handle the endogeneity problem that sometimes arises when subjects self-select into different levels of service. Results show a sustained treatment effect on recidivism, controlling for time at risk. This effect is not limited to the period during which services are delivered. Rather, it persists even after participation in the drug court program ceases. Results also show that the recidivism is lowest among subjects who participate at higher levels in certified drug treatment, status hearings, and drug testing. These positive findings are tempered with findings that more than three-fourths of clients are re-arrested within three years, regardless of participation in the drug treatment court, and that drug treatment court cases spend approximately the same number of days incarcerated as do control cases. Implications for strengthening drug treatment courts are discussed.     

A cognitive therapy treatment program for repeat DUI offenders

Driving under the influence is a devastating problem in the United States, killing almost 17,000 people in 2005. The present article describes a cognitive treatment program aimed at repeat drinking and driving offenders. Sixty-three participants were court mandated to the four-month outpatient treatment program. Before entering and after completing treatment, participants were administered self-report instruments measuring alcohol problems, readiness to change, self-esteem/efficacy, and criminal thinking patterns. Additionally, arrest histories were examined. Findings suggested that participants were characterized not only by repeated arrests, but elevated blood alcohol content and high levels of self-reported alcohol dependency and problem-drinking behaviors. The majority of clients expressed a readiness to change their drinking and driving behaviors with 87 percent graduating from the program. A DUI recidivism rate of 13 percent was found for graduates of the program at a twenty-one month follow-up. The results demonstrate that the treatment program is a valuable tool in the battle to reduce criminal recidivism.     

Professional attitudes regarding treatment and punishment of incest: Comparing police,child welfare,and community mental health

Brief case histories involving incest were presented to police officers, child welfare workers, and community mental health practitioners in a rural area in Canada. Intervention priorities involving “treatment versus punishment” were assessed across the three professional groups for each specific case vignette. Attitudes were assessed on three factors: perpetrator mentally ill rather than criminal, view regarding treatment of victims and mothers, and support for court mandated treatment. Police and community mental health practitioners had significantly different attitudes as to whether perpetrators of child sexual abuse should be viewed more as criminals or as mentally disturbed. Both mental health and child welfare staff differed significantly from police with a less punitive view towards victims and their mothers. All three profressional groups showed no difference in their modest endorsement of the use of mandated treatment by the courts. Gender was not found to influence response to case vignettes.     

The Juvenile Drug Court Judge and Lawyer: Four Common Mistakes in Treating Drug Court Adolescents

This article will present information gleaned from anecdotal experience of existing juvenile drug treatment courts regarding several common mistakes often made by those new to the drug court. The mistakes discussed include: 1) Believing the work and role responsibilities in a traditional juvenile court will not change significantly when entering a juvenile drug court; 2) Citing the elimination of drug and alcohol use as a final outcome goal when developing the mission statement for a juvenile drug court; 3) Believing that a juvenile drug court ensures accountability by keeping a close eye on participants and setting immediate consequences for any break in program rules; 4) Using vicarious learning to “teach a lesson”–making an example of an individual participant who has broken program rules in front of the large group. The goal of this article is not only to raise caution to these pitfalls, but also to help incoming judges and lawyers become aware of the changes that working in a juvenile drug court will demand.     

Defining a clinically useful model for assessing competence to consent to treatment

Burdened with the responsibility of making an initial assessment of their patients' capacity to make treatment decisions, clinicians need a sound clinical assessment model. Drawing on ethical, legal, and clinical sources, the author reviews the appropriateness of existing models and standards and describes why each fails the needs of the clinician. The patient's ability to form a therapeutic alliance is shown to be a valid assessment model for defining a treatment decision-making ability threshold because it adheres to widely accepted ethical and legal standards. Using threshold because it adheres to widely accepted ethical and legal standards. Using this model to set a threshold for the decision to bring cases to the attention of a court or administrative body, the therapist arrives at a satisfactory balance between competent treatment, patient autonomy, and judicially mandated due process imperatives while providing a forum for patient education and assessment of the clinician's technical skill. Explanations of case examples illustrate the use of the therapeutic alliance for this purpose in a variety of clinical situations. Specific recommendations are made on what may be represented to court in cases in which the patient's competence appears to fall below this treatment threshold.     

A Theoretical Model of Drug/DUI Courts: An Application of Structural Ritualization Theory

Past studies of Drug/DUI courts primarily focused on outcome evaluation and policy-driven issues, but lacked an effective theoretical framework for understanding drug court programs, in particular the interaction between the program and clients. In this study, we apply structural ritualization theory (SRT) to the Drug/DUI program and argue that such programs serve two key functions, to disrupt clients’ old rituals (e.g., drug/alcohol abuse, committing crimes), and to help lay a foundation for building new abstinent and noncriminal ritualized practices for clients both in and after the drug court program. We further argue that the effectiveness of drug program functions and services at the organizational level and the success of clients’ transformation at the individual level can be empirically measured and studied by four elements of SRT, including salience, repetitiveness, homologousness, and resources. Policy implications are drawn based on the contribution of SRT.     

Baseline subjective stress predicts 1-year outcomes among drug court clients

Psychological stress has long been known to predict negative changes in physical and behavioral health in the general population. The same relationships have been found in research on drug abusers. In this longitudinal study, 477 clients of two Kentucky drug courts were followed for 1 year to examine the relationship between subjective stress at intake and outcomes 1 year after the baseline of this 18-month drug court program. Greater baseline subjective stress was significantly associated with poorer employment, substance use, criminal justice, and health outcomes at 1-year follow-up, even after adjusting for selected demographic characteristics and baseline levels of the outcomes of interest. If these results are replicated in these and other drug courts, then a stress reduction treatment trial within the drug court context should be attempted and evaluated.     

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

A 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.     

Access to medicine and the dangers of patent linkage: lessons from Bayer Corp v. Union of India

In February 2010, the Delhi High Court delivered its decision in Bayer Corp v Union of India in which Bayer had appealed against an August 2009 decision of the same court. Both decisions prevented Bayer from introducing the concept of patent linkage into India's drug regulatory regime. Bayer appealed to the Indian Supreme Court, the highest court in India, which agreed on 2 March 2010 to hear the appeal. Given that India is regarded as a global pharmaceutical manufacturer of generic medications, how its judiciary and government perceive their international obligations has a significant impact on the global access to medicines regime. In rejecting the application of patent linkage, the case provides an opportunity for India to further acknowledge its international human rights obligations.     

A STUDY OF CLIENT SATISFACTION WITH FAMILY COURT COUNSELLING IN CASES INVOLVING DOMESTIC VIOLENCE

The Family Court of Australia provides conciliation counselling to couples who are involved in disputes regarding their children following separation. In situations where domestic violence has occurred, the appropriateness of providing counselling to such couples has been seriously questioned This study examines the experience of clients attending counselling at the family court. Two groups of clients are studied—one group who reports domestic violence as a significant issue and a comparison group who does not report domestic violence. The results indicate that the two groups do not differ in their expressed level of satisfaction with the counselling they have received and that both groups consider counselling to have been helpful in resolving their issues. The preliminary results of this study have implications for the provision of postseparation counselling/mediation to couples when domestic violence has occurred.     

The Influence of Administrative Law Judge and Political Appointee Decisions on Appellate Courts in National Labor Relations Board Cases

Scholars have long been simultaneously concerned with the factors that influence appellate court decision making and the level of deference that the courts allow for agencies. However, scholars have treated administrative agencies as unitary actors with a single level of decision making, but in reality agency decisions involve input from multiple actors within the agency. I argue that appellate courts rely more heavily on decisions made by actors in the bureaucracy with greater levels of expertise and who are less politically motivated as cues in their decision making. This theory is bolstered by legal precedent in the area of administrative law that suggests courts should more heavily rely on the expert judgment of administrative judges. Thus, as a result of their increased expertise, appearance of political neutrality, and institutional support, courts will be more reliant on decisions issued by administrative law judges (ALJs) than those issued by the political appointees as cues in their decision making. Using over 300 unfair labor practice decisions issued by the federal appeals courts on review of cases from the National Labor Relations Board (NLRB or Board), I develop a model of appeals court decision making in unfair labor practice cases as a function of the initial decision of the ALJ, the final order of the political appointees of the NLRB, case characteristics, the ideology of the deciding appeals court panel, Supreme Court influence, and economic factors. Though the ideology of the court plays a role in its decision making, cues from ALJ decision making and that of the Board weigh more heavily in appellate court outcomes. However, cues from ALJ decisions play the most consistent role in appellate court decision making, even in more difficult cases. This has important implications for agency strategy in courts and suggests that future research should consider the influence of lower‐level decision making over appellate court decision making in the area of administrative law.     

Court outcomes for clients referred to a community mental health court liaison service

Court liaison and diversion services come in a variety of forms, but the similarities and differences between these services are not well characterized. Findings from a six-year audit of the Newcastle (Australia) Mental Health Court Liaison (MHCL) service are reported, including client characteristics, offence and service contact profiles, court outcomes, and interrelationships among these variables. During the audit period, there were 2383 service episodes by 1858 clients (1478 males, 380 females). Drug and alcohol disorders (40.9%) and psychotic disorders (17.0%) were the most prevalent mental health problems, while assault (23.1%), theft (23.1%), offences against justice procedures (15.4%), driving offences (13.4%) and malicious damage to property (8.3%) were the most frequently recorded charges. Among service episodes with a finalized court outcome, 70.0% involved a punishment (bond: 49.5%; jail term: 29.7%). Females were less likely to be punished, but more likely to have their case dismissed under sections of the relevant Act that required further assessment and monitoring. Being married, or having an adjustment or drug and alcohol disorder, were also associated with an increased likelihood of punishment, while clients with a psychotic or bipolar disorder were less likely to be punished. Among clients who were punished, those referred from inpatient mental health services were more likely to receive a non-jail punishment, while unemployed clients were more likely to be jailed. A substantial proportion of clients had court outcomes that required an ongoing involvement with local mental health services. By being part of community mental health services, our MHCL service is able to work efficiently and effectively with the criminal justice system, while facilitating ready access to existing mental health services and continuation of care.