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The Fundamentals of Family Drug Court

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. The Family Disease of Drug and Alcohol Dependence.

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The Fundamentals of Family Drug Court

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  1. 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

  2. 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

  3. “No Safe Haven” “A devastating tornado of substance abuse and addiction is tearing through the nation’s 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

  4. 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.

  5. 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

  6. 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”

  7. 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)

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

  9. 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.

  10. DRUG ADDICTION IS A COMPLEX ILLNESSBiologicalPsychologicalSociologicalAddiction Is No Longer Just a “Moral Problem”

  11. Co-Occurring Issues of Parents • Medical • Psychological • Legal • Social

  12. Your Brain After Drugs

  13. Does Treatment Work in Combating Substance Abuse? YES…but Not if the addict or alcoholic Isn’t there!

  14. Perceived Need & Effort Made to Receive Specialty Treatment2004 National Survey on Drug Use and Health: National Findings

  15. 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

  16. 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.

  17. 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

  18. Over 1,600 drug courts Drug Court Activity 1989-2004 12 drug courts 1 drug court: Miami, FL 1989 1994 2005

  19. Drug Court “Best Practices” Publications: Adult Criminal Drug Courts www.ojp.usdoj.gov/BJA/grant/DrugCourts/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

  20. 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.

  21. Unlike These Judges

  22. Drug Court Judges Find the Good in Those Who Can’t See it in Themselves

  23. 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.

  24. 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.

  25. 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

  26. 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

  27. Benefits of Drug Court: National, Statewide, and Local Evaluations Process and Outcomes

  28. 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

  29. 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

  30. 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.

  31. 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

  32. 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

  33. 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

  34. Significantly Less Criminal & CPS Recidivism Among FDTC Parents % of Parents Young, N.K., 2003. Findings from the FDTC National Cross-Site Evaluation Retrospective Phase

  35. San Diego County, Ca NPC Research: Green, Worcel, Finigan, 2006

  36. 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.

  37. B.K. Roche, Ph.D. Yellowstone Family Treatment Court Program Evaluation. June 2005

  38. B.K. Roche, Ph.D. Yellowstone Family Treatment Court Program Evaluation. June 2005

  39. B.K. Roche, Ph.D. Yellowstone Family Treatment Court Program Evaluation. June 2005

  40. B.K. Roche, Ph.D. Yellowstone Family Treatment Court Program Evaluation. June 2005

  41. B.K. Roche, Ph.D. Yellowstone Family Treatment Court Program Evaluation. June 2005

  42. B.K. Roche, Ph.D. Yellowstone Family Treatment Court Program Evaluation. June 2005

  43. Drug Courts Save Money “A state taxpayer’s return on the upfront investment in drug courts is substantial.” ”a county’s investment in drug court pays off.”

  44. 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

  45. 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 *

  46. 844 drug free babies in 2004!

  47. The Promise of Drug Court We can capitalize on the consequences of a petition / charge to intervene earlier in child maltreatment and the parent’s “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 family’s presenting problems and capitalize on their strengths.

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

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