1. 1 The Fundamentals of Family Drug Court 2007 Drug and DUI Court Conference Wyndham Peachtree Conference Center Peachtree, GA Presented by Meghan M. Wheeler, Project Director National Drug Court Institute (NDCI)

2. 2 The Family Disease of Drug and Alcohol Dependence Children COA Roles Family Norms Neglect and abuse Biologic vulnerability Grandma/Extended Family Drug/alcohol dependence and codependence Father Drug/alcohol dependence and codependence; COA issues Mother Drug/alcohol dependence and codependence COA issues Pregnancy complications Fetus/Infant Fetal factors Intrauterine toxicity Neonatal toxicity / withdrawal Increased muscle tone Neglect/abuse

3. 3 “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, 1999 Joseph A. Califano, Jr., Chair and President The National Center on Addiction and Substance Abuse at Columbia University “No Safe Haven”

4. 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 12 th graders, 26% of 10 th graders and 14.1% of 8 th graders binge drinking in the past month.

5. 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. 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. 7 Future Implications for Child Victims Short Term: Re-occurrence of Victimization (2X) Out of Home Placements Poor School Performance / Behavior Problems –30% of 12 th graders, 26% of 10 th graders and 14.1% of 8 th 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. 8 The Impact of Child Neglect Child Trauma Academy (www.ChildTrauma.org) led by Bruce D. Perry, M.D., Ph.D.www.ChildTrauma.org

9. 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. 10 DRUG ADDICTION IS A COMPLEX ILLNESS Biological Psychological Sociological Addiction Is No Longer Just a “Moral Problem”

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

12. 12 Your Brain After Drugs

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

14. 14 Perceived Need & Effort Made to Receive Specialty Treatment 2004 National Survey on Drug Use and Health: National Findings

15. 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. 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. 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. 18 1 drug court: Miami, FL 1989 1994 12 drug courts 2005 Over 1,600 drug courts Drug Court Activity 1989-2004

19. 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. 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. 21 Unlike These Judges

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

23. 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. 24 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. FDTC Characteristics

25. 25 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 FDTC Characteristics

26. 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. 27 Benefits of Drug Court: National, Statewide, and Local Evaluations Process and Outcomes

28. 28 Participant Response To the Judge and the Court Hearings 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. 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. You get to speak if you need to. I believe I am respected and my opinion is heard. I believe I am respected and my opinion is heard. It is not intimidating It is not intimidating Coming in and seeing other people making movement and having their kids with them. Coming in and seeing other people making movement and having their kids with them. I am treated as a human rather than an addict I am treated as a human rather than an addict To CPS To CPS Got to know her and ending up liking her Got to know her and ending up liking her She is honest and trustworthy She is honest and trustworthy She is courteous, positive, respectful, encouraging, friendly She is courteous, positive, respectful, encouraging, friendly She's easy to contact, and is available if I have any questions She's easy to contact, and is available if I have any questions I feel that she works with me I feel that she works with me

29. 29 National Cross Site Evaluation The relationship between drug court factors and outcomes 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. 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 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. 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 NPC Research: Green, Worcel, Finigan, 2006

30. 30 National Cross Site Evaluation: Relationship of Treatment Experience to CW Outcomes Parents entering TX faster: Parents entering TX faster: Stay longer in treatment Stay longer in treatment More likely to complete treatment More likely to complete treatment Enter permanent placement more quickly & reach case closure more quickly Enter permanent placement more quickly & reach case closure more quickly Parents remaining in TX longer: Parents remaining in TX longer: More likely to complete treatment More likely to complete treatment Take longer to reach case closure. Take longer to reach case closure. Parent completing TX Parent completing TX More likely to graduate from FTDC More likely to graduate from FTDC Take longer to reach permanency, Take longer to reach permanency, Have longer cases, BUT Have longer cases, BUT Children are more likely to be reunified with parents. Children are more likely to be reunified with parents.

31. 31 Retrospective FDTC Evaluation 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 Young, N.K., 2003. Findings from the FDTC National Cross-Site Evaluation Retrospective Phase

32. FDTC Children Reach Permanent Placement 3 Months Sooner Have 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. 35 Outcome Variable Tier 1 & Tier 2 Cases Compariso n Cases Mean days from petition to date of permanent placement 290555 Percent of children reunified with original parent 37%31% Percent of cases with Termination of Parental Rights 30%38% Percent of Parents with a Treatment Entry 71%54% Mean days to Treatment Entry60245 Mean total days in Residential Treatment 2845 Mean total days in Outpatient Treatment 12557 Percent of cases closed in less than 24 months 47%12% San Diego County, Ca NPC Research: Green, Worcel, Finigan, 2006

36. 36 Yellowstone County, MT Children spent 1,002 days less in out-of-home care than the children in the comparison group. 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. 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. 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. 30.8% of the cases in YCFDTC the parents relinquished their parental rights compared to 0% of the comparison group doing so.

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

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

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

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

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

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

43. 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. 44 Cost Benefit of Drug Court Analysis of Foster Care Cost Yellowstone County, MT: $ $1,280,100 saved in foster care costs alone B.K. Roche, Ph.D. Yellowstone Family Treatment Court Program Evaluation. June 2005 *

45. 45 Cost Benefit of Drug Court Analysis of Foster Care Cost San Diego, Ca: $1.8 million saved in foster care costs alone * NPC Research, 2004. Findings from the FDTC National Cross-Site Evaluation Retrospective Study

46. 46 844 drug free babies in 2004!

47. 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. 48 For More Information National Drug Court Institute (NDCI) 703-575-9400 or www.ndci.org Mwheeler@ndci.org