1. Douglas B. Marlowe, J.D., Ph.D., FCPP
Targeting & Best Practices for Treatment Courts
Douglas B. Marlowe, J.D., Ph.D., FCPP

2. Annals of Research and Knowledge (ARK)
4/1/2014
Dispositional Continuum
Treatment / Public Health
Emphasis
Functioning of the individual
Punishment / Public Safety
Emphasis
Risk of recidivism
Cost to taxpayers
l--- Treatment Courts ---l
Pre-plea diversion
Post-plea diversion
Sentence to incarceration
Sentence to restrictive intermediate punishment (IP / RIP)
Sentence to probation or community supervision
Decriminalization/
medicalization
De-felonization

3. Risk Principle Not a risk for violence or dangerousness
Difficult or complicated prognosis
The higher the risk level, the more intensive the supervision and accountability should be, and vice versa
Mixing risk levels is contraindicated

4. Prognostic Risk Factors
Current age < 25 years
Delinquency onset < 16 years
Substance abuse onset < 14 years
Prior rehabilitation failures
Prior convictions or incarcerations
Antisocial Personality Disorder
Family history of crime or addiction
Criminal or delinquent peer affiliations

5. Prognostic Risk Tools Level of Service Inventory—Revised (LSI-R)
Level of Service Case Management Inventory (LS/CMI)
Correctional Offender Management Profiling for Alternative Sanctions (COMPAS)
Ohio Risk Assessment System (ORAS)
Risk and Needs Triage (RANT)
Risk Prediction Index (RPI)
Static Risk Tool
Wisconsin Risk & Need Assessment (WRN)
Federal Post Conviction Risk Assessment (PCRA)

6. Violence Risk Tools Historical, Clinical, Risk Assessment-20 (HCR-20)
Psychopathy Checklist- Revised (PCL-R)
Static-99
Spousal Assault Risk Assessment (SARA)
Sexual Violence Risk-20 (SVR-20)

7. Need Principle
Clinical disorders or functional impairments (diagnosis)
The higher the need level, the more intensive the treatment and rehabilitation services should be, and vice versa
Focus on criminogenic and responsivity needs first (especially addiction & mental illness)
Mixing need levels is contraindicated

8. Addiction and Mental Illness
Neurological or neurochemical brain disorders
Chronic, relapsing and progressive (worsen without treatment)
Worsen if punished for “distal” infractions, such as substance use
Worsen if not punished for “proximal” infractions, such as lying, treatment absences, or tainted urine specimens

9. Risk & Need Quadrants High Risk Low Risk High Need Low Need Treatment
Court
Treatment
Deferral
High Need
Intensive
Probation
Banked
Probation
Low Need

10. Treatment Court Case Likely to be in the community
Likely to recidivate or fail in treatment
Severe mental illness or substance dependence
NOT Empirically Relevant:
Drug dealing or violence charge / history
Motivated for treatment; good attitude
Failed treatment or probation previously
Unproven nexus between drug use and crime

11. Program Planning
15 times greater cost benefits }

12. Annual Staff Training
Five times greater cost benefits }

13. Evaluation
Four times greater cost benefits }

14. Judicial Assignments
Three times greater cost benefits }

15. } Team Functioning Twice the cost benefit
Judicial Officer, Prosecutor, Defense Attorney,
Treatment Provider, Probation Officer, Coordinator

16. Sentencing Reform
Require risk & need assessment before disposition (especially for felonies, serious misdemeanors, & probation/parole revocations)
Use immunity
Valid, reliable, & culturally unbiased instruments
Non-specialized risk tools may not be used to inform in/out decisions (expedited review)
Require professionals to consider risk and need in certain cases (expedited review)

17. Sentencing Reform (cont.)
Require professionals to consider effectiveness and cost-effectiveness (return rehabilitation to forefront of sentencing)
Require SAC to publish recidivism rates and costs of alternative dispositions
Include dispositional rationale on the record
Restrictive basis for appeal (abuse of discretion; clearly erroneous)
Publish data on dispositional decisions (blinded?)

18. Treatment Court Standards
As a condition of funding and accreditation, require treatment court teams (and other programs) to:
Attend pre-implementation and annual trainings
Report data annually on adherence to best practices
Develop and evaluate remedial plans for deficiencies
Target high risk and high need cases
Develop alternative tracks/programs for other cases
Apply graduated sanctions for distal infractions (right of interlocutory review)
Prioritize criminogenic and responsivity needs