Next Steps for FDTCs: Healthy Growth and Development Is Not Just ...

Next Steps for FDTCs:
Healthy Growth and
Development Is Not Just for
Children
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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3/26/2010

What Does the Research Tell Us?
Family Treatment Drug Court Evaluation
• Conducted by NPC Research
• Funded by the Center for Substance Abuse
Treatment, SAMHSA
• Final report is available on NPC’s website:
www.npcresearch.com
• Four Sites With Different FTDC Models
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3/26/2010

Sample Demographics and Case
Characteristics
• Over 75% of families in all sites were
unemployed
• Over 60% were single mothers
• Education leveled varied somewhat by site:
– San Diego: 45% less than HS education
– Santa Clara: 52% less than HS
– Suffolk: 26% less than HS
– Washoe: 56% less than HS
• Mothers ages ranged from 28-34,
• Average of 2 children per case
• Over 50% of families had at least one infant
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3/26/2010

Sample Demographics and Case
Characteristics continued
• Allegations
– Vast majority of cases had neglect allegations
(over 90%)
• Money Spent on Alcohol & Drugs
– At baseline, mothers spent an average of $98
on alcohol in the 30 days prior to the start of
their case (range of $3-$550)
– At baseline, mothers spent an average of $649
on drugs in the 30 days prior to the start of
their case (range of $20-$9,000)
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3/26/2010

Outcomes Summary
• Strong treatment findings:
– Drug court parents more likely to enter treatment, spend
more time in treatment, and complete treatment
• Longer time to permanent placement and case closure
for drug court parents could be explained by the
longer treatment stays
• Primary child welfare findings:
– Drug court children spend more time with parents during
the case and less time in out-of-home placements
– Drug court children more likely to be reunified with
children at the end of the case
– No differences in child welfare recidivism, but follow-up
period was short
• Court cases longer, but more compliance
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3/26/2010

Key Questions About FTDC
• Does how long it takes parents to enter
FTDC relate to outcomes (time spent in
treatment, treatment completion, and
reunification)?
• Does time spent in FTDC relate to
outcomes?
• Do the number of FTDC appearances relate
to outcomes?
• Does FTDC graduation relate to outcomes?
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3/26/2010

Variable
FTDC Experiences
and Treatment Outcomes
Statistically
Significant?
Nature of Relationship to
Treatment Outcomes
Time to FTDC entry
(petition to entry)
No
No relationship
Time spent in FTDC Yes Longer stays in FTDC are
related to longer stays in tx and
more tx completion
Number of FTDC
appearances
Yes
More FTDC appearances are
related to longer stays in tx and
more tx completion
FTDC graduation Yes Graduation is related to longer
stays in tx and more tx
completion
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3/26/2010

Treatment Experiences
and Reunification
Variable
(parent report)
Treatment access &
appropriateness
Frequency of meetings
with treatment
counselors
Statistically
Significant?
Yes
Yes
Nature of Relationship to
Reunification
The more accessible/ appropriate, the
greater the likelihood of reunification
The more meetings, the greater the
likelihood of reunification
Mothers who completed at least one treatment
episode are more likely to be reunified.
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3/26/2010

Court Observations
• Observations of both drug court and
regular court process suggest that there are
clear differences in the frequency and
consistency with which FTDC courts
provide:
– Emotional & Practical Support
– Accountability
– Monitoring
– Parent engagement in the process
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3/26/2010

Emotional and Practical Support
• Parents talked about how the drug court team, and in
particular the judge and the drug court-dedicated case
workers provide a support system.
“The drug court team and the drug court case worker have
helped me a lot. My first case worker, that wasn’t the drug court
one, didn’t spend much time with me, but my drug court case
worker always knew what was going on with me, and helped me
get what I needed to get my kids back.”
• Participants in drug court receive practical assistance.
Parents talked about:
– how the drug court helped get them housing and employment,
– helped with life improvement needs such as tattoo removal,
dentures and obtaining birth control.
• These practical and external supports helped to increase
parents’ sense of confidence and ability to make
improvements in their lives.
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3/26/2010

Accountability and Collaboration
• Parents also explained how frequent hearings and
attendance in drug court provided accountability for their
behavior because:
– “the team knows what’s going on with you and you get immediate
support for whatever is going on as soon as you need it.”
– “it’s helpful going every two weeks because things can come up
during that time, and in drug court these problems are addressed
quickly.”
• Frequent court attendance means that the judge and
others are well informed about the parents’ cases and able
to provide appropriate support for recovery and other
issues facing the parent.
“(attending drug court regularly) helps you feel less
alone, that someone knows what’s going on in your life
and the all the issues that you face, they know how to
support you and what you need.”
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3/26/2010

Sense of Accomplishment
• Parents who graduated from drug court spoke
eloquently about the significance of graduation.
Parents discussed how graduation from drug
court gave them a sense of accomplishment,
some for the first time in their life.
“It (graduation) was great. Everyone applauded for me, I
got a hug from the Judge, and they gave me flowers. I felt
like a beauty queen. I also felt that my graduated meant
that I finished something I started, and this is the first
time I ever accomplished something like this in my life.
Now I feel like I can succeed in life.”
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3/26/2010

Judicial Characteristics
• Drug court team members described the judicial
characteristics they believed to be related to
successful drug court experiences, such as:
– Being consistent, straightforward, and clear decisionmakers
– Judges who have these characteristics help clients
know what to expect and help keep clients
accountable.
• It is also important to drug court team members
that the judge be an active member of the drug
court team, which in turn encourages the
collaborative nature that is so important to
FTDCs.
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3/26/2010

Barriers to Parent’s Progress
• The two major barriers to success
identified in the parent interviews and
confirmed in the courtroom observations
are:
– When parents lacked needed support
– When there was an absence of collaboration
between the team members.
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3/26/2010

Putting It All Together:
What Have We Learned?
• Data strongly support the effectiveness of the FTDC
model in improving both treatment and child welfare
outcomes; “traditional” FTDC models may be most
effective
• FTDC influence on outcomes goes beyond simply
improving treatment completion rates
• Retention of families in FTDC programs is important
to success
• Quality of treatment provided is important to success
• FTDC influence on child welfare recidivism needs
additional data and research
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3/26/2010

NDCI Technical Assistance
Building Program
Capacity
Client Termination
Criteria
Development of
Ancillary Services
Incentives and
Sanctions
Program
Development
Review of Program
Design
Targeting /
Eligibility Criteria
Case Processing & Child
Protection Practices
Clinical Case
Management
Drug Testing
Maintaining Compliance
with ASFA & ICWA
Mandates
Program Sustainability
Roles & Responsibilities
Team Building and
Strategic Planning
Clarifying & Improving
the Scope of Family
Interventions
Cultural Proficiency
Family Reunification,
Recovery Planning and
Visitation
MIS Evaluation
Review of Effective
Treatment Design &
Practices
Screening / Assessment
Team Member Turnover &
Training of New Team
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3/26/2010

Working within a Parallel Universe
The Court and the Participant
• The creation of a drug
court may be scary; we
won’t know the outcomes
until we are well into it
• We come together to work
with people we may not
know, or may not have
worked with before
• We risk our time, our
reputation, and may give
up part of our turf in
approaching things in a
new way
• Committing to
participate in a Family
Drug Court is scary;
they do not know what
the outcomes will be
• They must work with
people they do not
know, and do not know
if they can like or trust
• They risk their time,
relationships, and entire
life style to change
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3/26/2010

Giant First Steps
• The community comes
together to identify
and assess the need for
change in treatment of
Substance Abusing
Parents with at-risk
children
• Protocols and written
policies are created to
keep the Team on
task, and to be able to
measure success
Th
e
piece
s
start
• A problem with
substance abuse is
identified, and the
parent is evaluated
for appropriateness
for this program and
safety of child
• Policies and
handbooks spell out
for the client what is
expected
to
com
e
togethe
r
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3/26/2010

Accountability Is for Everyone
• Weekly Staffings and
court appearances
ensure that services
are provided and are
working for parents
and children
• All Team members
hear the same
information at the
same time
• Feed-back comes
quickly when an
opportunity is missed,
or when success
occurs
• Progress is recorded
in Court, a very
public forum, within
short parameters
• Immediate impact on
progress in the
family plan is known
by all at the same
time - team members
and other participants
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3/26/2010

Learning
and
Growing
• The Team begins
recognizing
approaches that work,
resources that best fit,
and becomes more
confident in its work
• Team members
develop knowledge of
disciplines beyond
their own, and comfort
in their decision -
making
• The participant often
takes several steps
forward, and some
steps backward in
this journey
• They become more
confident in their
daily lives and make
decisions about their
future which takes
them out of their
original comfort zone
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3/26/2010

Playing Nice in the Sandbox
• Learning to challenge
thinking of others/
selves
• Forming
• Storming
• Norming
• Performing
• Learning to
negotiate/advocate
with authority figures
and systems
• Phase 1
• Phase 2
• Phase 3
• Phase 4
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3/26/2010

Celebrating Success
• Taking inventory of
our progress
• Informing the
community and
stakeholders
• Celebrating publicly
and privately
• Celebrate themselves
• Inform family
• Educate community
• Role-model for other
participants and
potential clients, and
their children
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3/26/2010

Building for Longevity
• Create a sustainable
system via:
• Written procedures
• Evaluations, reviews
and participant
surveys
• Retreats and new and
advanced trainings
• Eternal vigilance:
“One day at a time
for the rest of your
life”
• Support systems
• Respite and
education
• Alumni and
mentoring programs
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3/26/2010

The Lindner Case:
Sarah and Tom Lindner were married for 15 years and are now
separated. They have 5 children, now all in Foster Care due to the
drug and alcohol use of both parents. The children range in age
from 13 to 3 years of age; the youngest child is not Tom’s
biological child, but was accepted and raised by him and Sarah
until Child Protective services had to remove the children due to
extreme neglect, including failure to thrive of the youngest. The
children have been in care for 12 months, and both parents want
the children returned to them. Sarah is in drug court, but Tom is
proceeding on a regular child neglect petition, and saying that he
does not need the support of the FDTC. Sarah has complied as
best she can, but has some serious mental health issues around
chronic depression. Tom is complying with his court order, but is
not supportive to Sarah at all. The children want to be reunited as
a family, but get only 1 hour’s visitation per week with only one of
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3/26/2010

Discussion Points:
• How should ASFA timeframes be dealt
with?
• How do you decide which is the better
parent?
• What, if any, are barriers to reunification,
and how do you address them?
• What is the role of the Dependency Court
in this matter.
• What other systems need to be reviewed,
as a result of this case, if any?
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3/26/2010

NDCI Technical Assistance
Building Program
Capacity
Client Termination
Criteria
Development of
Ancillary Services
Incentives and
Sanctions
Program
Development
Review of Program
Design
Targeting /
Eligibility Criteria
Case Processing & Child
Protection Practices
Clinical Case
Management
Drug Testing
Maintaining Compliance
with ASFA & ICWA
Mandates
Program Sustainability
Roles & Responsibilities
Team Building and
Strategic Planning
Clarifying & Improving
the Scope of Family
Interventions
Cultural Proficiency
Family Reunification,
Recovery Planning and
Visitation
MIS Evaluation
Review of Effective
Treatment Design &
Practices
Screening / Assessment
Team Member Turnover &
Training of New Team
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3/26/2010