Transcript Action Research

Evidence-Based
Practices in Adult
Drug Court
Melissa Labriola, Ph.D.
Center for Court Innovation
([email protected])
Questions About Drug Courts?
 Do Drug Courts Work?
 For Whom do Drug Courts Work?
 Why do Drug Courts Work?
Evidence-Based
Practices
Do Drug Courts Work?
Documented Results
 Recidivism:
 Almost 100 evaluations of adult criminal drug courts
 Most reduce recidivism (about 4 of every 5 programs)
 Average recidivism reduction = 8-12 percentage points
 Drug Use:
 All evaluations (five) show reductions in drug use
 Several studies show larger effects on serious drug use
(e.g., heroin or cocaine) than on marijuana use
 Cost Savings: Multi-site studies all show savings,
mainly from reductions in recidivism and incarceration
Reduced Recidivism
Percent with Criminal Activity:
One Year Prior to 18-Month Interview
100%
Drug Court (n = 951)
Comparison (n = 523)
80%
60%
53%
40%*
40%
50%
36%**
20%
0%
Criminal Activity
+ p < .10 * p < .05 ** p < .01 *** p < .001
Source: Rossman et al. (2011)
Drug-Related Activity
Why Do Drug Courts Work?
Positive
Outcomes
Evidence-Based
Principles
• Treatment
• Reduced Recidivism
• Deterrence
• Reduced Drug Use
• Procedural Justice
• Cost Savings
• Staff/Collaboration
Target
Population
• Risk Level
• Leverage
• Treatment Need
Target Population
 Risk Level (higher-risk)
 Leverage (higher-leverage)
 Addiction Severity (“Clinical Need”):
 Larger effect with primary drug other than marijuana
 Clinical need may influence type/intensity of treatment
 Demographics: Age, sex, and race/ethnicity
 Motivation: Offenders who present with greater
interest or readiness-to-change at baseline
Why Do Drug Courts Work?
Positive
Outcomes
Evidence-Based
Principles
• Treatment
• Reduced Recidivism
• Deterrence
• Reduced Drug Use
• Procedural Justice
• Cost Savings
• Staff/Collaboration
Target
Population
• Risk Level
• Leverage
• Treatment Need
Risk Need Responsivity (RNR)
1. Risk Principle: Who to Treat? Medium- to High-Risk
2. Need Principle: What to Treat? Criminogenic needs
(and problematic non-criminogenic needs, e.g., trauma)
3. Responsivity Principle: How to Treat? Cognitive-
behavioral therapy (CBT) tailored to the needs, learning
style, motivation, and other attributes of the offender.
The “Central Eight” Factors
1. History of criminal behavior
2. Antisocial personality/temperment
3. Antisocial peers/associates
The
“Big Four”
4. Criminal thinking
5. Family or marital problems
6. School or work problems
7. Lack of pro-social leisure/recreational activities
8. Substance abuse
What About Other Needs?

Non-Criminogenic Needs

Examples:
 Trauma
history
 Depression,
 Low
self-esteem
 Medical

anxiety, and other mental health disorders
needs
Why Assess and Treat:
 Ethical
reasons (affect individual well-being)
 Can
interfere with treatment for criminogenic needs
(trauma especially should be treated simultaneously)

Low Collective Efficacy (Neighborhood-based)
Treatment Implementation

Treatment Group Size (ideally < 12 per group)

Sensitivity to Risk Level (separate groups by risk)

Dosage (100 hours medium-risk, 200+ hours high-risk)

Manualized Curricula (written lesson plans)

Fidelity to Curricula:

Frequent staff training and retraining (e.g., on CBT)

Regular staff observation/debriefing/supervision
Why Do Drug Courts Work?
Positive
Outcomes
Evidence-Based
Principles
• Treatment
• Reduced Recidivism
• Deterrence
• Reduced Drug Use
• Procedural Justice
• Cost Savings
• Staff/Collaboration
Target
Population
• Risk Level
• Leverage
• Treatment Need
Leverage: Drug Court Results
 High-leverage target population (felony)
 Policies to maximize leverage:
 Post-plea model (10% effect size)
 Jail/prison alternative set in advance AND alternative
always imposed on those who fail (10% effect size)
 Practices to maximize perceptions of leverage:

More staff note consequence of failing

More staff note that consequence of failing will be severe

More times that participants must promise to comply
Clear reminders given early and often!!!
Sanctions: 86-Site Findings
 High level of certainty (imposed in every case)
 Certainty more important than severity (use of
jail for first infraction did not improve outcomes)
 Formal sanctions schedule (aids expectations)
Source: Cissner et al. (2013)
Positive Incentives/Rewards


General Themes:

Incentives should be certain and frequent (like sanctions)

Consider developing an incentives schedule
Fishbowl Method:

Bowl with incentives, some certificates and some cash
value (e.g., gift certificates, movie tickets, etc.)

Call up participants to dip into bowl for set milestones

Okay for many/most incentives to be non cash value
Why Do Drug Courts Work?
Positive
Outcomes
Evidence-Based
Principles
• Treatment
• Reduced Recidivism
• Deterrence
• Reduced Drug Use
• Procedural Justice
• Cost Savings
• Staff/Collaboration
Target
Population
• Risk Level
• Leverage
• Treatment Need
Procedural Justice: Examples
 Voice:


You felt you had the opportunity to express your views in the court.
People in the court spoke up on your behalf.
 Respect:
 You felt pushed around in the court case by people with more power.
 You feel that you were treated with respect in the court.
 Neutrality:
 All sides had a fair chance to bring out the facts in court.
 You were disadvantaged…because of your age, income, sex, race…
 Understanding
 You understood what was going on in the court.
 You understood…your rights were during the processing of the case.
Research Findings

Compliance: Increases compliance with court orders
and reduces future crime (e.g., Lind et al. 1993; Tyler and Huo 2002)

Procedure v. Outcomes: More influential than
perceptions of the outcome (win or lose) (Tyler 1990; Tyler & Huo 2002)
 Aid to Deterrence: Complements deterrence by
reducing perceptions of unfair consequences

Rectifies Inequality: Effect is greater among those
with negative views at baseline (e.g., black offenders)
 Role of the Judge: Greatest influence on overall
perceptions (Abuwala and Farole 2008; Lee et al. 2013; Frazer 2006; Rossman et al. 2011)
The Judge: Drug Court Results
 Offender Perceptions: Perceptions of judge were a
key factor in reducing crime and drug use (Rossman et al. 2011)
 Observed Judicial Demeanor: Drug courts
produced greater crime and drug use reductions when
the judge was rated as more respectful, fair, attentive,
consistent, caring, and knowledgeable (Rossman et al. 2011)
 Role of Time: Significantly greater impact when
judge averaged > 3 minutes/hearing (Carey et al. 2012)
 Conclusion: It’s not just about having judicial status
hearings but their content (see also Goldkamp et al. 2001; Cissner and Farole 2005)
Additional Content Tips
 Time: Target > 3 minutes/hearing (average & median)
 Session Participation: Mostly judge and participant
 Response to Compliant Report: Target = praise
 Judicial Interaction:
 Judge talked directly to defendant (not via attorney)
 Judge asked non-probing questions
 Judge asked probing questions
 Judge imparted instructions or advice
 Judge explained consequences of future compliance
 Judge explained consequences of noncompliance
Why Do Drug Courts Work?
Positive
Outcomes
Evidence-Based
Principles
• Treatment
• Reduced Recidivism
• Deterrence
• Reduced Drug Use
• Procedural Justice
• Cost Savings
• Staff/Collaboration
Target
Population
• Risk Level
• Leverage
• Treatment Need
Staff/Collaboration: Research
 Staff Skills::
 Experience (1+ year working with criminal population)
 Stability (2+ years in position)
 Supervision (receive regular supervision)
 Buy-in (opportunity for input into program policies)
 Operational Leadership: Program has convener
and respected and knowledgeable leader.
 Collaboration:
 Treatment attends team meetings and court
(Carey et al. 2012)
 Prosecutor and defense attorney participate
(Cissner et al. 2012)
Resources: Web Sites
 National Institute of Justice: http://www.nij.gov/nij/topics/courts/drug-courts/welcome.htm
 Research to Practice (R2P) Project: http://www.research2practice.org/index.html
 National Association of Drug Court Professionals:
 General Page:
http://www.nadcp.org/
 Evidence-Based Standards:
http://www.nadcp.org/Standards
 Drug Court Clearinghouse at American University:
http://www.american.edu/spa/jpo/drug-court-clearinghouse.cfm
 Center for Court Innovation:
 General Drug Court Page:
http://www.courtinnovation.org/topic/drug-court
 Training and Technical Assistance: http://www.nadcp.org/