Transcript Powerpoint - NPC Research

Family Treatment Drug Court
National Evaluation
Overview & Phase I Preliminary Results
Beth L. Green, Ph.D.
Sonia Worcel, M.A., M.P.A.
Michael W. Finigan, Ph.D.
www.npcresearch.com
Presentation Overview
What are Family Treatment Drug Courts
(FTDCs)?
 Overview of National FTDC Evaluation
 Preliminary Phase I Results
 What Makes Drug Courts Work?
 Implications for Practice

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What are Family Treatment
Drug Courts?

AKA: Family Drug Courts, Family Treatment
Court, Family Dependency Drug Courts, etc.
 Family Treatment Drug Courts address the
needs of substance-abusing parents involved
with the child welfare system
 Goal is to increase positive treatment
outcomes and therefore increase probability
of successful reunification
 Maintaining safety and well-being of the child
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Key Service Components

Similar to Adult Drug Court:
– Increased judicial oversight
– Supportive but structured environment
– Integrated drug court team provides support &
wraparound services
– Accessible, appropriate treatment resources
– Relapse support

Differences from Adult Drug Court:
–
–
–
–
Predominantly women (85% or more)
“Threat” is different – termination of parental rights
Addresses family issues and child safety concerns
Successful treatment doesn’t necessarily mean
successful reunification
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Reasons for the FTDC Evaluation

Despite the huge increase in number of FTDCs, very
little research to date on FTDCs and their
effectiveness
– In 2006, 151 current FTDCs, many more being planned

Little is known about whether and how FTDCs work

With increased funding earmarked for FTDCs, federal
government is interested in the outcomes produced
by these courts

Also interested in how FTDCs work, and

Are FTDCs cost-beneficial?
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What is the FTDC National Evaluation?

A national evaluation funded by the Center for
Substance Abuse Treatment, conducted by
NPC Research, Portland, OR

Four FTDCs in the study: Santa Clara, CA;
San Diego, CA; Reno, NV; Suffolk, NY

Two primary phases
– Phase I: Historical (retrospective) administrative
data; comparison group largely “pre” FTDC
– Phase II: Larger study (n=2000), administrative
and interview data (on subset); comparison group
mostly from same time period of “unserved
eligibles”
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Four Sites With Different
FTDC Models

San Diego: System-wide reform; FTDC for
non-compliant parents
 Washoe: Traditional drug court model;
screens out severe MH, abuse allegations
 Suffolk: Neglect cases only, many children
not in out-of-home placements
 Santa Clara: Started as traditional drug court
model; changed to a system-wide model
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Phase1 Study Overview
50 drug court and 50 comparison cases
from each site (plus 50 SARMS cases
in San Diego) – total 450 families
 Some cases (primarily San Diego) were
pre-ASFA
 Data gathered from child welfare,
treatment, and court records
 Cases followed 5 years post-petition

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How Similar Were FTDC and
Comparison Group Participants?
No differences on most demographic
and risk-related variables
 FTDC participants less likely to be:

– Married, employed

FTDC participants more likely to have:
– Previous A & D treatment
– Infant children
– Children with more risk factors
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Expected Treatment & Child Welfare
System Outcomes

Treatment: Participants in FTDCs will
have:
– Decreased time to treatment entry
– Increased time spent in treatment
– Increased treatment completion

Child Welfare: Participants in FTDCs
will have:
– Decreased time to permanent placement
– Increased % reunified with parents
– Decreased child welfare recidivism
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Treatment Outcomes
Outcome
FTDC
Comparison Significant?
(p<.01)
Time to enter
Tx
73 days
181 days
YES
Days in Tx
302
184
YES
% Tx
episodes
completed
45%
34%
YES
Results based on regression models controlling
for demographic, risk and site variables. Sample
sizes vary due to missing data (n=334-397).
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Child Welfare Outcomes
Outcome
FTDC
Comparison Significant?
(p<.01)
Days to
permanency
360 days
435 days
YES
% Reunified
52%
41%
YES
% Subsequent
placements
10%
5%
NO
Results based on regression models controlling
for demographic, risk and site variables. Sample
sizes vary due to missing data (n=334-397).
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Summary of Site Differences

Treatment Results:
– 3 of 4 sites had consistently positive treatment
results, especially for treatment duration and
treatment completion

Child Welfare Results:
– Time to permanent placement only different for
site with pre-ASFA comparison group
– Reunification results positive for two sites using
more “traditional” FTDC models
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What Makes FTDCs Work?
Unpacking the “Black Box”
Research Question #1

What characteristics of the family drug
court process make a difference for
court, treatment and child welfare
outcomes?
– Time to enter FTDC
– Time spent in FTDC
– Graduation status
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Do Families Who Enter FTDC More
Quickly Have Different Outcomes?

YES: Enter treatment more quickly.
 YES: Enter permanent placement more
quickly.
 YES: Cas closure more quickly.
 BUT: How fast they enter FTDC not related
to:
– time spent in treatment,
– treatment completion, or
– type of permanent placement.
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Do Families Who Remain in FTDC
Longer Have Different Outcomes?
YES: More time spent in treatment
 YES: More likely to complete treatment.
 YES: Take longer to enter permanent
placements.


BUT: Not related to time to case closure
or likelihood of reunification.
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How are Graduates Different From
Non-Graduates?

Graduates (n=126); Non-Grads (n=63)
 Not different in:
– demographic or risk characteristics,
– How long it took them to begin FTDC or Tx
 Treatment predicts graduation: Parents
with longer treatment stays and who
completed treatment were more likely to
graduate.
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Do Families Who Graduate From
FTDC Have Different CW
Outcomes Than Those Who Don’t?

YES: Graduates:
– more likely to be reunified
– less likely to have parental rights
terminated,
• 80% of graduates reunified
• 21% of non-graduates reunified
• 44% of comparisons reunified
 BUT: Not related to time to case closure or
time to permanent placement
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Research Question #2

What characteristics of the treatment
process make a difference for child welfare
outcomes?
– Time to enter treatment
– Time spent in treatment
– Completing treatment
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Correlations Between Child Welfare
and Treatment Outcomes
Days to
Permanency
% Reunified
Subsequent
Placements
Time to Tx
.20**
-.12*
.04
Days in Tx
.24**
.18**
.01
Completed Tx
.01
.30**
.04
*Significant at p<.05
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**Significant at p<.01
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Summary Regression Results:
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
Are more likely to be reunified with parents.
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Is There a “Value Added” for FTDC in
Supporting Child Welfare Outcomes?


Clustered families with similar treatment
experiences to create “successful” and
“unsuccessful” groups
Analyzed whether child welfare results
were different for these groups of families
depending on whether they were FTDC or
Comparison
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Treatment Experiences & FTDC
Status Predict % of Children Reunified
100%
% children reunified
90%
86%
80%
70%
60%
63%
FTDC
Comparison
50%
40%
40%
30%
20%
10%
10%
0%
Successful Tx
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Unsuccessful Tx
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Timely entry
into FTDC, Tx
More days in
FTDC, Tx
More likely
to complete
Tx
For some,
shorter cases,
faster
permanency
Thus, longer
cases, longer
times to
permancy
More likely
to graduate
FTDC
More likely
to be
reunified
with children
Key Practice Issues for FTDCs

Data Suggest:
–
–
–
–

Identification and referral to FTDC quickly after petition
Helping parents access treatment quickly
Supporting successful Tx completion
Retaining parents until success is clear
Observations and Interviews suggest:
– Judicial monitoring and check-ins important
– Quality of relationship with judge important
– Quality of collaboration between child welfare, courts, and
treatment is critical -- communication
– Wrap around services critical
– Family connections & peer support
– Post-graduation support or connection

Key issue: How to ensure stability in placements
post-FTDC
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