Transcript Effective Strategies in Juvenile Drug Courts: Research and Best

Juvenile Drug Courts (Part I):
Creating a Phase Structure that Makes
Sense for Youth and Families
Sandra J. Altshuler, Ph.D., L.I.C.S.W.
Spokane County Behavioral Health Therapeutic Courts
With thanks to
Jacqueline van Wormer, Ph.D.
Washington State University
and
NATIONAL COUNCIL OF JUVENILE AND FAMILY COURT JUDGES
S
This I Believe
I believe juvenile drug court
teams and professionals are
strengthened, enlightened, and
reinvigorated when I provide
valuable training, technical
assistance, and resources,
which improves their
knowledge level and ability to
maintain fidelity to the
preferred model, which, in
turn, may increase positive
outcomes for youth and
families in their community.
Learning Objectives
S Participants will review briefly the need for diversion programs for
juveniles and the research on Juvenile Drug Courts (JDCs).
S Participants will review and discuss proper phase structures in JDCs.
S Participants will learn about JDC Incentives and Sanctions that DO
and DO NOT work to promote positive behavior change in youth.
S Participants will learn about contingency management (CM) and its
use in JDCs for adolescent’s substance abuse and use.
S Participants will learn how to develop behavior and activity contracts.
Overview
Juvenile Drug Courts: Why and How
S
Why We Want to Use
Alternatives
Probation/court monitoring, group homes, and correctional
facilities have, at best, only modest favorable effects on subsequent
recidivism. Some studies show negative effects (Lipsey and Cullen,
2007; Petrosino, Turpin-Petrosino, and Guckenburg, 2010).
Deterrence-oriented programs that focus on discipline, surveillance,
or threat of punitive consequences (e.g., prison visitation Scared
Straight–type programs, boot camps, and intensive probation
supervision) have no effect on recidivism and may actually increase
it (Lipsey, 2009).
Because…
“Therapeutic” programs oriented toward facilitating
constructive behavior change have shown very positive
effects—even for serious offenders (Lipsey, 2009; Lipsey and
Cullen, 2007; Lipsey and Wilson, 1998).
Are juvenile drug courts
effective?
Yes! But not always….
Depends on how (and if) they
implement the model
7
Are juvenile drug courts effective?
S Early research:
S Small samples and poor designs.
S Negative effects found by Hartmann & Rhineberger (2003);
S No effects on recidivism found by Wright and Clymer
(2001); Anspach et al., (2003)
S Positive Findings:
S Lutze & Mason (2007); Latessa et al (2002), Rodriguez &
Webb (2004), Shaffer et al., (2008) Hickert (2010),
Hennegeler (2006, 2012), NPC Research (2006, 2010)
S Latessa report (2013)
S Meta-Analysis:
S Null-findings for both Wilson et al (2006); Shaffer (2006)
S Small effect size – Mitchell et al (2012)
National Academy of Science
(2012)
Juvenile justice programs are more likely to have a positive impact
when they:
S Focus on high-risk offenders
S Connect sound risk/needs assessment with the treatment approach
taken
S Use a clearly specific program rooted in a theory of how adolescents
change
S Are tailored to the particular offender, demonstrate program integrity,
S Involve the adolescent’s family, and take into account community
context
New Key Findings
S To strengthen outcomes:
S Engage families
S Attend court & active involvement
S Support group method
S Engage entire family in services if able
S Adopt evidence-based treatment practices
S Utilize contingency-management procedures
S Evaluate and continually monitor team for adherence to 16
Strategies in Practice. Follow the model!!
Creating a
Responsive Phase Structure:
Making it Make Sense
S
Can We Strengthen Our Court
Sessions to Bring About Stronger
Behavior Change?
S What do youth behaviors look like during
phase one?
S How do you want them to look by phase four?
The Teenage Brain
It begins with the phase
structure
Phase Two
Phase One
Phase Three
Phase requirements for youth and family should start out small, increase, and
then decrease again after the youth work through treatment and court related
goals.
Phase Structure
Source: Betty Gurnell
Phase I: setting
the stage
Phase II: learning Phase III:
skills
maintaining the
change
Readiness and engagement
Involvement, stabilization
Reflection, enrichment
Focus on compliance
Beyond compliance
Maintain drug testing, court
appearance
High level of structure
Skill development
Expanded development
activities
Clarifying expectations,
building trust
Completing assignments
Enriching community
connections
The Four Steps in
Addressing Problem Behaviors
S Identify (define) the targeted behavior
S Identify (define) the current behavior
S Identify (define) the desired behavior
S Use small, achievable increments
Decision Matrix – Phase I
Behavior
Incentives
Attend school at least • Teacher signs
?? out of 20 days
attendance card each
day present and
acknowledges
•Small prize or coupon
for each week with no
absences
Sanctions
• After school study hall
for each day absent
over the limit to make
up all missed work
Decision Matrix – Phase II
Behavior
Attend regularly
Complete all
assignments
Incentives
•Select a book ,
notebook, pen after
two weeks of success
•Praise from teacher,
family, court
•Grades improve
Sanctions
•After school study
hall to complete
assignments (with
help as needed)
Decision Matrix – Phase III
Behavior
Attend regularly
Complete all
assignments
Improve grades
Incentives
Sanctions
•Praise from teacher,
family, court for
improvement
•Certificate of
achievement
•Select school related
gift: tuition, book
•Determine if tutor is
needed
•Attend extra class
or session for help
•Tighten curfew
What do we mean by individual
responses?
Comprehensive
Treatment Planning
Educational Linkages
Gender-Appropriate
Services
Cultural Competence
Family Engagement
Developmentally
Appropriate
Services
Focus on Strengths
Goal-Oriented
Incentives and
Sanctions
7 (Easy) Steps to Individualizing
Your Juvenile Drug Court
Start with…
1. Screening and assessment
And
2. Use the results to drive case planning
So we can…
3. Emphasize individualized responses over generic, pre-determined requirements
Which should help us…
4. Work with youth and families to provide input into the process (and get more buy-in)
And
5. Focus on strengths
And
6. Create lasting educational linkages
And
7. Develop individualized incentives and sanctions
Example of a Predetermined
Phase One
Phase I
Court
Appearance
Requirements
Expected
Duration
1 per week

2 Months
3 Individual sessions per week (one of
which will be substituted for a family
session – one per month)
 2 Group sessions per week
 3 AA meetings per week
 Random urinalysis, 2-3 per week
 Attend school daily / no referrals / active
participation
 Abide by court-ordered curfew
 Start a Journal
For advancement to Phase II – completion of
all Phase I assignments and 60 days of
consecutive, CLEAN urinalysis testing.
Orientation
Develop a structure that promotes
individualized case planning.
Court
Appearance
Requirements
1 per week

Youth/caregiver and team work to set goals
and develop a treatment and case plan (based
on the assessment) before the youth moves into
Phase II (Engagement)
 As measured by # / % treatment / case
plans developed

Follow a random urinalysis, 2-3 per week
 As measured by # / % followed UA
schedule

Youth/caregiver and team work to set
attainable school/work related goals
 As measured by # / % attainable goals
set
Expected
Duration
Based on
completion of
case plans
and goals
Engagement
Develop a structure that promotes
individualized case planning.
Court
Appearance
Requirements
1 per week

Engage in treatment and case plan. Demonstrate
progress, as measured by:
 # / % behavior contracts completed based
on treatment, case, and school plans

Engage in providing negative UAs according to
the UA schedule
• As measured by:
• # / % followed UA schedule
• # / % dropping clean UAs

Engage in pro-social activities as approved by the
JTDC team and self-selected by youth/caregivers.
 As measured by:
 # / % pro-social activities attended
Expected
Duration
Consider
using points
or a token
economy to
measure
progress,
rather than a
fixed
duration of
time.
Albuquerque, New Mexico
S One of 12 Learning Collaborative sites funded by
NCJFJC/OJJDP
S Engaged in full application of 16 Strategies, use of data to
drive program and adoption of standardized screening.
S Entails intensive support to restructure program to align
with best practices
Albuquerque, New Mexico
S 1st step: Surveyed youth re: what they wanted from the JDC
S 2nd step: To restructure phases to be more responsive to
youth and families
S Removed the “checklist” system and flipped to a reward
system.
S Youth earn points for various activities and earn their way
out of a phase.
Example
Example
S Points needed to phase:
S Move to Phase 2: 100 points
S Move to Phase 3: 70 points
S Move to Aftercare: 70 points
S Graduate from program: 40 points
Contact Information
Sandra J. Altshuler, Ph.D., L.I.C.S.W.
Spokane County Superior Court
1116 W. Broadway
Spokane WA 99203
(509) 477 6355
[email protected]
[email protected]
Ncjfcj.org