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

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Next Steps for FDTCsHealthy 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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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 NPCs website
  www.npcresearch.com
• Four Sites With Different FTDC Models

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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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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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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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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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FTDC Experiences and Treatment Outcomes
Variable 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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Treatment Experiences and Reunification
Variable (parent report) Statistically Significant? Nature of Relationship to Reunification
Treatment access appropriateness Yes The more accessible/ appropriate, the greater the likelihood of reunification
Frequency of meetings with treatment counselors Yes 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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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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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 wasnt the drug court one, didnt
  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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Accountability and Collaboration

• Parents also explained how frequent hearings and
  attendance in drug court provided accountability
  for their behavior because
• the team knows whats going on with you and you
  get immediate support for whatever is going on as
  soon as you need it.
• its 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 whats 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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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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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
  decision-makers
• 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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Barriers to Parents 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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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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NDCI Technical Assistance
Building Program Capacity Case Processing Child Protection Practices Clarifying Improving the Scope of Family Interventions
Client Termination Criteria Clinical Case Management Cultural Proficiency
Development of Ancillary Services Drug Testing Family Reunification, Recovery Planning and Visitation
Incentives and Sanctions Maintaining Compliance with ASFA ICWA Mandates MIS Evaluation
Program Development Program Sustainability Review of Effective Treatment Design Practices
Review of Program Design Roles Responsibilities Screening / Assessment
Targeting / Eligibility Criteria Team Building and Strategic Planning Team Member Turnover Training of New Team Members
___________ Other _______________ Other_________________


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Working within a Parallel UniverseThe Court and
the Participant

• The creation of a drug court may be scary we
  wont 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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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

• 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

come
together
to
start
The
pieces
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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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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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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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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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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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The Lindner CaseSarah 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 Toms 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 hours
visitation per week with only one of their
parents.
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• 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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NDCI Technical Assistance
Building Program Capacity Case Processing Child Protection Practices Clarifying Improving the Scope of Family Interventions
Client Termination Criteria Clinical Case Management Cultural Proficiency
Development of Ancillary Services Drug Testing Family Reunification, Recovery Planning and Visitation
Incentives and Sanctions Maintaining Compliance with ASFA ICWA Mandates MIS Evaluation
Program Development Program Sustainability Review of Effective Treatment Design Practices
Review of Program Design Roles Responsibilities Screening / Assessment
Targeting / Eligibility Criteria Team Building and Strategic Planning Team Member Turnover Training of New Team Members
___________ Other _______________ Other_________________