# Presentation: 348749

## Findings from the Retrospective PhaseFamily Drug Treatment CourtNational Cross-Site Evaluation

**Nancy K. Young, Ph.D.**
**Children and Family Futures**
**4940 Irvine Boulevard, Suite 202**
**Irvine, CA  92620**
**714.505.3525 Fax 714.505.3626**
**www.cffutures.com**

## Abstract

**The goal of Family Drug Treatment Courts (FDTC) is to protect children from abuse and neglect through timely decisions, coordinated services and the provision of timely substance abuse treatment and safe and permanent homes.**
**This study is the first phase of a federal initiative to evaluate the substance abuse treatment, child welfare and dependency court outcomes for clients who participated in FDTC compared with those receiving standard services. Case record data were abstracted from five sites using a retrospective quasi-experimental nonequivalent comparison group design. **
**Data collection was planned to extract records from 50 FDTC cases and 50 comparison cases per site. The final sample yielded 299 FDTC cases and 240 comparison cases, 90% female, mean age of 30 years, and half were Caucasian. **

## Abstract

**Compared to the families with standard services, FDTC clients:**
**Entered AOD treatment in significantly fewer days following the opening of the child protective services case (13 vs. 27 months)**
**Stayed in treatment longer (64 vs. 41 months)**
**Had a higher rate of completed treatment episodes (59% vs. 52%)**
**Had significantly less criminal and CPS recidivism**
**Have children who spent less time in out of home care (20 vs. 22 months)**
**Reunified with a parent significantly faster (11 vs. 13 months)**
**San Diego’s two-tiered model produced more favorable  outcomes with significant differences on the measures of case timing.**

## The Federal Sponsors

**U.S. Department of Health and Human Services**
**Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (CSAT)**
**Administration on Children, Youth and Families, Children’s Bureau, Office on Child Abuse and Neglect (OCAN)**
**Office of the Assistant Secretary for Planning and Evaluation (ASPE)**
**Department of Justice (DOJ)**
**Drug Court Program Office (DCPO)* **
**National Institute of Justice (NIJ)**

***The DCPO has subsequently been re-organized at DOJ**

## Two Phase Evaluation Strategy

## Study Questions

**What are the components and active ingredients of family drug treatment courts?**
**How do programs and procedures in the target family drug treatment courts differ from one another?**
**How do the various systems involved with family drug treatment courts work together?**
**Are family drug treatment courts more effective than standard services in achieving the key outcomes of the child welfare, substance abuse treatment and court systems?**

## Retrospective Study Conceptual Model

**System**
**Environment and Context of Partner Agencies**
**Treatment**
**Child Welfare Services**
**Dependency Court**

**Family**
**Strengths & Needs**
**AOD Severity**
**Child Welfare Risks**

**FDTC Program**
**Court oversight**
**Intensive case supervision**
**Treatment linkages**
**Systems’ Collaboration**

**Key Outcomes**
**Treatment**
**Access to Treatment**
**Engagement**
**Retention**
**Completion**
**Functional Status**
**Child Welfare Services**
**Safety**
**Permanence**
**Dependency Court**
**Case Resolution**
**Compliance with statutory timelines**

## Retrospective Phase Purpose

**Evaluation included**
**Documenting the program models and processes for substance abuse treatment, child welfare services and the court**
**Evaluating FDTC participants’ outcomes relative to a comparison group receiving standard services for**
**Substance abuse treatment engagement, retention and completion**
**Child safety and permanency**
**Timeliness of court interventions**
**Prospective phase is being implemented by NPC Research**

## Retrospective Phase Design

**Quasi Experimental - Comparison cases selected from either cases not offered FDTC services for administrative reasons or cases that entered CWS just prior to FDTC implementation**
**Each FDTC Site**** **
**Approximately 50 FDTC intakes and comparisons planned**
**San Diego included 50 additional cases that participated in SARMS only**
**Sample size allows use of simple statistical procedures to determine if there are significant intra- and inter-site differences in outcome**

## The Study Sites and Comparisons

**Selection criteria included length of FDTC operation and adequate sample size**
**Jackson County, Missouri & similar cases not offered FDTC**
**Washoe County, Nevada & similar cases not offered FDTC**
**San Diego, California & similar cases entering CWS prior to FDTC implementation**
**Santa Clara, California & similar cases entering CWS prior to FDTC implementation**
**Suffolk County, New York & another court in the same county with standard services**

## Two Distinct Models Implemented

**Integrated – Jefferson, Reno, Santa Clara, Suffolk**
**Both dependency matters and recovery management conducted in the same court with the same judicial officer**
**Two Tier – San Diego**
**Every parent with substance abuse allegations in court petition is offered services from a Substance Abuse Recovery Management Specialist (SARMS) – Parents are court ordered to participate at Jurisdictional Hearing**
**Dependency matters and recovery management conducted in same court with same judicial officer during initial phase**
**If parent is noncompliant with court orders, parent may be offered Dependency Drug Court participation and case may be transferred to a specialized judicial officer who increases monitoring of compliance and manages only the recovery aspects of the case **

## Common Components

**Specific Eligibility Criteria**
**More timely access to AOD assessment**
**More timely access to AOD treatment with specialized providers**
**Additional case management – generally provided by AOD system**
**More frequent and standardized reporting of AOD treatment participation and compliance**
**Team approach by child welfare and AOD treatment with more frequent case conferencing**
**Defense bar cooperation in non-adversarial approach to AOD treatment and recovery access**
**Increased judicial oversight of case with more frequent court hearings**

## Total Number of FDTC Graduates in 2000 and 2001

**San Diego****1**** ****	****	****	****71**
**Suffolk ****	****	****	****	****67****	****	****154**
**Santa Clara****	****	****	****52****	****	****  98**
**Washoe****	****	****	****	****52****	****	****  81**
**Jackson****	****	****	****40****	****	****  91**

**1 ****Only 2****nd**** Tier of DDC participants are eligible to graduate**

-   **Parents       Children**

## Data Collection

**Intent to treat sampling **
**Data abstraction instrument developed and refined until adequate inter-rater reliability**
**Total samples for all sites; FDTC and SARMS samples were combined for cross-site analyses**
**FDTC = 249**
**SARMS = 50**
**Comparison = 240**

## Parents

**N=539**
**Over 90% were women**
**Average age was 30**
**Half were Caucasian, about 30% African American and 17% Hispanic**
**Approximately one third did not graduate from high school**
**Over 40% had never been married**
**Over 80% had illicit drug use allegations and over ****30% had alcohol abuse allegations in initial court petition**

## Parents at Intake to CWS

## The 539 Parents had just over 1,500 Children; 1,135 were named in the CPS case
Average children per Parent 2.9 and 2.7

51% were girls

Average age approximately 4.5 years

Over half were under age 6

**Average children per Parent 2.9 and 2.7**
**51% were girls**
**Average age approximately 4.5 years**
**Over half were under age 6**

**Child Description**

## Significantly More FDTC Parents Entered Treatment within 18 Months of CPS Case

**FDTC**
**96%**

**Comparison**
**78%**

**SARMS**
**80%**

**p<.05**

## FDTC Parents Entered Treatmentin Significantly Fewer Days

**Average Days from**
**    ****CWS Case Opening to****	****	****394****	****      802**
**    ****Treatment Entry***
**Average Days from FDTC**
**     ****Entry to Treatment Entry****	**** 59****	****      **
**Median Days from FDTC**
**     ****Entry to Treatment Entry****	**** 19**

-   **FDTC       Comparison**

***p<.05**

## Significantly More FDTC Parents Participated in More Intensive Levels of Treatment

**p<.05**

**Percent**

##  FDTC Parents	Successfully Completed 59% of 919 	Treatment EpisodesComparison Group Parents 	Successfully Completed 52% of 467 	Treatment Episodes

**Successful Treatment Completion**

**Successful Completion: Completed or Transferred to Another Program **

## Significantly Less Criminal & CPS Recidivism Among FDTC Parents 

**Percent of Parents**

- *p<.05

## On Average, FDTC Children HaveLess Time in Out of Home Care and Reunify Significantly Faster than Comparisons

- Average Number of
-    Days in Out of Home Care	  	588		667
- Average Number of Days
-    to Reunification* 			 322		377

-   **FDTC      Comparison**

- *p<.05

## No Significant Differences in Type               of Child Permanency 

**Percent of Children**

## On Average, FDTC Children Reach Permanent Placement 3 Months SoonerHave Permanent Plan Ordered 5 Months Earlier and CPS Case Closed 4 Months Sooner 

**Number of Months**

## Summary - Sample Description

**FDTC Clients are predominantly women with an average age of 30**
**They have a high degree of multiple co-occurring disorders**
**Generally have low education attainment**
**A large percentage have never been married**
**FDTC Children are young with the majority under age 6**
**They exhibit a range of social, mental and behavioral challenges**

## Summary - Treatment Outcomes

**Significantly more FDTC parents enter treatment**
**They enter treatment in significantly fewer days**
**They participate in significantly more treatment episodes**
**They receive more intensive levels of treatment**
**On average, they stay in treatment longer**
**They complete nearly 60% of episodes**

## Summary - Child Safety

- FDTC parents have significantly less criminal recidivism
- FDTC parents have significantly less CPS recidivism

## Summary – Timeliness of Case Resolution

- There were no differences in the type of child permanency achieved – Reunification, Adoption, Guardianship or Planned Long-Term Care
- FDTC Children reached permanency faster
- FDTC Children who reunified, did so in significantly less time