The author(s) shown below used Federal funds provided by the U.S. 

Department of Justice and prepared the following final report: 

Document Title: Assessing the Efficacy of Treatment Modalities 

in the Context of Adult Drug Courts, Final 

Report 

Author(s): Donald F. Anspach Ph.D. ; Andrew S. Ferguson 

Document No.: 202901 

Date Received: 11/17/2003 

Award Number: 2000-DC-VX-0008 

This report has not been published by the U.S. Department of Justice. 

To provide better customer service, NCJRS has made this Federallyfunded grant final report available electronically in addition to

traditional paper copies.

 

Opinions or points of view expressed are those 

of the author(s) and do not necessarily reflect 

the official position or policies of the U.S. 

Department of Justice.
Assessing the Efficacy of Treatment Modalities 

in the Context of Adult Drug Courts 

t Final Report 

April 18,2003 

Prepared for: 

Dr. Janice T. Munsterman 

Office of Research and Evaluation 

National Institute of Justice 

8 10 Seventh Street, NW 

Washington, D.C. 2053 1 

* Prepared by: 

Donald F. Anspach, PhD. 

Department of Sociology 

University of Southern Maine 

96 Falmouth St 

P.O. Box 9300 

Portland, Maine 04101-9300 

anspach@usm.maine.edu 

(207)780-4760 

Andrew S. Ferguson 

USM Research Institutes 

University of Southern Maine 

125 John Roberts Rd. 

Suite 6 

South Portland, Maine 041 06 

aferguso@usm.maine.edu 

(207)228-8064 

This project was funded under grant #2000-DC-VX-008 by the US Department of Justice, Office of Justice 

Programs, National Institute of Justice. Points of view expressed are those of the authors and do not 

represent the official position of the funding agency. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Assessing the Efficacy of Treatment Modalities in the Context of Adult Drug Courts 

Abstract 

BY 

Donald F. Anspach and Andrew S. Ferguson 

Drug treatment courts have been heralded as one of the major justice reforms of the 20* 

century. They are intended to reduce the recidivism of drug involved offenders by 

changing their drug using habits. The purpose of this study was to examine the efficacy 

of treatment modalities in the adult drug court setting. The research examined treatment 

services and organizations involved in drug court operations across four jurisdictions: 

Bakersfield, California; Creek County Oklahoma; Jackson County, Missouri, and St. 

Mary Parish, Loukiana. The evaluation consists of an analysis of 2357 drug court 

participants as well as m exploratory study of the nature and quality of treatment inside 

the drug court. Using a combination of surveys, interviews, and observations of treatment 

sessions, this study examined the type of services delivered to the drug court offenders. 

These combined methods were used to begin exploring issues related to the integration of 

treatment within the drug court setting and the types of services provided to the offender. 

Each of the four drug court programs are diverse with respect to size, participant 

eligibility, program protocols, drug testing and treatment attendance requirements. There 

is also substantial diversity in the nature and types of treatment services provided and the 

content of those treatment services. Overall results of the observational study and survey 

of treatment staff reveal that counselors’ philosophies of addiction and effective 

interventions for treatment of substance abuse is broad and eclectic suggesting lack of a 

coherent, consistent approach in the manuer in which counselors not only think about but 

also how they respond to clients’ drug abuse. 

Previous research on the “black box” of the drug court intervention is limited. The 

research literature confirms the existence of wide variations in the delivery of key 

components of drug courts - treatment, testing and sanctions, but little information on 

how the delivery of these components are related to client outcomes. This research 

examined how variations in completion rates and recidivism are related to differences in 

program compliance requirements such as drug use and treatment attendance. While 

compliance with program requirements are the most important factors associated with 

graduation, some participant characteristics also play a signiscant role. Findings also 

indicate that program completion is the most important predictor of post-program 

recidivism. Offenders who “success~lly” complete the drug court program through 

graduation are at least three times 

found that program completion was not a significant predictor of recidivism. Rather, the 

low overall rate of recidivism found there was related to the high overall rate of treatment 

attendance regardless of whether participants graduated &om the program or not. 

likely to be rearrested. At one drug court it was 

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This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Assessing the Efficacy of Substance Abuse Treatment 

in the Context of Adult Drug Courts 

Preface 

This report was prepared for the United States Department of Justice, National 

Institute of Justice, under the supervision of Dr. Janice Munsterman. Dr. Donald F. 

Anspach of the University of Southern Maine was the principal investigator. Andrew S. 

Ferguson of the University of Southern Mabe was the research analyst. Through a sub 

contract with the Bureau of Governmental Research at University of Maryland, Dr. Faye 

Taxman and Dr. Jeff Bouffard conducted observations of treatment sessions and 

conducted surveys and interviews with treatment personnel at each of the four research 

sites. Donald Anspach and Andrew Ferguson conducted interviews with court personnel 

and collected participant level data at each site. 

The report is truly the result of a collaborative effort. Without the dedication of the 

entire research team this research would not have been possible. The entire research 

team reviewed and commented on various chapters of the report. The division of labor is 

as follows: Dr. Faye Taxman was the lead author of the first chapter of the report and Dr. 

JefEey Bouffard was the secondary author. Andrew Ferguson and JefEey Bouffard were 

the lead authors of Chapter 2. Donald Anspach was the lead author of Chapters 3,8, and 

9 with Andrew S. Ferguson as the secondary author. Faye Taxman, Donald Anspach and 

Jeffkey Bouffard were the authors of Chapter 7. Chapter 4 was written by JeiBey 

Bouffard, Donald Anspach and Andrew Ferguson. Jeff Bou&d was the lead author of 

Chapters 5 and 6 with Faye Taxman as the secondary author. Chapter 10 was written by 

Donald Anspach and Andrew Ferguson. Faye Taxman was the lead author of the 

Executive Summary with Jeff Bouffard, Donald Anspach, and Andrew Ferguson as 

secondary authors. 

April 18,2003 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
t Acknowledgements 

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The University of Southern Maine and the University of Maryland would like to give a 

special thanks to everyone for whom otherwise, this work would not have been possible. 

Special thanks, undoubtedly, are deserved to every member of the four Drug Court teams 

involved in this study. In \ particular we would like to thank: 

St. Mary Parish 

Staci Bertagna , 

Carolyn Dishman 

Billi DriskeU 

Hon. William Hunter 

Keena Lanceslin 

Lars Levy 

Brett Matherne 

Bernadette Melancon 

Ralph Melancon 

Lewis Pitman 

Peter Raymond, 

Walter J. Senette 

Bakersfield 

Lily Alvarez 

Carol Avry 

Men Belloumjni 

Hon. Frank Hoover 

Michael Johnson 

Hon. Sharon Mettler 

Marti Rodriguez 

Bonnie Sanders 

Stephen Tauser 

Steve Wilhehen 

University of Maryland 

Carol Gibbs 

Rebecca Silverman 

Lee Ann Slocum 

Julie Marshall 

University of Southern Maine 

Michelle Baker 

Dr. Vincent Collom 

Jody Giambattista 

Laura Phillips 

MarthaHamlin 

Creek County 

Angela Cooper 

Dana Davidson 

Andrea Dawkins 

Stephen Foster 

Larry Fugate 

Maureen Guerrero 

Dr. Paula Inbody 

Mike Loeffler 

Jessica Rainey 

Hon. Richard Woolery 

Jackson County 

Robert Baird 

Vicky Boyd 

Jeanna Brennan 

Monica Cervantes 

Judy Chase 

Hon. Greg Gillis 

Jim Nunnelly 

Denise St. Omer 

Joseph Reed 

Correctional Counselinn. Inc. 

Dr. Kenneth Robinson 

Glacier Consulting. Inc. 

Dr. Robert Kirchner 

Federal Bureau of Investigation 

David Lavezza 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Table of Contents 

Executive summary by F . Taxman. J . Bouffwd, D . Anspach and A . Fergus~n 

Chapter 1 Introduction ................................................................................................ 1-1 

Overview ................................................................................................................. 1- 1 

Drug Treatment Courts: The State ofKnowledge .................................................... 1-3 

Drug Treatment within the Drug Treatment Court Setting ........................................ 1-4 

by F . Taxman and J . Boutkd 

Purpose of this Study ................................................................................................ 1-6 

Chapter 2 Research Design and Methodology ............................................................. 2-1 

. Overview ................................................................................................................. 2-1 

Site Selection ........................................................................................................... 2-1 

Administrator Surveys and Interviews ...................................................................... 2-2 

Treatment Staff Surveys & Philosophical Orientation ............................................... 2-2 

Direct Treatment Observations ................................................................................. 2-3 

Drug Court Staff Interviews ..................................................................................... 2-6 

Retrospective Analysis of Participant Data ............................................................... 2-6 

Sources of Participant Data ...................................................................................... 2-7 

Data Elements Collected .......................................................................................... 2-8 

NCIC Data Elements ................................................................................................ 2-9 

Regression Analyses .............................................................................................. 2-10 

Chapter 3 Comparison ofthe Four Drug Court Programs ............................................ 3-1 

Overview ................................................................................................................. 3-1 

Overview of Each Jurisdiction .................................................................................. 3-1 

St . Mary Parish, LOU l~lana .................................................................................... 3-1 

Creek County, Oklahoma ..................................................................................... 3-2 

Bakersfield, California .......................................................................................... 3-3 

Processing Offenders ................................................................................................ 3-6 

by A . Faguson and J . Boukd 

by D . Anspach and A . Fergusan 

... 

.. 

Jackson County, Missouri ..................................................................................... 3-4 

Cross-Jurisdictional Comparisons of Drug Court Operations ...................... i ............. 3-5 

Sanctions and Rewards .............................................................................................. 3-9 

Drug Testing Protocols ........................................................................................... 3-10 

SU mmary ................................................................................................................ 3-11 

Chapter 4 Organization of Treatment Services ............................................................ 4-1 

by D . Anspach. J . Bouffard and A . Ferguson 

Overview ................................................................................................................. 4-1 

Methods ................................................................................................................... 4-1 

Treatment Service Structures According to Drug Court Personnel ............................ 4-1 

Treatment Structures Organization fiom the Perspective of Treatment Personnel ..... 4-3 

Treatment Funding Issues ..................................................................................... 4-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 4 Organization of Treatment Services 

Treatment Program Organkational Structure ........................................................ 4-4 

Delivery of Specific Substance Abuse Treatment Services ................................... 4-5 

Substance Abuse Program Structure & Duration ................................................... 4-6 

Delivery of Other Ancillary Services .................................................................... 4-8 

Aftercare .............................................................................................................. 4.9 

SU mmary ................................................................................................................ 4-10 

Delivery of Medical Services ................................................................................ 4-7 

Chapter 5 Treatment Counselors’ Perspectives on Drug Treatment Services ............... 5-1 

Overview ................................................................................................................. 5. 1 

Treatment Program Staffing Issues ........................................................................... 5-1 

by J . Boufird and F . Taxman 

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8. . I Substance Abuse Treatment Curricula ...................................................................... 5-6 

Communicating Expectations and Monitoring Compliance ...................................... 5-7 

Counselors’ Philosophy of Drug Abuse and Effective Treatment .............................. 5-9 

Characteristics of Clients in Treatment ...................... ............................................ 5-11 

Summary ................................................................................................................ 5-13 

Chapter 6 Direct Observations of Drug Treatment Activities ....................................... 6-1 

Overview ................................................................................................................. 6. 1 

Treatment Activity Characteristics ........................................................................... 6-1 

Clinical Features of Treatment Services .................................................................... 6-3 

SU mmary ................................................................................................................ 6-11 

by J . Boufhrd and F . Taxman 

Chapter 7 The Integration of Court Operations and Treatment Services ....................... 7-1 

The Importance of Service Delivery Systems ........................................................... 7-2 

Are Drug Courts Boundaryless Organizations? ......................................................... 7-4 

Methods and Sources of Information ........................................................................ 7-8 

Integration According to Court Personnel ................................................................. 7-9 

Philosophical Integration ...................................................................................... 7-9 

by D . Anspach. F . Taxman. J . Bouf€ard and A . Ferguson 

Overview ................................................................................................................. 7. 1 

Policy Development Integration ......................................................................... 7-11 

Operational-level Decision MakinglInformation Sharing .................................... 7-13 

Cross-Program Familiarity Issues ....................................................................... 7-14 

Summary of Findings about Levels of Integration .................................................. 7-16 

Integration According to Treatment Personnel .................................................... 7-14 

SU mmary ................................................................................................................ 7-17 

Chapter 8 Retrospective Study: Participant Characteristics, Program Fidelity 

Measures and Factors Associated with Program Completion ....................... 8-1 

by D . Anspach and A . Faguson 

Overview ................................................................................................................. 8-1 

Methods ................................................................................................................... 8-1 

Program Discharge and Completion Results ............................................................. 8-1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 8 Retrospective Study: Participant Characteristics. Program Fidelity 

Measures and Factors Associated with Program Completion 

Sample Characteristics ............................................................................................. 8-2 

Characteristics of Participants By Discharge Status .................................................. 8-2 

Substance Use Profiles ............................................................................................. 8-4 

Prior Experience With Substance Abuse Treatment .................................................. 8-5 

Criminal History Profiles .......................................................................................... 8-6 

Integrity of Drug Court Program Operations and Protocols ....................................... 8-7 

Drug Court Attendance Requirements .................................................................. 8-7 

Treatment Attendance Requirements .................................................................. 8-11 

New Arrests During Program Participation ............................................................. 8-12 

Drug Testing Protocols ......................................................................................... 8-9 

Factors Associated with In-Program Recidivism .................................................... 8-13 

Positive Drug Tests During Program Participation .................................................. 8-15 

Factors Predictive of Graduatioflermination ........................................................ 8-17 

. 

S~mmary ................................................................................................................ 8-20 

Chapter 9 Cross-site Comparisons of Rates of Post-Program Recidivism .................... 9-1 

by D . Anspach and A . Ferguson 

Overview ................................................................................................................. 9-1 

Methods ................................................................................................................... 9-2 

Fixed 12-Month Follow-Up Post-Program First Arrests ........................................... 9-3 

Length of Time to First Arrest .................................................................................. 9-5 

In-Program and Post-Program Recidivlsm ................................................................ 9-5 

Treatment Attendance and Post-Program Recidivism ............................................... 9-6 

Characteristics of Participants Associated With Post-Program Arrests ...................... 9-7 

Post-Program Arrest Offenses .................................................................................. 9-8 

Logistic Regressions ................................................................................................ 9-9 

Path Analysis ......................................................................................................... 9. 12 

... 

St . Mary’s Parish ................................................................................................ 9-13 

Creek County ..................................................................................................... 9-14 

Bakersfield ......................................................................................................... 9. 15 

Jackson County .................................................................................................. 9-16 

Conclusions ...................................................................................................... ; ..... 9-17 

Chapter 10 Conclusions ............................................................................................ 10-1 

Overview ............................................................................................................... 10-1 

Chapter Summaries ................................................................................................ 10. 1 

by D . Anspach and A . Ferguson 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
. I .... “*I 

Table of Figures 

Chapter 2 Research Design and Methodology ................................ 1 ............................ 2-1 

Table 2.2 Primary Data Elements Collected ........................................................... 2-9 

Table 2.1 Sample Construction .............................................................................. 2-7 I Table 2.3 NCIC Primary Data Elements .............................................................. 2.10 

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Chapter 3 Comparison ofthe Four Drug Court Programs ............................................ 3-1 

Table 3.1 Comparisons of Drug Court Structure. Operations and Phases ............... 3-6 

Table 3.2 Legal and Clinical Screenings and Clinical Assessments ........................ 3-7 

Table 3.3 Time Between Identification of Clients and Admission ......................... 3-7 

Table 3.4 Criminal History Profiles ....................................................................... 3-8 

Table 3.6 Drug Testing Protocol .......................................................................... 3-10 

... Table 3.5 Substance Use Profles ........................................................................... 3-9 

Chapter 4 Organization of Treatment Services 

Table 4.1 Types of Direct and Referred Drug Treatment Services Available .......... 4-3 

Table 4.2 Financing of Treatment Programs .......................................................... 4-4 

Table 4.5 Substance Abuse Program Structure & Duration .................................... 4-7 

Table 4.7 Other Ancillary Services Delivered ........................................................ 4-9 

Table 4.3 Treatment Program Organizational Structufe ......................................... 4-5 

Table 4.4 Specific Substance Abuse Services ........................................................ 4-6 

Table 4.6 Ancillary Medical Services Delivered .................................................... 4-8 

Chapter 5 Treatment Counselors’ Perspectives on Drug Treatment Services ............... 5-2 

Table 5.4 Treatment Staff -Related. Activities ........................................................ 5-5 

Table 5.6 Formal Treatment Curricula Descriptions ............................................... 5-7 

Table 5.2 Clinical Staff Qualifications/Experience ................................................. 5-3 

Table 5.3 Clinical StaiTCharacteristics .................................................................. 5-4 

Table 5.5 Intake and Treatment Planning Activities ............................................... 5-6 

Table 5.7 Communicating Expectations to Clients ................................................. 5-8 

Table 5.8 Drug Testing Procedures ........................................................................ 5-8 

Table 5.9 Behavioral Consequences ...................................................................... 5-9 

Table 5.10 StafTPhilosophy of Drug Use Causation ............................................ 5-10 

Table 5.1 1 St&Philosophy of Effective Drug Treatment .................................... 5-10 

Table 5.12 Client Referral Sources ...................................................................... 5-11 

Table 5.13 Primary Drug of Choice ..................................................................... 5-12 

Table 5.14 Client Attrition ................................................................................... 5-13 

Chapter 6 Direct Observations of Drug Treatment Activities ....................................... 6-1 

Table 6.1 Treatment Meeting Summary Characteristics ......................................... 6-2 

Table 6.3 Management Items ................................................................................. 6-4 

Table 6.4 Cognitive - Behavioral Items ................................................................. 6-6 

Table 6.2 Summary of Client Demographics (Observed in Meetings) .................... 6-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Chapter 6 Direct Observations of Drug Treatment Activities ....................................... 6-1 

Table 6.6 Safety and Self-Exploration Items .......................................................... 6-9 

Table 6.7 12-Steps (MA) and Therapeutic Community (TC) Items ................ 6-10 

Table 6.5 Education and Aftercare Items ............................................................... 6-7 

Chapter 7 The Integration of Court Operations and Treatment Services ....................... 7-1 

Figure 7.1 Conceptual Framework for Boundaryless Organizations ....................... 7-3 

Table 7.1 Cross-Site Comparisons of Phase System Requirements ......... 2 ............ 7-12 

Table 7.2 Cross-site Comparisons of Program Eligibility Requirements .............. 7-13 

Table 7.3 Counsellor Survey Results related to Treatment Integration ................. 7-15 

Chapter 8 Retrospective Study: Participant Characteristics. Program Fidelity 

Measures and Factors Associated with Program Completion ....................... 8.1 

Table 8.2 Characteristics of Participants ................................................................ 8-3 

Table 8.3 Participant Substance Abuse Profiles ..................................................... 8-5 

Table 8.4 Participant Substance Abuse Treatment Histories ................................... 8-6 

Table 8.6 Types of Prior Arrests Offenses’ ............................................................. 8-7 

Table 8.7 Drug Court Attendance .......................................................................... 8-8 

Table 8.8 Length Drug Court Program Participation .............................................. 8-9 

Table 8.1 1 Arrests During Drug Court Participation ............................................ 8-13 

Table 8.12 Logistic Regression of In-Program Arrests ......................................... 8-14 

Table 8.14 New Arrests and Positive Drug Tests by Discharge Status ................. 8-17 

... 

Table 8.5 Participant Prior Arrest Histories ............................................................ 8-6 

Table 8.9 Drug Testing Practices and Protocols ................................................... 8-10 

Table 8.10 Treatment Attendance with Program Requirements ............................ 8-12 

Table 8.1 3 In-Program Positive Drug Tests ......................................................... 8-16 

Table 8.15 Logistic Regression of Graduation Outcomes ..................................... 8-18 

Chapter 9 Cross-site Comparisons of Rates of Post-Program Recidivism .................... 9-1 

Figure 9.1 Post-Program Arrests Outcomes ........................................................... 9-3 

Table 9.1 Program Arrests Outcomes .................................................................... 9-4 

Table 9.2 Length of Time to Arrest By Discharge Status ....................................... 9-5 

Table 9.3 Relationship Between In-Program and Post-Program Recidivism ........... 9-6 

Table 9.4 Relationship Between Treatment Attendance and Recidivism ................ 9-6 

Table 9.5 Characteristics of Arrested Participants .................................................. 9-7 

Table 9.6 Arrest Charges by Discharge Status ....................................................... 9-8 

Table 9.7 Arrest Offenses by Discharge Status ...................................................... 9-9 

Table 9.8 Logistic Regression of Recidivism ....................................................... 9-11 

Figure 9.2 St . Mary Parish Path Model ................................................................ 9-13 

Figure 9.3 Creek County Path Model ................................................................... 9-14 

Figure 9.4 Bakersfield Path Model ...................................................................... 9-15 

Figure 9.5 Jackson County Path Model ................................................................ 9-16 

Chapter 10 Conclusions 

Figure 10.1 Post-Program Arrest Outcomes ........................................................ 10-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Executive Summary 

The United States has the western world's most serious (per capita) drug problem, 

whether expressed in terms of addiction to illicit drugs, drug related crime, or intravenous 

drug use-related HIV (Marlowe, 2002). For nearly thirty years, the criminal justice and 

drug treatment systems have struggled with a structural process to provide timely access to 

drug treatment services for offenders (Belenko, 2000; Taxman, 1998). In response to the 

need to provide drug treatment services, jurisdictions have created a number of innovations 

including case management services to advocate for services for offenders (e.g. Treatment 

Alternatives to Street 'Crime), specialized in-prison or in-jail treatment programs, 

specialized probation or day reporting programs, diversion programs, and drug courts. 

Studies on the efficacy of such innovations have mixed results, with some approaches 

reporting reductions in recidivism and others not; more often the research is of imuf€icient 

quantity or quality to convincingly determine the efficacy of the innovations (Sherman, et 

al, 1997; Anglin, et al, 1996; MacKenzie, 2000; Taxman, 1999). 

One theme echoed in many of the studies is that the overall operation of treatment 

services for offenders has not been affected by the innovations, and treatment services for 

offenders continue to be inadequate to meet the needs of offenders (Duffee and Carlson, 

1996; Lamb, et al, 1998). Overall, few meaningful changes at the systemic level have been 

realized as a result of these innovations in treatment delivery format. However, new 

demonstrations are evolving as to how to integrate treatment in the criminal justice system 

(Harrell, et al., 2002). Even more importantly these treatment programs continually 

struggle with ensuring the stability of treatment services as resources increase and decrease 

over time. Estimates are that of the 45 percent of offenders in need of drug treatment 

services (Taylor, Fitzgerald, Hunt, Reardon, & Bernstein, 2001) only a mere token of 

offenders receive any services. Additionally, few services are adequately matched to the 

treatment needs of the offender (Belenko, 2000; Farabee, et al, 1999; Taxman, 1998). 

Despite the attempts of the innovations described above, many scholars continue to suggest 

that the services are not integrated into the operating philosophy of criminal justice 

programs (Taxman and Bouffad, 2002b; 2000; Harrell, et al., 2002) and that there is a 

limited linkage between the treatment and criminal justice system. 

The most recent example of innovations in substance abuse service delivery 

systems for offenders, drug treatment courts, were developed in 1989 in Miami, Florida as 

a means to overcome the haphazard provision of treatment services, and to integrate 

treatment into the normal, daily operations of the court and supervision systems. The court 

was viewed as the vehicle to bring the conflicting models of punishment and rehabilitation 

into a setting where the two philosophies could be integrated, instead of relying upon 

disparate programmatic components of treatment, drug testing, supervisionloversight, and 

compliance management (Taxman and Bouffmd, 2002b; Goldkamp, White & Robinson, 

2001). One of the most unique, specialized features of the drug court is the use of the 

presiding judge to oversee the progress of the addicted offender. The judiciary provides a 

routine basis to ensure compkmce with both treatment and punishment conditions. In 

many ways, the concept of the drug treatment court reshapes criminal justice policy by 

forging the interdisciplinary team to address the addiction and criminal behavior of 

1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
offenders through integrated programming and through the altered role of the judiciary as a 

critical component of the program. As such, drug courts have been hailed as one of the 

major justice reforms of the latter part of the 20* century in the United States (Goldkamp, 

White, & Robinson, 2001). 

Drug courts provide a programmatic process to address addiction as a chronic 

behavior with relapsing1 occurrences. The traditional justice system has struggled with 

responding to reoccurring behavioraz conditions due to the tendency to be incident-driven 

and use the potential for incarceration as a response. Under the traditional system, little 

tolerance exists for thC reoccurring nature of addicted behavior, and the criminal justice 

system constantly struggles with providing appropriate and proportionate responses for 

non-compliant behavior of addicts, such as their continued drug use. Under the drug court 

model, fiequent status hearings provide positive reinforcement for the struggling addict and 

provide a means to respond to potential relapsing incidents. The drug court process 

recognizes the relapsing nature of addiction and provides the flexibility to respond 

accordingly. Therein lies the major difference between the drug court and the traditional 

treatment process for offenders-the integration of treatment goals within the fabric of the 

drug court process. 

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The drug court concept provides the opportunity to explore how treatment is 

integrated into the drug court setting. Few studies have examined this issue with a rigorous 

exploration of the organizational and structural issues regarding the use of treatment 

services and the subsequent impact of treatment delivery on client outcomes. Some critical 

questions need to be addressed regarding how treatment is utilized within the context of the 

drug court. In other words, how are drug treatment services provided within the fiamework 

of the drug court? What policies and procedures drive the drug court in recognition of the 

importance of treatment? The available literature on drug treatment courts does not address 

these questions, particularly the issues related to how treatment services are offered to 

offenders. Nor does it address the supporting policies and practices of the Drug Treatment 

Court that reinforce the goal of providing drug treatment: to reduce the recidivism of drug 

involved offenders by changing their drug using habits. The issues related to drug 

treatment are not well understood and the following focuses on such issues. 

Drug Treatment Courts: The State of Knowledge 

In the last decade while drug court programs thrived and grew to a nationwide 

phenomenon with over 700 courts (Cooper, 2001), studies of drug courts did not occur at 

the same pace. As noted in three reviews of drug courts studies, few studies use rigorous 

designs, which limit the conclusions that can be drawn about the efficacy of drug courts, 

compared to other innovations or traditional processes (Belenko, 1998; 1999; 2001). 

Some studies report findings that support the goals of reductions in judicial dockets, 

caseloads, jail bed days, police overtime, and system costs, although many of these studies 

do not have adequate comparison groups to substantiate the findings. At the offender level, 

within-program reductions in drug use and rearrest are generally reported, but again the 

nature of the studies limits the generalizability of the findings. The poor methodology used 

in many of these studies undermines the confidence that can be given to these apparently 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
,..*, , 

, 

positive findings. Overall, the tendency in this literature has been to find that program 

graduates do better than non-graduates but scholars note that the lack of comparison groups 

limits an understanding even on this issue. According to Goldkamp, White & Robinson, 

“The findings appear to show a dramatic and consistent drug court crime reduction effect, 

with drug court graduates generally showing substantially lower rearrest rates. ..from entry 

than nongraduates. As popular as these kinds of analyses may be among advocates seeking 

to declare the efficacy of drug courts, they are biased in the direction of showing positive 

results, and as such, are highly misleading. Basically, the much-heralded findings show 

that the successes succeed and the failures fail. (2001 :32) 

In a comprehensive review of drug court research, Belenko notes that the findings 

tend to support four major conclusions about drug courts practice in comparison to general 

trends fi-om other studies of correctional andor drug treatment programs. First, the drug 

court appears to serve offenders with more serious criminal histories or originating charges 

than other community based interventions. Second, drug use among drug court participants 

is lower than drug use in other community programs. Third, graduation rates fiom drug 

courts tend to be higher than fiom other community outpatient drug treatment programs for 

offenders. Finally, during-program rearrest rates tend to be lower than other community 

programming based on the available literature. In comparison to the general trends, 

scholars tend to find that drug courts are promising innovations to improve offender 

behavior (Sherman, et al, 1997; Taxman, 1999; MacKenzie, 2000), however the research 

literature does not support h conclusions about the effectiveness of the courts in all these 

domains. Similarly, the specific programmatic components that may produce these effects 

are not well documented as of yet. 

The general findings tend to suggest that drug treatment courts provide an avenue 

for drug using offenders to participate in drug treatment, and as the model is developed and 

implemented it is likely that positive outcomes can be achieved for serious drug offenders 

as a result of their participation in drug court programs. Studies on the actual nature of 

services provided to offenders in drug treatment court are limited, but the available studies 

tend to illustrate that there is variation in the quantity of core drug court services provided 

to offenders. Five major studies have been conducted that employ sound research methods 

to explore the efficacy of drug courts, and to measure the senices delivered to offenders 

(Harrell, Cavanaugh, and Roman, 1998; Deschenes, Turner, and Greenwood, 1995; 

Goldkamp, White, & Robinson 2001; Peters and Murrin, 1998; Gottfiedson et al, 2002). 

In each of these studies, the percentage of drug court clients participating in treatment 

varied considerably fiom 35 to 80 percent. For offenders participating in drug treatment 

services, the length of time in treatment also varied fiom under 30 days to over two years. 

Deschenes, Turner & Greenwood (1 995) found that 77 percent of the drug court clients in 

Maricopa County participated in drug treatment. The general finding appears to be that the 

longer the period of time in treatment, the greater the likelihood that the offender will 

graduate fiom drug court. And, more importantly, participation in drug treatment reduces 

the likelihood of rearrest. As shown in Figure 1, Gottfiedson et al(2002) found that those 

offenders who had participated in treatment had the best survival rates compared to other 

drug court Offenders that had supervision only, treatment only, or neither supervision nor 

treatment. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Figure 1: Survival Rate for Participants in Baltimore City's Drug Treatment Court By Type 

of Interventions Received 

f a 

cn 

t n 

8 

2 

3 

1.00 

0.90 

0.80 

0.70 

0.60 

0.50 

0.40 

0.30 

0.20 

0.10 

0.00 

0 2 4 6 8 10 12 14 16 18 20 22, '24 

Months 

e DC, Sup & Tx e DC, Tx only --6- DC, Sup only - 4 - DC, No Sup, No Tx +Control 

(N = 36) (N = 11) (N = 49) (N = 38) (N = 95) 

The impact of drug treatment participation among the drug court clients has not been 

thoroughly assessed in each of the studies. In the studies of the Baltimore City, Maryland 

court, the researchers found of the 48 percent of the drug court participants that participated 

in drug court, they spent an average of 47 percent of their drug court time in treatment. 

The rearrest rate for those assigned to drug treatment court is 66.2 percent over a 24-month 

post assignment as compared to 8 1.3 percent for the control group (p<.05). The average 

number of months to rearrest for the drug treatment court participant is 11 months as 

compared to 5 months for the control group. Goldkamp, White and Robinson (2001) found 

that the more treatment sessions participated in or the greater the percentage of time in 

treatment, the greater the reduction in rearrests during the one year from entry into a 

program. 

Drug Treatment witbin the Drug Treatment Court Setting 

While the limited studies on drug courts examine the service mix provided to 

offenders, it is not surprising that not all drug court clients receive drug treatment services. 

Few studies have actually examined the provision of such services and how these services 

are delivered. Existing research has found some codicting evidence regarding the access 

and availability to drug treatment sewices for the drug court, suggesting the need for more 

research into the linkages between court and treatment (Taxman and Bouffard, 2002; 

Cooper, 2001). 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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, 

’ In 1999, a survey of 212 drug treatment courts was conducted by the Treatment 

Accountability for Safer Communities Propams (TASC) with funding by the Office of 

Justice Programs and the Substance Abuse and Mental Health Administration. While the 

survey fhdmgs report that ‘treatment services designed for and used by drug treatment 

courts comport with scientifically established principles of effective interventions” 

(2001 :xii), Taxman and Bouffard in reviewing the survey results note that the “linkages to 

the treatment system appear for the most part to be compartmentalized.” (2002b). The 

treatment services offered in the drug treatment court reflect the services available through 

the general substance abuse treatment community instead of being tailored to the needs of 

the drug-involved offehders. For example, 5 1 percent of the TASC survey respondents 

reported not having formal placement criteria for dete&g type of treatment services an 

offender was assigned to. This result suggests a treatment system that lacks a fbll array of 

available services. Despite this, nearly 61 percent of the courts reported having dedicated 

slots in specific residential, detoxification and methadbne maintenance programs, however 

these dedicated slots represent a small percentage of the available service capacity. While 

the survey finds that courts reported access to a wide variety of services, this array is not 

typically available when needed. 

1 

Turner and her colleagues at RAND in a process study of 14 drug treatment courts 

note that “access to a continuum of alcohol and drug user treatment services and other 

related rehabilitative services was often dficult, reflecting financial issues, as well as 

dficulties with close coordination and information flow between treatment providers and 

other drug treatment court staff’ (Turner, et al., 2002: 1505). , In this study, the researchers 

found that the linkages between the drug treatment court and drug treatment system tends 

to be characterized by informality where the court accesses available services but the drug 

treatment court apd services are not well-integrated beyond these small-scde, often 

informal ties. While idormality in linkages suggests that the services may not be 

responsive to offender needs, it does reflect the lack of policy and operational practice 

development needed to address structural issues regarding organizational barriers and other 

impediments to coordinated service delivery. The researchers note that referral and 

communication among the treatment providers and criminal justice system in these 14 &g 

treatment courts is still in its infancy, with the tendency for it to occur on an “as needed” 

basis. This characterization may be reflective of the early developmental stage of the drug 

court but it also suggests that drug courts have not necessarily built an interdisciplinary 

team case management approach as recommended by the National Association of Drug 

Court Professionals (1997). More importantly, the researchers found that there was still 

some tension between supervision and rehabilitation objectives in some drug treatment 

courts. These tensions generally resulted &om the quality vs. quantity problems that affect 

drug courts where the push is to serve a larger number of offenders than is possible with 

available funds. Usually this results in short-changing some of the services that addictoffenders need to maintain their sobriety and crime-free lifestyle. 

Taxman and Bouffard (2002), using the survey data fiom the TASC survey of 2 12 

drug courts (see above), assessed some of the disconnects between the delivery of 

treatment services and drug court operations. Although the TASC study concluded that the 

drug courts engaged principles of best practices, a carehl review of the results suggests 

V 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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otherwise. In key areas, the drug court respondents highlighted the lack of policy and 

procedures that would support the drug court program’s mission. For example, this sample 

of drug courts tended to target offender’s eligible for drug court in reference only to their 

offense and criminal history, rather than in response to the type or severity of their 

substance abusing behavior. Half of the drug courts reported that they have non-clinical 

staff screen clients for drug treatment court eligibility, and nearly 60 percent of the drug 

treatment courts excluded offenders fiom participation who were “not motivated for 

treatment”. Half of the drug courts reported not having any formal placement criteria to 

determine what type of treatment services the offender should receive, and case 

management services were reportedly not uniformly delivered using a treatment team 

format. In addition, the case management services that did exist were id-equently 

provided by the drug treatment court itself According to these survey results, many of the 

courts have more than one agency conducting drug tests (e.g., treatment provider, 

probation, etc.) and often the results were not shared. While drug courts are designed to 

integrate services across systems, in order to create a boundaryless service delivery system, 

it appears fiom these survey results that few courts have developed such an approach. Tb,is 

raises many questions about the treatment services provided to offenders in the drug court 

setting and the impact of such services on outcomes. 

To date, research on the “black box” of drug courts’ actual intervention components 

is limited, particularly regarding the nature of drug treatment services provided within the 

context of drug courts. The findings &om the few well-designed studies of drug courts 

(Gottfredson, Najaka, & Duran, 2002; Goldkamp, White, & Robinson, 2001) confirm that 

there is variation in the delivery of key functional components of drug courts-treatment, 

testing, and sanctions. These findings (as well as the stated rationale for the model itself) 

suggest that the key ingredient of the drug court approach is the delivery of drug treatment 

services. With little information on the organizational and structural components of the 

drug treatment services offered in the drug court setting and their impact on client 

outcomes an understanding of the drug court model is limited. To address these issues, this 

study was designed to examine the delivery of treatment services in four drug court sites. 

Specifically the study involves a retrospective analysis of the impact of hctional drug 

court components on offender outcomes, both during program participation and during a 

one-year post program period. This study explores some of the issues related to the 

delivery of drug treatment within a drug court setting and then lays a foundation for hture 

work in this area. 

Methodology 

This study of drug treatment delivery in drug courts uses a combination of 

qualitative methodologies and quantitative analyses of information collected fiom four 

relatively long-standing drug courts. Fieldwork was conducted fiom February 2001 to May 

2002. On-site interviews were conducted with key stakeholders fiom all dimensions of the 

drug court (e.g., judges, probation officers, defense attorneys, prosecutors). Interviews 

were also conducted with treatment administrators and providers. Surveys were done with 

52 counseling staff employed in the treatment agencies utilized by these four courts and a 

total 124 treatment sessions were also observed using a structured tool designed to measure 

v1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
the nature and quantity of various clinical components of substance abuse treatment. A 

retrospective analysis of officially recorded information on 2,357 drug court participants 

also was conducted to explore how treatment participation is related to program completion 

rates, in-program and post program recidivism. The study methodology is designed to 

examine the delivery of drug treatment in the drug court setting and begin to explore the 

impact of this treatment across several client outcomes. 

Sites 

\ 

The sample of'drug courts examined in this evaluation includes two located in 

relatively rural areas and two located in more urban settings. AU four-drug court sites were 

chosen because their programs had been in operation long enough to have institutionalized 

their procedures. In fact each of the courts was designated as a "Mentor Court" by the 

National Association of Drug Court Professionals. Bgkersfield is a relatively large, longrunning court in a medium-sized California city, which utilized existing drug treatment 

providers within the local community. St Mary Parish is a rural court operating in 

Franklin, Louisiana, with a dedicated treatment provider that is part of the local county 

govement. Creek County is also a small, rural court operating in Oklahoma, which at the 

time of the evaluation was using two private treatment providers within the community. 

Jackson County' is a large court operating in a medium-sized Midwest City (Kansas City). 

This court, like St. Mary Parish made use of a dedicated treatment provider that was part of 

the court itselfand was operated by local government. 

' 

Retrospective Analysis of Drug Court Participants 

To understand the how drug court participation is related to program completion 

and recidivism, the study included a retrospective analysis of 2,357 offenders that were 

enrolled in drug court between January 1997 and December 2000. The sampling fiame 

consists of all enrollees in drug court, regardless of their level of participation. Mormation 

about offender behavior and program participation was collected both during their program 

participation (i.e., drug testing, treatment, graduation, and rearrest). In addition, 

information on rearrest rates was gathered for a 12-month post-program period. As will be 

discussed below, none of the four drug courts had a management information system that 

maintained complete documentation of drug court participants' activities while in the 

program (e.g. drug tests, drug treatment sessions attended, sanctions levied, supervision 

meetings, etc.). Rather, various sources in each jurisdiction had to be tapped to gather the 

needed information, including the court, treatment providers, and supervision staff records. 

The data set that was compiled across the four sites include program information (e.g. drug 

court program start and end dates, number of treatment sessions attended, number of drug 

tests administered and number of positive tests), characteristics of participants (e.g. age, 

gender, ethnicity, marital status, substance use histories, drug of choice, etc.), type of 

graduation (e.g. successhl, discharged, exceed program time fiame), and rearrests during 

and after program participation. Rearrest data was gathered from the National Crime 

Information Center (NCIC) for all of the sites. This data includes information on arrests 

and full criminal history as reported to the national database. For the most part, the most 

complete information is maintained by the treatment providers (as compared to the courts) 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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&d therefore the retrospective analysis tends to over-represent those drug court participants 

who actually attend their mandated drug treatment services. As will be discussed below, 

this limitation is significant because the most complete picture of drug treatment courts 

findings is fiom treatment providers, although other studies have found not all drug ‘court 

offenders actually participate in drug treatment programs (Harrell, Cavanaugh, and Roman, 

1998; Deschenes, Turner, and Greenwood, 1995; Goldkamp, White, & Robinson 2001; 

Peters and Murrin, 1998; Gottfiedson, Najaka, & Duran, 2002 

Procedures for the Qualitative Components of the Study ! 

As part of this study, the researchers examined the treatment components of the 

drug court program to learn more about the actual nature of services provided. Data 

collection methods examined the counselors’ philosophies of drug abuse causation and 

treatment, as well as the implementation of treatment services within the drug court context 

(using a structured, direct observation methodology). These data sources were then used to 

explore the orientation of counselors working with offenders in these four drug courts and 

to compare these orientations to the type of substance abuse treatment services deliyered. 

Observation of Treatment Services , 

Using weekly schedules provided by the treatment program administrators the 

research staff developed an observational schedule that maximized the number of meetings 

that could be observed during a four-day on-site visit. During’ each site visit trained 

observers were assigned to unobtrusively observe treatment meetings at the various 

programs in the jurisdiction. Counselors had previously informed their clients of the 

researchers’ upcoming Visit and no client in any program in any jurisdiction refbed to 

participate in a meeting under observation. Observers recorded the amounts of time (in 

minutes) spent on each of several possible treatment topics and activities taking place in 

each meeting. Observers also recorded narrative information and completed several 

summary scales to further describe the exact nature of the services being offered. 

Counselor Surveys 

Treatment program administrators also provided a list of staff who were directly 

involved in the delivery of services to drug court offenders. The researchers provided each 

of these counselors with a survey packet during the site visit. Instructions in the packet 

directed the counselors to complete the survey and return it directly to the researchers via 

mail, in order to safeguard their responses. A total of 54 of the 92 counselors (58%) 

completed the survey. The counselor survey included information such as counselor’s 

educational background, credentials and previous counseling experience, as well as typical 

counseling and related duties and caseload size. Counselors were asked to complete two 

questionnaires designed to uncover their philosophy of both drug abuse causation and the 

necessary components for effective treatment. The items comprising these two 

questionnaires largely mirror those developed by Taxman, et a1 (2001) including items 

representing conflict, labeling, social control, social learning, social disorganization and 

strain theories as well as some new items reflective of cognitive-behavioral (CBT) 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
approaches. For a discussion of the instrument refer to Taxman and Bouffard (2002a) and 

Taxman, Simpson, & Piquero (2002). 

Theories of Substance 

Abuse.. . Conflict 

Labeling 

Social Learning 

Social Control 

Strain 

Social Disorganization 

Disease Model 

Anti-Social Values 

Cognj tive-Behavioral 

Psychopathic 

Character 

Table 1. Content of Counselor Philosophy Questionnaires 

Causation Effective Treatment Components 

Powerlessness; Racism; Sexism. Understanding societal problems of racism and sexism; 

Stigma; Formal and Informal Labeling 

Deviance Amplification; Isolation. Addict 

as Master-status. 

Exposure to Drug Abuse; Role modeling 

criminal and non-aiminal behavior; 

Exposure to drug use attitudes and 

behaviors. Rewards and Reinforcements. 

Social bonds of Attachment, Commitment, 

Involvement; Belief in Morality of 

Norms/Rules; Low Self-Concept; 

Containment. 

Failure to Achieve Positively Valued 

Goals; Removal of Positive Stimuli; 

Exposure to Noxious Stimuli; Distancing 

fiom Society. 

Population Heterogeneity; Community 

Ecology; Community Control; Social Ills. 

Inherent predisposition to addiction, 

inability to moderate use. 

Lack of prosocial commitments, beliefs. 

Lack of social, emotional, and coping 

skills. 

Lack of respect or empathy for others. 

addressing coping strategies and internal controls. 

Avoiding internalization of negative labels and 

stigmatization; assuming mainstream role (e.& parent, 

peer counselor, etc.). 

Avoiding association with drug abuser, ledng new 

behavioral responses to b5&opportunities to drugs; 

developing prosocial and acceptable behaviors; 

teaching new lifestyle, peer associations and behavior. 

Developing bonds to significant others, social 

institutions (e.g. school or work) or internal controls; 

creating a positive self image; discipline. 

Develop coping skills to deal with stressll situations; 

teaching anger and stress management. 

Developing sense of control by the individual and 

within the community; mobilizing community support 

issues; addressing housing issues; addressing work and 

social network issues. 

Acceptance of “powerlessness”, Reliance on a “Higher 

Power“. 

Increase prosocial activities, recognize value of 

sobriety. 

Training in coping skills, life skills, cognitive 

monitoring and behavior management techniques. 

Perspective taking, empathy building. 

Summary of Main Findings 

Characteristics of the Drug Treatment Courts 

Drug courts can be designed to fit into the local socio-political-legal environment of a 

community. Nationally, 90 percent of drug courts are post-plea courts where the offender 

agrees to the drug court as a condition of the sentence with the hopes of reduction in the 

arrest history with the possible expungement of the conviction upon successkl completion of 

the program. The remaining 10 percent are pre-pleas where completion of the drug court 

generally results in an expungement of the record (Cooper, 2001). The actual process for 

establishing the target population (drug court program eligibility) and nature of the drug 

court’s program components is a local decision usually based on the wishes of the relevant 

stakeholders and the availability of different services within the treatment community. 

Nationally, 8 percent are misdemeanor only courts, 40 percent are felony only courts, and the 

remaining 52 percent are misdemeanor or felony courts (Cooper, 2001). The target 

populations of the four study courts generally consisted of felony and misdemeanants 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
offenders, although the Bakersfield court did not allow felony offenders (as a concession to 

local political considerations). 

The four drug courts included in this study adapted the general features of the drug 

court model to fit their particular needs. The courts for the most part were post-plea, 

except for Jackson County, Missouri. The courts used the existing judicial infi-astructure to 

deliver services, holding status hearings weekly except in Creek County where the hearings 

occurred twice a month. All drug court clients were expected to attend the status hearings. 

None of the four courts had a structured set of sanction protocols (i.e., graduated sanctions 

menus) that are recommended for drug courts. The sanctions employed by this sample of 

courts did not operate within a fiamework of a written behavioral contract signed by the 

offender upon entry into the drug court. Except for the Bakersfield court, drug testing was 

administered by the treatment service agencies, with the treatment system sharing 

information on the testing results with court personnel. In Bakersfield, a private drug 

testing firm was contracted by the court to administer the randomized urinalyses. This 

agency then also prodded reports to the court. True random testing occurred in 

Bakersfield where the offenders called in to determine the time and date of their drug test 

that week. Drug testing tended to be more fiequent in the early phases of the drug court 

program and was generally less intense as clients progressed in the program. 

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Treatment services were delivered by either an may of local providers or by a 

dedicated treatment provider contracted by the court. Both models of service acquisition 

included some access to residential drug treatment services if needed (though Creek County 

specilically did not offer any residential services for drug court clients). Treatment services 

were offered during the full duration of the drug court period, ranging fiom 12 to 15 months. 

This is the amount recommended by the Office of Justice Programs given the addiction 

backgrounds of the offenders. Creek County did offer shorter duration of treatment 

programming based on the severity of the addiction of offenders with a range of 3 to12 

months in duration. 

Drug treatment providers tend to be community-based organizations that are either 

part of the public health system or private agencies. Many offer a variety of services 

including group counseling, relapse prevention (later phases), social and coping skills, and 

case management services. Support services are often offered through the local self-help 

community (AA, 12-steps programs) in each jurisdiction. In only one jurisdiction (Creek 

County), did the treatment providers incorporate and use a formalized treatment 

curriculum. The use of a formalized curriculum has been suggested to be an important 

component of effective treatment services (Lamb, et al, 1998). None of the treatment 

providers offer medical services on-site, rather these services were provided through 

referral to other local providers. 

c X 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Table 2 Cross-Site Comparisons of Drug Court Structure, Operations and Phases 

Drug Court Structure 

Date of Inception 

Program Length 

Drug Court Status 

Hearings 

Random Testing 

Tested By 

Amount by Phase 

Status Hearing 

Drug Testing 

No. Drug Tests 

No. of Providers 

Treatment 

Diffefentiated Program 

Levels or Tracks’ 

Phase I 

Phase U 

Phase IJI 

Phase IV 

Closed Groups 

Formalized C&iculum 

Individual Counseling in 

addition to group 

St. Mary Parish Creek County Bakzrsfield Jackson County 

Post-plea, post 

adjudication 

1997 

15 months 

Weekly 

i YeS 

Treatment 

2x week, 2 months 

2x week, 4 months 

lx week, 3 months 

Monthly, 6 months 

66 

One Private 

One 

2 months 

4 months 

3 months 

6 months 

No 

No 

No 

Post-plea, post 

adjudication 

1997 

3,6,9,12 months 

Bi-Weekly 

No 

Treatment 

2x week, 3 months 

Ix week, 3 months 

lx biweekly, 3 

months 

Random, 3 months 

42 

Two Private*/ 

County Heath 

2 drug court tracks 

4 treatment tracks 

3 months 

3 months 

3 months 

3 months 

No 

Yes 

YeS 

Post-plea, post 

adjudication 

1993 

12 months 

Weekly 

YCS 

External 

2x week, 2 months 

Ix week, 4 months 

Ix week, 3 months 

64 

Multiple 

Contractors to 

County Health 

One 

4 months 

4 months 

4 months 

NA 

’ No 

Yes (some) 

YeS 

Pre-plea, pnadjudication 

1993 

12 months 

Weekly 

YeS 

Treatment 

2x week, 4 months 

Ix week, 4 months 

lx week, 4 months I 

.64 

County Health 

Si,treahnent tracks 

4 months 

4 months 

4 months 

NA 

No 

YeS 

YeS 

Each court has a different process for determining who is eligible for participation 

in the drug court program with different actors responsible for making these decisions in 

each jurisdiction. In two sites the i&tial, legal review of a case (of current offense and 

criminal history) is performed by prosecutors (Creek County and Jackson County), while 

probation is responsible for this review in the other two sites (St. Mary Parish and 

Bakersfield). None of the sites used a standardized risk assessment tool to guide the legal 

screening process. The legal screening generally precedes the clinical assessment that is 

typically conducted by the treatment provider. This bifUrcated decision-making process 

means that the severity of the substance abuse need is usually secondary to the participant’s 

legal (offence and criminal history) eligibility, and that decisions regarding participation 

tend to not include the addiction issues. 

~~ 

Does not include participants placed in residential treatment 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 3: Decision Making Process for Eligibility for Drug Court 

f 

i 

1 Target Population 

Legal Screening 

Legal Screening Tool 

Risk Screener 

Clinical Screening & 

Assessment 

Screening Instrument 

Clinical Assessment 

, Instrument 

4 Mental Health 

Assessment 

Case management 

Treatment criteria used 

to exclude 

St. Mary Parish Creek County Bakersfield Jackson CounQ 

felony or felony and misdemeanant First time felony 

misdemeanants misdemeanants offenders and 

misdemeanants. 

Probation fiom DA District Attorney Probation District Attorney 

Non-standardized Non-standardized Non-standardized Non-standardized 

No No No ’ No 

Treatment Provider Treatment Provider County Lkpt. of Treatment Provider 

OECX 

Mental Health 

AS1 SASSL LPQ, Sel f-Developed AS1 

Mortimer Non-standardized 

AS1 and Interview Self-Developed AS1 and Jnterview AS1 and Interview 

Bio-Psychosocial 

and Interview 

Treatment Provider Referred Treatment Provider Treatment provider 

Treatment Provider Treatment Provider County Dept. of District Attorney’s 

Mental health, Substance Abuse Mental health, Mental Health and 

substance abuse Severity, mental substance abuse lack of motivation 

Mental Health Office 

severity health, motivation severity 

Characteristics of the Participants in Drug Treatment Courts 

The following table illustrates the type of offenders participating in the four drug 

courts. For the most part, offenders in these courts have had a significant criminal justice 

history with over 59 percent having two or more prior arrests. Many of the offenders have 

had arrests for personal and property offenses as well as drug offenses. The instant offense 

tends to be a drug crime, with a majority representing felony offenses. Drug use histories 

vary by jurisdiction but the drug court tends to include offenders that abuse crackhocaine, 

amphetamines (“Meth”) and marijuana. Information on the severity of substance use was 

either not available or maintained by the program sites. Prior substance abuse treatment 

experience varied by site with a range of 18 percent (Bakersfield) to 48 percent (St. Mary 

Parish) with an average of 28 percent. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
St. Mary Parish Creek County Bakersfield Jackson County Total 

Prior Criminal History 

Number of Prior Arrests 

NOnC 

one 

Two or More 

Mean number of Prior Arrests 

Types of Prior Arrests 

Personal 

Prom 

Motor VehiclelDW 

Drus 

Other 

Personal 

property Motor Vehicle 

Drug 

DullDWl 

other 

Felony 

Misdemeanor 

Drug Court Arrest 

Drug court Arrest 

Substance Abuse 

Ever Used (Lifetime) 

Alwhol 

Marijuana 

cracwcocaine 

Amphetamines 

Opiates 

other 

Use Last 30 Days 

Alwhol 

Marijuana 

CracWCocaine 

Amphetamines 

Opiates 

other 

% Prior Treatment Experience 

Demographics 

% Male 

YO Caucasian 

Mean Age 

% High School GraduatdGED 

% Employed at Admission 

10.9 

23.2 

65.9 

3.6 

13.0 

29.5 

5.2 

38.8 

13.6 

6.4 

22.3 

0.5 

63.2 

4.1 

3.6 

65.2 

34.8 

95.9 

93.2 

81.8 

5.0 

22.3 

, 38.2 

44.1 

40.5 

35.0 

0.0 

13.2 

6.4 

48.2 

80 

54 

29 

37 

34.9 

20.8 

44.3 

1.9 

7.6 

19.2 

28.7 

37.7 

6.8 

2.1 

. 7.3 

I .6 

53.1 

34.4 

1.6 

63.5 

36.5 

89. I 

loo 

29.2 

58.9 

7.3 

24.0 

21.4 

92.7 

27.6 

13.5 

0.5 

6.8 

27.1 

79 

79 

33 

63 

8.6 

14.7 

76.7 

6.7 

12.7 

23.1 

3.2 

50.7 

10.3 

8.9 

9.3 

2.4 

67.4 

7.5 

4.7 

- 

100 

68.7 

59.5 

30.2 

67.5 

18.5 

10.4 

55.0 

45.4 

20.7 

51.3 

11.5 

9.0 

17.8 

46 

69 

33 

25 

28 

22.1 

28.5 

49.4 

2.2 

9.3 

27.1 

2.4 

54.7 

6.5 

2.3 

9.7 

0.1 

85.8 

0.8 

1.2 

96.8 " 

3.2 

88.8 

85. I 

53.6 

19.7 

1.4 

14.1 

64.0 

61.9 

29.0 

6.2 

0.4 

2.7 

37.5 

72 

32 

29 

52 

17.9 

23.1 

59.0 

3.7 

10.8 

25.5 

4.7 

50.6 

8.5 

4.7 

10.6 

0.9 

75.4 

5.9 

' 2.5 

59.7 

40.3 

I 

80.8 

76.5 

44.1 

43.7 

12.6 

1.6.9 

52.2 

55.3 

26.0 

26.4 

7.1 

6.5 

28.2 

65 

49 

31 

40 

Compliance with Drug Treatment Court Requirements 

The drug court model has as its primary intended intervention components of an 

effective substance abuse treatment delivery system, coupled with fiequent and random 

drug testing, and regular status hearings and community supervision under the guidance of 

the court to ensure offender compliance. In addition to examining whether the treatment 

delivered to clients in these drug courts comports with the scientific evidence regarding 

effective substance abuse treatment, in this study, we also measured clients' compliance 

... 

m 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
9 

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with the various functional components of the drug court program ’where such data existed. 

The quality and availability of data varied by site, and by client records. The files did not 

contain information on the number of status hearings or the sanctions provided by the court 

in response to any negative behavior. The tables below summarize the core components of 

compliance with the programs’ requirements (as could be assessed with the available data). 

Specifically, these data represent graduation rates, rearrest during the program period and 

post program rearrest (for 12 months past program discharge). 

The multilayered drug court model intends to deliver an intervention that is 

structured, intensive and demanding for the addict-offender. In these four drug courts the 

typical offender participated in the following services once a week during the initial stages 

of the drug court program, generally for the fist two months: 2 drug tests, two or three 

treatment sessions (for 90 to 120 minutes each), and one status hearing (except Creek 

County where the status hearing occurred bi-weekly). While the logic behind the 

structured intervention is compatible with the goals of assisting the addict-offender to 

become committed to recovery and to be held accountable for Mer behavior, while 

making progress in treatment, the results presented here suggest that the nature of the . 

intervention as delivered is not sufficiently intense (in either treatment dosage or 

supervision by the criminal justice system) to ensure compliance or therapeutic progress. 

As a general rule of thumb, the researchers defined “adequate” compliance as the offender 

participating in 70 percent of the expected services. The 70 percent “rule” was employed 

as a tool to gauge how the offender was responding to the intervention and is admittedly a 

purely arbitrary criterion, but represents a plausible middle ground between being too strict 

or lenient of a criterion, 

Table 5 displays the compliance for the offenders.by the court’s definition of 

successful completion status. Successhl completion refers to the graduation fiom the drug 

court program as determined by the administrating judge and drug court team. Overall, 

relative to the number of offenders who participated in drug court programs, the percentage 

of offenders successfully completing ranges fiom 29 percent (Jackson County) to 47 

percent (Bakersfield). Most surprising is the actual length of time that the offenders 

participate in the drug court program. Most drug courts have an expected length but often 

allow offenders to stay longer in the program ifthey are making progress towards dealing 

with their addictive behavior. In this four-drug court sample, it was common practice for 

offenders, both for successful and unsuccessful graduates, to participate in the program 

well beyond the expected program length (with a maximum duration of 44 months). The 

four courts fiequently allow offenders that are having difficulty meeting program 

requirements to extend their time in the drug court program, only to then terminate the 

offenders “unsuccesshlly” fiom the program. Across the four drug courts, this pattern 

occurred for over 22 percent of the cases of unsuccessll graduates. In some jurisdictions 

this means that the prosecutor can then reinstate the original charges and pursue 

prosecution of the offender due to an unsuccessfbl completion of the drug court program. 

Similarly 53 percent of the successful graduates of these drug courts participated in the 

program past the expected program length, suggesting that the 12 to 15 month time fiame 

is generally too short to address the relapsing nature of addiction. 

XiV 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 5: Overview of Program Completion Rate and Time Spent in Drug Court by 

Graduation Status 

St. Mary Creek Bakersjield Jackson Total 

Parish County County 

Completion 

YO Graduate 

Expected Length 

3 1.8% 48.4% 36.2% 29.0?? 33.1% 

15 months 3,6,9, & 12 12 months 12 months 12 months 

Total N 

Range (month) 

Mean (month) 

% Scheduled 

Time in Court 

26-50'?? 

5 1-75% 

76-1000/0 

10 1 - 125% 

G 

70 

9-42 

20.9 

0 

12.9 

21.4 

4.3 

t 

T 

150 

l-44 

9.8 

32.0 

22.0 

14.0 

0.7 

months 

G T G T G 

93 99 262 461 354 

3-33 1-36 6-33 1-42 6-45 

12.6 8.8 ' 14.6 8.1 16.4 

1.1 26.2 0.4 28.8 0.3 

9.7 12.1 3.4 16.7 2.0 

38.7 14.2 44.7 13.7 43.7 

11.8 7.0 21.7 4.5 15.0 

- 

T 

868 

1-43 

11.0 

20.9 

18.6 

20.5 

6.0 

G T 

779 ' 1578 

3-45 1-44 

15.7 9.9 

0.4 24.5 

4.3 18.0 

41.5 17.5 ' 

15.9 5.2 

> 125% I 61.4 14.0 38.7 15.2 29.8 11.1 39.0 22.6 37.9 17.9 

G-Graduate T=Terminate 

Besides variation in program compliance as measured by completion status, an 

analysis of the individual profiles of offenders finds significant differences between the 

types of offenders who are likely to successhlly complete the drug court. In all sites, 

Caucasians are more likely to complete than Afiican Americans or Hispanics. Graduates 

are also more likely to have higher educational backgrounds (high school diploma or 

above) than terminated clients. Users of cocaine/crack, amphetamines, and opiates are also 

less likely to graduate than users of marijuana. 

Multivariate analyses were conducted to examine individual and program 

compliance factors on graduation fiom the drug court program (successWterminated). In 

two sites (Bakersfield and Creek County), it was found that participants with a history of 

prior substance abuse treatment are less likely to graduate than particip&ts who are 

receiving treatment for the fist time. The second pattern that emerges concerns 

participants with three or more prior arrests. At the two urban locations (Jackson County 

and Bakersfield), it was found that participants with more serious criminal histories are also 

less likely to succeed in drug court. This pattern suggests that some drug court programs 

may have dif36culty dealing with participants presenting more severe drug using and 

criminal behaviors. 

. 

Compliance with drug testing and attendance at treatment sessions varies 

considerably depending on the program completion status of the offender, as shown in 

Table 6 below. As expected those offenders that do not provide the requisite number of 

urine tests or that fail to appear for treatment sessions are more likely to be terminated fiom 

the program across each of the four drug court sites. Program terminators are two to three 

times more likely to test positive for illicit drug use during their drug court program 

participation than those who are successfdly discharged. Regarding treatment sessions, 

most of the offenders whose cases result in termination are jnfrequent attendees of 

treatment sessions in all of the different drug court programs. Most surprising, in the 

Bakersfield Drug Court attendance at treatment sessions for graduates is very low (only 37 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
,I 

percent attend more than 70 percent of the required sessions) and these offenders are still 

allowed to graduate. A review of the compliance with treatment data illustrates that many 

offenders who successfidly graduate are required to' repeat various phases of the court 

program, with 27 percent of the graduates in treatment for 1.5 times the expected nmber 

of treatment sessions. The advantage of the drug court program is the flexibility to allow 

offenders that are making progress to extend their participation in treatment and then allow 

the offender to graduata. However, given relatively low completion rates (33 percent 

overall) this suggests that many offenders may be in need of a different type of treatment 

programming than is provided. (see qualitative study findings below). 

Completion 

% Graduate 

Expected Length 

Total N 

Drag Tests 

% Scheduled Tests Taken 

0-25% 

26-50?? 

5 1-75% 

76- 1 00% 

101-125% 

126-150% 

>150% 

Meet 700A of required tests 

YO Participants Positive 

Drug Treatment 

% Scheduled Treatment 

0-25% 

26-50% 

5 1-75% 

76- 1 00% 

101-125% 

126-1 50% 

>150?? 

Attended > 70% Sessions 

G=Gr; 

Table 6: Overview of Compliande with D& Test and Treatment 

Program Requirements by Site and Graduation Status 

St. Mary Creek Bakersfield Jackson Total 

Parish County County 

31.8% 48.4% 36.2% 29.0% 33.1% 

t 

15 month 3,6,9, & 12 12 months 12 months 

months 

G T G T G T G T, G' T 

;lo 150 93 99 262 46 1 354 "868 'I 779 1578 

0 

0 

0 

1.4 

8.6 

24.3 

67.1 

100 

57.1 

6.8 0 35.7 5.4 

10.1 16.7 25.5 27.2 

18.9 28.2 21.5 27.2 

10.1 38.4 4.0 15.2 

13.6 12.9 8.2 3.3 

13.5 3.8 5.1 2.1 

27.0 0 1 .o 14.6 

69.6 57.7 17.3 43.5 

81.9 52.6 89.8 53.8 

44.7 

19.5 

13.6 

10.3 

4.7 

2.4 

4.8 

25.6 

60.5 

0.9 31.1 1.8 31.7 

8.1 22.5 13.8 20.6 

21.2 14.5 21.5 15.4 

26.8 15.5 22.2 12.8 

21.5 6.7 13.7 7.2 

10.3 4.7 8.8 5.1 

11.2 5 .O 18.2 7.2 

75.7 34.7 67.2 35.3 

63.9 88.5 63.9 81.4 

45.6 

0 17.3 3.4 21.2 36.6 26.0 17.1 11.0 18.7 18.3 

2.9 17.9 14.6 30.3 31.4 19.2 12.2 5.7 19.4 15.2 

24.6 21.4 61.8 19.2 20.2 11.0 17.0 4.3 31.2 11.1 

18.9 14.5 15.7 8.0 8.5 1.7 22.0 3.1 13.9 5.1 

20.3 6.2 3.4 2.0 3.3 1 .O 17.1 1.8 8.3 2.4 

33.3 11.0 1.1 2.0 0 0 12.2 0.6 8.5 2.1 

98.6 58.6 83.1 38.4 36.6 17.1 70.7 10.7 64.5 24.1 

late T=Terminate 

0 11.7 0 16.2 0 41.1 0 73.5 0, 

Both the in-program arrest and post-program rearrest rates confirm that the 

predominate finding in other studies--successes succeed and failures M--prevails. Of all 

of the participants, 14 percent of graduates and 42 percent of terminated clients were 

arrested dwing program participation (including the extended time, beyond 12-15 months 

that the offender remained in the program; technical violations such as failure-to-appear 

were not considered as a new arrests). As discussed in Tables 5 and 6, nearly all drug court 

participants are not in compliance with the overall conditions of the drug court regarding 

drug testing attendance and positive rates, attendance at treatment sessions, and other 

mandated conditions. In fact, an examination of the program duration for graduates finds 

,, , 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
s 

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Completioll 

% Graduate 

Expected Length 

that 59 percent spend over the expected drug court time that indicates a fair degree of 

technical violations with program conditions. 

31.8% 48.4% 36.2% 29.00? 33.1% 

15 month 3,6,9, & 12 12 months 12 months 

Table 7: Within Program and Post Program Rearrest Rates by Site 

and Completion Status 

I St. Maty Parish Creek County Bakersfield Jackson County Total 

Mean Length To Rearrest 

(months) 

4.5 4.5 7.6 4.6 6.9 4.2 6.3 4.7 6.6 4.5 

, months 

G T G T G, T G T G T (4 

Within Program 

% Rearrests 

Post Program 

% Rearrest in 12 months 

9 I5* 11 19* 21 73 12 23* 14 42 

6 21 I1 39 13 53 7 38 9 41 

Post-Graduation Recidivism Rates 

The conclusions reached in reference to previous research on the effectiveness of 

drug court programs, specifically that “successes succeed and failures fail” continues in this 

data and in fact the trend continues past the time when participants graduate or are 

terminated fiom the drug court. In this study, rearrest data were obtained for each of the 

2,357 offenders for 12 months past the date of discharge fiom the drug.court program. As 

shown in Table 7 above, the trend continues with the terminated clients more likely to be 

rearrested for new offenses than the program completers. Rearrest rates varied by site, but 

overall 9 percent of those successllly completing the program and 41 percent of those 

discharged were rearrested for a new offense within twelve months. Terminated 

participants who were rearrested took an average of 4.5 months until rearrest whereas those 

successhlly completing who were rearrested took about 6.6 months. 

The results of a series of logistic regression models finds that discharge status 

(graduateheminate) is the most consistent variable associated with post-program 

recidivism. In three of the four drug court, graduation reduces the risk of recidivism. No 

other variable is consistent across the four sites. In two sites, a within drug court arrest 

contributes to recidivism. The logistic regression model appears to confirm that “success 

breeds success” whereas failures do not do as well, even after termination fiom the drug 

court program. 

Understanding the Dimensions of Drug Treatment Services 

The second part of the study explored the nature of the drug treatment services 

delivered to drug court offenders to understand some of the results fiom the drug court 

participation. This section of the study involved the use of surveys and direct observations 

to quat* the services in a manner that can assist in understanding the treatment program 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
compliance and completion rates. A combined qualitative/quantitative methodology was 

used to explore the issues regarding the delivery of treatment services as they OCCUT within 

the drug court setting. 

Counselor Characteristic 

Respondents 

(% Of solicited) 

% In Recovery 

Modal Highest Degree Held 

(% w/modal degree) 

Mean Years Providing Drug Treatment 

Mean Age in Years 

% White Counselors 

% fican American Counselors 

% Hispanic Counselors 

Mean Hours Worked per Week 

Mean Number of Clients Assigned to 

Counselor 

Mean Weekly Number of Groups 

(Hourslweek) 

Mean Clients per Group 

General Counselor Characteristics 

St. Mary Creek Bakersfield Jackson Total 

Parish County County 

3 3 21 8 38 

(50%) (30%) (65.6%) (53.3%) (54.4yo) 

0 66.6% 38% 500A 40% 

(100%) M.A.,<H.S. leSS (50%) (40%) 

4.0 2.5 4.7 6.1 4.8 

28.7 51.0 42.2 36.5 40.5 

33.3% 66.6% 1 9% 3 8% 28.6% 

66.6Yo 33.3% 24% 25% 28.6% 

0 0 3 8% 0 23% 

40.0 27.2 40.3 30.0 36.8 

76.7 28.7 34.3 25.0 35.3 

3.0 5.7 4.7 4.3 4.5 

(6.2 hours) (8.0 hours) (8.2 hours) (6.8 hours) (7.6 hours) 

13.5 9.7 10.1 13.1 10.9 

BA W.D., H.S. or BA H.S. or less 

(1 (48%) 

Counselor surveys were designed to gather information related to the characteristics 

of the counselors themselves, including their demographic characteristics, as well as their 

professional qualitications and typical responsibilities. Table 8 contains some basic 

information about this group of counselors working with drug-involved offenders. In 

general, counselors at these programs appear to have several years experience providing 

substance abuse treatment. The extent to which they had obtained advanced academic 

degrees varied by site, but was generally low. Similarly, varying proportions of counselors 

reported that they themselves were in recovery, with programs in three of the four sites 

employing at least some counselors in this category. The raciaVethnic background of 

counselors appeared to vary considerably, as did the average age of counselors employed at 

each site. Hispanic counselors were only employed in treatment programs at the California 

site. Counselors generally worked 30 to 40 hours per week, conducting between 3 and 6 

group meetings (lasting fiom 6 to 8 hours total) per week. Across all sites, counselors 

reported that 4 1 % percent of their time was spent in group or individual treatment tasks, 

with the remainder of their work time devoted to various administrative tasks (e.g., intakes, 

assessments, etc). Group size was generally consistent across sites at about 10 to 13 clients 

per group, while counselors’ assigned caseload varied greatly fiom 25 per counselor to 

nearly 77 per counselor at different sites. 

Table 8. General Counselor Characteristics 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Counselors’ Philosophies of Drug Abuse and Effective Treatment 

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The survey instruments also asked the counselors to rate their agreement with 

several statements intended to capture information about their perspective on the likely 

causes of drug use and abuse, as well as their opinions about what components were 

needed for effective substance abuse treatment. Counselors rated their agreement with 

each of these statements using a five-point Likert scale (“1” = “strongly agreed with the 

statement”, “5”= “strongly disagreed with the statement”). Each of these items was then 

aggregated into scales representing specific theories (e.g., Social Learning theory, Social 

Disorganization theory, etc). The average score, by site for all items on each of these 

theoretical “causation of drug abuse” scales are presented in Table 9. 

Counselors at all sites tended to moderately endorse the disease model, cognitivebehavioral skills deficits, psychopathic personality characteristics, antisocial values, social 

learning theory, social control theory and labeling theory as important causes of drug 

abuse. They tended to slightly disagree with items representing conflict and social 

disorganization theories, and generally had no opinion on strain theory as a cause of 

substance abuse. These results suggest that as a group these counselors tended to locate the 

causes of drug abuse within the personalities and individual experiences of the drug user, 

more so than as a result of external, macro-level social influences. 

Table 9. Mean Scores for Counselors’ Philosophy of Drug Use Causation 

(I=Strongly Agree, 5=Strongly Disagree) 

I Si. Mary Creek County Bakersjield Jackson Total 

Drug Use Cause Scales 

Conflict 

Labeling 

Social Control 

Social Disorganization 

Social Learning 

Strain 

Anti-social Values 

Cognitive Skills Deficits 

Disease Model 

Parish County 

3.4 

3.0 

2.6 

3.7 

3.0 

2.9 

2.4 

2.0 

1.7 

3.5 

2.7 

2.8 

3.1 

2.0 

3.3 

2.9 

2.0 

3.5 

3.2 

2.5 

2.2 

3.2 

2.1 

2.8 

2.5 

2.0 

2.1 

3.5 

2.5 

2.2 

3.4 

2.4 

3.5 

2.7 

I .9 

2.1 

3.3 

2.5 

2.3 

3.3 

2.3 

3.0 

2.6 

2.0 

2. I 

Psychopathy I 2.5 2.8 2.1 2.5 2.3 

t- Mean response for each scale is presented for responding counselors fiom all five of the programs at this site. 

$ - Mean response for each scale is-presented for responding counselors from both treatment pFograms at this site. 

In terms of the important components of effective drug treatment the counselors 

tended to moderately endorse items representing nearly all of the scales (see Table 10). 

This pattern of results suggests that this sample of drug court-involved counselors tended to 

support a diverse and eclectic approach to treatment, apparently being willing to apply 

almost any technique in an attempt to reduce drug use. It may also suggest that they do not 

generally have a strong affiliation or understanding of any particular approach to treatment, 

or that they do not implement a coherent treatment strategy in their programs. Given that 

the treatment providers in only one of the courts use a formalized curriculum in their 

treatment programs, it is not surprising that many of the counselors involved in these courts 

do not have a clearly defined idea of the important components of substance abuse 

prevent ion. 

xix 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Effective Component Scales 

COllflict 

Labeling 

Social Control 

Social Disorganization 

Social Learning 

Strain 

Anti-social Values 

Cognitive Skills Deficits 

Disease Model 

Psychopathic Character 

I 

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Table 11 presents information representing the proportion of all observed meetings 

in which any item from each category of treatment intervention occurred. For example, at 

the Bakersfield site (with five separate treatment programs observed) on average, only 

about 22 percent of the observed meetings contained any discussion of cognitivebehavioral components. In fact, despite the vast literature demonstrating the effectiveness 

of cognitive-behavioral treatment components for dealing with substance abusers in no site 

did more than 22 percent of the observed meetings include these treatment components. 

Items in the educatiodaflercare category (mostly informational-type components, such as 

teaching clients the basic concepts and vocabulary associated with treatment or the impacts 

of various drug classes) were also relatively rarely employed in these programs. Similarly, 

items drawn fiom the Alcoholics Anonymous (i.e., Disease Model) and Therapeutic 

Community Models (e.g., confiontation, the reliance on peers as the agent of change) were 

also relatively rarely employed (in less than 20% of meetings). 

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St. Mary Creek County Bakersfield Jackson 

Parish County Total 

1.4 1.8 1.8 2.2 I .9 

1.3 1.3 1.5 1.6 1.5 

I 1.0 1.6 1.6 1.4 1.5 

1.8 1.8 1.9 I .9 I .9 

1.8 1.7 1.5 1.3 1.5 

1.6 1.5 1.5 1.2 1.4 

1.8 1.8 1.6 I .4 1.6 

1.6 1.7 1.6 1.3 1.5 

1.8 2.8 1.7 1.8 1.8 

1.8 2.8 1.9 2.3 2.1 

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Finally, treatment components aimed at creating a safe (physically and 

psychologically) environment for clients, as well as those fostering self-exploration were 

somewhat more commonly employed, particularly in the prom operating in two sites 

where these items occurred in only about 25 percent of observed meetings. Consistent with 

the results from the philosophy of effective treatment intervention scales, it appears that the 

counselors in this sample of drug courts were employing a relatively wide range of 

treatment activities in serving their clients. On the other hand, the cost of this diversity in 

treatment components appears to be that most topic areas are dealt with sparingly. Most 

importantly, as shown in Table 1 1, the material is presented in a largely superficial and 

brief manner. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 

% Meerings 

Cognitive-Behavioral Items 

Education and Aftercare Items 

Safety and Self-Exploration Items 

12-Steps (MA) and Therapeutic 

Community (TC) Items 

SI. Mary Parish Creek County Bakersfield Jackson Couw Total 

19.5 16.8 22.4 ’ 15.3 18.5 

7.2 5.5 10.2 5.1 7.0 

21.8 14.8 26.1 12.2 18.8 

14.3 6.9 13.2 19.7 13.5 

Results presented in Table 12 are consistent with the idea that these programs 

employ a multi-faceted, yet superficial approach to treatment. In fact, these results suggest 

that this group of counselors are not only deahg with a wide range of treatment issues in a 

f‘broad-based” manner, in terms of how fi-equently their meetings focus on each group of 

topics, but also in terms of the amount of time in a given meeting that is spent on any 

particular topic when it is addressed. For instance, among all observed meetings at the five 

treatment programs operating in association with the Bakersfield court, the average amount 

of meeting time spent on cognitive-behavioral components was 1 1 %. Thus if the average 

meeting length at the five programs in Bakersfield was one and a halfhours, clients in these 

meetings would have spent approximately 10 minutes discussing cognitive-behavioral 

treatment components (when they discussed them at all, again only about 20% of the 

meetings dealt with this set of issues at all). Creek County spent the most time addressing 

cognitive-behavioral components (26% of the meeting time in meetings where CBT 

occurred); but, as indicated in Table 11 it is important to note that only about 17 percent of 

the meetings in Creek County contained any discussion of CBT components. In general 

the treatment topic area that received the most intense discussion, when it was presented, 

was the educatiodafiercare area. Again these represent informational type items, such as 

reviewing treatment-related concepts and terms or discussing plans for accessing services 

after participation in the drug court. These items do not generally represent the more 

intense or involved treatment components (and they were among the more rarely occurring 

items in terms of the proportion of meetings in which they were observed, see Table 1 1). 

% of Time 

Cognitive-Behavioral hems 

Education and Aftercare Items 

Safety and Self-Exploration Items 

Community (TC) Items 

12-Steps (MA) and Therapeutic 

Table 12. Observation of Treatment Time 

8.2 26.5 11.1 16.6 15.6 

30.5 42.7 27.0 27.3 31.9 

13.7 8.6 15.2 14.5 13.0 

6.0 7.2 3.5 12.4 7.3 

(Percent of Treatment Time Spent on Items in the Category)‘ 

I Sr. Mary Parish Creek County Bakersfied Jackson County Total 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Discussion and Implications of the Findings 

The drug treatment court model is a complex programming strategy that relies upon 

criminal justice and treatment actors to deliver well-integrated services within the court, 

supervision, and a treatment arena that emphasizes the importance of recovery as a means 

of reducing criminal conduct. Part of the drug court process is to develop a consensus 

among stakeholders about the value and importance of treatment as a tool to improve 

offender outcomes. Great strides have occurred as drug courts have evolved and grown 

exponentially (Cooper, 2001; Goldkamp, White & Robinson, 2001). Even more 

importantly the drug court environment has assisted in the growing realization that 

effective interventions that combine treatment and sanctions can address the behavioral 

problems of drug-addicted offenders. Prior studies and reviews have documented the 

I benefits fiom drug courts with the emphasis on improved outcomes of offenders in terms of 

treatment completion rates, reduced spbstance abuse, and reduced recidivism. 

This study was designed to explore the concept of treatment integration in four drug 

courts that are considered to be “mentor” courts. These courts have strong leadership fiom 

the judiciary who originally lead the way for the creation and growth of the drug court 

model as a tool to deal with the relapsing behavior of drug offenders. The study conducted 

a retrospective analysis of 2,537 offenders that participated in the four drug courts to 

examine the relationship between treatment quality and program compliance and program 

completion, in-program and post-program recidivism. The analyses presented here add to a 

small but growing literature on the impact of offender characteristics and program 

components on outcomes (Goldkamp, White, & Robinson, 2001; Gottfiedson, Najaka, & 

Duran, 2002; Harrell, Cavanaugh, & Roman, 1989), which in the case of drug courts is still 

inconclusive in response to the question of “does it work?” This study adds to the existing 

literature by examining both in-program and post-program recidivism In addition to the 

retrospective analysis of client outcomes is an exploratory study of the nature and quality 

of treatment inside the drug court. Using a combination of surveys, interviews, and 

observation of treatment sessions, we examined the type of services delivered to the drug 

court offenders in each of the four sites. These combined methods were used to begin 

exploring the issues related to integration of treatment within the drug court environment 

and the types of services provided to the offender. 

Several limitations of this study deserve recognition because they may have 

important impacts on the confidence of the findings. First, the overall design of this study 

does not include any comparison or control groups with which to compare drug court client 

outcomes. Instead, the study compares the drug court services, utilization of these services 

and rates of recidivism across the four different courts, two in rural settings and two in 

urban settings. Furthermore the comparison is made between courts that provide treatment 

services as a referral to the local treatment systems or courts that provide more direct, 

contracted services for drug court clients. The lack of a control or comparison group 

obviously limits the hdings fiom our study, and does not address some of the 

methodological issues that have been raised by Belenko (1 998, 1999,2001), Goldkamp, 

White and Robinson, (2001); Sherman, et al., (1997), and Taxman (1999). 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Second, results of this study were generated with the relatively limited data 

available at each site. The most notable impact of the limited availability of information k 

the lack of data on the number of status hearings attended or sanctions imposed, two of the 

main ingredients of the drug court model. None of the four sites maintained this 

information in a manner that was readily available to the evaluators. Thus, the study does 

not adequately examine some of the core functional aspects of the drug court, sanctions and 

judicial interactions. Another limitation is the treatment participation rates among drug 

court participants. In all of the sites, the courts do not maintain records of offenders that 

are screened, , but do not participate in drug court. The records merely reflect those that 

volunteer, and then offenders that begin to participate. The records do not allow for an 

analysis of differential participation rates for drug court and drug treatment separately. 

Finally, the data from the retrospective analysis and the exploratory study do not 

necessarily represent the same cohort of offenders. In the retrospective analysis, we needed 

a sufficient time period to allow the offenders to progress through the drug court. And, as 

the findings illustrated, we needed at least a 24-month window given the tendency in these 

four courts to extend the duration in drug court to adjust to the relapsing behavior of 

offenders. The time-frame of our funding fiom the National Institute of Justice would not 

have allowed for this window. The exploratory study of the nature and quality of treatment 

services delivered was structured as a single, cross-sectional snapshot of the treatment 

services employed in the courts. Anecdotally, most of these courts had relatively stable 

relationships with their treatment providers and the courts themselves had each been in 

operation for several years prior to this study. However, the possibility exists that 

variations in treatment type and quality has occurred over the period of time (several years) 

covered by the retrospective analysis of participant level data. Given the exploratory 

nature of the study overall and these specific limitations, the ability to make definitive 

statements about the impact of these specific types and amounts of substance abuse 

treatment services on outcomes is admittedly compromised. However, this study does 

provide a vehicle to identi@ possible hypotheses and research questions that could guide 

the next generation of studies focused on the effectiveness of specific drug court 

components (originating fi-om both the criminal justice and treatment systems). 

The findings from this study should be interpreted cautiously regarding whether 

offender characteristics or level of programmatic utilization influence in-program outcomes 

(e.g. graduation, rearrest, etc.). The findings suggest that it is likely that program 

compliance affects program completion and recidivism but it is equally plausible that these 

findings could be the result of selection bias. Many offender characteristics were not 

available in the data sets provided by the drug courts that may be pertinent to the analysis. 

Comparisons between graduates and terminated clients on race, gender, age, prior criminal 

history, and prior substance abuse suggest some dserences among the groups that may 

account for the likelihood to graduate. But many unmeasured independent (e.g. 

motivation, severity of use, etc.) and intervention variables (e.g. duration of treatment, 

clinical progress, sanctions imposed, etc.) may also account for these differences. 

Furthermore, the tendency of the drug court to continue involvement in drug court for those 

having compliance problems suggests that the concept of “graduation” is inadequately 

defined, measured and understood. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 

Even with these constraints, this study has been illum;.lting about drug courts and 

drug court operations. The drug court concept is one that requires all parties to coordinate 

services in a manner that is unique in most criminal justice program agencies. In each of 

these four drug courts, the result has usually been that the treatment agency is asked to 

deliver much of the direct support and clinical services-testing and treatment. The court 

is responsible for supervision and sanctions. The interviews with stakeholders and the 

review of data collected in each of the four sites suggests that despite its intention to 

provide a thorough integration of services, the drug court is more about “coordination” of 

services-linking services together from existing resources, rather than integrating services 

within a framework where there is increased scrutiny and demands fiom other agencies. 

In each domain of the drug court, whether it is treatment, testing, sanctions or supemision, 

the tendency is to allow the organization primarily responsible for the service to deliver it 

, as they see “fit”. 

None of the drug courts adopted any set policies or standards that would promote a 

well-integrated model (i.e., cooperation and joint-decision making across agency 

boundaries). Thus, the judiciary delivered sanctions, but these sanctions tended to be 

“individualized” to the needs of the offender instead of having any set standards or units of 

care consistent with the principles of contingency management systems or compliance 

management systems (Taxman, Soule, Gelb, 1999). Treatment, regardless of whether it is 

contracted out or brokered fiom among existing services, is run and administered by the 

treatment system with little input and oversight by the other members of the drug court 

team (e.g., judges, supervision staff). Testing is the responsibdity of the treatment system 

for the most part, and supervision and case management is left to the separate administering 

agencies. 

The analysis suggests that program completion rates are relatively low ranging from 

29 to 48 percent. This is on par with or slightly lower than the typical outpatient drug 

treatment program as determined by a nationwide study of outcomes fiom drug treatment 

programs (Simpson, et al, 1997). It is apparent that program compliance varies 

considerably but few offenders are in total compliance, in terms of attendance at requisite 

treatment sessions or maintenance of a drug-free status. The surveys of treatment providers 

mirror the findings fiom the Drug Abuse Treatment Outcome Studies (DATOS) sponsored 

by the National Institute on Drug Abuse where the researchers found that treatment 

providers tended to offer “eclectic” and a theoretical services (Simpson, et al, 1997; 

Etheridge, et a], 1997; Simpson et al, 1999). Few offered programs that were consistent 

with good quality cognitive behavioral services. The surveys revealed that the treatment 

providers tended to be in recovery and did not have advanced training. Even though halfof 

the programs had formalized curriculum, there was not a clear theoretical consensus among 

the counselors as to the causes for the addiction disorder or the best tools to provide clinical 

care. Both of these suggest that the treatment counselors are not following a prescriid 

formula for delivering services. This was apparent in the observations where the typical 

group therapy session consisted of a range of administrative, clinical, and support activities. 

The sessions were more focused on information sharing rather than skill building. 

XXiV 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Given the observations of the group sessions by the researchers, it seems plausible 

that some of the attendance problems for treatment sessions observed in the retrospective 

analysis’ may be due to the poor quality of services provided, the offender’s perception that 

the services are not beneficial, or the offender’s low level of satisfhction with the services 

provided. Regardless the observations and surveys confirm that there is a need for better 

management of the clinical services and better quality control. Such administrative actions 

may actually ameliorate some of the perceived issues with offender motivation to attend 

clinical sessions. 

Within program and post program rearrest rates among these drug court offenders 

suggest that the programmatic components may not be affecting behavior. The within 

program arrest rates, coupled with the low completion rates for the drug court program 

, overall, suggest that fbrther well-designed studies are needed to understand the impact of 

gffender characteristics and fbnctional program components on drug court outcomes. This 

study cannot answer the question but it does appear that even drug court program graduates 

fail, although their failure rates are less than terminators. However, some selection bias 

may be occurring in both who is defined as a graduate and the types of individuals that 

ultimately graduate. 

The retrospective study revealed some patterns in the drug court regarding program 

length of stay that have yet to be discussed in prior studies. In each of these four drug 

courts, the courts frequently extended the drug court time period. Presumably this is due to 

compliance problems and positive drug test(s) but the data available for this study only 

allows us to postulate this as a possible explanation. Regardless, 53 percent of the 

graduates and 23 percent of the terminators were in the drug court for more than the 

expected program length-some for up to twice as long. This suggests the potential for net 

widening, particularly for the terminators where the prosecution may decide to reinstate the 

original charges or incarcerated for program noncompliance. But it also suggests a 

warning sign for the graduates since the criteria for making a determination about 

graduation may be dependent on attitudes and values of individual judges or program staff 

instead of set program criteria. The graduates may also be in jeopardy for negative 

consequences unless the drug court program adopts set standards for program completion 

for the variety of relapse patterns of offenders. 

Conclusion and Future Research 

Drug courts offer promise to the integration of treatment within the criminal justice 

setting. This study reveals that drug courts are moving in the direction oc but have yet to 

fblly reap the benefits that it often acknowledges-namely the use of drug treatment as a 

means to reduce drug use and criminal conduct on the part of drug offenders. The drug 

treatment court concept requires attention to the value of digerent programmatic 

components. But there is more to be learned about the service delivery system, and how 

these services affect recidivism, reduced drug use and employment. More specifically 

fbture research studies on drug court model need to gain a better understanding of the 

values and perspectives of the drug court team-judges, prosecutors, defenders, 

supervision staff, treatment counselors, and others-on the services provided and the 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
components of effective interventions. Related is the issue regarding the sanctions imposed 

for different types of infi-actions and behaviors, and how treatment is intertwined in the 

sanctions. In this study, it appears that treatment participation was extended but it is unclear 

as to the circumstances that lead to this extension or the nature of the services provided. In 

fact, a better understanding of the use of different treatment services for different types of 

behaviors is warranted given the compliance issues exhibited by the offenders in these four 

courts. Finally given the issues raised in the exploratory study there is a need to examine 

the offender’s perception of the treatment services provided and the value of these services 

in gaining skills to achieve recovery and abstinence. This next generation of studies should 

be devoted to answerihg the question “what part of the drug court program works, and for 

whom” instead of focusing merely on the question of “does it work?“ 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 1 

Introduction 

t 

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48 

8 

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I 

Overview \ 

For nearly thuty years, the criminal justice and drug treatment system have 

struggled with a struchal process to provide timely access to drug treatment services for 

offenders. For years, criminal justice agencies have addressed substance using and 

abusing offenders by offering and/or requiring participation in programs designed to 

address their deficits. More often than not, the majority are referred to local substance 

abuse and/or mental health agencies that provide outpatient care upon release. Few 

offenders were offered services while incarcerated and few programs had long term 

success. In response to the need to provide drug treatment services, jurisdictions have 

created a number of innovations including case management services to advocate for 

services for offenders (e.g. Treatment Alternatives to Street Crime), specialized b-piison 

or in-jail treatment programs, specialized probation or day reporting programs, and 

diversion progrsims. Studies on the efficacy of such innovations have mixed results, with 

some programs reporting reductions in recidivism and others not (Sherman, et al, 1997; 

Anglin, et al, 1996; MacKenzie, 2000; Taxman, 1999). One theme echoed in many of the 

studies is that the overall operations of treatment and treatment services for offenders has 

not been affected by these innovations, and treatment services for offenders remain 

scarce (DuEee and Carlson, 1996). Overall, few systemic effects have been realized and 

programs consistently struggle with ensuring the stability of treatment services as 

resources increase and decrease. Estimates are that of the 45 percent of the offenders 

who are in need of drug treatment services (ADAM), only a mere token of these 

offenders receive any services, and often these services are mismatched with the needs of 

the offender (Farabee et. al., 1999). Further, while the drug treatment innovations appear 

to provide a limited linkage between the treatment and criminal justice system, many 

analyses continue to suggest that the services are not integrated into the operating 

philosophy of the criminal justice programs. 

means to overcome the often-inconsistent participation and delivery of treatment 

services, and to integrate treatment into the norrnal, daily operations of the court and 

supervision systems. The drug treatment court includes treatment, drug testing, 

supervisiodoversight, and compliance management with the specialized feature of the 

presiding judge overseeing the progress of the addicted offender. The judiciary provides 

a routine basis to ensure compliance with both treatment and punishment conditions, The 

drug treatment court is novel in that the judiciary maintains the integrity of the drug 

treatment court design by ensuring that all components of the program are integrated. In 

many ways, the concept of the drug treatment court reshapes criminal justice policy by 

forging the interdisciplinary team to address the addiction and criminal behavior of 

offenders through integrated programming and through the altered role of the judiciary. 

I 

Drug treatment courts evolved as a new innovation in 1989 in Miami, Florida as a 

1-1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Drug treatment courts rapidly expanded during the last decade to nearly 700 

courts. Funding fi-om the U.S. Department of Justice, and the creation of a specialized 

Drug Court Program Office in 1994, contriiuted extensively to the growth of the drug 

court movement. The availability of planning and implementation funds fiom the federal 

government provided the impetus for many jurisdictions to consider the drug treatment 

court. The drug treatment court is also perceived as being different fiom other 

“alternatives to incarceration” due to judicial involvement, prosecutorial role, and access 

to treatment services. By design, the drug treatment court places equal emphasis on 

treatment and public safety in the programming for the addicted offender. 

The underlying rationale for the drug treatment court centers on drug treatment 

goals, namely reduction in drug use, as a primary goal of the criminal justice system and 

that treatment intervention is important in order to achieve this goal. Stated simply, drug 

courts recognize that treatment is one of the primary interventions to achieve justice goals 

imd the role of the court is to ensure that these services are provided. 

Drug courts provide a programmatic process to address addiction as a chronic 

behavior with relapsing occurrences. The traditional justice system has struggled with 

responding to reoccurring behavioral conditions due to it’s tendency to be incidentdriven and the use incarceration as a potential response. Under the traditional system, 

little tolerance exists for the reoccurring nature of addicted behavior and the criminal 

justice system continues to struggle with providing appropriate and proportionate 

responses for non-compliant behavior. Under the drug court model, frequent status 

hearings provide positive reinforcement for the struggling addict as well as a means to 

respond to potential relapsing incidents. The drug court process recognizes the relapsing 

nature of addiction, and provides the flexiiility to respond accordingly. Therein lies the 

major difference between the drug court and the traditional treatment process for 

offenderethe integration of treatment goals within the fabric of the drug court process. 

The drug court concept, as implemented in a variety of settings, provides the 

opportunity to explore how treatment is integrated into the drug court setting. More 

importantly, key questions have to do with the organizational and structural delivery of 

services in a manner that reinforces the importance of treatment goals (e.g. retention in 

services, reduced drug use, etc.) along with justice goals. In other words, how are drug 

treatment services provided within the fiamework of the drug court? What policies and 

procedures drive the drug court that recognizes the importance of treatment? The 

available literature on drug treatment courts does not address these questions, particularly 

the issues related to how treatment services are offered to offenders. Nor does it address 

what are the supporting policies and practices of the drug treatment court that reinforce 

the goal of providing drug treatment: to reduce the recidivism of drug involved offenders 

by changing their drug using habits. We intend to examine these issues in this report as 

part of an exploratory study on the delivery of treatment services within the criminal 

justice system. 

In this chapter we will address some of the common issues related to drug 

treatment courts based on findings from the research literature. This chapter 

reviews the effectiveness of drug treatment courts, descnis the processes and activities 

that occur in the drug treatment court, reviews the key ingredients of their success, and 

outlines the research questions that will be addressed in this study. 

1-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Drug Treatment Courts: The State of Knowledge 

The decade of the 1990’s was one where dkg courts thrived, but studies of drug 

courts did not occur at the same pace. As noted in two annual reviews of drug courts, 

few studies use rigorous designs, which limits conclusions that can be drawn about the 

efficacy of drug courts, compared to other innovations (Belenko, 1999; 2001). Some 

studies report findings to support reductions in judicial dockets, caseloads, jail bed days, 

police overtime, and system costs, although many of these studies do not have adequate 

comparison groups, which makes the findings less valuable. At the offender level, 

within-progrm reductions in drug use are reported, but again these studies are limited to 

the nature of the design and small sample sizes. 

’ 

$, 

In two comprehensive reviews of drug court research, Belenko notes that the 

&dings tend to support four major conclusions about drug courts: 

Offenders with more serious criminal history or originating charges are 

participating in drug courts more than previous innovations. 

Drug use while in drug court among program participants tends to be lower 

than drug use in other programs 

Graduation rates fkom drug court tend to be higher than graduation rates fiom 

outpatient drug treatment programs, although it is unclear how offenders 

perform in outpatient drug treatment programs 

Re-arrest rates during drug court program participation period are lower than 

rearrest rates for other offenders that are not in drug court. 

The general findings tend to support that the drug treatment court is providing an 

avenue for drug using offenders to participate in drug treatment, and that as the model is 

developed and implemented it is likely that results can be achieved for serious drug 

offenders. 

Baltimore City, Maryland and supports Belenko’s general conclusions, but provides a 

more complete picture of the contribution of different drug court-related services that 

offenders receive and the impact on offender outcomes. In this study, the researchers 

randomly assigned 139 offenders to drug court and 96 to traditional supenision fiom 

February 1997-August 1998 (Gottfkedson, et al. 2002). The average age of the offender 

was 34 years old, 74 percent were male, 89 percent were Mican Americans, and the 

mean number of prior arrests was 12. The offenders participating in the study represent 

the complex offender pool of severe substance abuse and criminal history. Of the 139 

offenders assigned to drug treatment, 67 (48 percent) received some type of treatment 

services (predominately outpatient or intensive outpatient services) and 72 (52 percent) 

received no clinical treatment services at all. For those offenders that participated in 

treatment, the average drug court offender was in drug treatment for 199 of the 423 

supervised days, or a rate of 47 percent of the time involved in drug court. At least one 

status hearing was provided to 8 1 percent of the drug treatment court participants. 

One of the few experimental studies on drug treatment courts was conducted in 

1-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 

I 

I 

IE 

I 

Q 

,I 

I 

I 

I 

8 

4 

II 

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More importantly, the researchers explored the impact of some differential 

program components on offender outcomes and found that offenders involved in the drug 

treatment court have lower re-arrest rates than non-drug court participants. The rearrest 

rate for those assigned to the drug treatment court is 66.2 percent over a 24-month post 

assignment as compared to 81.3 percent for the control group (p<. 05). The average 

number of months to rearrest for drug court participants is 1 1 months, compared to 5 

months for the control group. While the main effects illustrate the efficacy of the drug 

court model, an analysis of the services provided within the group randomized to drug 

treatment court provides a slightly dserent picture. Differential rearrest rates occur for 

receiving drug treatment services (48 percent of the sample) had a 56.7 percent rearrest 

rate compared to 75 percent of the offenders who did not receive drug treatment services. 

Further, the study found that offenders who received treatment and supervision in the 

drug court were more likely not to fail than drug cods offenders receiving neither 

services. The study confirms the importance of drug treatment as a critical component of 

the drug court and the linkage that providing treatment services has to offender outcomes. 

Turner and her colleagues conducted a 36-month follow-up study on the Maricopa 

County First Time Drug Offender (FTDO) program. This study found that 77 percent of 

the offenders participating in drug court received drug treatment. In this study, the drug 

treatment group‘ also had a lower rearrest rate (33 percent) compared to the control group 

(44 percent), although the researchers do not report the differential rearrest rate for the 

drug court offenders based on participation in drug treatment. Discussions with these 

scholars confirm that offenders participating in drug treatment services had lower rearrest 

rates than others (Turner, 2002). However in this study, a small sample of interviewed 

offenders revealed that they had an easier time completing drug treatment court 

requirements than other probation requirements such as community services and payment 

of financial conditions. Little information was provided on the value of the treatment 

services. 

drug court participanth based on the acquisitioe of treatment services. Offenders 4, 

I 

Drug Treatment within the Drug Treatment Court Setting 

While it is assumed that drug treatment courts would include drug treatment 

services, the provision of such services within the drug court setting is largely unknown. 

In fact, few studies have been conducted to examine the organizational and structural 

issues related to the provision of drug treatment services. The limited studies have found 

some conflicting stories about the access and availability to drug treatment services for 

the drug court, suggesting the need for more research into these linkages. 

In 1999, a survey of 2 12 drug treatment courts was conducted by the Treatment 

Accountability for Safer Communities Programs (TASC), with hding by the Office of 

Justice Programs and Substance Abuse and Mental Health Administration. While the 

survey findings report that ‘treatment services designed for and used by drug treatment 

courts comport with scientifically established principles of effective interventions” 

(2001 :xi), Taxman and Bouffard in reviewing the survey results note that the “linkages 

to the treatment system appear for the most part to be compartmentalized.” (Taxman & 

Bouffard, 2002). The treatment services offered in the drug treatment court reflect the 

services available through the general substance abuse treatment community instead of 

1-4 

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This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I..“, , 

being tailored to the needs of the drug-involved offenders. For example, 5 1 percent of 

the survey respondents do not have formal placement criteria for determining level of 

care needed for the participant. This lack of ability to match the participant with the level 

of care needed is typically the result of a treatment system that lacks an array of services. 

Nearly 61 percent of the courts report having dedicated slots in specific residential, 

detoxification and methadone maintenance programs, which are a small percentage of the 

available services. While the survey hds that courts admit to access to a wide variety of 

services, this array is not typically available when needed. 

note that “access to a continuum of alcohol and drug user treatment services and other 

related rehabilitative services was often difficult, reflecting financial issues, as well as 

lack of coordination and information flow between treatment providers and other drug 

treatment court staff’ (Turner, et al., 2002: 1505). In this study, the researchers found 

that the linkages between the drug treatment court and drug treatment system tends to be 

characterized by informality where the court accesses available services but the drug 

treatment court and services are not integrated. While informality does not suggest that 

the services do not address an offender needs, it does address the lack of policy and 

operational practice that has developed to address structural issues regarding 

organizational barriers and impediments. In particular, the researchers note that referral 

and communication among the treatment providers and cd justice system in these 

14 drug treatment courts is still in its infancy, with the tendency for coordination to occur 

on an “as needed” basis. This characterization may be reflective of the early 

developmental stage of the drug court but it also suggests that drug courts have not 

necessarily built the interdisciplinary team case management approach as recommended 

by the National Association of Drug Court Professionals or the Office of Justice 

Programs. More importantly, the researchers found that there was still some tension 

between supervision and rehabilitation objectives in some drug treatment courts. These 

tensions generally resulted fiom the quality vs. quantity problems that affect drug courts 

where the push is to serve a larger number of offenders than funds allow to be served. 

Usually this results in short-changing some of the services that addict-offenders need to 

maintain their sobriety and crime-fiee lifestyle. 

drug courts (see above), confirm some of the disconnects between the delivery of 

treatment services and drug court operations. Although the survey reported that drug 

courts engaged principles of best practices, the results suggest otherwise. In key areas, 

the drug court respondents’highlight the lack of policy and operations that underscore the 

drug court program in that jurisdiction. For example, drug courts tend to target 

offender’s eligible for drug court by the offense and criminal history instead of the 

substance abusing behavior. Half of the drug courts report that they have non-clinical 

staff screen for eligible clients for the drug treatment court, and nearly 60 percent of the 

drug treatment courts exclude offenders fiom participation because they are not 

motivated for treatment. Half of the drug courts do not have any formal placement 

criteria to detennine what type of treatment services the offender should receive, and cm 

management services are not uniformly delivered in a team manner and infkequently are 

provided by the drug treatment court. Many of the courts have more than one agency 

conducting drug tests (e.g., treatment provider, probation, etc.) and often the results are 

Turner and her colleagues at RAND in a process study of 14 drug treatment courts 

Taxman and Bouffard (2002), using the survey data fiom the TASC survey of 212 

1-5 

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This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
not shared. While drug courts are designed to integrate services across systems, it 

appears that few courts have developed such an approach. This raises many unanswered 

questions about the treatment services provided to offenders in the drug court setting and 

the impact of such services on outcomes. 

\ Purpose of this Study 

Drug treatment courts are the nexus between the criminaljustice and treatment 

8, 

systems. They providt a programmatic means to integrate services-supenision and 

treatment-to reduce the substance abuse behavior of addict-criminals. Therein lies the 

premise underlying the drug treatment court-that the court can become an effective 

modality to provide the offender drug treatment services, to provide the leverage 

necessary to insure participation in drug treatment and achieve abstinence, to provide 

swift and certain negative sanctions for negative behavior, and to provide the addictoffender with some time to adjust to treatment, testing and sanctions. The drug treatment 

court changes the organizational dynamics by providing a mechanism to facilitate 

behavioral change that is theoretically sound; treatment combined with structured 

sanctions and rewards is consistent with the effective interventions. 

the treatment and criminal justice system have developed in the drug court setting. In this 

report we set out to address these questions through a thorough assessment of the 

treatment delivery system in four “mentor” courts. Mentor courts are designated by the 

National Association of Drug Court Professionals (NADCP) to be mature courts that 

have evolved. To examine the issues, the following research questions will be addressed: 

What types of treatment services are offered in the drug court setting? 

Is the treatment delivery system integrated into the drug court setting? 

How do the philosophies and interventions of treatment counselors 

coincide with the goals of the drug treatment court? 

What impact does participation in drug treatment have on outcomes for 

drug treatment court participants? 

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The questions that have not been addressed by current research studies are how 

The following study will address these and other issues related to the provision of 

treatment services within the drug treatment court. 

1-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
8 

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Chapter 2 

Research Design and Methodology 

Overview 

\ 

The purpose of the study is to examine the efficacy of treatment modalities on adult 

drug courts. It provides both an examination of current treatment practices and services 

delivered to drug court participants and provides a retrospective analysis of participant 

level data over a four-year period. A correlation between current treatment practices and 

the retrospective portion of the study assumes that treatment practices have not changed 

over time. 

The fieldwork was conducted over a thirteen-month period beginning in February 

2001 with the first site visit in Bakersfield, California and ending with the second site Visit 

to the Jackson County, Missouri drug court in February 2002. Information about the four 

drug court programs, their afHiated substance abuse treatment services, and participant 

records were obtained over the course of two or more site visits. During these &its, key 

staff responsible for court operations and the delivery of substance abuse treatment services 

were interviewed, the delivery of substance abuse treatment sessions was observed, and 

information about drug court participants was obtained from treatment and court records. 

The research employs both quantitative and qualitative techniques. The 

retrospective portion of the evaluation consists of an analysis of 2357 drug court 

participants who completed the program through termination or graduation. Participant 

level records were obtained from both treatment and court records, and criminal history and 

recidivism data was obtained from the National Crime Information Center (NCIC). The 

qualitative portion of the research consists of interviews with criminal justice and treatment 

personnel involved in drug court operations, surveys of treatment counselors as well as 

direct observations of treatment delivery. Overall, fourteen treatment administrators and 

twenty court staffwere interviewed. A total of 90 questionnaires were sent to treatment 

counselors and 52 ( 57.8%) were completed. And, a total of 124 treatment sessions were 

observed. 

The chapter is organized as follows. The next section provides an overview of the 

site selection process. This is followed by descriptions of each data collection technique, 

including the relevant procedures used to administer them. 

Site Selection 

The research examined treatment services and organizations involved in drug court 

operations across four jurisdictions: Bakersfield, California; Creek County, Oklahoma; 

Jackson County, Missouri; and St. Mary Parish, Louisiana. The four sites were selected 

after an examination and survey of the substance abuse treatment components of drug 

courts across the country. Emphasis was placed upon selecting sites that were considered 

more mature, had served as mentor drug courts, and where the same treatment providers 

2-1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
4 

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had been providing services to drug court participants for two years or more. Site selection 

emphasized a broad range of geographic and socio-economic differences in conjunction 

with varying levels of treatment components. 

Specifically, the four sites selected include a drug court that is a single-site court 

with multiple treatment providers (Bakersfield, California), a multi-site drug court with a 

single treatment component (Jackson County, Missouri) and two single-site drug courts 

with one treatment component (Creek County, Oklahoma and St. Mary Parish, Louisiana). 

Site selection includes drug courts fiom two rural communities (Creek County, Oklahoma 

and the St. Mary Parish, Louisiana) and two urban areas (Bakersfield, California and 

Jackson County, Missouri). (See Chapter 3). 

Administrator Surveys and Interviews 

Chapter 5 - Each treatment program administrator was given a survey to obtain 

information on the operation of the program, its organizational structure, funding sources, 

array of services, stafFng levels, client characteristics, and so on. (See Appendix A for a 

copy of this protocol). Administrators were asked to complete the survey and return it to 

the researchers during the site visit. The researchers also conducted an interview with each 

treatment program administrator, which is Wher described below. During this face-toface interview, the administrator was also given the opportunity to seek clar5cation on any 

of the survey items that may have been unclear. In some instances the administrators were 

allowed to mail the completed survey to the researchers at a later date in order to locate 

some of the detailed information (e.g., distribution of clients across racial categories) being 

sought. Administrators were also asked to complete an informed consent form for this 

survey and the administrator's face-to-face interview. This consent form was similar in 

content to the one employed for the Treatment Staff Surveys, with the exception that 

administrators were not offered compensation for their time in completing the interview 

and survey. 

Interviews were conducted with program administrators at each site with each 

interview lasting approximately one hour. During this time the researcher was able to 

clarifjl any issues regarding information collected from the Administrator Survey and also 

to solicit additional information on such issues as the use of drug testing, provision of 

aftercare services, and communication with the drug court. (See Appendix B for a copy of 

this interview protocol). 

Treatment Staff Surveys & Pbilosophical Orientation 

Chapter 6 - Prior to visiting each site, treatment program administrators were 

contacted and asked to provide a list of staffwho were directly involved in the delivery of 

services to drug court clients. The researchers then brought a survey packet for each of the 

previously identified staffmembers, during the site visit and delivered them in person to 

the counselors. The packet included the survey instrument (described below), a stamped 

envelope addressed to the researchers, and a consent form explaining the purpose of the 

2-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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study, any anticipated risks and benefits for participating in the survey portion of the 

project (including the $25 stipend for retuming the completed survey). Instructions in the 

packet directed the counselors to complete the survey and return it directly to the 

researchers via mail, in order to safeguard their responses. 

experience providing drug treatment services, credentials, average amount of the spent on 

several activities during a typical week (e.g., assessments, group counseling, etc), 

demographic information, program characteristics (e.g., clientls expected length of stay in 

the program, use of a wait list, use of drug testing) and the provision of treatment adjuncts 

(aftercare drug treatment, medical services, legal aid, etc), among other types of data. (See 

Appendix C for a copy of the Treatment Staff Survey). 

complete a Philosophy of Drug Abuse Causation and Treatment Survey (this instrument is 

also included in Appendix C). This instrument asked counselors to rate their level of 

agreement (using 5-point Likert scales, l=strongly agree, 5= strongly disagree) with 

various statements about the causes of drug use. These items include questions such as 

"Most drug abusers have significant social skill deficits which lead to their drug abuse". 

to be important aspects of effective drug treatment, such as "Effective drug abuse treatment 

includes a focus on social skill deficits common to drug abusers". Both the "causes of drug 

abuse" and "treatment of drug abuse" questions are organized into scales representing 

various criminological and psychological theories of drug abuse, including for example, 

conflict perspective, control theory, social learning theory, and psychoanalytic approaches. 

These data were sought in an attempt to uncover the relationship between what counselors 

think are important causes of drug abuse and the types of interventions they believe are 

effective. 

The staff survey included items soliciting information on educational background, 

In addition to this programmatic and staff level data, counselors were asked to 

Counselors were also asked a similar set of questions regarding what they believed 

Direct Treatment Observations 

Chapter 7 - Prior to visiting the treatment programs associated with each of the 

courts, the research staff contacted each treatment provider in the jurisdiction and requested 

schedules of treatment activities for the week of the visit. These schedules were used to 

plan for the direct observation of various treatment services at each program. The number 

of programs involved in the provision of clinical services varied by court, fiom a single 

court-run treatment program at St. Mary Parish drug court, to a dozen or more potential 

providers at the Bakersfield site. As such, the researchers were forced in some sites to 

observe only those programs that served a large proportion of the court's clients. For 

example in Bakersfield, with several community-based providers working with the court, 

the researchers decided to observe meetings at the 5 programs serving the largest number 

of the drug court's clients. Limitations on the number of observational staffmeant that not 

all meetings at all sites (even among this reduced number of programs at Bakersfield) could 

be observed. The researchers developed an observational schedule that maximized the 

number of meetings that could be observed during the 4-day time period spent at each site. 

2-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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In some cases, the programs offered more meetings at a single, given time than 

could be observed with the number of raters available (for example, 3 meetings all taking 

place at 6pm, with only 2 observers available). Factors other than the limited number of 

observational staffalso worked against observing every scheduled meeting during the site 

visit. For instance, some treatment programs (particularly in Bakersfield) failed to offer 

Illy half of the meetings it was scheduled to provide. In this example, the cancelled 

meetings were the result of staffhiling to show up for the groups they were scheduled to 

provide. 

observed, the researchers were able to attend a large proportion of all the meetings offered 

in these programs. While recognizing the potential limitations in the sample of observed 

meetings, given the exploratory nature of the evaluation, the proportion of meetings that 

were observed seems to have generated an adequate sample fiom which to draw some 

tentative conclusions and pose some important questions about the implementation of this 

type of program. 

The observational technique used in this study is based on previous work by 

Taxman and Bouffard (2000) employing a similar structured observational technique in 

jail-based therapeutic community programs. The technique employed in the cpent 

evaluation was revised fiom its original version in order to improve its accuracy in 

quantifjiug the amount of time spent on various treatment activities. The current version 

of the observational protocol measures the amount of time spent on various treatment 

topics and activities by having trained observers record, in five-minute increments, the 

amount of time dedicated to these various treatment items, as they directly observe the 

activities. (See Appendix D for a copy of the observational instrument). 

During each site visit, trained observers were assigned to observe treatment 

meetings at the various programs in the jurisdiction. Attempts were made, in jurisdictions 

with more than one provider, to have the same rater attend all the meetings at a single site, 

in order to facilitate the clients' becoming comfortable with being observed. Generally, 

observers sat unobtrusively in the treatment meetings and only interacted with clients or 

staff in introducing themselves during the initial meeting. Observers were also instructed 

to readily answer any questions that client's had regarding the purpose of their presence, 

but were told to reffain fiom fizther involvement in any treatment activities or discussions. 

Observers introduced themselves during their initial observation, explaiig the purpose of 

the visit, the confidential nature of the data being gathered, and that any client who wished 

not to be observed was fiee to attend an alternate treatment activi~ with no penalty 

whatsoever. The researchers had reached agreements with each provider that any client 

wishing not to be observed would be allowed to switch meetings during the period of the 

site visit. No client in any program in any jurisdiction refbsed to participate in a meeting 

under observation. Clients had all been previously informed of the researchers' upcoming 

visit. 

decrease client (and possibly stam openness, the observation of meetings over a period of 

several days allows the clients and staff time to become accustomed to the observer's 

presence and return to more typical behavior. In fact, the anecdotal impression of all the 

observers was that enough dattering behavior occurred, relevant to both client and staff 

Despite these limitations on the total number of meetings that cduld possibly be 

I 

While the presence of an observer in the treatment meetings may be expected to 

2-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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conduct (e.g., clients sleeping in treatment, staff allowing them to sleep without 

contiontation) during the observations that the researchers were able to observe relatively 

normative examples of the treatment experiences provided in these programs. 

each site, Training involved several meetings with the senior research staff and the 

graduate student observers to discuss the overall method and particularly the definitions of 

each observational item. In addition, senior research staff and the graduate student 

observers practiced using the instrument in actual drug abuse treatment activities in several 

local programs before the site visits occurred. Observers and senior research stafFmet to 

discuss their rating decisions after each of these practice observations, so that consensus 

was reached about the implementation of the definitions in realistic settings. 

observers met after each day's observations at the actual research sites, to discuss any 

ambiguities they might have encountered during those observations. Observers were 

instructed to write a detailed note descriiing any ambiguous treatment activity, which was 

then used in the post-observation meetings to descni that activity to the other observers. 

During these post-observation researcher meetings, the graduate student observers 

described any activities they felt might have been ambiguously coded and together with the 

senior research staff worked to reach a consensus on what item that activity represented. In 

this way, all ambiguous items were coded in a manner consistent with the intended 

definitions across observers. Items that did not fit the criteria for any of the pre-defined 

items were coded as "other" and the detailed notation about that activity was subsequently 

examined to create several new items (e.g., video-clients spent treatment time watching a 

video tape). 

Given the nature of the observational method employed in this project, traditional 

measures of inter-item reliability, such as Cronbach's Alpha, are inappropriate, since the 

items being observed are not intended to represent parts of a unidimensional scale. As 

such, it is difEcult to quantifl the level of inter-item reliability for the measure. Inter-rater 

reliability is equally dacult to quantifl using traditional statistical techniques, however 

comparisons of observer's ratings taken fiom two of the practice observations indicate that 

the level of agreement was relatively high. 

In addition, the original observation technique developed by Taxman and Boufhd 

(2000) showed relatively good indications of inter-rater reliability, even without using the 

improved method for quantifLing the amount of time spent on each item. Improvements in 

the measurement of time devoted to each treatment item likely serve to improve the 

consistency of this type of observational technique, given that the operational definitions of 

each item are similar to those employed in the original method. 

Within this observational method raters were allowed to code more than one item as 

occurring simultaneously. For example, in a hypothetical case a treatment group may have 

discussed "Existing Cognitive Processes" for 60 minutes and "Family Issues" during 15 

minutes of that overall 60-minute discussion. In this case, the observational data would 

suggest a total of 75 minutes worth of activity occurred, within a 60-minute period. 

However, the intent of these observations is to ascertain the amount of time that the group 

spent on each of several types of topic or activity, relative to the overall length of the 

Observers were trained in the use of the observational instrUtnent prior to Visitkg 

In an additional attempt to ensure the consistent application of the item definitions, 

2-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, *(I, h, 

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meeting. In other words, the observational data is a means to cataloging the emphasis of 

these programs in terms of their overall approach to treatment (i.e., cognitive-behavioral, 

12-steps, psychoanalytic, etc). To this end, rather global measures of the types of activities 

and topics provided were sought, rather than outlining in spec& detail the exact nature of 

each topic. 

The fact that some topics/activities may be multiply classified does not detract fiom 

the fact that for 15 minutes the group did discuss "Family Issues" and also spent 60 minutes 

discussing "Existing Cognitive Processes" more generally. In terms of the ov&all goal of 

the project, this set of results would suggest that at least in this meeting the program 

appears to be cognitive-behavioral in its approach. If this pattern of results was repeated in 

many of the treatment meetings offered by this program, we could then reasonably 

conclude that the program is cognitive-behavioral in its overall treatment approach. 

4, 

each item separately, with no attempts being made in this exploratory study to examine the 

prevalence of specific, combined topics or activities (e.g., existing cognitive processes 

related to family issues). While these issues may indeed be of importance to 

understanding, at a more complex level, the intricacies of drug treatment within the drug 

court context, those sorts of questions are somewhat beyond the scope of this initial 

evaluation, which merely attempts to describe the overall approach, implementation and 

integration of these treatment programs within the drug court structure. 

In line with this goal and for simplicity's sake, results will be presented in terms of 

Drug Court Staff Interviews 

Chapter 3 - Prior to visiting each site, members of the drug court staffwere 

contacted for an interview during the week of the Visit. A total of twenty interviews were 

conducted with drug court personnel, including judges, prosecutors, defenders, and case 

managers. The purpose of these forty-minute interviews was to obtain descriptive 

information about the drug court. Additionally, drug court staffwere asked open-ended 

questions about the relationship between substance abuse and crime, and the role substance 

abuse treatment played in the drug court setting. (See Appendix E for a copy of this 

interview schedule.) 

In addition, a separate interview was conducted at each site with the person 

responsible for case management regarding the availability of treatment services. During 

the initial fieldwork phase of the study, OJF released Treatment Services in Adult Drug 

Courts: Report on the 1999 National Drug Court Study by Elizabeth Peyton and Robert 

Gossweiler, 2001. The research team incorporated the TASC survey into the research 

study by conducting an interview with staffat each site using the questionnaire. This 

instrument supplements other interviews conducted for this project. 

Retrospective Analysis of Participant Data 

Chapters 3, 8, & 9 - The retrospective portion of the evaluation consists of an 

analysis of 2357 participants who were enrolled in drug court (enrolled one or more days 

2-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
between January 1' 1997 and December 31"' 2000), were either terminated or graduated, 

for whom both a minimum amount of follow-up time (12 months) had elapsed since 

graduation or discharge, and for whom NCIC criminal history information was available. 

Initially, information on a total of 4003 drug court participants was obtained over the fouryear period (January 1' 1997 and December 3 1' 2000). Of these, 366 participants were 

excluded fiom the study as they were still active at the time fieldwork was conducted. An 

additional 61 7 participants who were assessed but were not admitted into the drug court 

were also excluded (referred to as administrative opt-outs). Of the remaining 3,020 drug 

court participants, 385 participants were not matched with NCIC records and of those that 

were matched with NCIC, an additional 278 participants were excluded given that less than 

12 months time had elapsed fiom their date of discharge. 

Table 2.1 documents the specific manner in which the sample was constructed. 

Total 48 month enrollments 

1997-2000 

Total Cases Still active at time of data 

rwlleciion 

Number of Administrative 

opt outs 

Total Terminates and Graduates 

Table 2.1 Sample Construction I 

St. Maly Creek Bakersfield Jackson Totals 

55 1 402 1054 19% 4003 

109 65 127 65 8' 366 

74 16 I34 3 93 617 

368 321 793 1538 3020 

Parish County Counry 

NCIC 

Matched NCIC Graduates and 

Terminates Discharged for 12 Months 

Total Cases With 

Scheduled Data Time 

I 

Terminates and Graduates Matched With I 220 312 727 1376 2635 

0 120 4 154 278 

220 192 723 1222 2357 

Sources of Participant Data 

Information on drug court participants existed in a number of mediums and formats, 

the content of which varied considerably both within and across sites. 

St. Mary Parish: Demographic information on drug court participants was obtained fiom a 

database that is maintained by staff at the Fairview Treatment Center. The data consists of 

elements associated with the Addiction Severity Index (administered to all participants at 

intake and graduates upon discharge). Participant case files maintained on hard-copy form 

were reviewed to collect treatment attendance records, drug test results and verification of 

discharge information. 

Creek County: Participant level data fiom Creek County was obtained manually fiom a 

review of participant case files maintained on hard copy by staff at CBTI. The research 

team devised a data collection instrument and a staff member fiom CBTI manually 

completed the form for each drug court participant. 

Bakersfield: Data was obtained fiom a Ikcrosoft Access database specificdy designed for 

the drug court. Staff fiom the Kern County Department of Mental Health maintains the 

2-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Ir 

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database that includes participant demographics, treatment attendance records, progress 

notes and drug testing information 

Jackson County: Information on participants at the Jackson County drug court was 

maintained in a variety of locations. Some data was obtained fiom the High Intensity Drug 

Tracking System Automated Treatment Tracking System (HATTS) which includes the 

Addiction Severity Index (ASI), treatment services information, drug testing, sanction 

information, and MA attendance. Demographic and discharge information on drug 

court participants was obtained fiom multiple sources including HATTS, a prdsecutorial 

database, spreadsheets maintained by the Drug Court Coordinator and manually fiom hard 

copy forms. Treatment attendance and drug testing information was obtained &om both 

HATTS and spreadsheets maintained by the treatment provider. 

Data Elements Collected 

Cross-site participant data includes general demographics, treatment attendance, 

outcomes of drug and alcohol testing, and program termination status. The types of data 

elements stored electronically and the manner in which it was stored varied considerably 

across sites. As a result, some data elements collected were not included in the final 

analysis. Table 2.2 summarizes the percent of primary cross-site data elements included in 

the final study. Table 2.2 does not list secondary elements constructed @e.: age 

constructed fiom date of birth and date of admission) nor NCIC criminal history 

information obtained independently fiom the Justice Department. 

end dates, frequency of treatment sessions attended, number of drug tests administered and 

corresponding results. As shown in Table 2.2, the majority of missing drug test and 

treatment attendance information is attributable to both the Bakersfield and Jackson County 

drug court sites. In Bakersfield, a new management information system was introduced in 

the 1999-2000 year period and drug testing and treatment attendance information on outdated participants was not updated. Similarly, the Jackson County drug court also introduced 

a new management information system in 2000-2001, however, during this time period, the 

research was able to recover some drug testing information that was located in a separate 

excel spreadsheet maintained by the Treatment provider. 

The research would have benefited fiom the collection of other types of program 

information that was either unavailable, or impossible to collect given the amount of time 

allocated for each site visit. Specifkally, types and fi-equency of sanctions and reasons for 

discharge were not routinely maintained by any of the sites across the study time period. 

Obtaining start and end dates for treatment proved problematic as well. This information 

typically existed on hard-copy form and maintained by the treatment provider. In the case 

of the Bakersfield site, for example, the drug court program maintained this information but 

the data elements did not differentiate between date of assessment and actual start of 

treatment. In the case of Jackson County, treatment start and end dates were available fiom 

the treatment provider but impossible to collect since collection required a review of hardcopy records for over 2,000 participants. 

Program information collected on participants includes drug court program start and 

2-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 

Frequency and types of demographic information on participants also varied across 

sites. The St. Mary Parish Drug Court maintained the most information on participant 

characteiistics collecting AS1 (Addiction Severity Index - Long Version) in autom?ed 

form Treatment providers at both the Jackson County and Bakersfield sites also used the 

ASI, however, the drug court program in their Management Information System 

maintained only certain variables fiom the ASI. And, in the case of the Creek County Drug 

Court, participant characteristics consistent with the AS1 were derived fiom a hard-copy 

bio-psychosocial assessment independently developed by the treatment provider and 

collected manually by the research team at the time of the site visit. 

Table 2.2 Primary Data Elements Collected 

Pro- Information 

Drug Court Program Start Date 

Drug Court Program End Date 

Number of Treatment Sessions Attended 

Number of Drug Tests Administered 

Number of Positive Drug Tests 

Date of Birth 

Gender 

Race/Ethnicity 

Last Grade Completed 

Employment Status at Admission 

Marital Status 

Number of Financial Dependents 

Received Prior Substance Abuse Tx 

Age at First Use 

Type of Substance First Used 

Ever Used Alcohol 

Used Alcohol Last 30 days 

Length of Time Use of Alcohol 

Ever Used Marijuana 

Used Marijuana Last 30 days 

Length of Time Use of Marijuana 

Ever Used CracWCocaine 

Used CracWCocaine Last 30 days 

Length of Time Use of CracWCocaine 

Ever Used Amphetamines 

Used Amphetamines Last 30 days 

Length of Time Use of Amphetamines 

Ever Used Opiates 

Used Opiates Last 30 days 

Length of Time Use of Opiates 

Ever Used Other Substances 

Used Other Substances Last 30 days 

Length of Time Use of Other Substances 

Participant Characteristics 

Substance Use Histories 

NCIC Data Elements 

St. Mary Creek Bakersfield Jackson Total . 

Parish Comfy County 

N=220 N=l92 N=723 N=1222 N=2357 

100 

100 

97.3 

99.1 

99.1 

100 

100 

100 

100 

100 

100 

100 

100 

1 00 

100 

100 

100 

I00 

100 

I00 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

97.9 

91.7 

91.7 

100 

98.4 

100 

100 

IO0 

99.5 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

1 00 

100 

100 

1 00 

100 

100 

100 

I00 

100 

100 

100 

1 00 

100 

61.5 

66.0 

66.0 

100 

99.9 

100 

67.1 

100 

100 

35.5 

100 

64.2 

64.2 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

100 

30.2 

87.1 

87.1 

100 

100 

99.9 

30.5 

38.5 

37.4 

36.1 

29.1 

33.3 

33.1 

39.5 

39.5 

39.5 

39.5 

39.5 

39.5 

39.5 

39.5 

39.5 

39.5 

39.5 

39.5 

39.s 

39.5 

39.5 

39.5 

39.5 

39.5 

100 

100 

51.6 

82.1 

82. I 

100 

99.8 

100 

53.9 

68.1 

67.5 

47.1 

63.2 

54.4 

54.3 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

68.6 

Table 2.3 summarizes information collected on participant arrest histories obtained 

fiom the National Crime Information Center (NCIC). Primary data elements include: date 

2-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I I 

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of f3st arrest, frequency and general types of prior arrests, initiating offense upon drug 

court admission as well as types and corresponding dates of subsequent post-admission 

drug coh arrests. 

Table 2.3 NCIC Primary Data Elements 

NCIC Prior Arrest Information 1 

Date I of First Arrest 

First Arrest Charge 

Number of Prior Arrests 

Number of Prior Personal Arrests 

Number of Prior Property Arrests 

Number of Prior Drug Arrests 

Number of Prior Motor Vehicle Arrests 

Number of Prior Arrests (Other) ,,I , 

Regression Analyses 

NCIC Post-Admission Arrest Information 

Date of ld Arrest post-Admission DC 

1“ Arrest Charge post-Admission M=’ 

Date of 2“ Arrest post-Admission DC 

2” Arrest Charge post-Admission DC 

Date of 3d Arrest post-Admission DC 

3d Arrest Charge post-Admission DC 

Date of 4’h Arrest post-Admission DC 

4* Arrest Charge post-Admission DC 

Date of 5* Arrest post-Admission DC 

Srn Arrest Charge post-Admission DC 

Date of Last Arrest 

Last Arrest Charge 

Most Seriops Charge post-Admission DC 

Number of Arrests post-Admission DC 

Chapters 8 & 9 - Step-wise regression methods are employed in chapters 8 and 9. 

These analyses provide information about compliance in drug court, the factors 

contributing to the likelihood of graduatioddischarge, and the extent these combined 

measures relate to post-program recidivism Each of the multivariate models complement 

the accompanying bivariate analyses presented in each chapter by assessing the salience of 

each factor among control variables. Separate models are estimated for each site as 

variations in missing cases prohibit the inclusion of all variables at all four sites. The high 

degree of collinearity among many of the independent variables necessitates the use of the 

stepwise method. 

characteristics and program compliance measures on graduation. Since drug court 

graduation is largely a hction of compliance with drug court protocols, the relationship 

will be explicitly tested in the models in order to ascertain which aspects of compliance are 

most critical. Those background variables remaining signiscant in the models amidst 

program compliance play a crucial, independent role. Successhl completion of the drug 

court program (or graduation) serves as the dependent variable of interest. Graduation is 

coded “1” and program termination is coded “0.” The logistic regression models predict 

the odds of graduation versus termination at each of the four sites. Three compliance 

indicators include positive drug tests, in-program arrests, and treatment attendance. 

program compliance, discharge status, and time at risk (exposure) are tested on the 

In chapter 8, regression modeis test the combined effect of participant 

In chapter 9, the relationships among participant characteristics, measures of 

2-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

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likelihood of recidivism at each of the four sites. Post-program arrest serves as the 

dependent variable of interest. Those not arrested are coded “0” and those who were 

arrested one or more times after program participation are coded “1 .” The logistic 

regression models predict the odds of arrest versus no arrest at each site. The independent 

variables pertaining to participant characteristics are divided into general demographics, 

prior substance use and arrest histories and program compliance measures. 

DemograDhics: Gender dummy coded (females = 1). After exploratory analysis of each 

racial category, no variation within race was found. Therefore, race is also dummy coded 

(nonwhites = 1). Givep its non-normal distribution and the possibility of non-linear effects, 

participants’ age is recoded into four categories. The “Less than 20 years” category is 

omitted as the baseline. Three other categories (“20 to 29 years,” “30 to 39 years,” and “40 

or more years”) are analyzed against the reference group. The participants’ number of 

hancial dependents is dummy coded (one or more dependents=l). Education is dummy 

coded with “not a high school graduate” serving as the baseline (high school graduate or 

greater=l). Employment status at time of admission is also included. Those participants 

who held a job at the time at which they entered the program are coded “1 .” The last 

variable included in the model, marital status, was also dummy coded (not married = 0). 

Substance Use and Arrest Histories: Prior use of alcohol, marijuana, crackkocahe, 

methamphetamine, opiates, and other substances are each dummy coded (ever used=l). 

Prior substance abuse treatment is also included. Those participants who had ever received 

prior substance abuse treatment at the time at which they entered the program are coded 

“1”. Participants’ prior arrest was coded as a categorical variable and then dummy coded. 

The “no prior arrest” category is omitted as the baseline. Two other categories (“one or 

two arrests” and “three or more arrests”) are analyzed against the reference group. The age 

of the participant at the time of their first arrest is also included in the model. To improve 

the skewness of this measke, the variable was transformed with the natural logarithm. The 

last variable included in this model represents the participants’ age at first use. This 

continuous variable is normally distributed. 

Compliance Measures: The compliance measure taps those participants who had one or 

more arrests during their participation in the drug court program. This measure is dummy 

coded (those having one or more arrests = 1). The next set of compliance indicators 

represents participant compliance in relation to positive urinalysis. Approximately 24% of 

the sample had no positive tests. The remaining 76% of participants were coded into three 

separate categories of roughly equal size, creating a quartile measure. Dummy variables 

were constructed fiom these quartiles. The “no percent positive test” category is omitted as 

the baseline. The three other categories r.01 to .08 percent positive,” “.09 to -28 percent 

positive,” and “.29 to 1 .O percent positive”) are each analyzed against the reference group. 

The final compliance measure, treatment attendance, is computed as a percentage reflecting 

the actual number of treatment sessions attended over the theoretical minimum number of 

sessions expected to attend. The treatment attendance measure ranges fiom 0 to 283%. It 

approximates a normal distribution and is employed in the model as a continuous variable. 

I 

2-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 3 

I 

Comparison of the Four Drug Court Programs: 

Court Personnel Perspectives on Drug Court 

Overview 

This chapter provides information about the four drug courts and how participants 

are processed through drug court programs. The goal of the chapter is to provide both a 

descriptive account of how the programs are organized and compare key operational 

populations, and drug testing protocols. 

Policy level information was obtained fiom client handbooks, policy and procedure 

manuals and interviews with drug court personnel; (2) Information about participants was 

obtained fiom treatment and drug court records as well as the NCIC. Detailed 

descriptions of these data sources can be found in Chapter 2. 

The chapter is organized as follows: The first section provides a brief overview of 

each drug court program under study. The second section provides cross-site comparisons 

of structural and operational aspects of each program. 

' components of the four drug courts, including program structure, eligibility, target 

Information for this chapter was obtained fiom two primary data sources: (1) 

Overview of Each Jurisdiction 

As described in Chapter 2, this research examined drug court operations in four 

mentor courts. As documented below, the four jurisdictions include a program that is a 

single-site court with multiple treatment providers (Bakersfield, California), a multi-site 

drug court with a single treatment component (Jackson County, Missouri) and two singlesite drug courts with one treatment component (Creek County, Oklahoma and St. Mary 

Parish, Louisiana). Site selection includes drug courts fkom two rural communities 

(Creek County, Oklahoma and the St. Mary Parish, Louisiana) and two urban areas 

(Bakersfield, California and Jackson County, Missouri). 

St. Mary Parish, Louisiana 

The St. Mary Parish drug court, located in the 16th Judicial District in Franklin, 

Louisiana (pop. 5,000), is the first drug court jurisdiction. Thk parish is 63% white, 32% 

-can American 1% Native American, and 4 % other. Offshore 02 and gas, fishing and 

sugar cane industries dominate the local economy. The cities ofNew Orleans and La 

Fayette are within an hour's drive of the parish courthouse. The Office of Justice 

3-1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
t 

,I 

Programs reports that since implementation in 1997, the St. Mary Parish Drug Court has 

served 577 participants of which 133 have graduated fiom the program’. 

The St. Mary Parish drug court has a single treatment agency providing direct 

services to drug court participants. It is a post-plea, post adjudication program that meets 

weekly. With a capacity for 200 participants at any one time, the drug court program 

consists of four phases designed to take fiom nine to sixteen months to complete. 

The drug court team consists of the judge, treatment provider and counselors, 

sheriff, compliance monitor, probation officer, public defender and prosecutor. Both case 

dnnagement and treatment services are provided by the Fairview Treatment Center, 

The Fairview Treatment Center provides detoxification, residential, in-patient, and 

outpatient treatment services. Through various arrangements with other organizations, 

the program also provides a range of ancillary services. 

eligibility. Eligible defendants are clinically screened and assessed by the direct 

treatment provider and the entire drug court team recommends placement in the program. 

The defendant executes a post-bail conviction contract and enters a two-week oqieniation 

phase of the program during which they may voluntarily opt out. According,to 

interviews with aUg court personnel, the entire process fiom initial identification of the 

client to admission to the drug court takes less than two weeks. 

\ 

which is also the dedicated provider serving other drug courts in the 16th Judicial district. I, 

I 

The District Attorney’s Ofke has its own probation officer who determines legal 

Creek County, Oklahoma 

The second jurisdiction is located in Sapulpa, Oklahoma (pop. 19,166), the seat of 

Creek County District Court. The local economy consists of agriculture and small 

manufacturing. Creek County (pop. 63,370) is a primarily rural area that is evolving into 

a suburb of Tulsa and Oklahoma City. The population is 82% white, 3% AfXcan 

American, 9% Native American and 6% other. The Office of Justice Program reports 

that since implementation in 1997, the Creek County Drug Court has served 673 

participants of which 169 have graduated*. 

The Creek County Drug Court contracts with a single treatment agency providing 

direct services to participants. It is a post-plea, post-adjudication program enrolling up to 

150 participants at any one time and meets on a bi-weekly schedule. 

misdemeanor and felony docket. Most misdemeanant defendants are placed in a 

modified treatment program consisting of one of three treatment tracks lasting 3-montbs, 

6-months, or 9-months respectively. Felony defendants are typically placed in the 111 

This program is unique in having two separate drug court dockets - a 

OJP Drug Court Clearinghouse and Technical Assistance Project. “Drug Court Activity Update: 

Summary Information on All Programs and Detailed information on Adult Drug Courts. June 20,2001. 

’ OJP Drug Court Clearinghouse and Technical Assistance Project. “Drug Court Activity Update: 

. Summary Information on A11 Programs and Detailed information on Adult Drug Courts. June 20,2001. 

3-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 

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a 

~g court program requiring four phases of treatment that is at least twelve months in 

duration. Operated by the prosecutors office, the drug court team consists of the drug 

court judge, the district attorney and assistant, the state’s Community Sentencing Board’s 

probation officers, the Creek County Clerk of Courts, two public defenders and the 

dedicated treatment provider. 

The district attorney conducts a legal screening to determine initial eligibilrty of 

defendants. The legal skreenhg considers the defendant’s current charges and prior 

convictions and makes a qualitative assessment as to the offenders’ level of involvement 

with alcohol and/or drugs. Potential drug court participants who satisfy legal screening 

requirements are refe&ed to the dedicated proyider where a clinical assessment is 

conducted. Results of the clinical assessment serve as the basis for determining entry 

into the program, as well as initial placement decisions. The entire process is estimated 

by court personnel to t&e less than three weeks to complete. 

Bakersfield, California 

The Bakersfield Municipal Court serving Kern County (pop. 659,000), California 

is the third drug court jurisdiction in the study. It is one of three adult drug cp~& in Kern 

County serving ti population of 386,000 people. The metropolitan area is 66% white, 

21% Hispanic, 9% Afiican American and 4% other. The Office of Justice Programs 

reports that since implementation in 1993, the Bakersfield Municipal Drug Court has 

served 2660 participants of which 666 have grad~ated.~ 

with a capacity for 350 clients at any one time. It is a misdemeanant only drug court that 

consists of four phases and is designed to take approximately twelve months to complete. 

The Bakersfield Municipal Drug Court has seven (7) prima,ry treatment agencies 

providing substance abuse treatment services to drug court participants. The drug court 

meets four times a week in the afternoon. Two substance abuse specialists fiom 

Bakersfield Department of Mental Health serve as case managers for the drug court. The 

drug court team also includes the judge, drug court coordinator, probation officer, the 

district attorney, representatives from the treatment community, and data entry personnel. 

To enter the drug court, defendants are legally screened by the Department of 

Probation. The legal screening considers the defendant’s current charges and prior 

convictions and makes a qualitative assessment as to the offenders’ level of involvement 

with alcohol andor drugs. Potential clients meeting the program’s legal screening 

requirements are referred to one of the two Substance Abuse Specialists who conduct a 

clinical screening. Suitable candidates are offered a drug court contract and, once 

executed, are assigned to a treatment provider in the geographical proximity of their 

residence where a clinical assessment is conducted. According to drug court personnel, 

the process fiom identiiication to admission takes approximately two to three weeks to 

complete. 

The Bakersfield Municipal Drug Court is a post-plea, post adjudication program 

OJP Drug Court Clearinghouse and Technical Assistance Project. “Drug Court Activity Update: 

Summary Information on All Prdgrams and Detailed information on Adult Drug Courts. June 20,2001. 

3-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Jackson County, Missouri 

The fourth jurisdiction is the Jackson County Circuit Court located m Kansas City 

and Independence, Missouri. With a population of 654,880, Jackson County is one of the 

most densely populated counties in the State of Missouri. The county is 70% white, 23% 

African American, 1.5% Asian, 0.5% Native American and 5% Other. The drug court is 

a multi-site program serving both Kansas City (pop. 443,400) and Independence, 

Missouri (pop. 116,000). The Office of Justice Programs reports that since 

implementation in 1993, the Jackson County Drug Court has served 3765 participants of 

which 17 17 have graduated4. 

single treatment agency. Unlike the other three drug courts, this is a deferred prosecution 

diversion drug court program. The drug court has a capacity for 400 participants and 

meets four times a week. The program targets first-time and second-time non-violent 

drug involved offenders. According to drug court personnel, the program is designed to 

take a minimum of twelve months to complete. Participants are required to complete 

three phases of the program that includes specific court and treatment requirements. 

Court Commissioner, public defender (District Defender), diversion managers (Missouri 

Pretrial Release Officers - probation officers), the treatment provider, a client advocate 

and data entry personnel. The Drug Court Commissioner is appointed by an elected 

judiciary and serves as a drug court judge. Case management services are provided 

through the prosecutor’s office that is also responsible for overseeing the program. 

With the exception of residential treatment, drug court participants receive 

substance abuse treatment services fiom the sole dedicated treatment agency, County 

Court Services. Serving the drug court since 1995, County Court Services is responsible 

for all clinical assessments and treatment placements. Participants are placed in one of 

six levels of care, four of which are monitored by County Court Services who provides 

three of these levels of care: outpatient, intensive outpatient, and a therapeutic community 

at a day treatment center. They also determine when residential placements are 

appropriate. 

Case managers conduct legal screenings on all drug-involved arrestees referred to 

the drug court prosecutor by law enforcement. At their initial appearance, eligible 

defendants are offered the opportunity to participate in the drug court program, When a 

defendant chooses to participate, they are assigned one of the eight Diversion Managers 

(probation officers). Then they are sent to County Court Services where defendants are 

clinically assessed and assigned to an appropriate level of care. After a treatment level 

has been assigned, the defendant makes a second appearance before the Commissioner, 

executes the Drug Court Diversion Contract, and enters the first phase of treatment. Staff 

, 

The Jackson County COMBAT Drug Court Diversion program contracts with a 

The drug court team consists of the drug court prosecutor, case manager, the Drug 

OJP Drug Court Clearinghouse and Technical Assistance Project. “Drug Court Activity Update: 4 

Summary Information on All Programs and Detailed information on Adult Drug Courts. June 20,2001. 

3-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
E 4 

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members indicate that the process fiom initial identifkation to admission to the drug 

court takes approximately three weeks. 

Cross-Jurisdictional Comparisons of Drug Court Operations 

This section examines structural characteristics of the four drug court program. 

Concern lies with comparing key ingredients of the four programs. Table 3.1 presents 

cross-site comparisons of structural characteristics of the four drug courts as reported by 

drug court personnel and described in policy and procedure manuals. It presents 

information on prograin operations, number qf levels or tracts and the number of program 

phases. The first row compares the drug court’program structures. 

There are differences among the four programs in the types of drug court 

structures affecting the’selection and processing of cvs. Three drug courts are post-plea, 

post-adjudication programs while the Jackson County drug court is a pre-plea, drug court 

diversion program. There are also differences in target populations. While all four 

programs comport with federal requirements excluding violent offenders, the selection of 

target populations differ by site. The two rural drug courts target both felony and , 

misdemeanor offenders. The two urban drug courts are different. The Jackson Couhty 

drug court targets only first-time offenders and the Bakersfield program only targets 

offenders with misdemeanor and OWDWI charges. 

programs have a single track for processing cases (Table 3.1 row 2). However, the Creek 

County and the Jackson County drug courts have multiple tracks or levels of care. At the 

Creek County site, substance involved defendants with minor criminal charges (e.g. 

OUI/DWI) are placed in one of three “modified” tracks of three, six, or nine months in 

duration. Participants with more serious offenses are placed in the regular twelve-month 

track. Various levels of care are provided participants at the Jackson County site 

depending on the severity of their addiction problem. However, participants at all levels 

of care at this site are expected to participate in the program for twelve months. What 

varies is the intensity of treatment they receive - residential treatment, day treatment, or’ 

intensive outpatient. And, offenders with less serious substance problems are assigned to 

outpatient pro grams. 

programs offer a step-down phased system of requirements meaning that as participants 

progress through program phases, both treatment and court requirements decrease. While 

step-down requirements vary by site, they are similar insofar as phases include 

attendance requirements at treatment sessions, drug court status hearings, and drug 

testing. Two sites have a four-phase program and two have a three phase program. 

Table 3.1 are used as by court personnel and participants as benchmarks to determine 

progress towards program completion and graduation. In Chapter 4, we wiU discuss 

whether differentials could be discerned in how participants were processed during 

treatment sessions we observed. 

Like most drug courts in the United States, the St. Mary Parish and Bakersfield 

Table 3.1 also presents cross-site comparisons of program phasing. All four 

Interviews with court personnel suggest that the drug court phases described in 

3-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 

Drug Court Smcture 

Differentiated ProgTam 

St. Maly Parish Creek Countj Bakersjield Jackson County 

Post-plea, post Post-plea, post Post-plea, post Pre-plea, preadjudication adjudication adjudication adjudication 

One 2 drug court tracks One Six treatment tracks 

Levels or T&' 

Phase I 

Phase II 

Phase III 

Phase IV 

Program Length6 

Date of Inception 

Target Population 

Processing Offenders 

One of the critical issues for drug courts is the selection of potential participants 

from the target population. Program eligibility (descnid in Table 3.1) 'establishes the 

universe of offenders fiom which court and treatment personnel select potential drug 

court participants. The initial determination or selection of specific clients occurs on the 

basis of a legal screening, which is conducted by court personnel. Drug court personnel 

report they select offenders on the basis of legal criteria who ire then subsequently 

screened by treatment providers who assess the nature and extent of their substance abuse 

problems. 

perspectives on the intake process at each jurisdiction. It indicates how participants are 

processed into the drug court and by whom. As shown in Table 3.2, either the 

prosecutor's office or probation officers conduct the legal screenings. No standardized 

risk screeners were employed by any of the four courts. 

Potential participants who meet legal eligibility requirements are referred to 

treatment providers who conduct clinical screenings and assessments. With the exception 

of the Bakersfield drug court, the drug courts are sirnilar with respect to designating 

treatment staff to conduct clinical screenings and assessments, In addition to an 

interview with the potential participant, three of the four drug courts use the AS1 as a 

clinical screening and assessment tool. The Creek County drug court uses the SASSI, 

LPQ, and Mortimer instruments. (For a more thorough discussion of this issue from 

treatment personnel perspectives see Chapter 5 below.) 

Information in Table 3.2 consists of cross-site comparisons of court personnel 

4 treatment tracks 

' 2 months 3 months 4 months 4 months 

4 months 3 months 4 months 4 months 

3 months 3 months 4 months 4 months 

6months 3 months NA NA 

15 months 12 nionths ' 12 months 12 months 

. 1997 1997 1993 1993 

First time felony First time felony DUl/qWIand First time felony 

and misdemeanants and mkdemeanants misdemeanant and misdemeanants 

Offenders only - 

' Does not include participants placed in residential treatment 

Program and phase lengths reflect minimum time fiames for completion. 

, 

3-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
d."., , 

Legal Screening 

Legal Screening Tool 

Clinical Screening 

Screening Instrument 

Table 3.2 Intake: Legal and Clinical Screenings and Clinical Assessments 

St. Mary Parish Creek County Bakersfield Jackson County 

Probation fiom DA District Attorney Probation District Attorney 

Non-standardized Non-standardized Non-standardized Non-standardized 

Treatment Provider Treatment Provider County Dept. of Treatment Provider 

Office 

Mental Health 

AS1 SASSI, LPQ, Self-Developed MI - 

Clinical Assessment 

Mortimer Non-standardized 

Treatment Provider Treatment Provider Treatment Provider Treatment Provider 

Clinical Assessment 

Instrument 

Mental Health Assessment 

Case management 

An important issue regarding the intake process is the length of time between the 

identification of potential participants and admission to the program - that is, how long it 

takes participants to be admitted to the program. Table 3.3 Summarizes interviews and 

official policy and procedure manuals as to the amount of time involved between initial 

identification of participants and program admission. Overall, court personnel at each 

site report the entire screening and assessment process - the length of time it takes 

between referral and admission into treatment - is typically completed within three 

weeks. Unfortunately, participant level data was not available to assess the amount of 

time it actually takes to be admitted into these drug court programs. 

AS1 and Interview Self-Developed AS1 and Interview AS1 and Interview 

Bio-Psychosocial 

and Interview 

Treatment Provider Referred Treatment Provider Treatment provider 

Treatment Provider Treatment Provider County Dept. of District Attorney's 

Mental Health Office 

Table 3.3 Court Personnel Perceptions of Time Between 

Identification of Clients and Admission 

Time between initial identification to 

completion of clinical screening 

Time between initial identification to 

completion of assessment 

Time between determination of clinical 

eligibility and admission to treatment 

Time period between initial identification 

and admission to drug court 

St. Mary Creek County Bakersjield Jackson 

Parish County 

1 -2 days More than two 3-5 day 1 Week 

1 week 1-2 days 3-5 days 1 week 

Same day 1-2 days 1 -2weeks 1 week 

2 weeks 3 weeks 2 to 3 weeks 3 weeks 

weeks 

Table 3.4 presents cross-site comparisons of actual criminal history profiles of 

participants obtained fiom NCIC files. The first column shows the number of arrests 

prior to entering the drug court program (excluding the admission offense). This is 

followed by the type of offenses. The final column examines the type of arrest offense 

immediately preceding participant admission into the drug court program. 

3-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
J 

Actual criminal history profiles are largely consistent with characteristics of the 

target population described in Table 3.1. Overall, N,CIC data indicate that 82. I% of the 

drug court participants have one or more prior arrests. There are cross-site variations in 

the number of reported prior .arrests. In particular, drug court participants at the Creek 

County and Jackson County sites have fewer reported arrests than other sites reflecting 

differences in their target populations. 

It will be recalled fiom Table 3.1 that Jackson County is a program for first and 

second time offenders. As shown in table 3.4, over eighty-five percent of participants at 

that site have fewer than two prior arrests. At the Creek County drug corn, the 

distribution of the number of prior arrests is, k expected: bimodal, matching their 

multiple track programs for offenders. Overall, the majority of arrests (75%) 

immediately preceding admission to the program were drug related. 

Table 3.5 examines information about participant's actual drug usage in terms of 

the past 30 days and lifetime use. Those findings indicate drug court participants are 

polysubstance abusers. At each site, more than half of the participants report lifetime use 

of alcohol and marijuana as well as other drugs. At each site more than half of the 

participants also report the use of other drugs including: crackhocaine, opiates, Fd'a 

amphetamines. Past thirty day use and lifetime use are fairly consistent qcross sites. 

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Table 3.4 Cross-Site Comparisons of Actual Participant Level Criminal History Profiles 

Number of Prior Arrests 

None 

One 

Two or More 

Personal 

Property 

Motor VehicldDWI 

Drug 

Other 

Personal 

Property 

Motor Vehicle 

Drug 

DWWI 

Other 

Felony 

Misdemeanor 

Types of Prior Arrests 

Drug court Arrest 

Drug court Arrest 

St. Mary Creek County Bakersfield Jackson Total 

Parish County 

10.9 34.9 8.6 22.1 17.9 

23.2 20.8 14.7 28.5 23.1 

65.9 44.3 76.7 49.4 59.0 

13.0 7.6 13.2 9.3 10.9 

29.5 19.2 23.0 27.0 25.4 

5.2 28.7 3.1 2.4 4.6 

38.8 37.9 50.3 54.2 50.2 

13.6 6.8 9.6 6.3 8.2 

6.4 2.1 8.9 2.3 4.7 

22.3 7.3 9.3 9.7 10.6 

0.5 1.6 2.4 0.1 0.9 

63.2 53.1 67.4 85.8 75.4 

4.1 34.4 7.5 0.8 5.9 

3.6 1.6 4.7 1.2 2.5 

65.2 63.5 96.8 59.7 

34.8 36.5 100 3.2 40.3 

, 

3-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 3.5 Cross-Site Comparisons of Participant Level Substance Use Profiles 

Ever Used (Lifetime) 

Almhol 

Marijuana 

Crack/Cocaine 

Amphetamines 

Opiates 

other 

Use Last 30 Days 

Alcohol 

Marijuana 

Crack/Cocainc 

Amphetamines 

Opiates 

Other 

St. Mq Creek County Bakersfield Jackson Total 

Parish County 

95.9 89.1 68.7 89.9 81.3 

93.2 100 59.5 88.5 78.0 

81.8 29.2 30.2 58.8 45.8 

5.0 58.9 67.5 23.9 45.3 

22.3 7.3 18.5 1.7 13.1 

38.2 24.0 10.4 16.6 17.7 

44.1 22.7 55.0 66.0 53.1 

40.5 98.9 45.4 65.4 56.7 

35.0 27.6 20.7 31.0 26.5 

0.0 14.1 51.3 7.2 27.2 

13.2 0.5 11.5 0.5 7.4 

6.4 6.8 9.0 3.1 6.7 

Sanctions and Rewards 

It will be recalled fiom Chapter 2 that participant level sanction and reward 

information was not available at any of the sites. However, interviews with drug court 

personnel indicate that each program routinely employs sanctions and rewards during 

status hearings. Sanctions and rewards are given to emure participant compliance with 

program goals and objectives. Court personnel report that rewards are used to 

acknowledge participant progress. Typical rewards range fiom applause, verbal praise 

and various gift certificates to reductions in treatment sessions and drug testing, phase 

advancement and graduation. Unique rewards include tailored post cards sent by the 

Bakersfield judge to drug court participants. 

failure to attend scheduled counseling sessions and drug court hearings. Interviews 

indicate that typical sanctions include termination, docket placement, jail time, 

community service, curfews, increased treatment and drug testing. Unique sanctions 

include the “Rosemary Special“ and the “Focus Sanction”. The “Rosemary Special” 

sanction was developed at the Bakersfield site. Named after a client who ultimately 

graduated, this innovative sanction consists of required daily attendance at meetings of 

Alcoholics Anonymous and drug court hearings over a two-week time fim. It serves as 

a final warning to clients who are not in compliance with the program. 

The Jackson County Drug Court developed an intervention sanction referred to as 

the “Focus Sanction” for participants experiencing difficulty maintaining an acceptable 

level of compliance with the program. It consists of the requirement to attend forty-eight 

hours of intensive treatment at the residential treatment fkcility and is intended to provide 

participants a second chance in the program. Participants who continue to experience 

compliance dif€iculties are reportedly terminated fiom the program. 

Sanctions are imposed in response to positive urinalysis, new criminal charges, 

3-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

r 

Phase 

Expected Minimm 

Number of Drug Tests 

2 

Drug Testing Protocols 

3 months 3 months 4 months 4 months 

.25x week Unspeci5ed 

6 months 3 months 

66 42 64 64 

Drug testing is the f3h Key Component of drug courts: “Abstinence is monitored 

by frequent alcohol and other drug testing. ” The fiequent use of drug testing in the drug 

court model is based on the assumption that close monitoring and sanctions for continued 

drug use will bring about reductions in drug use and, hence, crime. Although drug testing 

is a common requirement for participants at each drug court, there are cross-site 

differences in the drug testing protocol. 

Bakersfield and St. Mary Parish drug court programs. Contracts with two separate drug 

testing services at the Bakersfield site require clients to phone calls for the date and time 

of their tests. The treatment provider at the St. Mary Parish drug court conducts random 

drug tests using a color-coded system. According to drug court personnel, drug testing at 

the Jackson County and Creek County drug courts are conducted on a random basis. 

Drug tests are reported to be administered by the treatment provider prior to treatment 

sessions. Drug tests at these sites are random only insofar as clients do not know whether 

they will be tested on the day of their scheduled treatment or court session. 

There are cross-site variations in the drug testing protocol regarding the frequency 

of drug testing. The treatment provider reported that clients are typically drug tested 

once a week at the Creek County drug court. Drug testing at other sites is reportedly 

more fiequently and varies by phase. For example, at the Bakersfield site drug testing is 

reported by court personnel to be as fiequent as 10 times a month for Phase I participants. 

testing protocol, we calculated the minimum number of drug tests that would be required 

of participants who completed the program through graduation. This information is 

presented in Row 8 of Table 3.6. There are cross-site variations in this estimated 

minimum number of required drug tests ranging fiom 42 tests at the Creek County drug 

court to 64 tests for participants completing the program at St. Mary Parish. Chapter 8 

compares these drug-testing protocols with actual drug testing practices at each site. 

As shown in Table 3.6, a randomized drug testing protocol is in place at the 

On the basis of interviews with court personnel and an examination of the drug 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

1 

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Summary 

Findings in this chapter suggest that the four drug courts are fairly diverse having 

their own distinct program characteristics. At the policy level, what are considered to be 

some of the most important characteristics of drug courts - determination of eligibility, 

drug testing, and graduated sanctions - are highly variable across sites. Although all 

programs have structured drug court phases, there are cross-site differences in this 

protocol - such as differences in the number and length of phases. In fact, one drug court 

reports using a modified program for less serious offenders with only ninety days allotted 

for the delivery of treatment services. There are drug-testing policies at each of the drug 

court sites but only two programs use a randomized drug testing protocol. At the two 

other drug courts, drug testing is random only insofar as clients do not know whether they 

will be tested on the day of their scheduled treatment session or drug court status hearing. 

This chapter also addressed several issues about the integrity of these drug court 

programs. By comparing policy level findings about target populations with participant 

level data abut actual criminal substance use histories, we found consistency between 

drug court policies and participant level information. 

of graduated sanctions, drug testing and substance abuse treatment. The drug courts in 

this study attempt to enhance alcohol and drug treatment with institutionalized policies 

and procedures that include substance abuse treatment, graduated sanctions and drug 

testing. 

Nationally, drug courts attempt to reduce recidivism and drug use through the use 

3-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 4 

Organization of Treatment Services 

Overview 

The main purpose of the drug court program lies in the provision of substance 

abuse treatment services. This chapter examines the delivery of substance abuse 

treatment services and the organizational characteristics of the treatment delivery system. 

It identifies commonalities and dfirences in the range of available treatment 

interventions among the providers at these four sites. In particular, we examine the 

structure, funding, and component services offered as part of the treatment delivery 

system. 

I 

Methods 

Information presented in this chapter is derived fiom multiple data sources 

including interviews with key team members and administrators such as drug court 

judges, case managers, prosecutors, public defenders, and shea. In addition, each 

court provided official program documents (typically the policy and procedures manual 

and client handbook’). Also, each director of treatment associated with these courts 

(except in Bakersfield where a sample of the programs serving the largest number of drug 

courts were studied and multiple program directors were surveyed) completed a survey 

that provided more in depth information. Supplementing the survey was an onsite 

interview used to clarify any details fiom the survey itsell: Respondents were allowed to 

provide their best estimates of some information. While this presents possible difliculties 

in terms of the accuracy of some of the information provided to the evaluators, due to the 

small size of the programs, it was assumed that the approximations would be very close 

to the actual situation in question. 

substance abuse delivery systems. It is followed by an examination of the treatment 

system fiom the perspective of criminal justice personnel. The final section of the 

chapter examines the delivery systems fiom the perspective of the treatment personnel. 

The chapter is organized as follows. The next section provides an overview of the 

Treatment Service Structures According to Drug Court Personnel. 

The first series of results are based on information collected from drug court 

personnel. According to the drug court staff, the major substance abuse treatment service 

component is delivered in an outpatient setting. Both treatment and court personnel 

~ 

’ A more complete description of these procedures is found above in Chapter 2. 

4- 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
,I 

report that outpatient treatment is typically delivered in a model where the client moves 

fiom most intensive to least intensive treatment structured around specific phases’. 

treatment services directly through dedicated providers with whom they have so& 

formal agreement. This was found at three of the four drug courts in this study (St. Mary 

Parish, Creek County, and Jackson County). The exception is the Bakersfield drug court 

that utilized multiple external treatment providers assigning drug court clients to 

dedicated slots located within geographical proximity of the clients’ residence. 

Nationally, Peyton and Gossweiler (2001) found that most drug courts obtain 

Substance abuke treatment services such as relapse prevention axe typically 

obtained through referrals to other agencies located in the community. The use of these 

referrarokerage services has the potential to extend drug treatment beyond the 

boundaries of the drug court program itself. Relationships with providers external to the 

primary treatment agencies are less formal and varied. Informal arrangements are 

typically made with these providers on an as needed basis. 

referred drug treatment services available. Each of the four sites in this study provides 

access to a variety of treatment services but there are broad variations in the number and 

types of services available and whether they are delivered by direct providers (ie. 

associated with the court) or external providers (i.e., through a referral to another 

community service agency). In comparison with the Jackson County and St. Mary Parish 

sites, the Creek County and Bakersfield sites are more reliant on referrals to external 

programs to provide treatment and ancillary services. Overall, participants tend to be 

referred out for detoxitication services and residential treatment. However, other types of 

referrals include community-based therapeutic communities, relapse prevention, and 

outpatient treatment. None of the programs in this study provide a methadone 

maintenance intervention. However, one drug court did provide Naltrexone 

pharmacological treatment. 

they offer. In Jackson County such services include residential treatment, intensive 

outpatient, outpatient services, and relapse prevention and a therapeutic community. 

Overall, the direct service provider at St. Mary Parish drug court offers more types of 

services than other sites. In fact, the direct provider offers 73% of the twelve services 

listed in Table 4.1. The corresponding figures for services provided by the direct 

providers at the other sites are: 36% at Creek County and 55% at the Jackson County site 

respectively. 

t 

Table 4.1 summarizes drug court case managers’ reports of the types of direct and 

Two of the direct providers are fairly robust in the number and types of services 

Generally, though, it appears that this “phased-system of treatment services” means simply that 

requirements for treatment attendance and drug testing frequency are gradually decreased. As discussed 

below in Chapter 6, observers of treatment services themselves could rarely discern the phase of a given 

treatment session or meeting, suggesting that the treatment as actually delivered is typically invariant across 

phases of treatment. In other words, it was not possible for our observers of the treatment activities 

themselves to notice any different focus of treatment across meetings purporting to be of different phases. 

We return to this issue in Chapter 7 when results of the direct observations are reported more fully. 

Generally, treatment administrators reported that clients participate in the particular modality offered to 

them for fixed lengths of time. Other treatment and ancillary services are reportedly made available 

through referrals to external agencies. 

4-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Overall, drug treatment services reported as available at the four sites in this study 

are comparable to those reported as available in 2 12 drug court sites surveyed nationally 

by Peyton and Gossweiler. Across the board, treatment services provided at these four 

sites do not necessarily represent the standard of care with “highly individualized 

placements and lengths of stay in one or more treatment modality contingent on 

individual client needs” described by the Ten Key Components (DCPO). However, each 

of the four sites does attempt to provide access to a variety of treatment services using 

either informal referrals or in fewer cases, direct service provision. 

Table 4.1 Types of Direct and Referred Drug Treatment Services Available 

Treatment Structures Organization from the Perspective of Treatment Personnel 

Treatment Funding Issues 

The following information about treatment structure and organization was 

obtained from interviews and surveys completed by treatment administrators. Table 4.2 

summarizes variations in the types and level of funding across sites. Overall programs 

vary considerably in the size of their operating budgets ranging from a low of $45,000 

annually to over $1 million. Only two of the sites report receiving hds fi-om federal 

sources - primarily from the Department of Justice. All of the sites rely on state funding 

fiom criminal justice or mental health agencies or general funds. In addition, three ofthe 

four programs receive hding from either local or private (client fees) sources. There 

4-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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are rurdurban differences in the size of these operating budgets with urban drug courts 

sites having substantially more funding. 

The largest proportion of the programs’ budgets allocated to providing services 

for drug court clients varied across sites, though several seemed to focus their resources 

on group treatment services, likely reflecting a need to maximize treatment dollars by 

providing services to ~y offenders at once. Finally, this group of administrators varied 

widely on what they reported they would spend any additional monies on, were they to 

become available, likely reflecting specific perceived local needs. Such needs range fiom 

staff training, case management and additional group and individual counseling services. 

Counryt 

Outpatient$ Residential 

Table 4.2 Financing of Treatment Programs 

Overall Program 

Budget (in thousands 

of Dollars) 

Federal Sources ’ 

State Sources 

Local Sources 

Private Sources 

Largest Portion of 

Program Budget 

First Choice for Any 

Additional Funds 

a- Residential Treatment 

I St. Mary I Creek I ,Bakersfield 

$250-$500 $45-$90 $l,Oo(H (2) $l,OOo+ 

$90-250 (1) (a) 

$45-90 (1) 

NIR (1) 

US DO1 (1) 

N/R (1) 

US DOJ None SAP1 (2) None (a & b) 

Office of Dept. of Mental State CJ State CJ 

Alcohol and Health & Agencies (3) Agencies (3) 

Drug Abuse Substance Medicaid (3) (a & b) 

Abuse General Mental 

Fund (3) HealtWWork 

Programs (b) 

County Tribal None county ( 1) county 

Other (1) Funds’ 

Client Fees None Client Fees Client Fees 

(2) (2) 

32% 50% 30% Group 45% 

Treatment Group (1) 25% CaSe 

Adjuncts Treatment Individual( 1) Management 

Services N/R (3) (a) 

Treatment Individual Tx. (a) 

StaiTTraining Group Group (1) Individual 

Services (1) Facilities (b) 

Adjuncts (2) 

Program “a”, large, male-female facility 

LocalTaxes 

None 

52% 

Individual 

Treatment 

Services 

LocalTaxes 

None 

55% 

Treatment 

Services 

Group 

Jackson I 

Counv 

Outpatient Residential 

I 

USDOJ I None 

Agency 

T Training Management 

~urt clients during the 

I not complete the survey. 

Treatment Program Organizational Structure 

A pattern of diversity emerges (see Table 4.3) with regard to the overall structure 

of the treatment programs at these four sites. Treatment program administrators at the 

Bakersfield and Creek County sites descrikd their agencies as independent, communitybased, non-profit organizations, while the treatment program at St. Mary Parish and 

Jackson County site were described as being more directly afliliated with the drug court 

4-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
itseK Many administrators describe their programs as community-based, non-profit 

agencies with several reporting afltiliation with larger community service agencies. A 

prokssional manager ran most programs, (e.g., a Chief Executive OEcer) while the 

treatment provider at St. Mary Parish was part of a state agency. 

intensive outpatient or outpatient drug-fiee, with two programs reporting residential 

services, services for dually-diagnosed clients, and services for women with children. 

At all four drug court sites, providers commonly described their services as either 

Organizational 

Structure 

Larger APcy? 

Who Runs Agency? 

Program Activities 

a - Residential Treatment 

Sf. Mary Creek Bakersfield Jackson 

Parish County? County 

Outpatient $ Residential Outpatient Residential 

(# Programs) 

Community- Non-Profit Non-Profit Non-Profit, Independent NonProfit, 

Based, State Community (3) Community Agency Community 

I 

Substance ServiceAgency LocalMH Services SeniceS 

Abuse Agency Agency (2) Agencies Agency 

Government above Yes (2) above above 

.(a & b) 

State Yes, same as No(3) Yes,sameas No Yes, same as 

(2 other units) (a & b) 

Government Board (1) (a& b) 

County CEO CEO (4) CEO N/A CEO 

Inpatient? Outpatient Outpatient Detox & Outpatient 

Intensive Drug-Free and Drug-Free Residential Drug-Free, 

Outpatient and Intensive (5) (a 82 b) Jntensive 

SelEHelp Outpatient Intensive Outpatient 

Outpatient Dual and Dual 

. (3) diagnosis (a) Diagnosis 

Diagnosis (2) Women & 

Women w/ Kids (b) 

Children (2) 

Dual 

Pmgram “a”, large, mde-female hcility 

Delivery of Specific Substance Abuse Treatment Services 

Results presented in Table 4.4 provide more specific detail about the nature of the 

services reported by program administrators. Nearly all programs report offering 

individual, group, general substance abuse, relapse prevention, social/coping skills, and 

self-help (1Zsteps) interventions directly. In addition, it was common for these programs 

to offer fhmily treatment sessions, anger management, follow-up counseling and case 

management service directly to their clients. While administrators report offering many 

of these services directly to clients, some of these service areas were not always observed 

(See Chapter 7 for more on this issue) during the site visits (e.g., fw, educational and 

aftercare activities). 

4-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
J Table 4.4 Specific Substance Abuse Services 

b - Residential Treatment Program "b", smaller, all female fsility 

t- Data is presented fiom the treatment program that served only a small proportion of drug court clients during the 

evaluation period. The program, which served most of the court's clients during this time, did not complete the survey. 

$- Information is presented for all five of the outpatient programs examined at this site. 

Substance Abuse Program Structure & Duration 

In terms of the duration of the treatment programs, again variations in the number 

and length of specific program phases were reported (see Table 4.5). Many programs 

reported information on the structure of program phases that appears to reflect their ideal 

rather than actual practices, while some programs did not provide even ideal lengths of 

stay in various phases of treatment. In general, according to program administrators' 

reports introductory phases of treatment appeared to last from 2 to 4 months, at which 

time clients would begin to move into more intensive treatment stages, where again they 

could spend fiorn 3 to 4 months, before moving to what was us* a jinal transition 

PbThe outline shown in Table 4.5 represents a very general summary of the 

information provided in that programs overall reported vastly different time fiames and 

numbers of distinct treatment phases @om 2 to 4 phases). The St. Mary Parish program 

appears to be the most well organized in terms of its use of structured program phases, 

including the use of a follow-up phase (4) and specific written goals to be accomplished 

. 

4-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
in’each phase of treatment. Other programs did not appear to be as well organized in 

their use of graduated phases of treatment delivery. In fact, it was often difficult for 

observers of meetings to determine what phase of treatment a given group was intended 

tobeapartof. 

Table 4.5 Substance Abuse Program Structure & Duration 

St. Mary Creek Bakersfield Jackson 

Parish County? County 

Outpatient $ Residential Outpatient Residential 

+ (# Programs) 

Phase 1 8 weeks 3 months 6 months (1) 4 months (a) 16 weeks N/R 

Phase2 16weeks 3 months 90 days (1) 4 months (a) 16 weeks N/R 

Phase3 12weeks 3 months N/R (5) 4 months (a) 16 weeks Nm’ 

Phase4 24weelcs N/A N/R (5) N/A NIA N/R 

Closed Groups No No open (5) No No , No 

Formalized Cm’culum No Yes Yes (3) (4 Yes YeS 

N/R (4) 1-2 day @) 

N/R (4) 1-2 day (b) 

4- 100 days 

@I 

Both (2) (a&b) 

No (2) Yes (b) 

t, 

Delivery of Medical Services 

Referring to the delivery of medical services (Table 4.6), it appears that the 

majority of programs referred clients to other agencies, with the exception of the 

residential program at the Jackson County site (which was part of a larger communify 

service agency which itself included divisions responsible for community health 

services). While it would not necessarily be expected that drug treatment service 

providers offer medical services, the ability to provide these services to a population that 

is likely to have multiple co-occurring medical issues, is no doubt a benefit to the clients 

in residential treatment at Jackson County. 

4-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 

Adult Primary Care 

Pediatric Care 

Prenatal Care 

Post Partum Care 

Physical Exams 

TB Testing 

STDm Testing 

HW Testing 

Medical Detoxification 

Methadone Treatment 

Prescribed Medication 

Birth Control 

Acupuncture 

Other 

b - Residential Treatment 

Table 4.6 Ancillary Medical Services Delivered 

9 Mary Creek Bakersfield Jackron 

Parish Counryt County 

Outpatient $ Residential Outpatient Residential 

(# Programs) (b only) 

NIA NIA Referral (4) Referral Referral Direct 

(1) 

NR (1) 

N/R (1) 

NR (1) 

NR (1) 

NR (2) 

N/R (1) 

NR (1) 

N/R (1) 

N/R (3) 

N/R (2) 

Direct (1) 

Referral (4) 

NIA NIA Referral (4) Referral NIA Direct 

NIA NIA Referral (4) Referral NIA Direst 

NIA NIA Referral (4) Referral Referral Direct 

NIA NIA Referral (3) Referral Referral Dim 

Direct NIA Referral (4) Referral Referral Direct 

Direct NIA Referral (4) Referral Referral Direct 

Direct NIA Referral (4) Referral Refd Direct 

Referral NIA Referral (2) Referral Referral Referral 

NIA NIA Refd (3) Referral NIA Refd 

Referral NIA Referral (2) Referral Refd Dited 

N/R (1) 

N/R (2) 

NR (1) 

N/R (1) 

Referral NIA Referral(3) Refd Referral Direct 

NIA NIA NIA (4) NIA Ref& RefNIA NIA NIA (4) NIA N/R N/R 

Program “b”, smaller, all female facility 

Delivery of Other Ancillary Services 

The delivery of other social and treatment services to clients involved in drug 

court treatment occurs primarily through referrals to other agencies according to 

administrators’ reports (see Table 4.7). With the exception of some aftercare services 

provided directly by the treatment program at Bakersfield, St. Mary Parish and Jackson 

County, many other services such as vocational interventions, transportation and housing 

are provided via referral to other agencies. Similarly, services for specific groups, the 

hearing and sight impaired and Spanish speakers did not tend to be offered “in house” by 

these programs. 

4-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I’ 

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Si. Mary 

Parish 

Table 4.7 Other Ancillary Services Delivered 

Creek ’ Bakersjeld Jackson 

Countyt County 

OutDatient 1 I Residential Outpatient I Residential 

Direct (1) 

Referral (3) 

Direct (1) 

Referral (3) 

Direct (3) 

I I I (# irogamS) I &only) I I 

Academic I . Referral Referral Referral I Referral I Referral 

NIA Referral Referral 

Direct Referral Referral 

Referral Direct & Direct 

Job Training Referral Referral 

Career Counseling Referral Referral 

Outpatient 

Aftercare-Outpatient 

DrUg-FEe. 

Merare-Residential 

Aftercare-1 2 StepdSelf 

Help 

Aftercare-Vocational 

Education 

Job Placement Direct Referral 

Other Career Services Referral 

Locating Housing Referral 

Referral 

Referral 

Direct Referral Direct (2) Referral Direct & Direct 

NIA Referral Direct (1) Referral Referral Direct 

Referral Referral Direct (2) Direct Refd Direct 

NIA Referral Referral (2) NIA Referral Referral 

Refmal (I) 

Referral (I) 

Referral 

Legal Assistance Direct Referral 

Spanish Services 

Sight Impaired I NIA I Referral 

Services - __ . - __ I I 

Hearing Impaired I NIA I Referral 

Services I I 

Aftercare-Intensive I Dired Referral 

Aftercare 

Aftercare services create the possibility of continuity for participants who have 

received substance abuse treatment services and can introduce some quality control for 

participants who have completed the treatment program. As indicated above, 

administrator surveys indicate that either direct or referred aftercare services are provided 

by treatment providers. 

treatment administrators. They indicate that the whether aftercare is provided in these 

drug court programs is partly a definitional issue. For example, the aftercare program at 

the Jackson County site consists of graduates voluntarily attending twelve-step meetings. 

The three-month aftercare program at the Bakersfield site consists of one monthly drug 

Court personnel interviews were not as conclusive about aftercare services as 

4-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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test. In Creek County, some graduates with felony convictions are still on probation and 

receive probationary supervision as “aftercare“. 

treatment program. Court personnel report an aftercare program at St. Mary Parish 

consisting of the fourth phase of the program, “Continued Care”. It is six months long 

consisting of one drug test, attendance at two treatment sessions, and three AA meetings 

a month. Other court personnel report that only some graduates at St. Mary Parish 

receiving aftercare services and only because they are stiU on probationary supervision. 

The treatment provider offers a voluntary aftercare maintenance program. Despite these 

provisions, based on court personnel interviews it does not appear that the provision of a 

specijically designed post-graduation aftercare program exists at any site. 

Finally, the aftercare program at the St. Mary Parish appears to be part of the 

Summary 

Overall, information in this chapter suggests that an array of direct and referred 

services are available to treat a variety of substance abuse and associated problems of 

drug court participants. According to reports of both treatment and drug court personnel, 

a direct provider delivers the bulk of the substance abuse treatment services at three of 

the four drug court programs while other services such as medical and other ancillary 

social services are made available to participants through an inforrid referral system 

The direct providers are delivering what they describe as outpatient or intensive 

outpatient services in a group format consisting of a fixed-length, step-down program 

delivered in phases. However, there are considerable cross-site variations in the nature 

and type of services provided, the number of phases and the length of each phase. The 

direct provider at St. Mary Parish also offers a range of services including residential 

treatment and the direct provider at the Jackson County site also offers residential 

treatment. Other than the provision of direct outpatient substance abuse treatment 

services, the Creek County treatment provider is a stand alone service referring 

participants out to other agencies for most services. 

relation to the surrounding populations they serve, with urban providers having larger 

budgets. Most programs rely heavily on state fimds and vary in the priority they place on 

hding various types of treatment activities. 

In general, the treatment providers at these sites have budgets that vary in size in 

At the onset of this chapter, we discussed the fact that the provision of access to a 

continuum of alcohol, drug and other related treatment and rehabilitation services is one 

of the Key Components (4*) of drug courts. It appears that there are several impediments 

to the delivery of this type of “continuwn of care”, including the reliance on informal 

referral systems for the provision of ancillary services. This is especially pronounced in 

courts where multiple substance abuse treatment providers are utilized (e.g. Bakersfield) 

or where the primary drug treatment providers are predominately community-based 

programs. We return to this issue in Chapter 7 - Integration of Treatment Services, but it 

appears that the form of relationship that exists between the court and the substance abuse 

treatment agencies can have important impacts on the nature and extent of service 

delivery (in terms of both substance abuse and ancillary services). 

4-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 

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At each site, when particular services are not directly provided, attempts may be 

kde to refer participants to other agencies for those services. However, there was no 

indication at any site that direct providers were substantively involved in ensuring that 

participants received those services for which they were referred. 

related services directly to clients. However, to the exteat that these client populations 

suffer fiom multiple social, interpersonal and psychological needs, the reliance on 

informal referral systems, without formalized cooperative agreements with external 

providers may well hamper the abiIity of the drug court to effectively provide the entire 

range of services necessary for the high need, high risk cwl justice populations they 

serve. 

It may be unfair to expect these programs to provide a wide spectrum of non-drug 

4-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 5 

Treatment Counselors’ Perspectives on Drug Treatment Services 

Overview 

This chapter presents information gathered fiom surveys of treatment counselors at each 

of the treatment agencies involved in the evaluation of these four adult drug court programs. 

Information gathered through the sweys includes that related to the qualifkations, experience 

and philosophical orientation of counselors, as well as their typical daily activities. In addition, 

idormation about client characteristics (drug of choice, demographics), as well as staff 

clx$acteristics is presented as reported by the program administrators on the Administrator’s 

Survey. A full discussion of these two surveys can be found in Chapter 2. 

Treatment Program Stafling Issues 

The following section presents information collected fiom Administrator surveys 

regarding the characteristics of the clinical and other staff employed by the treatment programs 

utilized by these four drug courts. As can be seen in Table 5.1, the number of clinical and other 

staff varies with the overall size of the pr6gram Fortunately, most of the treatment programs 

seem to employ large proportions of clinical staff, relative to the numbers of other staE(clerical, 

management, security). On the other hand, few programs report employing large numbers of 

security staff (which may not be crucial in predominately outpatient programs), medical stafF or 

case management staff. The lack of medical staE appears consistent with results presented 

above concerning the referral of clients for needed medical care, however the relatively low 

numbers of case managers in these programs might suggest that responsibility for activities such 

as transitional planning and referral to adjunctive social services may be pushed onto clinical 

st&, or that these activities are not given suflicient priority within the programs. 

I 

5-1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, I 

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ManagerslSupemsors 

Clinical Staff 

Medical Staff 

security Staff 

Clerical StafF 

Case Managers 

other 

Total 

a- Residential Tr 

Table 5.1 Staffing Levels 

St. Mwy Creek Bakersfield 

Parish 

\ 

310 

410 ‘ 

0 

011 ’ 

24 

UO 

f 1112 

County7 

1 IO 

112 

+I Contract 

0 

0 

1 IO 

0 

610 

Outpatient # 

Avg. Full 

Time 

Equivalent 

1.5 

b t 5.4 

1 

0 

3.5 

1 

(all 5 at one 

program) 0 

12 

Jackson 

County 

Outpatient 

2lO 

W1.1 

+l Contract 

010 

010 

412 

010 

,, 41 

1311 3 

Residential 

20 

2010 

01 1 

011 

1 IO 

010 

I 

2312 

33 (b) 

ment Program “a”, large, male-female facility 

b- Residential Treatment Program “b”, smaller, all female facility 

t - Data is presented fiom the treatment program that served only a small proportion of drug court clients during the 

evaluation period. The program, which served most of the court’s clients during this time, did not complete the 

administrator’s survey. 

$- Average Full Time Equivalent positions per treatment program. This aggregated information is presented for all five of 

the outpatient programs examined at this site. 

Results presented in Table 5.2 demonstrate what is a common finding in correctional and 

substance abuse treatment programs in general, specifically that many of the clinical staff 

employed in these programs have relatively low levels of education (the majority have 

Bachelor’s degrees or less). On the other hand, compared to their educational achievements, 

relatively large proportions of the clinical staff do hold some type of appropriate substance abuse 

treatment credentials. Ako, among those who reported on the recovery status of their counselors 

it was not uncommon for clinical staff in these programs to be recovering substance abusers 

themselves. This finding is also relatively common in the substance abuse treatment literature. 

5-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Staff Qualijicoiions 

M.D. 

PAMP 

RNflN 

Ph.D. 

Master’s 

‘ll!l, Bachelor’s 

, High School or less 

Recovering 

CertificationslLicensures 

Sf. Man, Creek Bakersfield 

Parish 

0 

0 

0 

0 

0 

5 

8 

6 

5 

Couniyt 

0 

0 

0 

1 

2 

3 

0 

1 

N/R 

Outpatient$ 

Mean (N) 

[Rangel 

0.6 (5) 

(0-11 

0 

0.2 (5) 

10-11 

0.2 (5) 

10-11 

1.2 (5) 

10-41 

1 (5) 

10-31 

3 (5) 

to-81 

5.5 (2) 

t4-73 

3.8 (4) 

11-61 

Jackron 

County 

Outpatient Residential 

0 1 

0’ 0 

0 1 

0 0 

12 5 

1 4 

1 12 

9 7 

8 7 

Nld (b) 

a- Residential Treatment Program “a”, large, male-female facility 

b- Residential Treatment Program “b”, smaller, all female facility 

t- Data is presented fiom the treatment program that served only a small proportion of drug court clients during the 

evaluation period. The program, which served most of the court’s clients during this time, did not complete the 

administrator’s survey. 

$ - Momation is presented for all five of the outpatient programs examined at this site (Mean number of positions of each 

type, per program; Number of programs responding Range of the number of positions of each type at each program). 

In general, the response rate for counselor surveys varied across sites (see Table 513). In 

Creek County, the program that lost its contract to provide services to drug court clients during 

our visit, failed to return the majority of our surveys. While the overall response rate was 60%, 

information was obtained fiom counselors fiom every program in every jurisdiction. Most 

counselors reported working 40 hours per week and had relatively large numbers of clients 

assigned to them (as many as 35 clients in some programs). Overall, the counselors varied in 

their racial background, with few African American counselors in most of the programs. Also, 

many of the programs did not employ any Hispanic counselors. These results could be expected 

to negatively impact the delivery of culturally appropriate treatment. While most counselors 

reported their age as around 40 years old, there was some variation, with St. Mary Parish 

employing somewhat younger counselors. Most counselors had been with their respective 

treatment programs for at least 2 years and many had a number of years experience providing 

substance abuse treatment and other social services to offender populations. 

5-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 4 

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Table 5.3 Clinical Staff Characteristics 

Staff Characteristics 

Number of 

Respondents 

(Response YO) 

Mean % in Recovery 

Modal Highest Degree 

Held (Proportion 

w/modal degree) 

Mean Hours Worked 

per Week 

'Mean Number of 

,I( , Clients 

Mean YO of White 

Counselors 

Mean '3'0 of Afiican 

American Counselors 

Mean % of Hispanic 

Counselors 

Mean Age in Years 

Mean Years with this 

Program 

Mean Years Providing 

Drug Treatment 

Mean Years Providing 

Social Services 

Mean Years Working 

with Offenders 

St. Mary Creek Bakersfield Jackson 

Parish Countyt County 

Outpatient: Residential ' Outpatient Residential 

3 3 21 16 8 3 

(50%) (30%) (62%) (84%) (53%) (30%) 

0 

BA 

(313) 

40 

76.7 

1/3 

2/3 

0 

28.7 

1.9 

4 

4 

4.5 

2/3 

PbD.~ (1/3) 

M.A. (1/3), 

H.S. or less 

27.2 

28.7 

213 

113 

0 

51.0 

2.2 

2.5 

11.6 

3.1 

(113) 

3 8% 

H.S. or less 

(48%) 

40.3 

34.3 

19% 

24% 

3 8% 

42.2 

2.8 

4.7 

10.2 

5.6 

94% 

H.S. or less 

(81%) 

40.3 

12.2 

81% 

o?? 

0% 

40.8 

1.8 

3.2 

4.3 

4.7 

50% * 

B.A. 

(SPA) 

30.0 

25.0 

3 8% 

25% 

0 

36.5 

2. I 

6.1 

6.6 

6.0 

113 

BA or some 

College 

(313) 

40.0 

24.3 

1 13 

2/3 

0 

42.0 

5.0 

6.0 

8.1 

9.4 

- Aggregated data is presented based on information fiom counselors at both treatment programs. 

3- Means for each category are presented which summarize the information provided by all responding counselors at all five 

of the outpatient programs examined at this site, as well as fiom the two residential programs. 

Most counselors report conducting about one group activity per day, of approximately 10 

to 15 clients per group, for approximately one to one and a half hours per meeting (see Table 

5.4). They also report having one or two individual sessions per day, lasting anywhere fiom 30 

minutes to approximately an hour. Other activities vary widely by site, but few programs appear 

to spend substantial amounts of time involved in family counseling. This result fiom the 

counselor surveys contradicts data fiom the program administrators who generally reported that 

the programs did, in fact provide family counseling services directly to their clients. Generally, 

this group of counselors reported spending a good deal of time on admissions-related duties, but 

did not report what would seem to be a large amount of time spent on related assessments. 

5-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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StaflActiviry Type 

Mean Weekly Number 

of Groups 

(Hours/Week) 

Mean Clients per 

Group 

Mean Weekly 

Individual Sessions 

(HoudWeek) 

Mean Weekly Number 

of Assessments 

(Hodweek) 

Mean Weekly Hours of 

Case Management 

Mean Weekly Hours of 

Discharge Duties 

Mean Weekly Hours of 

Family Counseling 

Mean Weekly Hours of 

Admissions 

Mean Weekly Other 

Duties 

Table 5.4 Treatment Staff-Related Activities 

St. Maty Creek Bakersfield 

Parish 

3.0 

(6.2 hrs) 

13.5 

31 

(3.5 hrs) 

1 

(1.5 h) 

13.3 

I .o 

0 

5.5 

’ 1.0 

Countyt 

5.7 

(8.0 hrs) 

9.7 

1.3 

(0.7 Ius) 

0 

4.0 

2.0 

0 

4 

0 

Outpatient$ 

4.7 

(8.2 h) 

10.1 

8.3 

(4.8 Ius) 

4 

(4.4 Ius) 

6.9 

2.5 

1.5 

11.0 

3.2 

Residential 

4.7 

(5.4 hrs) 

21.2 

7.2 

’ (9.5 hrs) 

1.4 

(2.8 hrs) 

8.4 

2.5 

1.3 

8.7 

4.4 

Jackson 

County 

Outpatient Residential 

4.3 

(6.8 hrs) 

13.1 

13.2 

(13.8 hrs) 

1.9 

(3.4 hrs) 

3.6 

1 .o 

0 

3.0 

(8.2 hrs) 

7.7 

11.5 

(1 5.2 hrs) 

2.8 

(4.5 hrs) 

2.0 

2.0 

I 

1.5 

0 2.5 

2.5 1.5 

t- Aggregated data is presented based on information kom counselors at both treatment programs. 

2- The mean for each category is presented which represents the information provided by all responding counselors fiom all 

five of the outpatient programs examined at this site, as well as kom the two residential programs. 

Results presented in Table 5.5 suggest that all of the programs involved in this evaluation 

make use of a standard intake-screening tool, most commonly the Addiction Severity Index. 

Nearly all of the counselors responding to the survey felt the tool was usell. Nearly all 

counselors also reported that their programs used individualized treatment plans for their clients, 

but very few reported that the client was involved in the development of these plans. Most 

counselors reported spending about five hours per week on treatment planning activities and that 

their clients’ plans were commonly updated “as needed” without specmg how ~equent that 

might be. 

5-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

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IntakdPlanning Items 

Table 5.5 Intake and Treatment Planning Activities 

St. Mary Creek Bbkersfield 2 Jackson 

Parish Countyt County I 

Outpatient Residential Outpatient Residential 

Program Uses Intake 

Screening Tool 

Typical Tool 

The Tool is Usell 

Individualized 

Treatment Plans 

Who Creates ar 

Updates Plan 

How OAen Updated 

Mean Weekly Hours 

YeS 

(1 00%) 

AS1 

(86%) 

YeS 

(95%) 

' {Yes 

(I 00%) 

SM 

(71%) 

YeS 

(1 00%) 

AS1 

(1 00%) 

YeS 

(1 00%) 

YeS 

(1 Oo?/o) 

Staff 

(56%) 

YeS 

( 1 00%) 

AS1 

(50%) 

YeS 

(1 00%) 

YeS 

( 1 Wh) 

StafF 

(88%) 

YeS 

(100%) 

AS1 

(67%) 

VeS 

(100%) 

YeS 

( 1 oOw 

Staff 

(67%) 

AsNeeded AsNeeded' AsNeeded AsNeeded Monthly ' 

Less than 

Monthly 

(313) (113) (43%) (63%) (3 8%) (67%) 

2.1 1 .o 5.4 4.6 4.7 9.5 

Planning Treatment I 

t - Modal data is presented based on responses fiom the counselors at both programs. 

$- modal response. for each category is presented based on information %om all responding counselors %oh all five of the 

outpatient programs examined at this site, as well as &om the two residential programs. 

Substance Abuse Treatment Curricula 

Almost all of the responding counselors reported that their programs used a formal 

curriculum in the provision of drug abuse treatment, with the exception of 2 out of 3 counselors 

fiom the St. Mary Parish site (see Table 5.6). However, observers noted that the St. Mary Parish 

site does use a structured curriculum in the first phase of treatment, so it is likely that these 

counselors were referring to the later phases of treatment. Generally, the counselors felt 

positively about these treatment curricula, rating them as effective and appropriate for their 

clients. This group of counselors also reported fiequent use of videotapes, workbooks and to a 

lesser extent journal or diaries and audiotapes as treatment adjuncts. 

5 -6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 5.6 Formal Treatment Curricula Descriptions 

Treorment Curricula I St. Mary Creek Bakersfield # 

Items 

Use Formal 

CurriCUlUm 

Curriculum is 

Effective 

Clear to clients 

Too Structured for 

Clients 

Too Complex fbr 

Clients 

Too Time Consuming 

Too Basic for Clients 

Not Relevant to Clients 

Curricula Adjuncts 

Use Video Tapes 

Use Audio Tapes 

Use Workbooks 

Parish Countyt 

(percent “Yes”) (percent “Yes”) 

113 

1/1 

1/1 

Oil 

01 1 

01 1 

011 

01 1 

3/3 

313 

313 

2i3 

2/2 

2/2 

012 

% 

012 

012 

% 

2/3 

1 13 

313 

Outpatient 

(percent 

“Yes”) 

70% 

93% 

79% 

14% 

14% 

0% 

PYO 

14% 

81% 

43% 

71% 

Residential 

(percent 

“Yes”) 

57% 

100% 

88% 

13% 

13% 

13% 

13% 

13% 

75% 

50% 

81% 

Jackson 

County 

Outpatient Residential 

(Per- (percent 

“Yes”) “Yes”) 

50% 67% 

100% , 100% 

100% loOO? 

o?! 0% 

o?? 0% 

0% 0% 

0% oo? 

0% 0% 

IW! 100% 

3 8Yo 33% . 

88% 100% 

Use Journals or Diaries I 3/3 2i3 48% 81% 50% 50% 

t- Aggregated data is presented from counselors at both treatment programs. 

1- The mean number of counselors responding “yes” for each category is presented for all five of the outpatient programs 

examined at this site, as well as for counselors from the two residential programs. 

Communicating Expectations and Monitoring Compliance 

The majority of counselors in all sites reported that their programs used some form of 

behavior modification; with many reporting their programs used specjjic written contracts to 

reinforce appropriate client behaviors (see Table 5.7). Nearly all counselors reported that their 

clients were made known of the behaviors expected of them through some combination of verbal 

and written explanations. Programs appeared to be split as to whether the responsibility for 

explaining these expectations fell to the treatment or drug court staff. 

5-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
+ 

Table 5.7 Communicating Expectations to Clients 

Communication Items St. Mary Creek Bakersfield $ Jackson 

Parish Countyt County , 

Outpatient Residential Outpatient Residential 

Use Behavior 

Modification 

Use Written 

Behavioral Contra 

Restricted Behaviors 

Made Known 

Rules Made Known By 

whom? 

Drug Testing Items 

Programs Drug Tat 

Frequency? 

Clients? 

Reports Generated? 

Reports Shared with 

Drug court? 

Graduation Criteria 

Made Known 

St. Mary Creek Bakersjield $ Jackson 

Parish County7 County 

Outpatient Residential Outpatient Residential 

YeS Yes (Both YeS YeS YeS YeS 

Random Random Random Random Random Random 

Programs) 

(ProgFa 4 

Weekly 

(Program b) 

Programs) 

Programs) 

Yes Yes (Both YeS Yes YeS YeS 

YeS Yes (Both Yes Yes Yes YeS 

YeS 

313 

yes, 

313 

Drug court 

Staff 

(3131, 

Written 

(313) 

Verbal 

YeS 

313 

YeS 

?4 

YeS 

313 

Treatment Staff 

(313) 

Writtell 

(313) 

YeS 

YeS 

89% 

YeS 

' (95% 

Treatment 

' staff 

(47%) 

verbal , 

(89%) 

Written 

75% 

YeS 

67% 

Yes 

47% 

YeS 

I 100% 

Drug court 

Staff 

(94%) 

Verbal 

(94%) 

Written 

YCS 

1ooo/. 

'Yes 100% 

YeS 

loOO/o 

Drug court 

Staf€ 

(63%) 

Written 

(88%) 

Verbal 

YeS 

33% 

YeS 

33% 

YS 

100% 8, 

Treatment 

Staff 

(I OW!) 

Verbal 

(100%) ' 

I (U3) (74%) (69%) (88%) 

t- Aggregated data is presented fiom counselors at both programs. 

$- The modal counselor response for each category is presented for responding counselors at all five of the outpatient programs 

examined at this site, as well as fiom the two residential programs. 

All of the responding counselors reported that their clients were drug tested as part of 

participation in treatment, with the majority of programs reporting random testing (with 

unspecified fi-equencies). All counselors also reported that their agencies generated reports about 

clients' drug testing and shared those results with the drug court (pee Table5.8). 

Table 5.8 Drug Testing Procedures 

5-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Token Economy 

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33% 67% 75% 100% 75% 33% 

0% 0% . 5% OYO 13% 3 3% 

comnionly reported, such as reductions in treatment attendance and drug testing fi-equency. 

These in particular varied by site and likely reflect policies of the overall drug court, more than 

the treatment programs themselves. For instance, in B&ersfield, the court had a relatively strict 

drug testing regime for clients, which likely explains the lower rates for the use of “decreased 

drug testing frequency" (only 13-26%, compared to 67% in St. Mary Parish). Again, the use of 

token economies and financial rewards were generally rare as reinforcements. 

\ 

Table 5.9 Behavioral Consequences 

Bakersfield $ Jackson 4 County St. Mary Creek 

Parish County? 

OutDatient Residential OutDatient Residential 

Sanctions 

Loss of Privileges 67% 33% 20%. , 75%. 6%‘ , Extra Treatment I 1ooo/o 100% 75 % 47% 8 8% 67% 

Extra Support 

Homework 

Extra Drug Testing 

Fines or Fees 

Token Economy 

Verbal Praise fiom 

Staff 

Verbal Praise fiom 

Other Clients 

Reduce Treatment 

Reduce Drug Testing 

Financial Rewards 

Vouchers, etc. 

Rewards 

67% 

,I ow0 

1Wh 

05 

3 3% 

, 100% 

33% 

67% 

67% 

0% 

0% 

100% 

67% 

1 OOYO 

67% 

0% 

100% 

67% 

33% 

33% 

0% 

0% 

80% 

50% 

65% 

1% 

I % 

85% 

75% 

40% 

26% 

0% 

15% 

33% 

93% 

47% 

0% 

20% 

94% 

81% 

87% 

13% 

0% 

WO 

88% 

50% 

75% 

63% 

25% , 

lW? 

100% 

75% 

88% 

71% 

88% 

100% 

IOOO? 

33% 

‘ 0% 

, 0% 

1 WYO 

33% 

o?? 

33% 

0% 

004l 

Counselors’ Philosophy of Drug Abuse and Effective Treatment 

Counselors were asked to rate their agreement with several statements intended to capture 

information about their perspective on the likely causes of drug use and abuse, as well as their 

opinions about what components were needed for effective substance abuse treatment. 

Counselors rated their agreement with each of these statements using a five-point Likert scale 

(“1” = “strongly agreed with the statement”, ‘3”= “strongly disagreed with the statement”). 

Each of these items was then aggregated into scales representing specific theories (e.g., Social 

Learning theory, Social Disorganization theory, etc). The average score, by site for all items on 

each of these theoretical scales are presented in Table 5.10. 

disease model, cognitive-behavioral skills deficits, psychopathic characteristics, antisocial 

values, social learning theory, social control theory, and labeling theory as important causes of 

drug abuse. They tended to slightly disagree with items representing conflict, social 

disorganization, and strain theories. These results would tend to suggest that the counselors 

located the causes of drug abuse within the personalities and individual experiences of the drug 

According to these results, counselors at all sites tended to moderately endorse the 

5-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
user, more so than as a result of external social influences. In terms of the important aspects of 

effective drug treatment the counselors tended to moderately endorse items representing nearly 

all of the scales (see Table 5.1 1). This pattern of results may suggest that counselors are willing 

to apply almost any technique in an attempt to reduce drug use. It may also suggest that they do 

not generally have a strong Bation or understanding of any particular approach to treatment, 

or that they do not implement a coherent treatment strategy in their programs. 

Mean Scores: 

Drug Use Cause 

Scales 

Conflict 

Labeling 

Social Control 

Social Disorganization 

Social Learning 

Strain 

Anti-social Values 

Cognitive Skills 

Deficits 

Disease Model 

Psychopathy 

Table 5.10 StaHPhilosophy of Drug Use Causation (l=Strongly Agree, 5--strongly Disagree) 

St, Mary Creek Bakersfield $ Jackson 

Parish County? County 

Outpatient Residential Outpatient Residential 

3.4 3.5 3.2 3.2 3.5 3.8 

3.0 2.7 2.5 2.4 2.5 2.2 

2.6 2.8 2.2 2.2 2.2 2.6 

3.7 3.1 3.2 3.4 3.4 3.1 

3.0 2.0 2.1 2.5 2.4 2.5 

2.9 3.3 2.8 2.9 3.5 2.9 

2.4 2.9 2.5 2.7 2.7 2.4 

2.0 2.0 2.0 2.0 1.9 1.8 

1.7 3.5 2.1 1.7 2.1 1 .s 

2.5 2.8 2. I 2.5 2.5 2.5 

Mean Scores: 

EfJective Zntervention 

Scales 

Conflict 

Social Control 

Social Disorganization 

Social Learning 

Strain 

Anti-social Values 

Cognitive Skills 

Deficits 

Disease Model 

Psychopathy 

Labeling 

Table 5.11 Staff Philosophy of Effective Drug Treatment (l=StrOngly Agree, 5-StrongIy Disagree) 

St. Mary Creek Bakersfield $ Jackson 

Parish County? County 

Outpatient Residential Outpatient Residential 

I .4 1.8 1.8 2.1 2.2 2.5 

1.3 1.3 1.5 1.6 1.6 1 .5 

1 .o 1.6 1.6 1.5 I .4 1.3 

1.8 1.8 1.9 2.0 1.9 1.8 

I .8 1.7 1.5 I .5 1.3 1.7 

1.6 1.5 1.5 1.5 I .2 1.7 

I .8 1.8 1.6 I .7 I .4 1.6 

1.6 1.7 1.6 1.6 1.3 1.3 

1.8 2.8 1.7 I .5 1.8 1.5 

1.8 2.8 I .9 2.6 2.3 2.3 

5-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Drug court 

Other Courts 

Other CJ Agencies 

Self-Referred 

Other Referrals 

Characteristics of Clients in Treatment 

St. Mary Creek Bakersfield # Jackson 

Parish Counryt County 

Outpatient Residential Outpatient Residential 

Mean (?f) 

[Rangel 80% 5% 35.3 (3) N/R 72% 25% 

20% 95% 24.8 (4) NIR 6% 25% 

{ 1 -90%] 

[0-59%] 

0% 0% 37.5 (4) NIR 20% 40-50% 

0% 0% 4 (4) N/R 1% I ooh 

0% 0% 7.5% (4) N/R 2% 20%' 

[0-100%] 

[@I I%] 

[0-25%] 

5-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Heroin 

Powder Cocaine 

Crack Cocaine 

Am phetamjnes 

BarbituratedTranqdh 

MarijuanaMashish 

LSD 

PCP 

Inhalants 

Over the Counter Drugs 

Alcohol 

b- Residential Treatmen 

Table 5.13 Primary Drug of Choice 

St. Mary Creek Bakersfield # Jackson ’ 

Parish Counyt County 

Outpatient Residential Outpatient Residential 

Mean (N) 

\ IRangel o?? o?! 6.25 (4) 0% 4% 0% 

4% 0% 

[0- 1 6%] (b) 

3% OYO 10 (4) 2Ph 

, [O-3-%] (b) 

[0-6W?] (b) 

6% 50-60?! 0 (4) 0% 8% 5% 

(b) 

6% 0% 11.3 (4) 1 0% 4% 0% I 

[8- 16%] (b) 

48% 3040% 0 (4) 0% 35% 1 0% 

6% 0% 5.8 (4) 0% 0% o?? (b) 

[O-1 I %] (b) 

0% 0% 0 (4) 0% 10% , ’ 0% 

(b) 

0% 0% 11.8 (4) 0% 0% o?? 0) 

[4-23%] (b) 

11% 60% 6.25 (4) 0% 0% 20% 

[0- 1 6%] (b) 

4 

1 8% 2Yo 38.8 (4) ’ 7580% 40?? 70% 

0% 1 % 0 (4) 0% ’ 0% ‘I 0% 

’rogram “b”, smaller, all female facility 

t- Data is presented fiom the treatment program that served only a small proportion of drug court clients during the evaluation 

period. The program which served most of the court’s clients during this time did not complete the administrator’s survey. 

$- lnfmation is presented for all five of the outpatient programs examined at this site (Mean number of clients in each group, 

across all responding programs; Number of programs responding; Range of the number of clients in each group). Proportions 

reported as estimates, therefore they total more than 1 OWO. 

The clients in this group of drug courts also seemed to vary in terms of their prirnary drug 

of choice (see Table 5.13). For example, Jackson County seemed to predominateJy treat clients 

whose primary drug of choice was either crack cocaine or marijuana, while Sites 1 and 3 seemed 

to be serving a client population heavily involved with amphetamine use, and the largest group 

of clients at St. Mary Parish reported using primarily marijuana. To some extent these drug of 

choice results reflect the drug which is currently presenting the largest problem in each area, but 

to some extent these results may also reflect the perspective of each court as to what drug is a 

“problem” locally, particularly since only Creek County reported a large proportion of clients 

whose primary drug of choice was alcohol (which is commonly associated with criminal 

behavior, but whose may not carry the same societal outcry as a perceived methamphetamine 

“epidemic”). 

5-12 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Reason For Leaving 

Completed or 

Graduated 

“Against Medical 

Advice” 

Returned to Prison or 

Jail 

Removed for Rule 

Violation 

Level of Care 

Deaths 

Referred to Another 

Clients in these treatment programs tended to “successfblly complete” treatment at 

widely dserent rates (see Table 5.14). It is important to note that these proportions are reported 

fiom the treatment providers and represent completion of the treatment program, not completion 

of the drug court requirements. In any event, in St. Mary Parish (where the court and treatment 

provider are parts of the same agency) as few as 30% of clients ‘‘successllly complete” 

treatment, while in Bakersfield anywhere fiom 66% to 76% of clients complete either residential 

or outpatient treatment successhlly according to the programs themselves. Interestingly, as 

many as 30% of clients, in some sites are apparently permitted to leave treatment “against 

medical advice”, despite their being mandated to treatment by the court. Very few clients are 

reportedly referred to another level of care or are returned to prison or jail, however varying 

proportions seem to be removed fiom treatment for failing to meet program rules and 

requirements. 

St. Mary Creek Bakersfield # Jackson 

Parish County? County 

Outpatient Residential Outpatient Residential 

Mean (N) 

rRange1 

30% 50% 66 (3) 77% (a) 28Ye 80% 

1% 25% 0 (3) N/R (4 30% 5% 

1% 0% 6.6 (3) N/R 1 PA WO 

[28-100%] 75% (b) 

25% (b) 

[0-15%] (a b) 

[M2Yo] N/R (b) 

[O-lo%] 

50% 25% 24 (3) 18% (a) 30% 15% 

17% 0% 6.6 (3) N/R (a & b) 0% 0% 

1% >I% 0 (3) N/R (a & b) 2% 0% 

Summary 

In general, staff at these drug treatment programs tended to have relatively low levels of 

education, but some had professional licensures or certifications and histories of overcoming 

substance abuse themselves. Very few minority counselors were employed by these programs, 

despite many of them serving relatively large proportions of minority clients. In terms of daily 

activities, many counselors reported conducting a single treatment group (about one hour long) 

per day, along with one or two individual counseling sessions daily. 

A substantial proportion of their time was spent on admissions related duties, but 

unexpectedly small amounts of time were spent conducting assessments given the amount of 

time dedicated to admission duties. All programs reported using a structured screening 

5-13 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, -*’, -*, , 

instrument and developing individual treatment plans, but most sites reported little involvement 

of the client in the treatment planning process. 

There was much more variability in terms of communicating expectations to clients, with 

some reporting that treatment staffwere responsible for this, while others reported that drug 

court staff performed these tasks. There was also mush less consistent use of written contracts, 

with some programs relying on verbal communication of program criteria. All programs 

reported drug testing and sharing that information with the drug court staff. Some programs 

reported using behavior modilkation techniques, with the most common sanction3 being items 

such as loss of privileges, extra treatment or support meetings, or increased drug testing. Typical 

benefits included verbal praise fiom counselors or other clients, with some programs reducing 

treatment or drug testing requirements as well. 

Counselors’ philosophies of the causes of, and effective treatment for substance abuse 

issues tended to suggest a eclectic approach, in that they commonly endorsed items fiom various 

scales in similar ways. This pattern of results likely indicates the lack of a coherent, consistent 

approach to the manner in which these counselors think about and respond to clients’ drug abuse. 

The validity of this claim is supported by results presented in Chapter 6, that find that the 

services delivered to clients are often of an amalgamated nature, employing multiple, sometimes 

conflicting approaches at the same time. 

Clients were typically males in their twenties, but racial and ethnic characteristics varied 

by site. The largest proportions of Mcan American clients were reported in the large, Midwestern metropolitan site, while the largest proportion of Hispanic clients was reported in the 

California site. Primary drug of choice (crack cocaine, marijuana, and amphetamines were 

common in several sites) also varied considerably by site, reflecting each regions prevailing drug 

problem and court guidelines which sometimes restricted eligibility of alcohol-only abusers. 

Other characteristics such as employment and parental status also varied across sites, sometimes 

in response to court policies (some mandated employment while participating in the drug court). 

The proportion of clients graduating or successhlly completing the treatment program (not 

necessarily the drug court program itsell) also varied widely by site, possibly being influenced 

by court requirements, levels of drug testing and other supervision (as is commonly found with 

Intensive Supervision Probation programs). 

5-14 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 6 

Direct Observations of Drug Treatment Activities 

Overview 

In this section tesults from the direct observation ,of group treatment activities are 

presented in an attempt to assess the nature of these treatment services, as they are 

actually implemented. The researchers attended varying numbers of meetings at each 

site, depending up the number of treatment programs operating in each jurisdiction and 

the number of meetings offered by the programs. The numbers of meetings observed in 

residential treatment programs in both Bakersfield and 4 were purposellly kept 

relatively small (see Table 6.1) given that small proportions of the overall drug court 

client population in these jurisdictions were actually referred to residential treatment 

(based on an examination of retrospective data provided by the courts themselves). ‘As 

such the researchers made the decision to focus available resources (observers) on the 

more thorough examination of the typical (outpatient) services received by drug court 

clients in these jurisdictions. 

It is worth noting that in Bakersfield, the court personnel reported that clients 

were most commonly referred to residential treatment because of their lack of housing, 

not in response to any perceived need for more “intensive” treatment, Residential clients 

,in Jackson County were commonly participating in a short-term residential placement, as 

a result of dif€iculties encountered in one of the 3 levels of outpatient care typically 

offered to clients in this jurisdiction. After a short-term stay in residential treatment these 

clients typically returned to their previous outpatient programs. 

I 

Treatment Activity Characteristics 

Overall the scheduled length of the typical treatment meeting in these programs 

ranged from one hour and ten minutes to approximately two hours, with an average 

scheduled duration ofjust under one and a half hours (see Table 6.1). In terms of the 

actual duration of these meetings (the amount of time elapsed between the time they 

began and when they actually ended, as opposed to when they were scheduled to end) 

was somewhat shorter. In fact, the average actual length of a meeting observed in all 

sites accounted for only about 80% of the total scheduled treatment time. Some of the 

“l~st’~ treatment time represents time allotted for “breaks” in the middle of meetings 

(usually only about 5 minutes in duration), but some of this “lo~t~’ treatment time was 

also explained by meetings ending prematurely. In fact, meetings ending as much as 30 

minutes before the scheduled end-time were not uncommon in this sample of observed 

treatment meetings. As a result of this “lost” treatment time, the amount of treatment 

time actually delivered in the average meeting, across all sites, represented only about 

75% of the total scheduled treatment time. With the exception of sites 2 and 3, whose 

6- 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
programs had more defined treatment phases, the majority of the programs in the 

remaining sites did not conduct meetings that were identifiable as part of an specific 

treatment phase. The typical format for treatment meetings in all sites was a staff-lead 

discussion of various treatment issues. The one exception is Creek County, where clients 

commonly attended meetings in which they simply reviewed their assignments fiom 

treatment workbooks. 

Finally, the outpatient programs in Bakersfield in particular seemed to have 

difEculty delivering all of the groups they were scheduled to during the week'of the 

observations. In fact, across the 4 outpatient sites where the researchers observed 

meetings, 8 separate meetings were cancelled. In one site, where the researchers were 

scheduled to observe the only 5 English-speaking groups the program was to offer during 

that week, 2 of the 5 were cancelled. Unfortunately, clients were not made aware of 

' these cancellations until they showed up for treatment (nor was the observer notified 

prior to the meetings' scheduled start times). Court staffand various clients in several 

programs in this site, reported that meeting cancellations were a common occurrence and 

a major concern for the court administration. This was also an issue that the court 

staffers admitted some difficulty in trying to resolve short of canceling contracts with the 

programs involved. 

Treatment 

Characteristics 

Table 6.1 Treatment Meeting Summary Characteristics 

St. Mary Creek Bakersfield Jackson 

Parish County? Counry 

Outpatient? Residential Outpatient Residential ' 

Total Number of 27 26 8 45 5 

Medings Observed 

Scheduled Length 

(SL) in Minutes 

Actual Length in 

Minutes (% of SL) 

Minutes of Break (% 

of SL) 

Real Treatment Time 

in Minutes[=ALBreaks] 

Meeting is Part of 

Phase? 

Typical Meeting 

Format (%) 

(% of SL) 

122 

88 

(72%) 

16 

(13%) 

72 

(59%) 

100% 

Staff Lead 

Discussion 

97 84 

59 74 

(61%) (8 8%) 

5 4 

54 70 

(56%) (83%) 

(5%) (5%) 

70% 3 8% 

Work Staff Lead 

Book/Hornework Discussion 

71 

55 

(78%) 

0 

(@/q) 

55 

(78%) 

0% 

Staff Lead 

Discussion 

69 

59 

(86%) 

4 

(6%) 

55 

(80%) 

31% 

StaffLead 

Discussion 

78 

70 

2 

68 

(87%) 

(90%) 

(3%) 

0% 

Staff Lead 

Discussion ~~ 

I (69Yo) Review (48%) (69%) (50%) (6Ph) (40%) 

t - Numbers represent aggregated data across multiple treatment programs at these sites. 

The average number of clients in the observed meetings ranged fiom about 7 to as 

many as 27 clients (see Table 6.2). Residential programs in this sample tended to have 

larger numbers of clients per group meeting. The proportion of male clients varied by 

site, but generally males made up the majority, with the exception of the outpatient 

programs in Bakersfield. In all jurisdictions except Jackson County, whites made up the 

majority of clients, though only slightly in Bakersfield. Interestingly, there appears to 

have been a disproportionate number of &can American clients in residential treatment 

6-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

1 

I 

i 

bl 

I 

e 

Client Characteristics 

Number of Participants 

YO Male 

% White non-Hispanic 

% African American 

% Hispanic 

(relative to the proportion in outpatient program) in Bakersfield. Similarly, Hispanic 

clients appear to be more likely placed in outpatient, rather than residential treatment m 

Bakersfield. The reasons for these discrepancies are not known, although it is possible 

that African American clients in this jurisdiction were more likely to, be homeless (the 

courts stated criteria for assigning someone to residential, rather than outpatient 

treatment). It is unclear why Hispanic clients would be more likely placed in outpatient 

care, than in residential, given that the proportions of white clients in each type of 

treatment are more symmetrical (suggesting it is not an effect related to relatiye rates of 

homelessness among non-black clients). Interestingly, these differences in type of 

treatment assignment by race/ethnic group do not appear in Jackson County, where 

residential treatment is used as a supplement for those clients experiencing problems in 

their outpatient program (rather than being assigned based on housing status as m 

, Bakersfield) 

St. Mary Creek Bakersfield Jackson 

Parish County Counfy 

Outpatientt Residential Outpatient Residential 

14.2 6.7 6.7 25.0 14.2 26/2 

75% 75% 44% I 57% 85% 86% 

63 Yo 87% 53% 57% 13% 14% 

34% 5% 8% 35% 85% 78% 

3% 7% 3 8% 6% 2% 6% 

)I' I 

Table 6.2 Summary of Client Demographics (Observed in Meetings) 

Clinical Features of Treatment Services 

The following sections describe the specific treatment activities and topics 

covered during the sample of meetings observed in each of the 4 jurisdictions. These 

aspects of treatment delivery are categorized into several general domains including the 

management of the meeting (introducing new clients, dealing with group rules, building 

the sense of community and clients' motivation); cognitive-behavioral topics (dealing 

with current or alternative thoughts, feelings, attitudes, relapse prevention, problem 

solving); education and aftercare items (drug education, vocational education, parenting 

skills, relationshipdco-dependency issues, cultural issues); safety and self-exploration 

(self-esteem, fdy issues, defense mechanisms, physical and psychological safety in the 

group); and lZstepS/"herapeutic Community items (codiontation by peers or staff, 

acceptance of powerlessness, making amends). 

In terms of the management of this sample of meetings, issues of community 

management (e.g., reviewing the rules about how to appropriately participate in group 

discussions) were commonly used @e., a relatively large proportion of the observed 

meetings in each site) in many sites (see Table 6.3). In addition, motivation building 

(e.g., helping clients stay focused on treatment) was commonly observed in a large 

proportion of meetings, though usually this topic was not dealt with for extended periods 

of time when mentioned (only as much as 18% of total treatment time in residential 

meetings in Bakersfield). A traditional technique in group therapy, having clients "check 

in" (usually clients introduce themselves and discuss how they are currently feeling), was 

6-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
also commonly used in most sites (in as many as 73% of all meetings observed in 

Bakersfield). As might be expected, the proportion of overall treatment the allotted to 

this activity was relatively brief (less than 25% of the meeting’s actual duration in most 

sites). Many sites (almost 58% of observed meetings in Bakersfield outpatient programs) 

also commonly spent some time intended for treatment delivery to set up the room they 

were meeting in (e.g., arranging chairs). Other items in this category were less 

commonly observed or were discussed only for relatively short durations when they did 

occur. In particular, pull-ups (formalized co&ontations about inappropriate client 

behaviors) and other forms of sanctions were rarely observed in these meetings, nor were 

relaxation-training techniques, or physical exercise commonly used. 

Table 63 Management Items I, 

Item 

% of Meetingsf 

(%Time) $ 

lntroduce New Clients 

Check-In 

Meeting Set-Up 

community 

Management 

Group/comunity 

Issues 

Community Building 

Physical Exercise 

Relaxatioflraining 

Treatment Readiness 

Motivation Building 

Pull UpdSanctions 

Rewards 

* - Cell values for ex 

SI. Mary Creek Bakersfield Jackson 

Parish County County I 

Outpatient Residential Outpatient Residential 

N=l3 N=27* N=26* N=8 N45 N=5 

15.4 

61.5 

(23.9) 

46.2 

53.8 

(1 5.0) 

15.4 

(8.0) 

0 

0 

0 

38.5 

(26.8) 

23.1 

(9.6) 

0 

7.7 

(6.8) 

(4.7) 

11.1 

(13.3) 

14.8 

(4.4) 

33.3 

(6.0) 

55.6 

(29.9) 

7.4 

(3 -8) 

3.7 

(28.6) 

0 

0 

14.8 

(1 5.8) 

33.3 

0 

7.4 

(7.0) 

23.1 

(4.8) 

73.1 

(12.0) 

57.7 

(7.5) 

19.2 

(12.2) 

0 

0 

0 

0 

15.4 

(8.7) 

57.7 

(10.3) 

0 

23.1 

0 

62.5 

(34.3) 

25 

(5.5) 

25 

,(14.2) 

25 

(8.5) 

37.5 

(13.7) 

0 

0 

0 

15 

(17.9) 

0 

50 

6.7 

26:7 

(23.8) 

53.8 

(7.3) 

53.3 

(1 5.3) 

17.8 

(23.8) 

22.2 

(37.8) . 2.2 

0 

35.6 

(33.6) 

51.1 

(13.6) 

8.9 

(7.5) 

28.9 

(1.9) ’ 

(22.8) 

20 

(5.3) 

40 

(16.4) 

0 

40 

(1.3) 

20 

(31.7) 

0 

0. 

20 

(25.0) 

20 

(1.8) 

80 

0 

20 

( 10.0) 

(1.8) (5.0) (4.9) (8.1) (7.1) (1.2) 

item represent aggregated data across multiple treatment programs at these sites. 

2 - Percent of Achlal Treatment Time spent on each item when used. 

Results for the use of various cognitive-behavioral treatment components are 

presented in Table 6.4. Meetings in this sample tended to commonly discuss clients’ 

triggers, attempting to improve their awareness of their thought processes (as many as 

80% of the observed meetings in residential treatment at Jackson County and typically at 

least 22% of meetings in all sites). The proportion of treatment time spent on these topics 

was somewhat more modest, usually being around 5-15% of the total amount of 

treatment time, but as high as 35% of the meeting time in outpatient treatment in Jackson 

County. Relapse prevention, while similar to “trigger analysis”, is more focused on 

6-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
6 

E 

1 

f 

C 

U 

L1 

I 

t 

I‘ 

B 

I] 

a 

B 

I 

1 

I 

I 

, -vi 

he,$ing clients develop alternative ways of dealing with potentially problematic events 

and was less commonly (lower proportion of observed meetings) and less extensively 

(smaller percentage of the treatment time when it occurred) used in all of the sites. This 

disparity may suggest that these programs increase their focus on developing ways to 

deal with triggering event, in addition to calling increased attention to them. 

Many programs also commonly examined the existing emotional processes of 

their clients (as many as 65% of observed meetings in outpatient programs at 

Bakersfield), though the use of this item was considerably lower in Creek County, 

particularly. Again though, when used the proportion of treatment time devoted to it 

varied widely, fiom a high of 20% of the meeting in Bakersfield residential and Creek 

County, to a low of 2.4% of treatment time h St. Mary Parish. Other cognitivebehavioral items were observed to varying degrees of fi-equency and duration, depending 

on the site. For instance, existing and alternative cognitive processes and attitudedvalues 

were relatively common occurrences in treatment activities in several sites, as were 

discussions of the need to develop alternative (pro-social) activities and goals. Despite 

being relatively common, in terms of the number of meetings in which they occurred, the 

amount of treatment time spent on each of these topics was generally short 

(approximately 5% in many sites). Anger management was relatively rare in these 

programs, however in Bakersfield, those meetings were it did occur seemed to give the 

topic a good deal of focus. In general, the use of cognitive-behavioral techniques appears 

relatively common in these programs’ activities, but it appears that they may not spend 

much time focused on specific issues in this realm. The more general topic of “problem 

solvinglcoping skills“ was both relatively common (meetings) and extensive (15% of 

treatment time or more in 4 of the 6 program groups). This result too may suggest that 

the programs are attempting cognitive-behavioral treatment interventions, but are doing 

so in a more generic, rather than focused manner. 

rarely, or briefly covered in many of the sites. For instance, structured social skill 

training (using a pre-packaged curriculum) was almost never used in any sites. The 

expense associated with purchasing these, often proprietary materials may account for 

this pattern Similarly, several treatment components associated with Rational Emotive 

Therapy were idiequently and briefly used in most sites (emotion management, 

disputing, and Self-acceptance). It would appear that while some of these programs are 

employing cognitive-behavioral treatment strategies, few are employing this specific 

form of therapy. 

Some general conclusions can also be reached in regards to the items that were 

6-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
kern 

YO of Meetings7 

(%Time) $ 

TriggerdAwareness 

Relapse Prevention 

Anger Management 

Feelings/Thoughts & 

Behavior 

Existing 

AttitudesNalues 

Alternative 

AttitudesNalues 

Existing Emotional 

Processes 

Alternative Emotional 

Processes 

Existing Cognitive 

Processes 

Alternative Cognitive 

Processes 

Alternative Activities 

Alternative Goals 

Problem 

Solving/Coping 

Structured Social 

Skills 

Emotion Management 

Disputing 

Self-Acceptance 

* - Cell values for eac 

Table 6.4 Cognitive - Behavioral Items 

St. Man Creek Bakersfield Jackson 

Parish 

N=13 

38.5 

(6.8) 

7.7 

(1 -0) 

23.1 

(10.1) 

7.7 

(5.11 

38.5 

(15.5) 

46.1 

(6.5) 

46.1 

(8.9) 

7.7 

(2.7) 

23.1 

(7-3) 

30.8 

(8.0) 

23.1 

(4.0) 

0 

38.5 

(22.1) 

0 

0 

0 

0 

County 

N=27* 

40.7 

(16.0) 

14.8 

(83.5) 

11.1 

(37.5) 

22.2 

(19.7) 

11.1 

(15.1) 

22.2 

(16.5) 

7.4 

( 19.9) 

3.7 

(3-3) 

14.8 

(12.2) 

40.7 

(11.5) 

33.3 

2.2 

(13.9) 

37.0 

3.7 

(60.0) 

0 

0 

0 

(8.1) 

(54.4) 

Outpatient 

N=26* 

38.5 

(1 1.6) 

19.2 

(1 4.8) 

7.7 4 

(5 1.5) 

11.5 

(4.6) 

11.5 

(1.9) 

19.2 

(3.5) 

65.4 

(7.6) 

26.9 

(4.1) 

42.3 

(6.0) 

42.3 

(15.1) 

30.8 

(6.9) 

23.7 

(6.3) 

42.3 

(1 0.3) 

0 

0 

0 

0 

Residential 

N=8 

37.5 

(3.2) 

0 

12.5 

(loo) 

12.5 

(7.5) 

12.5 

(1.7) 

12.5 

(3.4) 

62.5 

(19.7) 

62.5 

(7.9) 

50.0 

(4.6) 

37.5 

(3.2) 

25.0 

, (3.5) 

37.5 

(2.9) 

37.5 

(7.4) 

0 

12.5 

(3.0) 

0 

25.0 

Cou?lly 

Outpatient Residential 

N=45 N=5 

22.2 

(35.4) 

13.3 

(100%) 

4.4 

(20.0) 

11.1 

(1 4.9) 

44.4 

(6.1) 

35.6 

(6.1) 

26.7 

(7.3) 

8.9 

(5.8) ' 

22:2 

(5.3) 

13.3 

(7.4) 

11.1 

(7.4) 

13.3 

(5.8) 

24.4 

(22.7) 

0 

80.0 

(9.9) 

40.0 

(70.0) 

0 

0 

60.0 

(4.7) ' 

40.0 

(6.1) 

60.0 

(2.4) 

20.0 

(3.7) 

60.0 

(5.2) 

60.0 

(4.0) 

0 

40.0 

(2.4) 

60.0 

(1 6.0) 

0 

4.4 0 

(2.5) 

0 0 

4.4 ,O 

(3.4) (2.3) 

tem represent aggregated data across multiple treatment programs at these sites. 

t - Percent of Meetings in which each item was used. 

$ - Percent of Actual Treatment Time spent on each item when used. 

6-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

1 

I 

1 

1 

1 

B 

P 

1 

Item 

% of Meetings? 

(%Time) $ 

Clinical Education 

Drug Education 

Drug Videos 

Academic Education 

Vocational Education 

)I’ I 

’ Job Skills Training 

Health Issues 

Parenting Skills 

HomeworkNorkbooks 

RelationshipdCe 

Dependency 

- Cell values for each 

f 

I 

I 

1 

II 

I 

E 

I 

St. Mary Creek Bakersfield Jachon 

Parish County County 

Outpatient Residential Outpatient Residential 

N=l3 N=27* N=26* N=8 N=45 N=5 

30.8 7.4 30.8 12.5 26.7 20 

(45.5) (18.1) (11.7) (23.8) (22.2) (36.6) 7.7 11.1 46.2 0 8.9 20 

(2.0) (71 .S) (41.2) (1 1.5) (1.8) 0 11.1 3.8 0 20 0 

0 0 0 0 0 0 

0 0 0 0 0 0 

0 3.7 0 0 0 0 

7.7 0 15.4 12.5 2.2 20 

(3.0) (30.7) (92.6) (2.8) (1 00.0) 

7.7 7.4 7.7 0 0 0 

(1.0) (39.5) (54.3) 

7.7 59.3 7.7 0 2.2 0 

(96.0) (58.0) (26.8) (59.4) 

23.1 0 7.7 0 4.4 20 

(49. I) (16.4) ’ (36.2) (1 5.9) 

(58.3) (61.2) (94.2) 

(84.4) 

item represent aggregated data across multiple treatment programs at these sites. 

Table 6.5 Education and Aftercare Items 

Results for the use of education and aftercare items among this sample of 

programs suggest that they are not focusing a great deal on these issues (see Table 6.5). 

For example, neither academic nor vocational education activities took place during any 

of the meetings observed in these sites. Similarly, job skills training was only observed 

in one site and only in one meeting (though this one meeting was dominated by this 

activity). On the other hand, clinical education (preparing clients for participation in 

treatment, by teaching them the vocabulary of a specific treatment approach, for 

example) was relatively common in these programs, occuning in as many as 30% of 

meetings in some sites. The fiequency of these clinical education activities varied by 

site, as did the amount of time devoted to the activity, when it was employed (anywhere 

fiom 20% to 45% of meeting time). Drug education (e.g., providing information about 

the impact of various drugs) also occurred in most of the programs observed (except the 

residential program in Bakersfield). Again, the incidence of this activity and its duration 

when used, varied by site. Outpatient programs in Bakersfield in particular seemed to 

rely heavily on drug education, both in terms of the percent of meetings in which it was 

covered and in terms of the amount of time devoted to it within those meetings. Drug 

education videos, though used somewhat sparingly (only in relatively small numbers of 

meetings in Creek County, and outpatient programs in sites 1 and 4) in these program, 

dominated treatment meeting time when they were used (60% to 95% of the meethig). 

Reviewing homework or workbook assignments were used very Mequently except in 

Creek County, where they appeared to make up the majority of treatment activit.ies, both 

in terms of frequency and amount of time devoted to them. 

6-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Health issues (e.g., information on sexually transmitted diseases, nutrition and 

meal planning) also seemed to be covered to varying degrees in most of these sites, with 

the exception of Creek County. There was relatively wide variation here as well, in tenns 

of both fi-equency and average amount of time devoted to health issues. Unfortunately, 

parenting skills training appeared to be relatively rare, occurring in only 3 program 

groups (sites 2,3, and outpatient programs in Bakersfield). Even within these programs 

where this activity was observed the Gequency of its occurrence was extremely low 

(about 7% of meetings in these 3 program groups), though the amount of treatment time 

devoted to it did appear to be extensive (between 40% and 50% of the meeting) in two of 

these. \ 

Issues such as gender expectations and relationshipdco-dependency were also 

generally addressed sparingly among these programs, with St. Mary Parish being the 

major exception (about 20% of meetings dealt with these issues to some degree). Issues 

of cultural diversity were almost never addressed in these programs, occurring only in 

Jackson County. Even in this site, the examination of cultural diversity issues was 

uncommon in the outpatient programs, and was not given much attention in the 20% of 

meetings in which they occurred in the residential programs. In general it appears the 

programs would benefit fiom improving the cultural sensitivity of their interventiond, 

especially in liglp of the fact that several of the sites serve substantial minorit$ 

populations. Interestingly, Jackson County, which at least attempted to deal with cultural 

issues, had the largest proportion of Afiican American clients participating in groups. It 

is dScult, due to the low counselor response rate in some sites, to accurately estimate 

the proportion of minority counselors in each site, but culturally sensitive treatment may 

be facilitated by the use of a more diverse group of counselors. 

Finally, in terms of preparing clients for eventual program graduation by 

discussing issues related to aftercare treatment or other needed social services, this group 

of programs appeared to fall short of an ideal level of preparation. In general, when a 

few of these sites did provide for the discussion of aftercare issues, this took place in less 

than 10% of the observed meetings, and was only briefly discussed in those few meetings 

(again less than 10% of the actual treatment meeting time). 

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This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Item 

% of Meetings? 

(%Time) # 

Self-Estedfficacy 

Healing/Nurhuing 

Family Issues 

, Experiences on the 

Street 

0th Life Experiences 

Recent Incidences 

Diaries/Journals 

Letters 

Defense Mechanisms 

Physical Safety 

Psychological Safety 

Counselor Shares 

Experiences 

* - Cell valuesfor ea( 

Table 6.6 Safety and Self-Exploration Item 

st. Maw Creek Bakersfield 

Parish 

N=l3 

15.4 

(6.6) 

0 

38.5 

(8.4) 

38.5 

(21.8) 

30.8 

(4.4) 

61.5 

(8.1) 

7.7 

(3 1.4) 

7.7 

(19.6) 

23.1 

(15.6) 

7.7 

(23.8) 

7.7 

23.1 

(7.5) 

Counry 

N=27* 

7.4 

(7- 1 ) 

0, 

22.2 

(6.5) 

33.3 

(11.1) 

29.6 

(6.2) 

44.4 

(1 6.5) 

7.4 

(1 4.5) 

0 

7.4 

0 

0 

25.9 

(2.3) 

Outpatient 

N=26* 

11.5 

(36.3) 

3.8 

(3.8) 

50.0 

(9.3) 

38.5 

(5.5) 

36.9 

(8.9) 

69.2 

(8.4) 

0 

3.8 

(50.8) 

38.5 ’ 

(5.0) 

3.8 

(2-8) 

15.4 

(29.0) 

42.3 

Residential 

N=8 

25.0 

(6.9) 

12.5 

(6.9) 

25.0 

(20.9) 

12.5 

(1.8) 

12.5 

(2.2) 

75.0 

(20.5) 

12.5 

(23.8) 

25.0 

(6.5) 

0 

0 

12.5 

37.5 

(1.8) 

Jackson 

Counry 

Outpatient Residential 

N45 N=5 

6.7 60.0 

(38.0) (5.8) 

0 0 

6.7 

28.9 

( 10.5) 

6.7 

(1 6.3) 

35.6 

(37.5) 

0 

(3.1) 

40.0 

40.0 

0 

60.0 

( 14.3) 

0 

(3.0) 

(4.3) 

0 20.0 

(12.3) 

22.2 60.0 

(I 4.0) (7.0) 2.2 0 

(1.2) 

4.4 0 

(1.8) 

33.3 20.0 

(3.9) (4.8) (7.3) (21.0) (8.2) (5.3) 

item represent aggregated data across multiple treatment programs at these sites. 

t - Percent of Meetings in which each item was used. 

$ - Percent of Actual Treatment Time spent on each item when used. 

This group of programs appeared to provide more extensive opportunities for 

clients’ self-exploration and development of feelings of safety within the group context 

(see Table 6.6). Among the more commonly employed activities in this area was the 

discussion of recent incidents (in at least 35% of meetings) as a means of facilitating 

client self-exploration, as well as the counselors’ sharing of their own perspectives on 

treatment-related topics (in at least 20% of meetings observed in all sites). While 

relatively common in their occurrence, both of these activities tended to be brief in 

duration, accounting for between 5 and 20% of the meeting time. This would suggest 

that meetings were not just “rap sessions” in which clients and counselors merely 

discussed current events, but more likely that they used these areas as ways to draw 

parallels between more abstract treatment concepts and real-life occurrences. Family 

issues occurred in some sites in large proportions of observed meetings (50% of meetings 

in Bakersfield outpatient programs), but were generally briefly covered (about 5% to 

10% of actual treatment time in most sites). 

Experiences on the street and the review of other sorts of life experiences were 

also relatively common, occurring in moderate numbers of meetings in all sites, though 

again, usually only for brief periods of time. Coupled with results showing that issues of 

self-esteem and self-efficacy were common across these sites, the results for reviewing 

6-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Item 

% of Meetingst 

(%Time) # 

past life experiences would suggest that these programs were relatively focused on 

improving client's ability for introspection. Similarly, all but the residential program in 

Bakersfield used examination of client defense mechanisms to some degree, further 

supporting the idea that the programs attempted to get clients to look at themselves m 

some detail. These results also fit with the relatively common use of trigger analysis 

described in the Cognitive-Behavioral Treatment items section above. Clients' comfort 

level with this introspection would likely be fiuther improved ifthe programs were more 

consistent in their attempts to develop the clients' sense of physical and psychological 

safety within the treatment context, as these issues appeared to be somewhat 

underutilized. Similarly, the use of formal techniques to foster self-exploration, such as 

having clients keep and review journals or diaries could be more thoroughly empbyed 

than they were in these programs. 

St. Mq Creek Bakersfield Jackson 

Parish County County 

Outpatient Residential Outpatient Residential 

N-13 N=27* N=26* N=8 N+5 N=5 

Table 6.7 12-Steps (MA) and Therapeutic Community (TC) Items I 

Acceptance of 

Powerlessness 

Spirituality/Higher 

Power 

Moral Inventory 

Making Amends 

Other AA Traditions 

23.1 

(1.7) 

7.7 

(6.3) 

7.7 

(1.3) 

0 

0 

3.7 

(7.1) 

18.5 

(3.0) 

3.7 

(7.5) 

0 

14.1 

19.2 

11.5 

0 

(4.3) - 

(5.1) 

3.8 

19.2 

(1.1) 

0 11.1 

(8.4) 

25.0 60.0 

(3.4) (3.5) 

' 12.5 20.0 

(8.3) ( 1 -2) 

12.5 40.0 

(53.3) (2.4) 

50.0 40.0 

60.0 

(12.2) 

22.2 

(7.5) 

4.4 

(5.4) 

11.1 

(30.0) . 

35.6 I (8.2) (6.8) ( 14.3) (6.7) (13.0) 

* - Cell values fbr each item represent aggregated data across multiple treatment programs at these sites. 

3 - Percent of Actual Treatment Time spent on each item when used. 

- Percent of Meetings in which each item was used. 

According to the results presented in Table 6.7, the degree to which this sample of 

drug court programs employed treatment components characteristic of 12-steps programs 

varied by site. In general, however some of these issues did appear in all of the programs 

observed. Several programs included discussion of the need to accept ones' 

powerlessness over addiction, the reliance on a higher power, and Alcoholics 

Anonymous "traditions" of "making amends" and taking a "moral inventory", though in 

general these issues were not dealt with for long periods of time (usually about 5% of the 

actual treatment time). Thus, despite the common use of cognitive-behavioral treatment 

techniques, the influence of the 12-stepddisease-mode1 continues to permeate these 

programs, if only in the form of brief mentions or reminders of these concepts. To some 

extent this is not unexpected given the results fiom the counselor's survey on philosophy 

of effective treatment, which demonstrated an eclectic approach to treatment among this 

sample of counselors. 

6-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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The use of confiontation in dealing with inappropriate thoughts, statements or 

behaviors is a common component of therapeutic community programs (many of which 

typically adopt a 12-step/self-heIp style of treatment). The use of confiontation varied 

within these programs, but did occur to some extent in every site, and was usually more 

likely to have’ originated fiom the counselors than other clients. However, when 

confrontation did occur it tended to be relatively brief, suggesting that the inappropriate 

behavior was pointed out and the group likely then proceeded to other business. Creek 

County seemed to be particularly unlikely to use confrontation either by counselors or 

clients. This may be related to the fact that the programs in Creek County predominately 

focused on clients reviewing their workbook,assignmentg, rather than participating in 

treatment groups characterized by more clinical interaction. 

Summary 

Results fiom the observation of treatment activities themselves suggest that the 

treatment programs involved with these four drug courts are implementing drug treqtment 

interventions characterized by a broad range of therapeutic approaches. In general, ‘the 

observational results reveal a pattern of mixed approaches, including cognitivebehavioral techhiques, like trigger analysis and examination of existing emotional 

processes, coupled to a lesser extent with techniques derived fiom 12-steps programs 

(acceptance of powerlessness, reliance on a higher power). In addition, staff survey 

results (presented in Chapter 5) indicate that this group of counselors, as a whole, tended 

to endorse an approach to substance abuse treatment that is amalgamated in nature, 

employing multiple, sometimes conflicting approaches concurrently with little in-depth 

focus on any particular therapeutic issue. 

While this approach to substance abuse treatment may sound like an effective 

intervention style, potentially addressing multiple client needs, this set of results also 

suggests that the actual impact of this style among these programs was that they spent 

relatively small amounts of time on any specific treatment item. For instance, the 

programs tended to spend relatively larger amounts of time on increasing client’s 

awareness of possible triggers, but at least partly because they were also attempting 

several other treatment approaches, they did not appear to adequately provide information 

on what to do with the knowledge of triggers (i.e., much less emphasis on “relapse 

prevent ion”). 

approach to treatment leads to the delivery of sometimes-inconsistent messages to clients. 

For instance, the 12-steps approach to substance abuse treatment advocates that clients 

recognize they are powerless to control their addiction and must turn their lives over to a 

higher power to help them maintain abstinence. On the other hand, cognitive-behavioral 

(CBT) approaches to drug treatment require the client to recognize the role that his or her 

thoughts and emotions play in perpetuating the addictive behavior and to take control of 

those internal processes by examining them and learning new social, emotional, and 

cognitive skills. The contemporaneous use of these two approaches (CBT and 12-steps) 

work against one another in terms of their underlying views of the origins of substance 

In addition to impeding the delivery of other effective treatment items, the this 

6-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
+ 

84 

abuse. Similarly, delivering only superficial treatment fiom the CBT perspective likely 

undermines the effectiveness of these approaches that much previous research has 

demonstrated. 

fact preferred, in that they may be more likely effective in reducing substance abuse and 

criminal behavior, however this does not mean that treatment approaches based on 

incompatible philosoplhcal positions should be forced together. In general these 

programs are more likely to deliver effective treatment ifthey coordinate a coherent 

treatment approach tvat can tackle multiple client needs. In general, the treatment 

literature suggests that cognitive-behavioral approaches ‘are effective for offender 

populations. As such, the programs may benefit fiom solidmg their use of these types 

of techniques. 

Similarly and despite the reports of the program administrators themselves, very 

little family counseling was observed during this evaluation period. While some of the 

group treatment activities observed did specifically deal with “family“ issues among the 

clients themselves, few if any sessions involving the use of family members were 

observed to have taken place during the site visits. The enlisting of family memberd in 

the continued clean living of these clients might be an especially useful adjunct, 

particularly because most of the clients in these drug courts lived in the ‘community 

during their treatment. 

culturally specific programming, as evidenced in the low fiequency with which raters 

observed these topics being discussed in treatment groups. Again, the provision of the 

specially tailored services may be expected to improve the efficacy of treatment for these 

specific sub-groups of clients. While white and male clients tended to dominate the 

proportion of groups in most sites, there were still substantial minority and female 

populations in each jurisdiction, who may benefit fiom services specifically tailored to 

their unique set of needs 

As previously mentioned, programs which address multiple client needs are in 

1 

Finally, none of the programs appeared to provide much in the way of gender or 

6-12 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 7 

The Integration of Court Operations and Treatment Services 

Overview 

Drug Courts, boot camps, intensive supervision programs, day reporting centers, 

jail and prisons have all tried in recent years to incorporate drug treatment into their menu 

of services for offenders. Many of these programs have failed because of the inability to 

provide sufficient treatment to effect behavior change within the context of the criminal 

justice system (Farabee, Prendergast, Cartier, Wexler, Knight, and Anglin, 1999; Latessa 

& Holsinger, 1999). The difEiculties associated with the provision of drug treatment 

services are often compounded by more general concerns, such as the perception that 

substance abusing offenders are not motivated enough for treatment (Farabee, et al., 

1999) or that treatment is an opportunity that offenders do not deserve @see and 

Carlson, 1996; Taxman, 1998). 

In fact, the treatment delivery system for offender populations is as crucial an 

issue as the offender’s level of motivation to participate in substance abuse treatment 

services. Both researchers and practitioners tend to focus on the role the offender plays 

in successfbl treatment, rather than examine the impact of service delivery itself. Critics 

fiequently cite the fact that offenders do not take advantage of available services or that 

offenders are prone to quit treatment, resulting in inadequate treatment duration. Others 

cite the failure of offenders to attend treatment activities, continued use of illicit 

substances while in treatment, and non-compliance with court-ordered conditions of 

release (Petersilia, 1999; Taxman, Soule, and Gelb, 1999). 

Scholars have also noted that the delivery system itselfoften fails offenders by 

using ineffective intervention strategies, such as psycho-education and self-help services 

(Sherman, Gottfredson, MacKenzie, Eck, Reuter, and Bushway, 1997; Simpson, Joe, 

Fletcher, Hubbard, and Anglin, 1999; Taxman and Piquero, 1997; Taxman, 1999). As 

another example of the delivery of poor treatment services, offenders are fiequently given 

standard treatment plans that are not tailored to the needs of the individual. Similarly, 

few programs provide sufficient opportunity to build the client’s motivation for change or 

to prepare the offender before entering the treatment process (Simpson et al, 1997). Each 

of these issues- treatment access, treatment content, and client retention-are often 

perceived as an outcome of poor client motivation, when in fact these are often the result 

of structural and organizational factors that impede the client’s involvement in effective 

drug treatment services. Few studies have examined how treatment delivery itself 

interferes with the offender benefiting from participation in treatment services (Wexler, 

Falkin, and Lipton & Rosenblum, 1992; Taxman, 1998). 

Farabee and his colleagues (1 999) identified six common barriers to effective! 

treatment for the offender including client identification, assessment, and referral; 

recruitment and training of treatment stay redeployment of correctional staff; over7- 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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reliance on institutional versus therapeutic sanctions; aftercare and the use of coercion in 

treatment delivery systems. These barriers are especially pertinent to ”behind the wall” 

prograk, but they also affect community-based treatment programs. 

to develop “boundaryless~’ systems of care that join public health and criminal justice 

agencies in the pursuit of recidivism reduction. For example, a typical problem is that 

many offenders have too little time in prisodjail to benefit fiom the full duration of a 

treatment program Another important issue is the fact that program eligibm criteria 

are often ambiguous, making it diffcult to identlfjl the characteristics of offenders who 

will likely benefit fiom the treatment program. Farabee and colleagues’ concerns 

regarding treatment staff refer to whether the staff are employed by a correctional or 

health agency and the degree to which the treatment staff are skilled at addressing the 

clinical needs of the offender, who often has some criminogenic traits that need clinical 

‘attention. Treatment programs require special correctional staff, the provision of which 

often places more demands on a correctional institution to ensure that the security staff is 

compatible with the treatment program Aftercare is fiequently desired, but seldom 

materializes because it requires crossing organizational boundaries to link offenders to 

treatment services in the community. 

Several of these barriers to effective treatment are particulatly relevant to the need 

The Importance of Service Delivery Systems 

In recent years, several attempts have been made to incorporate treatment within 

the criminal justice system in a manner that moves away fiom the traditional emphasis on 

coordination and collaboration as an operational framework. Instead, these integrated 

service models are based on the concept of “boundaryless” organizations. Boundaryless 

organizations are characterized by shared inter-agency goals and operational practices at 

key decision points that are common to both criminal justice and treatment agencies. 

This approach emphasizes the creation of policies and operational practices that 

transcend agency boundaries, overcome “bureaucratic turf issues”, and develop processes 

that benefit the individual agencies. 

perspective focused on creating integrated processes that contribute to desired outcomes, 

rather than focusing on the performance of parts of the system. As noted by Hammer 

(1 996): 

The concept of a boundaryless organization evolves fiom organizational-system 

The problems that afflict modern organizations are not task problems. They are process 

problems. The reason we are slow to deliver results is not that personnel are performing 

individual tasks slowly and efficiently; fifty years of time-and-motion studies and 

automation have seen to that. We are slow because some of our personnel are performing 

tasks that need not be done at all to achieve the desired result and because we encounter 

agonizing delays in getting the work from the person who does one task to the person 

who does the next one. .. We are inflexible not because individuals are locked into fixed 

ways of operating, but because no one has an understanding of how individual tasks 

combine to create a result, an understanding absolutely necessary far changing how the 

results are created (pg. 5-6). 

Figure 7.1 illustrates how these boundaryless processes must occur in order to 

allow the criminal justice and treatment systems to work together on key decision points. 

7-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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"6e implementation of both treatment and correctional services will be streamlined by 

the coordination of these systems in regards to these key decision points. In their work 

with private sector companies, Askenos, Ulrich, Jick, and Kerr (1995) have shown that 

the creation of boundaryless (i.e. seamless) organizations requires a new focus, allowing 

processes to hction far better as a whole than do their separate parts. Within this 

fi-amework the roles and responsibilities of each organization remain consistent with their 

original goals, but they also work in concert with the other agencies' inputs. In fact, 

Askenos, et al(1995) suggests that: 

... there are still leaders who have authority and accountability, there are still people with 

special functional skills, there are still distinctions betweq customers and suppliers, and 

work continues to be done in different places (pg. 4). 

By focusing each organization on the overall process and not simply 011 their own 

goals and responsibilities, services can be implemented in a manner that maximizes their 

overall efficiency and effectiveness. 

Figure 7.1 

Conceptual Framework for Boundaryless Organizations (Policies and Practices) 

I Assessment I I I I I 

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Treatment Placement 

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Treatment 

System 

Criminal 

Justice 

System 

I Supervision/Mo;lit oring I I 3 I I 

Drug Testing 

Discharge & Completion 

I I 1 I I 

Moore (1 991) in his discussion of integrated services has suggested that each 

agency would participate in key decisions regarding the client, including placement in 

appropriate services, modification of treatment plans based upon client progress, the 

7-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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transition to other services when deemed appropriate and eventual discharge fiom the 

system. Rather than mere coordination of services and efforts around these issues there 

would be an integration and synthesis of agencies’ policies and operational practices. 

Within the systems approach to service delivery the initial focus must be on building the 

infi-astructure needed to support the functions of each agency. In order to accomplish 

this, policy development must focus on such issues as client assessment, referral, 

placement, tracking and monitoring, service planning, transition through services, and 

eventual discharge. In terms of the criminaljustice/treatment system, such boyndary 

spanning activities, especially as related to the initial development of integrated policies 

appears to be an essential next step in the evolution of effective treatment delivery 

systems. 

the Washington-Baltimore High Intensity Drug Trafficking Area (HIDTA) project has 

implemented an integrated criminal justice/treatment system of services (Taxman and 

Lockwood, 1996). A five-year long process evaluation of this seamless system is 

underway and early results suggest that this is a promising approach for the delivery of 

effective drug treatment services to criminal justice clients. For example, preliminary 

data suggest a significant reduction in the rearrest rates for offenders involved in the 

process compared to those involved in a traditional service delivery model (Taxman and 

Cronin, 2000). This integrated system of service delivery is characterized by several 

distinct core components, including client focused policies, delivery systems based on a 

continuum of care, and the use of coerced treatment, behavioral contracts, and graduated 

sanctions with clients, as well as the prioritization of system resources. Each of these 

core components is implemented With the cooperation of both criminal justice and 

relevant public health agencies. 

hctions of different organizations, such as public health, criminal justice, social 

services, mental health and other relevant agencies. In so doing, the seamless system 

approach expands the organizational boundaries of these participating agencies. In the 

traditional service delivery model these two entities would likely try to “coordinate” 

fiagmented services, typically struggling over which agency ultimately ”controls” the 

decision-making regarding the client. In a systems or seamless organizational approach, 

participating agencies would initially agree upon certain guiding principles of care then 

determine the appropriate roles and functions for each player in delivering that level of 

care. From this organizational perspective the emphasis is then on the effective operation 

of the system itself and its complementary parts, rather than on the role of any one 

agency. 

As an example of an attempt to create a “boundaryless” service delivery system, 

This systemic approach to service delivery is designed to combine the roles and 

Are Drug Courts Boundaryless Organizations? 

By design drug court programs appear to be the epitome of “boundaryless” 

organizations, but the extent to which this sort of integration has been achieved is largely 

unevaluated. Drug courts are compulsory, court-ordered substance abuse treatment 

programs that attempt to incorporate two competing perspectives on the causes of 

substance abuse and addiction, specifically the criminal justice and medical models. The 

7-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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criminal justice model conceptualizes drug addiction as one of many antisocial behaviors 

manifested by criminals, while the medical model conceptualizes addiction as a chronic 

and relapsing disease. Consistent with these differing conceptualizations of addictions, 

the courts and treatment community also tend to use differing types of interventions to 

respond to addictions (and associated criminal behaviors). Traditionally, courts have 

employed legal sanctions, such as incarceration or probation sentences. Partly, these 

responses arise out of a concern for public safety, as well as an attempt to change the 

substance abusing/criminal behavior through deterrence and/or incapacitation, On the 

other hand, the treatment community tends to emphasize therapeutic relationships and the 

use of treatment services (eg, awareness and new skills building) as means of changing 

behavior and reducing substance abuse. Operating fiom difKering theoretical perspectives 

and employment of vastly different types of behavior change techniques, the courts and 

example, I,( , Nolan (1 998) claims: 

, treatment community have not always worked well together traditionally. As an 

... The relationships between these organizations are often strained by philosophical 

differences between the traditional adjudicative perspective of the courts expecting 

external supervision and probation like-monitoring and the theraptic orientation of the 

treatment provider seeking to increase interpersonal skills of clients based upon the 

identification of their treatment needs to prevent relapse (Nolan, 1998:llO-112). 

Prior to the development of drug courts as a response to the problem of drug 

abuse and crime, these philosophical and operational differences resulted in treatment and 

criminal justice personnel working within their own autonomous domains. This 

arrangement resulted in little cooperation and integration of efforts between these parties. 

In fact, the closest approximation of cooperation occurred only when courts “sent” 

offenders to treatment, seemingly with little interest or knowledge of what might actually 

take place there. As Goldkamp (1998: 170) points out: 

At the heart of the treatment drug court is a newly negotiated working relationship 

between treatment providers and the criminal court. The drug court does not simply refer 

cases out to treatment, as in the traditional probation model. Rather, partly out of 

dissatisfaction with how the probation model has worked, the drug court works out a 

regimen or range of treatment services that will be provided during the period the court 

has the defendant or offender under its control. As the drug court model has evolved this 

has also meant involvement of related health and social services (such as education, 

employment, housing, etc.) to strengthen the treatment process and to build strong links 

to the community and aftercare. Thus, in the drug couri, the criminal court has been 

challenging the substance abuse treatment profession to create a treatment approach that 

can be effective within criminal justice boundaries, all while linked more accountably to 

the criminal court judge. 

While the development of the drug court model has been predicated on the 

integration of treatment services and court operations, the concept of integration in this 

context has not been fully elucidated thus far. The idea of integrating treatment services 

into the traditional criminal justice system is innovative and potentially more effective 

than the traditional arrangement. However, little thought seems to have been given so fhr 

to what “integration” means in drug courts. Further, there have been few attempts to 

define exactly what this integration of services should look like, other than general 

statements such as “Drug courts integrate alcohol and other drug treatment services with 

justice system case processing” (DCPO, 2000). Similarly, researchers have largely 

ignored the implementation and effectiveness of varying types and levels of integration. 

7-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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It stands to reason that the degree of integration between treatment and court operations 

can affect the success of a drug court program, particularly in terms of the overall ability 

to deliver effective services that will reduce both substance abuse and criminal 

involvement (and maybe increase other desirable behaviors such as fhdy, educational or 

employment participation). 

relationships between treatment and criminal justice personnel are often imbued with 

difficulties. As noted above, treatment and criminal justice organizations represent vastly 

different cultures and ideologies. There are potential conflicts over the purposes and 

goals of each party's activities and there are often competing differences in the preferred 

means employed to achieve these goals. Inability to resolve these conflicts can interfere 

with the cooperation that is intended to be a central component of the drug court model 

Writing about this specific issue and how the drug court model can address it, Goldkamp 

(1 998: 170) suggests: 

Anecdotal accounts fiom various drug court personnel indicate that the 

I 

. . .these conflicts have to be resolved in a working relationship that is new and 

comprehensive, and which integrates values and features of the respective disciplines in 

an operating fiamework acceptable to the criminal court. 

The drug court model differs fiom prior efforts to deliver drug treatment to 

offenders with substance abuse problems because court and treatment operations are 

specifically intended to be integrated (however that is defined), both in the development 

and implementation of each set of services. 

justice and treatment services in other settings, specifically about the need to integrate 

these services at several levels. For instance, services need to be coordinated or 

integrated in terms of several different decision points, such as assessment, treatment 

placement, movement through treatment phases, program graduation, response to 

misbehavior (e.g., imposition of graduated sanctions), and drug testing procedures. In 

addition, integration or coordination must take place at the level of policy development, 

development and management of fimding sources, and various other operational and 

administrative responsibilities, such as record keeping and information sharing. 

Examples of some of these areas are more filly presented below. 

Taxman and Bouffard (2001) have written about the integration of criminal 

a. Philosophical Integration 

Do drug court administrators and staff share a similar view of the causes and 

appropriate responses to substance abuse and criminal behavior as those held 

by treatment program administrators and staft? 

b. Policy Development & Funding Integration 

Do directors of each agency (and their superiors), as well as those who make 

funding decisions work together to develop integrated policies and share 

financial responsibilities for the operation and continuation of the program? 

Is there a steering committee composed of members of various relevant 

treatment, criminal justice and community agencies? 

7-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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c. Operat ional-level Decision-MakingAnfomtion Sharing Integration 

' 

Do line staff within each agency routinely work together to make decisions 

regarding the handling (e.g., screening, placement, imposition of sanctions) of 

individual cases? Are there institutionalized policies and procedures in place 

to support this integration and cooperation among line st& in case planning? 

For instance, are there regularly scheduled treatment planning meetings 

involving both staff! Are there procedures in place for the sharing, of 

assessmendre-assessment, drug testing or treatment progress information? 

d. Cross-Program Familiarity Issues 

Do members of each programs' (court versus treatment) staffhave a working 

familiarity with the goals and relevant procedures employed by their 

counterparts? Do staffmembers share similar goals and are they able and 

willing to work together to achieve these shared goals? 

,L* I 

The importance of integrating treatment operations with court operations is 

underlined in the first Key Component of drug courtsg. To the extent that this integration 

of services is the central tenet of the drug court model, the most important issue affecting 

drug court program operations and success centers on the effective collaboration and 

communication between both treatment and criminal justice personnel. 

environment for monitoring the progress of the offender using state-of-the-art technology 

including scient& needs assessment, appropriate treatment placement, fiequent drug 

testing, and graduated sanctions. In essence, drug courts integrate aspects ofthe 

treatment and criminal justice system to form a unique service delivery system 

Combining the coercive power of the court with what is hopefidly effective and 

scientifically based treatment practices; these program jointly promote abstinence and 

pro-social behavior, through an integrated set of criminal justice and treatment services. 

(Belenko, 1998; NDCIR, p6). 

Although the integration between treatment providers and court operations is a 

Key Component of drug courts and the literature clearly indicates that communication 

between substance abuse treatment staff and criminal justice staffare critical to the 

success of the program, there is a paucity of research attempting to demonstrate the 

extent to which integration has been achieved. One of the goals of the current evaluation 

then is to explore the process of examining integration at various levels within these drug 

courts, as well as to explore the types of data collection techniques that might be used to 

address these issues. 

Drug courts are intended to incorporate treatment principles within a structured 

Key Component #1: Drug courts integrate alcohol and other drug treatment services with justice system 

case processing. 

7-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Methods and Sources of Information 

As we have seen, defining the term integration remains problematic in itself A 

review of the literature reveals several meanings to integration in the drug court context. 

Several sources were consulted to begin to synthesize our thinking about the concept of 

integration within the drug court context. The first source is a recent NIDA CJ-DATS 

Request for Proposals. The RFP continues the emphasis upon goals of collaboration and 

communication as important ingredients of integration. A second source of in,formation 

regarding the issue of integrated services is the Drug Court Planning Office who 

identified a series of “benchmarks” for each of the Ten Key Components of Drug Courts. 

Although these benchmarks are targeted at practitioners, for use as a guide to developing 

drug court programs that are faithfid to the original model, they are also helpfid in 

operationaliziig a definition of “integrated” services. 

This research utilized several different approaches to garner usefbl information to 

explore the level and types of integration occurring within the four drug courts programs. 

First, we examined drug court policy statements contained in official documents. It is 

likely that an examination of existing policies “on the books” will provide some 

information about how well the programs were at least intended to be integrated. Our 

evaluation illustrates integration of policy in terms of the phasing system. 

criminal justice personnel. These interviews allowed us to explore some of the issues 

surrounding different levels of integration such as court staffviews about the relationship 

between crime and substance abuse and the role the court plays in the treatment process. 

A third source of information involves the use of surveys of counselors providing 

treatment services (see chapter 2). These surveys were used to collect information 

directly from those involved in the development and day-to-day operation of the court 

programs. Specific topics included fist hand information about the operation of 

coudtreatment services, at various decision points, such as screening, assessment, 

treatment placement, enforcement of graduated sanctions, and program graduation. More 

integrated programs would likely have more collaboration on each of these issues, with 

both treatment and court personnel having regular and formalized input into these key 

decision areas. 

Fourth, we examined how court and treatment organizations maintained 

communications with one another. The collaboration and communication between 

treatment and court personnel was recently identified by MDA as an important 

dimension of integration in the drug court context. Several questions in our interview 

schedules for both treatment and court personnel examined relationships between 

treatment and criminal justice staff and the extent that collaboration and communication 

occurred between treatment and court organizations’o. These questions allow us to 

examine the level of criminal justice involvement in treatment and conversely, the level 

of treatment involvement in criminal justice operations. 

,<< 

The second source of information about integration involves interviews with 

lo The recent NIDA request for applications for CJ-DATS (2002) refers to “An Integrated Systems 

Approach” that includes “collaboration and communication between drug treatment and criminal justice 

staff as components. 

7-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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The final source of information about integration was obtained fkom observations 

of drug court stafhngs and court status hearings. These direct observations of the court’s 

hearipps were used to assess the desee of intwation and cooperation within the 

courtroom itself. StafEngs and court room sessions were attended by one team member 

during the site visit. The purpose of this observation was to document the extent that 

team decisions about drug court participants during staflings were reflected in courtroom 

decisions by the judge. I 

Integration According to Court Personnel 

Interviews with court personnel provide one way to assess the level of integration 

between court and treatment in the drug court context. Criminal justice staffwere 

questioned about the role substance abuse plays in crime, the priority that substance 

abuse treatment occupies in the program, communications about participants in pre-court 

staffhgs, the extent that information is shared across program components, and the 

typical problems encountered in working with treatment personnel. Their responses are 

organized around the various levels of integration discussed above. 

I 

Philosophical Integration 

One indicator of philosophical integration is the extent that court staff have views 

about the relationship between substance abuse and crime that are compatible with the 

goals of substance abuse treatment. Overall, court stafFappeG to believe that substance 

abuse and crime are highly related - though not necessarily causally so. Most believed 

that substance abuse issues occur fist and that criminal activity follows. Here are some 

of the responses €tom judges, prosecutors, sherfi, and police to the question: How are 

substance abuse and crime related -if at all? 

Many people come to crime through drugs. It’s environmental. Many crimes are caused 

by drug use. 

Substance abuse and crime are both highly correlated With poverty. 

I think substance abuse is a social problem, not a Criminal problem. I would support 

substance abuse being a mental health problem. I don’t know what causes people to steal 

but if you solve the drug problem, it will solve the crime problem in 85% of the cases. 

Substance abuse is caused by people being unable to solve problems encountered in life 

and this seems to be a way of escaping. Crime seems to be related to lack of education 

and having a job. 

Substance abuse is caused by environmental factors. Environmental factors like 

upbringing and emotional pain and child abuse. Crime is caused by lack of self discipline 

and morals. 

It’s a chicken and egg problem. Substance abuse is family generated, culture generated, 

poverty generated and peer generated. 

The source of crime is as old as humanity- poverty and lack of education. I do not know 

the causes of substance abuse We could get into peer pressure to use, good and evil .... 

7-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Illegal drugs are expensive. People commit crimes to buy drugs -women sell 

themselves. There is a strong correlation with poverty as well as physical and sexual 

abuSe, and there is a genetic tendency toward addiction. 

Moreover, court personnel believe that the delivery of substance abuse treatment 

services is the primary goal of their drug court program. 

\ 

We focus on treatment. Other requirements are second. 

Yes, people sometimes go to jail for missing treatment. 

Treatment is really the core component. Clients do not get to write their own program, 

Treatment is the primary goal of the program. 

\ 

In addition, court personnel believe that coerced treatment is effective and believe 

their role is to ensure participants are in compliance with the performance expectations of 

drug court and treatment programs. Moreover, court personnel do not believe that most 

of the participants in their drug court program would succeed with only a substance abuse 

treatment program. They believe that many drug court participants need the leverage and 

structure provided by the drug court. Here are some of their comments: 

Treatment by itself is no more effective than probation by itself. 

Four out of ten fail the drug court program but 80% of the probationers fail probation. 

Some would succeed. There are various levels of addiction. Going to treatment will 

resolve their problem, for others, even our intervention is not going to help. A significant 

portion got pretty lousy parenting, the court acts as parents holding them responsible. 

They would not be as successfid. Our group (drug court) is better than anywhere else. 

This is Maybeny. We know everybody. 

No, they would not. It fails to understand that treatment and criminal justice are in 

conflict. There are clashes with treatment I can’t pretend crimes don’t happen. 

That’s been proven by NLDA. It works because coerced treatment works. You do not 

have to wait till they hit bottom. 

In a way, yes and no. There is a need for judicial review but not every two weeks but 

every six weeks given the community sentence structure which has built in supervision. 

Some would and others would not - it depends on the level of addiction. 

No, the judge is an authority figure. Just treatment has been available. 

About 40% would succeed with treatment. In our court, a lot of people go to drug court 

and don’t need to. 

Oh no. The rare person might. These people have poor jobs, education. Life happens. It 

is never their fiult. 

No way, I’ve been there. Treatment was no more effective than probation: 60-70% of 

the people in drug court are a success because they have no contact with the criminal 

justice system after graduation. 

7-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

Policy Development Integration 

One important drug court policy indicative of the level of integration between 

court and treatment operations is the phase system. Outpatient treatment is typically 

delivered as a step-down program in several phases consisting of specific requirements 

for participants. Nationally, not all drug courts deliver their program in phases. When 

they do have a phase system, there may be a single set of requirements fiom treatment or 

the courts that participants are expected to complete or separate sets of requirements for 

treatment and drug court programs. 

The extent that both court requirements and treatment requirements are 

incorporated into the phase system is one indicator of integration because it represents the 

end result of collaboration between treatment and court personnel at the level of policy. 

We assessed the content of phases as descrikd in the Policies and Procedures Manuals of 

each drug court and described those phases in Chapter 4. Here we are concerned with the 

articulation and identification of specific court and treatment requirements in the policies 

that govern the operation of the drug court. 

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Since the four drug courts provide a step-down phased system of requirements, it 

is possible to ident@ separate components of drug court requirements and substance 

abuse treatment requirements for each program phase. As shown in Table 7.1 (next 

page), we were able to identifL both specific court and treatment requirements expected 

of participants fiom a review of the Policy and Procedures Manuals. Participants at each 

site are expected to comply with requirements fiom both treatment and the courts 

reflecting a level of co-ordination in providing clients clear information and in 

implementing an integrated phasing system. Overall, the number and content of 

requirements expected of participants varies by site. 

7-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 7.1 Cross-Site Comparisons of Phase System Requirements 

Phase 1 

Develop and Initiate Treatment Plan 

Psychosocial and Physical Assessments 

Attend Treatpent as Required 

Attend Drug Court as Required 

Report to Case Management as Required 

Engage Significant Others in Recovery Process 

Drug testing as Required 

Attend MA 

Obtain MA Sponsor 

Assess Job SkillsEducation 

Obtain Stable Housing 

Obtain Employment, Training or Education 

No New Criminal Charges 

Pay Court Costflees 

Minimum Sobriety Requirement 

Develop Recovery Plan 

Attend Treatment as Required 

Attend Drug Court as Required 

Report to Case Management as Required 

Drug Testing as Required 

Engage Significant Others in Recovery Process 

Attend MA 

ObtainRvlaintain MA Sponsor 

Assess Job SkilldEducation 

Obtain Stable Housing 

Obtain Employment, Training or Education 

Complete Community Service 

No New Criminal Charges 

Minimum Sobriety Requirement 

Pay Court Costflees 

Update Recovery Plan 

Attend Treatment as Required 

Attend Drug Court as Required 

Report to Case Management as Required 

Drug Testing as Required 

Engage Significant Others in Recovery Process 

Attend MA 

ObtaidMaintain WA Sponsor 

Obtain Stable Housing 

Obtain Employment, Training or Education 

Complete Community Service 

No New Criminal Charges 

Resolution of All Outstanding Warrants 

Minimum Sobriety Requirement 

Pay Court Costsffees 

Phase 2 

Phase 3 

St. Mary Creek BaRmsfield Jackson 

Parish County County 

1 0 

0 0 

Unspecified 30 days 

a 

a 

0 0 

Unspecified 90 days a 

7-12 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Who determines Legal 

eligibility 

Legal criteria used to 

exclude 

Who determines 

clinical eligibility 

Standardized 

lnstments 

Treatment criteria used 

to exclude 

Operational-level Decision Makinghformation Sharing 

Creek Comfy Bakersfield Jackson County 

Probation Prosecutor Arraignment Court Prosecutor I 

St. Maty Parish 

& Probation 

Violent Offenders Violent Offenders Violent & Felony Violent &Multiple 

Clinical staff Clinical staff Clinical staff Clinical staff 

AS1 SASS1 AS1 and others AS1 and others 

Offenders Offenders 

Mental health issues, Substance Abuse Substance Abuse Mental Health Issues 

Severity Health, Motivation Health Issues Motivation 

Substance Abuse Severity, Mental Severity, Mental and Lack of 

One of the key decision points in the drug court context centers on how people are 

admitted to the program. Prior to drug courts, the courts (or their designated agency such 

as probation) referred offenders to treatment. Ideally, in the drug court model, the 

decision about who is admitted to the program is a collaborative one. 

In Chapter 3, wk discussed who was involved in decision making about drug court 

admissions. As can be seen in Table 7.2, the processing of offenders begins with the e 

determination of lega1,eligibility which is conducted by court personnel. A substance 

abuse screening and assessment is conducted’ by treatmeht staff on those individuals who 

satis@ the local drug court’s legal criteria. Should a defendant meet legal and clinical 

eligWity requirements, at a minimum both treatment and court personnel at each site 

played a role in providing information to the drug court judge who ultimately makes the 

hd decision. , 

Contrary to the old probation model where the criteria used to refer defendants to 

treatment were largely subjective in nature, these drug courts have made a basic 

improvement in objectifying the process by using standardized clinical measures., 

However, the degree to which these measures are actually employed in ;the admission 

process could not be ascertained in this evaluation given the absence of necessary override information. Table 7.2 outlines the specific legal and clinical eligibility requirements 

used to determine eligibility and also exclude defendants referred to drug court. As can 

be seen in Table 7.2, these procedures requires collaboration md cooperation between 

drug court and treatment personnel. 

Table 7.2 Cross-site Comparisons of Program Eligibility Requirements 

Although observations of drug court staflings and status hearings were not a 

formal part of the research, members of the research team observed and documented 

both. At each site, there was collaboration and cooperation among court and treatment 

staff. Client treatment attendance, performance and progress were fiequentiy discussed 

between team members during “stafigs”. 

However, observations of the judge-participant dialogue revealed that the most 

common discussion topics centered upon general well-being, drug-test results, MA 

7-13 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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meeting attendance, and areas pertaining to either housing or employment. Only on a 

few occasions were discussions of treatment performance, participation and attendance 

(which occurred during the stalling) follow through into the courtroom dialogue. In this 

sense, it can be said that each of the courts have a relatively low-level of treatment 

integration, placing more emphasis upon aspects of participants lives other than the 

treatment they are receiving. On the other hand, the four drug courts seem to be highly 

integrated in relation to the decision-making surrounding the use of sanctions and 

rewards. Only on very few occasions did we observe the judge override 

recommendations made by treatment staff. 

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Cross-Program Familiarity Issues 

Although treatment staff from all sites are reportedly involved in court operations 

by attending pre-court staff meetings and court hearings, only five out of twenty court 

personnel interviewed indicated they attended any treatment sessions. Only two persons 

indicated attending treatment sessions on more than one occasion. 

Court personnel were able to describe in a general way the roles that treatment 

personnel play within the drug court context and they had basic knowledge of the content 

of the drug treatment program. However, court personnel seemed less knowledgeable 

about the details of the treatment process. For example, only four respondents could, 

when asked, provide specific details about treatment screenings and assessments such as 

the type of screening test used. Court personnel's knowledge of treatment operations also 

appears to be role specific. Case managers and judges seem more informed about how 

eligibility was determined and what information was used fkom assessments to make 

admission decisions than defense counsel and sheriffs who seemed less informed about 

how treatment decisions were being made. 

Court staff fkom three sites indicated that they met regularly with treatment staff, 

usually at pre-hearing staf€ings immediately before court hearings. The Bakersfield drug 

court did not conduct pre-court stafigs. At this site, court status hearings are adjourned 

to discuss problem cases when they occur. 

Interviews with drug court personnel indicate that decision making about 

participant progress is based on multi-disciplinary information provided by members of 

the drug court team who are present at pre-court stafigs. This is consistent with 

descriptions contained in the policies and procedures manuals and pre-court staffhgs we 

observed during our site visits. While there are cross-site variations in the composition of 

these staffings, those attending were comprised of both treatment and court personnel. 

Finally, court personnel reported few conflicts with treatment personnel. The difficulties 

they did encounter centered on the impact of staff changes and turnover. 

Integration According to Treatment Personnel 

7- 14 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Some of the items in surveys of treatment personnel also addressed integration 

(See Table 7.3). Most counselors reported regular contacts with the drug court staff’ as 

well as with supervision (e.g., probation). Treatment stareport fiequent attendance at 

drug court hearings, and overall felt that their communication with the court was bilateral 

and ranked their communication as just slightly better than average in terms of 

effectiveness. Finally, all counselors at each of the four courts reported that their 

agencies generated drug testing results and shared those results with the drug court team. 

Another area that stands out in terms of the delivery of treatment services 

involves the treatment, planning process (presented in Chapter 5). While every program 

reported developing individualized treatment’plans for drug court clients, very few 

reported that the client played a significant role in developing their plans. We drug 

court personnel often attended treatment-planning meetings, few counselors reported that 

court personnel were actively involved in the treatment planning process. This suggests 

that both parties could provide more usehl input in this process. , 

Table 7.3 Counsellor Survey Results related to Treatment Integration 

I Sr. Mary Creek Bakersfield Jackson 

Parish County ’ County 

Outpatient Residential 1 Outpatient Residential 

Number of Respondents 

(Response %) 

Regular Drug Court 

Contact? 

Regular Probation 

Contact’? 

Drug Court StaffAid in 

Treatment Planning? 

Drug Court Staff Attend 

Planning Meeting? 

Treatment Staff go to 

Court Hearings? 

Is Information Sharing 

Bilateral? 

Drug Testing Reports 

Shared with Court? 

Mean “ht5 Sharing“ 

Effectiveness Rating 

3 

(50%) 

100% 

3 

(30?’0) 

33% 

21 

(62%) 

79% 

16 

(84%) 

69% 

8 

(53%) 

86% 

3 

67% 

(30%) 

1Wh 33% 80% 1 Wh 

20% 

13% 

75% 

87% 

100% 

1.9 

IOOO? 1 00% 

67% 37% 50% 0% 

100% 67% 21% 1 00% 

63% 

0% 

100% 67% 68% WO 

100% 67% 74% 1 oo?/o 67% 

1Wh 100% 100% 100% 1 Oooh 

1.9 2.0 2.4 1.8 3.0 

At least in one site, the drug court personnel reported problems overseeing the 

activities of their community-based treatment programs, particularly around the issue of 

cancelled treatment meetings. On the other hand, courts which operated their own 

treatment services seemed much more able to gather information and exert influence over 

the quality and quantity of services delivered to their participants. Related to this is the 

issue of court personnel understanding what actually takes place in treatment. Again, 

staff at one court in particular were unable to distinguish between the services delivered 

I’ The exception is counselors at Creek County (see Table 7.4). Note that two of the three counselors who 

responded liom this site worked for a treatment program, which at the time of the evaluation, did not serve 

a large number of the drug court’s clients. Since that time this program has become the sole provider of 

services for the court, so their communication with the court may have increased substantially. 

7-15 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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in’”treatment” and those delivered in the “support groups” (12-steps-based) that they also 

mandated clients to attend. In other words, in this site the court personnel were sending 

participants to services that they did not llly, or even partially understand. 

This example is emblematic of a broader issue concerning the level of integration 

between court and treatment services that are needed in order to deliver a more effective 

intervention. There are several important consequences of court personnel having only 

limited knowledge of tHe techniques and realistic goals of substance abuse treatment, not 

the least of which is the impact on their expectations for the speed and degree of change 

which may be expectep of participants during the typical drug court stay. 

Most programs reported mechanisms’like written reports, sharing of drug test 

results and attendance of both staff at treatment planning meetings and court hearings. 

Despite this, continued development of communication between the two parties appears 

useful. Similarly, cross training for each group might’h-ther aid in each side 

understanding the views and techniques of the other. While several judges expressed an 

interest in attending treatment groups, in order to better understand the process, they also 

generally thought that doing so would cause problems for the participants, in terms of 

their comfort level. In light of these concerns, it would seem particularly usell for ’, 

treatment staff to periodically provide training sessions for court personnel, so that they 

can at least develop an academic understanding of the processes involved, even if there 

are practical barriers to the observation of actual treatment services. 

I 

Summary of Findings about Levels of Integration 

What do these findings suggest? Perhaps, they are best summarized in terms of 

our previous discussion of levels of integration. The integration of court and treatment 

operations in the drug court context occurs at least at four levels. 

Treatment and court staff share similar views about the causes of and 

responses to substance abuse and criminal behavior. Court personnel 

believe substance abuse is related to and precedes criminal behavior - it is 

criminogenic. 

0 AU sites indicate both court and treatment staff have worked together to 

develop policies and procedures and share financial responsibilities. 

Clearly, there are cross site differences in the degree this has occurred. 

0 Criminal justice and treatment staffgenerally work together to make 

decisions regarding the handling of individual cases. There is a division 

of labor and agreements on this process. Existing policies and procedures 

are in place to support this collaboration and cooperation in case planning, 

assessment, and drug testing. Intake decisions are a case in point. Intake 

decision making tends to be compartmentalized. The determination of 

eligibility begins ‘with a legal screening conducted by court personnel. 

This is typically followed by treatment screening and assessments. The 

7-16 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

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final admission decision appears to be a joint decision, however, oveiride 

information was not available to test this empirically. 

Criminal justice staff have limited knowledge about substance abuse 

treatment. On the other hand, treatment personnel seem more 

knowledgeable about the criminal justice system in general and court 

operations in the drug court context. Although treatment staff from all 

sites were involved in drug court operations by attending pre-court staff 

meetings and court hearings themselves, only a few court personnel report 

attending any treatment sessions. 

Summary 

This chapter has explored integration issues between treatment and court 

operations in the drug court context. While each program has its own distinct 

characteristics, we find that the drug courts have institutionalized lines of communication 

between court and treatment operations through several common mechanisms: 1) 

conducting pre-court meetings where court and treatment staffare able to meet and 

discuss client progress; 2) combining court and treatment requirements for participants in 

the phase system; and, 3) placing representatives from both treatment and the courts on 

drug court steering cormnittees and other decision making and policy making bodies. 

familiarity by staff, it involves different levels of system integration- philosophical, 

policy, and operations. The types of integration that are best for drug courts have yet to 

be demonstrated. Future research might consider such questions as these: 

Integration is not, however, simply a matter of cooperation and cross-program 

0 

0 

What should key actors in criminal justice know about treatment? 

Does more communication, greater criminal justice involvement in the 

therapeutic process and greater treatment provider involvement in criminal 

justice process have any impact? 

Does collaboration and communication result in better treatment 

engagement and adherence, better or faster progress in treatment or better 

outcomes? 

Drug courts are intended to incorporate treatment principles within a structured 

environment for monitoring the progress of the offender. In essence, drug courts 

integrate aspects of the treatment and criminal justice system to form a unique service 

delivery system. At the beginning of this chapter, we raised the empirical question about 

the extent that the integration of criminal justice and treatment services was characteristic 

of the four drug court programs in this study. It was suggested that the most important 

issue affecting drug court program operation and success appears to center on the 

effective collaboration and communication between both treatment and criminal justice 

agencies and personnel. 

This integrated set of criminal justice and treatment services are intended to 

jointly promote abstinence and pro-social behavior. By design, various components of 

7-17 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
criminal justice and substance abuse treatment systems are intended to work together as 

part of the drug court model to combine the coercive power of the court with what is 

hopefidy effective and scientifically based treatment practices (Belenko, 1998:6). The 

findings in this chapter suggest that variability in integration at various levels at some 

drug courts may limit effectiveness in the delivery of the program. 

The next two chapters examine how participant characteristics and hctional 

components of the drug court model are associated with program completion and postprogram recidivism, The analysis is intended to fill a gap in the research literature by 

addressing how some of the core components associated with the ‘%lack box” of the drug 

court model are related to program completion and post-program recidivism. 

3 

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7-18 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 

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Chapter 8 

Retrospective Study : Participant Characteristics, Program Fidelity 

Measures and Factors Associated with Program Completion 

Overview 

Previous chapters addressed the overall structure of each drug treatment court, the 

' content of their respective treatment programs and the integration of treatment and drug 

court components. The next two chapters are concerned with how participant level 

compliance with the performance expectations of these drug court programs are related to 

program completion and post-program recidivism. These chapters examjne how 

functional components of the drug court model and participant characteristics are 

associated with discharge outcomes and post-program recidivism. They are based on an 

analysis of 2,357 offenders who participated in these programs between January 1997 

and December 2000. The analysis is intended to fill a gap'in the research literature by 

addressing how some of the core components associated with the "black box" of the drug 

court model are associated with participant level results. 

Drug treatment courts require that participants comply with certain program 

requirements including: attendance at status hearings, no new criminal conduct, 

abstaining fiom alcohol and drug use, and attending substance abuse treatment. This 

chapter examines participant compliance with programmatic requirements and assesses 

how program compliance and participant characteristics are associated with program 

completion. 

Belenko (2001) notes that comparative data on the relationships between 

organizational components of the drug court and program completion is generally lacking 

in the research literature. Goldkamp et. al. (2001:42) suggests that the impact ofthe drugcourt - "the drug court effect"- derives fiom a number of program operations the salience 

of which is likely to vary across jurisdictions. 

and completion of the drug court program. These studies suggest that program completers 

tend to have different characteristics than non-completers. For example, Peters et. al. 

(1 999) found that a number of participant characteristics were positively associated with 

discharge outcomes in Escambia County. Successfd completion of the drug court 

program was associated with such characteristics as being employed, living with parents 

and having completed high school or obtained a GED. And, graduates were more likely 

to report marijuana and alcohol use as their substance of choice in contrast to terminated 

participants who were more likely to report problems with cocaine and opiate use. 

Other studies have focused on the relationship between participant characteristics 

8- 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
The goals of this chapter are threefold: (1) provide an overview of participant 

characteristics of each drug court program; (2) examine the integrity of each program 

across several program fidelity measures (drug test&, treatment attendance, and 

program participation); and, (3) identifj. factors associated with program completion. 

Findings indicate that in some jurisdictions there are gaps between drug court 

programs as designed and actual drug court programs in operation that may pose a 

challenge to the integrit$ of those programs. Generally speaking, the findings also 

indicate that participant compliance with drug court protocols are positively associated 

with graduation outcopes. While compliance with program requirements are the most 

important factors associated with graduation, other factors, such as participant 

characteristics, also play a significant role. 

tabular descriptions of participant characteristics and examines how they are associated 

with program completion. The second section examines program completion rates across 

a variety of program fidelity measures. Multivariate logistic regression models are 

introduced in the last section of the chapter to assess the salience of these factors on 

program completion. 

Methods 

The chapter is organized as follows: The first section presents bivariate crossTo understand how drug court operations are related to discharge outcomes, this 

study includes an analysis of 2357 offenders who were enrolled in the four drug court 

programs between January 1997 and December 2000. This sampling fiame consists of 

all enrollees in drug court, regardless of their level of participation. As the study is not 

designed to assess the impact or success of drug court programs, there is no comparison 

or control group. The information presented in this chapter is based on participant data 

obtained fiom drug court and treatment records (including: offender characteristics, 

participant attendance in drug court, participation in treatment, drug testing as well as 

program discharge status). Policy level information was obtained fiom client handbooks, 

policy and procedure manuals and interviews with drug court personnel (See Chapter 2 

for more information). 

Program Discharge and Completion Results 

Table 8.1 presents aggregate program completion rates for each of the four sites. 

Overall, 33% of the 2357 participants completed drug court through graduation and 67% 

were expelled. Cross-site comparisons indicate that graduation rates range between a low 

of 29% at the Jackson County drug court to a high of 48% at the Creek County drug 

court. Graduation rates in this study are lower than reported nationwide. In his review of 

37 drug court research evaluations, Belenko (2001 :28) reports that graduation rates itom 

eight drug courts programs averaged 47% and ranged between 36% and 60%. 

I 8- 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
E 

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, St. Mary Creek Bakersjield Jackson Total 

GTOGTOGTOGTOGTO 

32 68 100 48 52 100 36 64.8 100 29 71 100 33 67 100 

70 150 220 93 99 192 262 461 723 354 868 1222 779 1578 2357 

Parish County County 

Sample Characteristics 

Cross-site comparisons of demographic characteristics of participants are 

presented in Table 8.2. Overall, the majority of participants in the study are males (65%). 

, This is consistent across sites with the exception of the Bakersfield drug court where the 

there are more female (54%) than male (46%) participants. There are also few age 

differences across sites. Drug court participants' ages range between 17 and 64 with a 

mean age of 31 years (not shown). 

participants are predominately found at the Jackson County (68%) and the St. Mary 

Parish (46%) drug court programs. The race and ethnic composition of drug court 

participants roughly reflects the population demographics 'of each area. 

Overall, most drug court participants are not married (86%). And, less than halfof 

all participants (42%) have dependents. Participants with dependents range fiom a low of 

13% in Bakersfield to a high of 59% in Creek County. 

the time of their admission (63%) and had.completed their high school education (63%), 

participants at the three other sites were typically unemployed and most had neither 

completed high school nor obtained their GED. The percent of participants who 

completed high school or obtained a GED ranges fiom a high of 63% at Creek County to 

a low 29% in Bakersfield. 

Approximately half of all drug court participants are white (51%). Non-white 

With the exception of Creek County where most participants were employed at 

Characteristics of Participants By Discharge Status 

Tuming fiom a description of overall participant characteristics to an examination 

of how these demographic variables are associated with graduation (Shown on the right 

of each column), Table 8.2 also presents cross site analyses of the association between 

demographic factors and program graduation. The dependent variable here is rate of 

program graduation (0-1 00%). T-tests are performed on all dichotomous demographic 

variables and analysis of variance is analyzed for all variables involving multiple 

categories. 

8-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Gender 

1) Male 

2) Female 

Total 

% G T-Tat Sig. 

Race 

1) White 

2) Non-white 

Total 

% G T-Test Sig. 

Age 

1) 19 or Younger 

2) 20-29 

4) 40 or Older 

3) 30-39 

Total 

% G ANOVA Sig. 

Marital Status 

1) Married 

2) Not Married 

Toral 

% G T-Test Sig. 

Number of 

Dependents 

1) None 

2) One 

3) Two or more 

Total 

% G ANOVA Sig. 

Education 

1) Less than HS 

2) Some HS 

3) HS or 

Equivalent 

4) Post HS 

Education 

Total 

% G ANOVA Sig. 

Employed at 

Admission 

1) Yes 

2) No 

Total 

% G T-Test Sig. 

% - reflects the ove 

, I 

I, 

Table 8.2 Overall Cross-Site Demographic Characteristics of Participants and 

Analysis of Variance of Graduation Status 

St. Mary Creek County Bakersjield Jackson County I Total 

Parish 

% N %G % N %G % N %G Yo N % G Yo N %G 

80 176 

20 44 

100 220 

54 118 

46 102 

100 220 

16 34 

34 76 

37 82 

13 28 

100 220 

, 

10 21 

90 199 

100 220 

61 135 

10 22 

29 63 

100 220 

23 50 

41 91 

27 59 

9 20 

100 220 

33 72 

67 148 

100 220 

31 1 79 

36 

32 

4 

37 

25 

32 

18 

33 

33 

43 

32 

I :4* 

48 

30 

32 

29 

36 

37 

32 

30 

31 

34 

35 

32 

39 

28 

32 

1 percent of participants. 

21 

100 

79 

21 

100 

12 

29 

32 

27 

100 

23 

77 

100 

41 

28 

31 

100 

6 

31 

58 

5 

100 

63 

37 

100 

151 

41 

192 

152 

40 

1 92 

23 

56 

61 

52 

192 

44 

147 

191 

79 

53 

60 

192 

11 

60 

111 

10 

48 

49 

48 

49 

45 

48 

26 

46 

49 

60 

1 :4 48,* 

52 

48 

48 

48 

53 

45 

48 

55 

30 

56 

70 

192 48 

23***;2:4* 

121 52 

71 42 

192 48 

46 

54 

100 

69 

31 

100 

3 

32 

44 

21 

100 

17 

83 

100 

87 

5 

8 

100 

7 

68 

11 

14 

100 

28 

72 

100 

332 

391 

723 

4 

496 

227 

723 

24 

230 

316 

153 

723 

126 

597 

723 

223 

14 

20 

257 

32 

332 

53 

68 

723 

200 

523 

723 

34 

38 

36 

38 

33 

36 

38 

37 

37 

34 

36 

30 

38 

36 

56 

86 

55 

57 

12* 

25 

37 

38 

43 

36 

47 

32 

36 

19 *** 

72 880 27 

28 342 35 

100 1222 29 

1.y 

32 3% 42 

68 826 

100 1222 29 

1 Q*** 

19 237 18 

35 426 31 

29 356 30, 

17 203 36 I 

100 1222 ' 29 

12*'';1.3***;1:4*** 

8 

92 

100 

46 

26 

28 

100 

5 

44 

36 

15 

100 

36 58 

421 28 

457 29 

1 Q*** 

203 32 

114 20 

124 35 

441 '29 

12*;23** 

18 . 6 

I64 23 

136 36 

55 38 

43 202 40 

57 269 22 

100 471 29 

1 Q*** 

65 1539 31 

35 818 37 

I( I 

51 1162 41 

49 1195 26 

100 2357 33 

1.y I 

13 318 20 

33 788 34 

35 815 34 

19 436 39 

100 12***;13***;1:4*** 2357 33 

14 

86 

100 

58 

18 

24 

100 

9 

51 

28 

12 

227 

1364 

1591 

640 

203 

267 

1110 

111 

647 

359 

153 

41 

34 

36 

41 

35 

39 

40 

27 

32 

42 

42 

100 1270 36 

1 3";1 :4**;,,**3:4* 

37 595 45 

63 1011 30 

100 1606 35 

1Q *** 

%G - refless the ppcent of participants graduating. . *** p<.OOl, p<.Ol, p<.05; two-tailed tests 

8-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 8.2 indicates several statistically si@cant demographic differences 

between program graduates and terminated participants. At one or more sites, 

statistically sigmficant demographic differences include: gender, race, age, marital status, 

number of dependents, education, and employment status. 

Differences by gender in program completion are statistically sign5cant. Women 

(37%) are more likely to graduate than men (3 1%)). More white participants graduate 

fi-om drug court (41%) than non-whites (26%). The pattern between race and program 

completion is consistent across all four sites with fewer non-white than white participants 

graduating fiom drug court. A higher percent of older participants graduate than younger 

participants, with younger participants (aged 19 and under) being the least likely to 

graduate. 

Although few participants were married (14%), married participants are 

somewhat more likely to graduate (41%) than participants who were not married (34%). 

he only statistically significant differences in marital status were found at the Jackson 

County drug court. And, there is a curvilinear relationship between number of 

dependents and overall completion rates. This relationship varies by site with signiscant 

dserences at both the Bakersfield and Jackson county drug court locations. 

Overall, participants who have completed high school are more likely to graduate 

(42%) than participants who have not completed high school (32% and 27%). These 

educational differences are statistically significant at both the Jackson County and Creek 

County drug courts. Employment status at admission is also positively associated with 

program completion. This relationship is statistically significant at both the Jackson 

County and Bakersfield drug courts. 

. 

Substance Use Profiles 

Table 8.3 presents cross-site information about participant substance use histories. 

Data was obtained from individual treatment and drug court files and available for 161 8 

or 69% of the 2357 participants in the study. Drug court participants can be characterized 

as poly-substance users with over 90% reporting lifetime use of two or more substances. 

The most fi-equently used substances are marijuana and alcohol, however, the use 

of other drugs such as cocaine/crack (44%) amphetamines (44%) and opiates (1 3%) were 

also reported. Overall, there are no differences between graduates and terminated 

participants in the use of specific substances. There are two site-specific exceptions. The 

percent of graduates reporting prior amphetamine use (33%) at the Jackson County site is 

larger than reported by terminated participants (1 5%); the percent of graduates reporting 

prior opiate use (1 1 %) at the Bakersfield site is lower than reported by terminated 

participants (23%). Participant drug use in the thirty-day period prior to admission to 

drug court also varies across sites but is consistent with lifetime use reported above. 

8-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Substance Use 

History 

Lifetime History 

St. Mary Parish Creek County Bakersfield Jackson County Total 

G T 0 G T 0 G T 0 G T OGTO 

Alcohol 

Marijuana 

CocaindCrack 

Amphetamines 

Opiates 

Other 

0 

Use Last 30 Days 

Alcohol 

Marijuana 

CocaindCrack 

Amphetamines 

@Sates 

mer 

CN) 

97.1 95.3 

94.3 92.7 

80.0 82.7 

7.1 4.0 

21.4 22.7 

42.9 36.0 

70 150 

95.9 

93.2 

81.8 

5.0 

22.3 

38.2 

220 

90.3 

100 

24.7 

54.8 

6.5 

24.7 

93 

87.9 

100 

33.3 

62.6 

8.1 

23.2 

99 

89.1 

100 

29.2 

58.9 

7.3 

24.0 

192 

67.9 

58.8 

30.9 

69.8 

11.1 

10.3 

262 

69.2 68.7 

59.9 59.5 

29.7 30.2 

66.2 67.5 

22.8 18.5 

10.4 10.4 

461 723 

94.5 

83.6 

56.3 

32.0 

0.8 

9.5 

128 

86.8 

85.6 

52.7 

15.2 

1.7 * 

12.1 

355 

88.8 

85.1 

53.6 

19.7 

1.4 

14.1 

483 

81.6 

75.9 

42.0 

50.6 

9.2 

19.0 

553 

805 

76.8 

45.2 

40.1 

14.4 

15.8 

1065 

80.8 

76.5 

44.1 

43.7 

12.6 

16.9 

1618 

50.0 41.3 

45.7 38.0 

42.9 31.3 

10.0 14.7 

10.0 4.7 

70 150 

44.1 

40.5 

35.0 

13.2 

6.4 

220 

2.2 

96.8 

24.7 

39.4 

88.9 

30.3 

26.3 

1 .o 

5.1 

99 

21.4 

92.7 

27.6 

13.5 

0.5 

6.8 

192 

52.7 

41.2 

19.1 

51.5 

5.3 

9.2 

262 

56.4 55.0 

47.7 45.4 

21.7 20.7 

51.2 51.3 

15.0 11.5 

8.9 9.0 

461 723 

72.7 

58.6 

25.0 

7.0 

2.3 

128 

60.8 

63.1 

30.4 

5.9 

0.6 

2.8 

355 

64.0 

61.9 

29.0 

6.2 

0.4 

2.7 

483 

48.5 

55.2 

24.4 

26.0 

3.8 

7.6 

553 

54.2 

55.3 

26.8 

26.6 

8.8 

5.9 

1065 

52.2 

55.3 

26.0 

26.4 

7.1 

6.5 

1618 

8.6 

93 

Wraduated T=Terminated O=Overall 

Prior Experience With Substance Abuse Treatment 

Cross-site information regarding prior experiences with treatment for substance 

use was available for a total of 1490 participants or 63% of the entire sample. As shown 

in Table 8.4, the majority of participants (72%) did not receive substance abuse treatment 

services prior to their admission to the drug court program. The fact that they are 

receiving substance abuse treatment for the first time stands in sharp contrast to other 

drug courts reported by Belenko (2001 121) where most participants report having 

previously received substance abuse treatment services. There are, however, cross-site 

variations in first time treatment experiences. At the Jackson County and St. Mary Parish 

drug courts, between 52%-62% of participants are receiving substance abuse treatment 

for the first time. This is in contrast to the Creek County and Bakersfield drug courts 

where 73%-82% of the participants had never received prior substance abuse treatment. 

An examination of the relationship between prior substance abuse treatment and 

discharge status is also presented in Table 8.4. Here we find that prior treatment 

experience is negatively associated with drug court graduation. A larger percent of 

participants (38%) with no prior treatment experience graduated fiom drug court than 

those with prior treatment experiences (28%). With the exception of the St. Mary Parish 

drug court, the negative relationship between prior treatment experience and graduation 

holds across all sites and is statistically significant at both the Creek County and 

Bakersfield drug courts. 

8-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Experience 

1)Yes 

2)No 

Total 

% G T-Test Sig. 

8. 

Table 8.4 Cross Site Comparisons of Participant Substance Abuse Treatment Histones 

Parish County County 

'Yo N %G % N %G % N %G 'Yo N 'Yo G Yo N %G 

48 106 33 , 27 52 37 18 129 22 38 133 27 28 420 28 

52 114 31 73 140 53 82 594 39 62 222 31 72 1070 38 

100 220 32 100 192 48 100 723 36 100 355 30 100 1490 36, 

1 2* ] .f** 1 s*** 

Number of Prior 

1)None 

2)One 

3)TwoorMore 

Total 

% G ANOVA 

Sig. 

1 Arrests 

1 

I. 

I Median 

Range 

Mean 

St.Dev. 

St. Mary Creek County Bakersfield Jackson County Total Parish 

% N %G % N %G % N %G % N %G % N %G 

11 24 46 35 67 48 9 62 55 22 270 40 18 423 44 

23 51 27 21 40 53 15 106 58 29 348 32 23 545 38 

66 145 31 44 85 47 76 555 30 49 604 22 59 1389 28 

100 220 32 100 192 48 100 723 36 100 1222 29 100 2357 33 13***;23*** 1 .f;l.$**;2.3*** 13***;2.3*** 

G T 0 G T 0 G T 0 G T 0 G T 0 

2.50 3.0 3.0 1.0 1.0 1.0 3.0 5.0 4.0 1.0 2.0 1.0 1.0 2.0 2.0 

0-18 0-28 0-28 0-13 0-12 0-13 0-31 0-77 0-77 0-14 0-20 0-20 0-31 0-77 0-77 

3.39 3.67 3.58 1.73 2.15 1.95 4.19 8.23 6.77 1.59 2.45 2.20 2.64 4.24 3.71 

3.29 3.72 3.59 2.10 2.81 2.50 4.60 8.83 7.82 1.95 2.66 2.50 3.43 5.93 5.29 

Obtained from NCIC records, Table 8.5 presents prior criminal history 

information for drug court participants at each site. Overall, the majority of participants 

(82%) had one or more prior arrests with a median of two and range between 0 and 7712. 

Among participants with prior arrests, 23% had only one prior arrest and the remaining 

59% had two or more prior arrests. The median number of prior arrests at each site 

ranges &om a low of one to a high of four. 

1 

As expected, the largest percent of participants with no prior arrests were fi-om 

Jackson County (22%) and Creek County (35%) where some program tracks focus on 

first and second time offenders. And, the number of arrests prior to entering drug court 

are negatively associated with graduation at both the Bakersfield and Jackson County 

drug courts. The Creek County and St. Mary Parish drug courts, however, show few 

differences in the number of prior arrests by completion status. 

This data presentation excludes the initiating drug court arrest. 

8-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
t 

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TypesofPrior 

Arrests 

Personal 

Propee 

DWmv 

DrugRelated 

Other 

Total % 

N 

I 

, 

St. Mary Parish Creek County t t Bakersfield Jackson County Total $1 

G TOGTOGTOGTOGTO 

15.9 11.7 13.0 10.4 5.0 7.6 9.7 13.7 12.7 9.4 9.3 9.3 11.5 10.4 10.8 

25.1 31.4 29.5 16.5 21.8 19.2 19.1 25.1 23.1 23.5 28.3 27.1 21.3 27.3‘ 25.5 

6.2 4.7 5.2 34.0 23.6 28.7 2.8 3.5 3.2 2.3 2.4 2.4 6.1 4.0 4.7 

35.5 40.2 38.8 32.8 42.3 37.7 56.4 47.7 50.7 58.6 53.3 54.7 52.8 49.6 50.6 

17.3 12.4 13.6 6.3 7.3 6.8 8.9 11.0 10.3 6.2 6.6 6.5 8.3 8.6 8.5 

100 100 100 100 100 100 1002 100 100 100 100 100 100 1001 100 

70 50 220 93 99 192 62 461 723 354 868 1222 ‘4779 578 2357 

Integrity of Drug Court Program Operations and Protocols 

The drug court provides a programmatic process to address the chronic nature of 

addiction through drug testing, sanctions, -frequent status hearings and treatment. 

Goldkamp et. al. (2001) and Belenko (2001 :22) argue that more information is needed 

about these functional components of drug court operations to learn how clients, sta 

and organizational factors interact to affect client and system outcomes. By assessing the 

integrity of several program fidelity measures, this section of the chapter examines the 

“black box” of the drug court model. In three key areas, policy level descriptions of drug 

court program protocols are measured against actual drug court practices among both 

terminated participants and program graduates. These fidelity measures include: program 

duration, drug testing and treatment attendance requirements. Findings indicate that in 

some jurisdictions there are gaps between drug court programs as designed and drug 

court program in operation that may pose a challenge to the integrity of those programs. 

Drug Court Attendance Requirements 

As described in Chapter 3, potential drug court participants are informed about 

various program performance expectations including the length of the program. Table 

8.7 compares policy level descriptions of the length of the four drug court programs with 

how much time participants actually spent in drug court. Overall, program participation 

ranges fiom one day to forty-five months with a median participation length of eleven 

months. As expected, participation is positively associated with program completion 

status. The 779 graduates took a median of fourteen months to complete the program 

with a range between three months and forty-five months. Median length for the 1578 

8-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
i 

I 

I 

1 

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I 

1 

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a 

Length of 

1 

6 

I 

I 

I 

I 

I 

I 

I 

St. Mary Creek Bu kersjield Jackson Total 

Parish County County 

15 month 3,6,9, & 12 months 12 months 12 months 

terminated participants was eight months and ranged between one day and forty-four 

months. Overall, participants who successfblly complete the drug court did so in about 

14 months (median) or 15.7 months (mean). 

Table 8.7 Cross-site Comparisons of Drug Court Attendance 

Program I 

Actual IG T 0 G T 0 G T 0 G T 0 G T 0 

Attendance 

Range in 

Months 

Months 

Mean Months 

St. Dev. 

Total N 

Mepian 

9-42 1-44 1-44 3-33 1-36 1-36 6-33 1-42 1-42 6-45 1-43 1-45 345 144 1-45 

20 7.7 11 12 6 10 14 6 10 14 9 12 14 8 11 

20.9 9.8 13.3 12.6 8.8 10.6 14.6 8.1 10.5 16.4 11.0 12.6 15.7 9.9 11.8 

8.1 8.0 9.4 5.7 7.1 6.7 4.4 6.6 6.7 6.0 7.3 7.4 6.1 7.3 7.4 

70 150 220 93 99 192 262 461 723 354 868 1222 779 1578 2357 

G=Graduated T=Terminated O=Overall 

Table 8.8 examines this same data differently. It compares policy level 

descriptions of the intended or scheduled length of the drug court program with the 

percent of time participants actually spent in the program. Differences in the amount of 

time spent in drug court by completion status are shown as a percentage of the scheduled 

program length. Terminated participants attended, on average 67% (median) of the 

program’s scheduled length before they were discharged. In contrast, graduates 

completed the program in 1 17% (median) of the program’s intended scheduled length. 

disparities, in the amount of time it takes Participants to complete the drug court 

programl3. The amount of time taken by a third of the participants to complete the 

program exceeds program protocols. In fact, 38% of the graduates completed the 

program only afier participating for more than 125% of the program’s scheduled time. 

There are cross-site variations in completion dserentials exceeding 125% that range 

fiom 30% of the graduates at Bakersfield to 61% of the graduates at St. Mary Parish. 

scheduled time. The percent of graduates completing the program in less than 76% of the 

scheduled time ranges fiom 2% in Jackson County to 13% at St. Mary Parish. 

These findings also suggest that a significant number of people are terminated 

fiom drug court after having participated for an amount of amount of time that exceeds 

the intended length of the program. In fact, 18% of the terminated participants were 

unsuccessfblly discharged fiom the program after attending more than 125% of the 

program’s scheduled length. The percent of terminated participants attending more than 

125% of the scheduled program length ranges from 14% at St. Mary Parish to 23% at the 

Jackson County drug court. Findings indicate that at each of the four drug courts, the 

It is important to note that these findings indicate broad variations and, perhaps, 

In addition, a few graduates (5%) completed the program in less than 76% of the 

l3 There are many legitimate reasons for overriding program protocols. Here, it is the number of overrides 

that is at issue. 

8-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
IE 

Program 

Length 

% Scheduled 

Len@ 

0-25% 

26-50% 

51-75% 

76-100% 

101-125% 

>125% 

% Totals 

Mean% 

Median% 

Range 

N 

, 

SI. Mary Creek Bakersfield Jackson Totals 

Parish County County 

15 month 3,6,9, & 12 months 12 months 12 months 

G T 0 G T 0 G T 0 G T 0 G T 0 

0 17.4 11.8 0 25.3 13.0 , 0 25.2 16.0 0 11.4 8.1 0 16.9 11.3 

0 32.0 21.8 1.1 26.2 14.1 0.4 28.8 18.6 0.3 20.9 14.9 0.4 24.5 166 ' 

12.9 22.0 19.1 9.7 12.1 10.9 3.4 16.7 11.9 2,O 18.6 13.8 4.3 18.0 13.5 

21.4 14.0 14.1 38.7 14.2 20.9 44.7 13.7 18.6 43.7 20.5 18.2 41.5 17.5 25.4 

4.3 0.7 4.1 , 11.8 7.0 14.5 21.7 4.5 17.1 15.0 6.0 17.7 15.9 5.2 * 8.7 

61.4 14.0 29.1 38.7 15.2 26.6 29.8 1,l.l 17.8 39.0 22.6 27.3 37.9 J7.9 24.5 

100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 

139% 65% 88% 127% 75% 100% 122% 68% 87Yo 137% 92% 104% 131% 81% 98% 

133% 53% 73% 117% 50% 100% 117% 50% 83% 117% 75% 100% 117% 67% 92% 

280% 293%' 293% 300% 300% 300% 275% 358% 350% 375% 358% 375% 375% 358% 375% 

70 150 220 93 99 192 262 461 723 354 868 1222 779 1578 2357 

60- 7- 7- 42- 8- 8- 50- 8- 8- 50- 8- 8- ~ 42- 7- 7- 

,I ,I 

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m 

I 

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I 

B 

actual length of time clients participated was extended beyond program protocols. 

Overall, 54% of the graduates and 23% of those who were terminated actually attended 

the program for an amount of time that exceeded these standards. 

Table 8.8 Cross-Site Comparisons of the Actual Length Drug Court Program Participation 

Drug Testing Protocols 

As previously discussed in Chapter 3, while a drug testing protocol is in place at 

each of the four sites, there are cross-site variations in the required fiequency of drug 

testing. On the basis of hterviews with court personnel and an examination of the drug 

testing protocol at each site, we calculated the minimum number of drug tests required 

for program completion. Information about the expected number of drug tests required 

by program protocols is summarized in Row 2 of Table 8.9. Drug testing information 

was available for 1935 (82%) of the 2357 drug court participants. 

In order to explore the relationship between the drug testing protocols and actual 

drug testing practices, we calculated the minimum number of drug tests each participant 

was required to receive over the cowse of their program participation with the number of 

drug tests each participant actually received. 

~~ 

Example 

Participation Length: 10 weeks 

Actual Number of Drug Tests Received: 

Number of Drug Tests Required: 2-3 times per Week 

21 tests 

Participation length (10 weeks) x 

Minimum number of tests required per week (2) = 20 Total tests 

Actual Number of Drug Tests (2 1) / 

Minimum Number of Expected Tests (20) = 

Participant received 105% of the expected minimum required tests. 

1.05 

8-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
u 

I 

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a 

Drug Tests 

Percent 

Expected 

Actual % of 

TeStS 

0-25% 

2650% 

51-75% 

76-1000/0 

126-150% 

>1500? 

1O1-125% 

Total % 

I 

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D 

8 

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St. Maw Creek Bakersfield Jackson Totals 

Parish County County 

15 month 3,6,9, & 12 months 12 months 12 months 

G T 0 G T 0 G T 0' G T 0 G T 0 

0 6.8 4.6 0 35.7 19.9 5.4 44.7 29.6 0.9 31.1 21.9 1.8 31.7 21.7 

0 10.1 6.9 16.7 25.5 21.6 27.2 19.5 22.4 8.1 22.5 18.1 13.8 20.6 18.2 

0 18.9 12.8 28.2 21.5 24.4 27.2 13.6 18.9 21.2 14.5 16.6 21.5 15.4 17.5 

1.4 10.1 7.4 38.4 4.0 19.3 15.2 10.3 12.1 26.8 15.5 18.9 22.2 12.8 15.9 

24.3 13.5 17.0 3.8 5.1 3.9 2.1 2.4 2.3 10.3 4.7 6.4 8.8 5.1 6.4 

67.1 27.0 39.9 0 1,0 0.6 14.6 4.8 10.5 11.2 5.0 6.9 18.2 7.2 10.9 

loo loo 100 100 100 100 100 100 100 loo 100 100 loo loo loo 

8.6 13.6 11.4 12.9 8.2 10.3 3.3 4.7 4.2 21.5 6.7 11.1 13.7 7.2 9.4 

I 

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D 

Mean% 

Median% 

Range 

N 

, f 

44 

This method provides a conservative estimate and introduces a control for 

program participation length by projecting the minimum number of drug tests required 

given the amount of time each client participated in the program. 

versus the number required ranges between 0% and 390% and varies both by completion 

status and by jurisdiction. Controlling for the length of program participation, drug court 

graduates have a higher'average drug testing completion rate than terminated participants. 

Findings in Table 8.9 indicate that the average percent of drug tests received 

200% 116% 143% 76% 48% 60% 94% 48% 66% 98% 58% 70% 105% 62% 77% 

180% 110% 136% 76% 37.5% 59% 66% 31% 48% 94% 47% 67% 8W0 48% 65% 

100- 0- 0- 26- 4- 4- 19- 0- 0- 23- 2- 2- 19- 0- 0- 

391% 323% 391% 138% 158% 158% 347% 288% 347% 216% 238% 238% 391% 323% 391% 

70 150 220 78 98 176 184 293 477 321 743 1064 653 1282 1935 

Overall, more drug tests were administered to graduates at the St. Mary Parish 

and Jackson County drug courts than called for by the drug testing protocols of those 

programs. And, fewer than the expected nu&er of drug tests were administered to 

terminated participants at both the Creek County and Bakersfield drug courts. 

who received 70% or more of the drug tests than called for by the drug testing protocol. 

To err on the side of caution, the 70% figure serves as a purely arbitrary but more 

realistic expectation and conservative benchmark for evaluating rninitnum standards of 

program delivery. 

The eighth row'of Table 8.9 presents information on the number of participants ' 

G=Graduated T=Terminated O=Overall 

Overall, 46% of participants received the minimum number of drug tests (70% or 

more) as called for by their respective drug testing protocols. This represents 67% of the 

graduates and 35% of those who were terminated. Variations in the percentage of 

participants who received 70% or more of the expected number of drug tests ranges fi-om 

a high of 100% for graduates at St. Mary Parish to a low of 17% for terminated 

participants at the Creek County drug court. 

8-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

These findings suggest that not all participants receive the number of drug tests 

called for by the program's drug testing protocol. Given that many terminated 

participants were not administered the expected miaimUm number of drug tests they were 

required to receive, future research should address the relationship between participant 

compliance with drug testing protocols and the rationale behind program discharge. 

Treatment Attendance Requirements 

At the centerpiece of the drug court program is the provision of substance abuse 

treatment services. To date, five major studies have been conducted that employ sound 

research methods to explore the efficacy of drug courts, and to measure the services 

delivered to offenders (Harrell, Cavanaugh, and Roman, 1998; Deschenes, Turner, and 

Greenwood, 1995; Goldkamp, White, & Robinson 2001; Peters and Murrin, 1998; 

Gottfiedson et a], 2002). In each of these studies, the percentage of drug court clients 

participating in treatment varied considerably fiom 35 to 80 percent. For offenders 

participating in drug treatment services, the length of time in treatment also varied fiom 

under 30 days to over two years. Deschenes, Turner & Greenwood (1995) found that 77 

percent of the drug court clients in Maricopa County participated in drug treatment. The 

general finding appears to be that the longer the period of time in treatment, the greater 

the likelihood that the offender will graduate fiom drug court. And, more importantly, 

participation in drug treatment reduces the likelihood of rearrest. 

Previous chapters described actual treatment operations and the content of 

treatment sessions. This section of the chapter examines participant compliance with 

treatment attendance protocols. By comparing the minimum number of treatment 

sessions required by the substance abuse treatment protocol at each site against the actual 

number of treatment sessions participants attended, this study begins to explore how 

compliance with treatment protocols in the context of drug courts is related to discharge 

outcomes. 

As used to assess drug testing protocols, this section also employs a 70% 

benchmark to measure minimum standards of program delivery. Table 8.10 examines the 

number of actual treatment sessions attended with the expected minimum number of 

treatment sessions required, controlling for length of program participation. Overall, 

36% of drug court participants attended more than the minimum expected number of 

treatment sessions. However, the rate of treatment session attendance varies both by 

discharge status and by jurisdiction. The rate of treatment session attendance ranges fiom 

25% at Bakersfield to 72% at the St. Mary Parish drug court. As expected, the frequency 

of treatment attendance is positively associated with more graduates (64%) attending a 

greater percentage of the required treatment sessions (70%) than terminated participants 

(24%). The percent of graduates attending 70% or more of required treatment sessions 

range fiom 99% at St. Mary Parish to a low of 37% of graduates at Baker~field'~. 

" It is interesting to also note that some drug court participants graduate fiom the program having 

completed less than 50% of the expected treatment sessions. For example, overall, 18.7% of the graduates 

attended less than 50% of the minimum expected number treatment sessions required to successfiilly 

complete the program (Not shown). 

8-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

+ 

f I 

I 

Actual Number of 

Sessions Attended 

Mean 

st. Dev. 

Median 

Range 

Table 8.10 Comparison of Actual Treatment Attendance with Program Requirements 

26-50% 

5 1-75% 

76- 100% 

I01-125% 

126150% 

>150% 

Total % 

Attended > 70% 

I 

I Mean % 

Median % 

YO Range 

N 

I 

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t 

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D 

St. Mary Parish Creek Counfy BoRmsfield Jackson Corcnty Tot& 

G T 0 G T 0 G T 0 G T 0 G T 0 

115.7 63.0 80.0 , 71.6 41.9 55.9 51.9 21.2 31.7 93.4 16.5 25.0 74.2 28.8 41.9 

38.1 46.5 50.3 20.6 31.2 30.5 22.2 18.4 24.5 41.8 27.9 38.3 37.4 34.2 40.7 

110 52 76 76 36 55 46 16 27 95 4 5 , 72.5 16 30 * 

53- 1-243 1-243 30- 2-131 2-131 22- 0-91 0-120 24- 0-162 0-176 22- 0-243 0-243 

209 t 130 120 176 209 

69 145 214 89 99 188 153 292' 445 41 328 369 352 864 1216, 

0 11.7 7.1 0 16.2 8.5 0 41.1 24.9 0 73.5 55.4 0 45.6 32.4 

0 17.3 11.8 3.4 21.2 12.8 36.6 26.0 30.5 17.1 11.0 15.0 18.7 '18.3 18.4 

2.9 17.9 13.2 14.6 30.3 22.8 31.4 19.2 24.0 12.2 5.7 8.3 19.4 15.2 16.4 

24.6 21.4 22.6 61.8 19.2 39.4 20.2 11.0 14.6 17.0 4.3 7.4 31.2 11.1 16.9 

18.9 14.5 16.1 15.7 8.0 11.7 8.5 1.7 4.2 22.0 3.1 6.6 13.9 5.1 7.6 

20.3 6.2 10.8 3.4 2.0 3.2 3.3 1.0 1.8 17.1 1.8 4.5 8.3 2.4 4.2 

33.3 11.0 18.4 1.1 2.0 1.6 0 0 0 12.2 0.6 2.8'0 8.5 2.1 3.9 

100 100 100 100 100 100 100 100 100 100 100 'loo 100 100 100 

98.6 58.6 72.2 83.1 38.4 59.0 36.6 17.1 25.2 70.7 10.7 22.3 64.5 24.1 35.8 

136% 84% 102% 91% 63% 76% 66% 40% 49% 102% 22Yo 39% 90% 43% 57% 

134% 77% 96% 91% 57% 81% 58% 33% 47% 103% 5% 17% 87% 31% 50% 

62- 2- 2- 36- 7- 7- 28- 0- OL 26- 0- 0- 26- 0- 0- 

243% 283% 283% 155% 156% 156% 150% 150% 150% 191% 176% 191% 243% 283% 283% 

69 145 214 89 99 188 153 292 445 41 328 369 352 864 1219 

ninated O=Overall 

These findings suggest that a number of participants complete the drug court 

without having attended the requisite number of treatment sessions called for by program 

protocols. Conversely, there are a number of participants who did not complete drug 

court who attended more than the expected number of treatment sessions. Overall, 24% 

of terminated participants completed more than the 70% of the expected number of 

treatment sessions required and 4.5% attended more than 125% of the treatment sessions 

expected. As in the case of drug testing protocols, future research should address the 

relationship between participant compliance with treatment attendance requirements and 

the rationale behind program discharge. 

New Arrests During Program Participation 

One of the major goals of drug court programs is to reduce criminal offending 

behaviors. Consequently, arrests occurring during participation in drug court (in-program 

arrests) are considered serious ir&actions of the drug court contract. The data collection 

time-fiame allowed researchers to obtain information about in-program arrest activity 

occurring between the date of admission through the date of program discharge. 

Obtained fiom NCIC records, Table 8.1 1 presents information on the incidence of arrests 

during drug court participation. 

8-12 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
m 4 

Number of InArrests 

1)None 

2)One 

3) Two or More 

Total 

I...- 

i 

% G T-Tes{?ig. *** 

Overall, 33% of participants were arrested one or more times during their 

participation in drug court. A total of 17% ofparticipants were arrested once and, 

St. MaJy Parish Creek County Bakersfield Jackson County I Total 

% N Yo G Yo N%G% N%G% N%G%N%G 

87 191 34 85 163 51 46 335 62 73 ’ 892” 35 67 1581 42 

12 27 22 I1 21 33 27 196 20 12 150 23 17 394 22 

1 2 0 4 8 38 27 192 7 15 180 4 16 382 7 

100 220 32 100 192 48 100 723 36 100 1222 29 100 2357 33 1.y**;]~***;2.f* 1 .y;] 3***;23*** 1 .y*;13***;23*** 

16% 

I 

.I 

‘I 

were arrested two or more times. There are cross-site variations in the percent of 

participants with in-program arrests and the fiequency of arrests. A higher percent of 

participants at the Bakersfield drug court (54%) had in-program arrests and Bakersfield 

participants had the highest rate (27%) of multiple (two or more) in-program arrests. 

Fewer participants at the two rural sites have in-program arrests and they have the lowest 

rate of multiple arrests. The percent of participants with in-program arrests ranges fiom 

13% at St. Mary Parish and 15% at Creek County to 27% at Jackson County and 54% at 

the Bakersfield drug cburt. , 

Factors Associated with In-Program Recidivism I 

I 

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6 

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Step-wise logistic regression models are employed to test the combined effect of 

participant characteristics, drug test results and treatment attendance on in-program 

recidivism at each site. These multivariate models complement the bivariate analyses , 

presented thus far by assessing the salience of each factor among control variables. The 

high degree of collinearity among many of the independent variables necessitates the use 

of the stepwise method. Separate models are estimated for each site as variations in 

missing cases prohibit the inclusion of all variables at all four sites. In-program arrest 

serves as the dependent variable of interest. Those not arrested are coded “0” and those 

who were arrested one or more times during program participation are coded “1 .” The 

logistic regression models predict the odds of arrest vs. no arrest at each site. 

Table 8.12 presents the step-wise logistic regression results for the odds of inprogram arrest at each of the four sites. Beginning with the St. Mary Parish program, we 

fhd no variables were significant in predicting the likelihood of in-program recidivism. 

In the Creek County drug court, only one variable is specified. Those participants who 

reported life-time use of amphetamines are 3.1 times more likely to be arrested during 

drug court participation than those participants with did not report use of amphetamines. 

With only one variable sigmficant, the model is quite weak with only 3.3% of the 

variance in in-program recidivism explained. 

8-13 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 8.12 Odds Ratios from the Stepwise Logistic Regression of In-Program Arrests on 

Participant Characteristics and Compliance Measures' 

Dem ogaphics 

Female (male = 0) 

Race (Caucasian = 0) 

Age 20 - 29 (Less than 20 = 0) 

Age 30 - 39 (Less than 20 = 0) 

Age 40 + (Less than 20 = 0) 

On or More Dependents (None = 0) 

High School Graduate (Less than High School = 0) 

Employed at Admission (Not Employed = 0) 

Marital Status (Not Married = 0) 

History 

Ever used Alcohol (No Use = 0) 

Ever used Marijuana (No Use = 0) 

Ever used CracWCocaine (No Use = 0) 

Ever used Methamphetamines (No Use = 0) 

Ever used Opiates (No Use = 0) 

Ever used Other Substances (No Use = 0) 

Received Prior Treatment (No Prior Tx = 0) 

One or Two Prior Arrests (No Arrest = 0) 

Three or More Prior Arrests (No Arrest = 0) 

Age at First Arrest (Log) 

Age at First Use 

Compliance 

Percent Positive UA .01 thru .08 (None = 0) 

Percent Positive UA .09 thru .28 (None = 0) 

Percent Positive UA .29 thru 1 .O (None = 0) 

Percent Tx Attendance (Actual/Expected Minimum) 

Constant 

Cox & Snell R2 

N 

St. Mary Creek BakemjZeld Jackson 

Parish County ' County 

OR - OR - OR - OR 

b 

ns 

ns 

ns 

ns 

ns 

ns 

b 

b 

b 

b 

ns 

b 

b 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

.147'** 

b 

219 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

b 

b 

b 

b 

ns 

3.10' 

ns 

ns 

ns 

ns 

ns 

ns 

b 

b 

ns 

ns 

ns 

-082"' 

.033 

191 

ns 

ns 

ns 

ns 

ns 

0 

C 

334"' 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

1.93'" 

.632*' 

ns 

.308*" C 

1.60' 

2.70-* 

.267'*' 

5.37". 

79.97"' 

* 120 

723 

ns 

ns 

ns 

ns 

S32" C 

C 

C 

C 

C 

C 

C 

C 

C 

C 

C 

ns 

ns 

.435*'* C 

ns 

ns 

1.36' C 

3.93 

.027 

1221 

e.. pc.001, **p<.OI, *p<.05; twetailed tests 

Variables not tested in model due to low cell counts. 

Variables not tested due to high percentage of missing cases. 

ns-Not Significant 

8-14 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 

1 

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Unlike the previous two sites, several variables are significant in predicting the 

odds of in-program arrests at the Bakersfield drug court. First, those who were employed 

at the tihe of their admission to the drug court are nearly two times (inverse of 34) less 

likely to recidivate during drug court participation than those who were not employed. 

Second, those who received prior substance abuse treatment are nearly two times more 

likely to have in-program arrests than those receiving treatment for the first time. And, as 

age at first arrest increases, the likelihood of in-program recidivism decreases. Increases 

in the fiequency of positive drug tests also increases the odds of in-program vests. And, 

as treatment session attendance increases, the likelihood of in-program recidivism 

decreases. Overall, 12% of the variance in in-program recidivism is explained at the 

Bakersfield site. 

predicting the odds of in-program arrests. Participants aged 40 and older are nearly twotimes (inverse of .532) less likely to recidivate during program participation than those 

who are younger. As in the case of the Bakersfield drug court, as age at first arrest 

increases, the likelihood of in-program recidivism decreases. Lastly, fiequent percent 

positive drug tests increases the likelihood of in-program recidivism by 1.36 times. 

Overall results of the analysis indicate that there is no one common predictor of 

in-program recidivism across sites. Those factors found to be predictive of in-program 

recidivism are mixed and site-specific. The most common predictor, age at first arrest 

and positive drug tests, were specified at both the Bakersfield and Jackson County drug 

courts. At both sites, as age at first arrest increases, the likelihood of in-program 

recidivism decreases. And, participants with fiequent positive drug screens are more 

likely to have in-program arrests. 

With respect to the Jackson County drug court, three variables are sign%cant in 

Positive Drug Tests During Program Participation 

The requirement of abstinence fkom the use of alcohol and drugs is a core 

component of drug court programs. Frequent, random, and monitored drug testing is one 

of the Key Components of drug courts. However, other studies have not generally 

reported information about in-program drug use. Drug testing information presented here 

was available for a total 1942 drug court participants. (See Chapter 3 for a description of 

the drug testing protocols at each site.) 

The relationship between positive drug tests and program completion is presented 

in Table 8.12. Overall, 76% of the participants tested positive one or more times for drug 

use during program participation. Among those participants testing positive, the median 

number of positive drug tests is 4 and ranges between 1 and 47. 

There are both variations in positive drug tests by completion status and cross-site 

variations in the rate of positive drug tests. The percent of participants who tested 

positive one or more times ranges fiom a high of 84% in Jackson County to a low of 58% 

in Bakersfield. The median number of positive drug tests ranges from two at the 

Bakersfield drug court to five at the Jackson County drug court. 

County drug court had the highest rate of positive drug tests (27%). The St. Mary Parish 

Overall, a total of 18% of the drug tests administered were positive. The Creek 

8-15 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
drug court, conversely, had the lowest percent positive rate (8%). As expected, Sndings 

in Table 8.13 indicate that testing positive for drug use while participating in drug court is 

negatively associated with program completion. Overall, 50% of those with no positive 

drug tests graduated. For participants with one positive drug test, 30% graduated and 

those with two or more positive drug tests, 28% graduated. This negative association is 

statistically significant overall as well as at each of the four drug court locations. 

Drug Tests 

Table 8.13 Cross-site Comparisons of In-Program Positive Drug Tests I, Number of Positive I St. Mary Parish ' Creek Counv Bakersfield Jackson County Total $3 

% N % G % N % G % N %G % N %G % N %G 

I. 

1) None 

2) One 

3) Two or More 

Total 

% G ANOVA Sig. 

G T 0 G T 0 G T 0 G T ,O' G T 0 

26 57 53 27 47 79 42 201 42 16 170 49 24 475 50 

15 32 19 12 22 36 18 87 26 14 148 34 15 289 30 

59 130 26 61 107 31 40 190 40 70 751 25 61 1178 28 

100 219 32 100 176 44 100 478 38 100 1069 30 100 1942 34 

12***;1 S*** 12**';13*** 12**;2.3* 12'**;1.3***;2.3* 12***;13*** 

I P<.OOI, **P<.Ol, *k.OS;h+tailed tests 

, *** G=Graduated T=Terminated O=Overall 

Percent of Tests 

Positive 

Median 

Range 

Ma 

St. Dev. 

Totals N 

2.4 10.9 8.2 7.3 42.3 26.8 3.9 18.2 12.4 6.4 26.7 20.6 5.4 24.3 17.8 

4.0 3.0 3.0 4.0 4.0 4.0 2.0 2.0 2.0 4.0 5.0 5.0 4.0 4.0 4.0 

5.6 4.6 4.8 4.6 5.7 5.4 3.4 3.4 3.'4 5.1 6.6 6.2 4.7 5.7 5.4 

5.14 4.24 4.48 3.10 5.60 4.96 2.84 3.96 3.59 4.51 5.78 5.50 4.17 5.47 5.15 

40 122 162 41 88 129 99 178 277 238 661 899 418 1049 1467 

1-22 1-25 1-25 1-12 1-35 1-35 1-16 1-34 1-34 1-24 1-47 1-47 1-24 1-47 1-47 

The occurrence of positive drug tests and the occurrence of new arrests are two 

indicators of non-compliance with drug court program requirements. Table 8.13 

examines the interaction between in-program arrests and positive drug tests on program 

completion. 

Overall, 17% of drug court participants had neither an arrest nor a positive drug 

test during program participation. Among the 332 participants who had neither a positive 

test nor an in-program arrest, 62% graduated from drug court and 38% were terminated. 

The majority of participants (5 1 %) only tested positive for drug use but were not arrested. 

Among the 992 participants who only tested positive for drug use, 35% graduated and 

65% were terminated. A total of 7% of drug court participants were arrested during 

participation in drug court but had no positive drug tests. Among these participants, 20% 

graduated and 80% were terminated. And, among the 25% of participants who had tested 

positive and were arrested during program participation, 15% graduated from the drug 

court and 85% were terminated. 

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Overall fhdings from Table 8.14 suggest that participants who abstain fiom drug 

and alcohol use and refiain &om participation in new criminal conduct are nearly three 

times more likely to graduate than those Participants who had a drug court arrest and no 

8-16 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

positive tests, and four times more likely to graduate than those who tested positive and 

were arrested during program participation. 

Table 8.14 New Arrests and Positive Drug Tests by Discharge Status 

St. Mary Parish Creek County Bakersfield JacRson County Totals 

1) Neither Drug Court 

Arrest nor Positive UA 

2) Positive UA andNo 

Drug court Arrest 

3) Drug court hest 

and No Positive UA 

4) Bothmg Court 

Arrest and Positive UA 

Total ’” ’ I % G AMOVA Sig. 

p<.OO1, **p<.Ol, *p<.05 1 Waduated *** T=Tmini , 

?! 

% N %G Yo N %G % N %G % N %G Yo N %G 

23 51 53 24 43 79 21 100 72 13 138 54 17 332 62 

63 139 27 61 106 33 21 100 67 60 647 32 51 992 35 

3 6 50 2 4 75 21 101 13 3 32 31 7 143 20 

11 23 I3 13 23 26 37 177 18 24 252 I1 25 475 15 

100 219 32 100 176 44 100 478 38 100 1069 30 100 1942 34 

two-tailed tests 

ted Wverall 

Factors Predictive of Graduationflerrnination 

Step-wise logistic regression models are employed to test the combined effect of 

participant characteristics and program compliance measures on graduation at each of the 

four sites. These multivariate models complement the bivariate analyses presented thus far 

by assessing the salience of each factor among control variables. The high degree of 

collinearity among many of the independent variables necessitates the use of the stepwise 

method. Given that drug court graduation is largely a hction of compliance with drug 

court protocols, the relationship will be explicitly tested in the models in order to ascertain 

which aspects of compliance are most critical. Further, participant characteristics 

significant in these models among program compliance measures will play a crucial, 

independent role. Successful completion of the drug court program (graduation) serves as 

the dependent variable of interest. Graduation is coded “1” and program termination is 

coded “0.” The logistic regression models predict the odds of graduation versus 

termination at each of the four sites. The three compliance indicators include positive 

urinalysis, arrests during drug court participation, and treatment attendance measures. 

While compliance with program requirements of the drug court are the most 

important factors associated with graduation, some participant characteristics also play a 

significant role. However, the findings are site specific. At one site, graduation is 

predicted by treatment attendance and clean drug tests suggesting a positive drug court 

effect. At other sites, characteristics of participants at entrance to the drug court program 

such as more serious criminal records and extensive treatment histories are associated 

with termination 

8-17 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 8.15 Odds Ratios from the Stepwise Logistic Regression of Graduation on Participant 

Characteristics and Compliance Measures' 

Demographics 

Female (male = 0) 

Race (Caucasian = 0) 

Age 20 - 29 (Less than 20 = 0) 

Age30-39(L.essthan20=0) 

Age 40 + (Less than 20 = 0) 

On or More Dependents (None = 0) 

High School Graduate (Less than High School = 0) 

Employed at Admission (Not Employed = 0) 

Marital Status (Not Married = 0) 

History 

Ever used Alcohol (No Use = 0) 

Ever used Marijuana (No Use = 0) 

Ever used CracWCocaine (No Use = 0) 

Ever used Methamphekmines (No Use = 0) 

Ever used Opiates (No Use = 0) 

Ever used Other Substances (No Use = 0) 

Received Prior Treatment (No Prior Tx = 0) 

One or Two Prior Arrests (No Arrest = 0) 

Three or More Prior Arrests (No Arrest = 0) 

Age at First Arrest (Log) 

Age at First Use 

Compliance 

Failure to Appear (No=O) 

Percent Positive UA -01 thru .08 (None = 0) 

Percent Positive UA .09 thru .28 (None = 0) 

Percent Positive UA .29 thru I .O (None = 0) 

Percent Tx Attendance (ActuaVExpected Minimum) 

Drug court Arrest (No = 0) 

Constant 

Cox & Snell R2 

N 

St. Maty Creek Bakersfield Jackson 

Parish County County 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

b 

b 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

b 

b 

ns 

-244"' 

.195"' 

ns 

1 1.29"' 

.084"' 

.244 

219 

- OR 

Ns 

Ns 

NS 

NS 

Ns 

Ns 

2.90'" 

NS 

Ns 

Ns 

Ns 

Ns 

Ns 

Ns 

.391' 

Ns 

Ns 

Ns 

Ns 

b 

b 

Ns 

Ns 

Ns 

44.02"' 

.033"* 

.25 1 

191 

b 

- OR 

ns 

riS 

ns 

ns 

ns 

c 

C 

ns 

ns 

ns 

ns 

1.56' 

ns 

0.56' 

ns 

.254-* 

ns 

-473"' 

ns 

C 

.105*'* 

.072"' 

2.68"' 

ns 

21.74"' 

b 

.648 

.362 

723 

- OR 

ns 

-620" 

ns 

ns 

ns 

c 

C' 

C 

c 

C 

c 

C 

C 

c 

C 

c, 

ns 

.489*- 

ns 

C 

.1w" 

.196**' 

3.88'" 

ns 

.092**' C 

1.47" 

.330 

1221 

*.. p<.001, **p<.OI, *p<.05; two-tailed tests 

bVariable~ not tested in model due to low cell counts. 

ns-Not Significant 

Variables not tested due to high percentage of missing cases. 

8-18 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 8.1 5 presents the step-wise logistic regression results for the odds of 

graduation at each of the four sites. At the St. Mary Parish program, three program 

compliance measures are significant in predicting the likelihood of graduation. As 

expected, participants that do not have any positive drug screens are four times (inverse 

of .244) and 5 times (inverse of. 195) more likely to graduate than those who test positive 

either in the “low” or “moderate” range. The model also reveals the importance of 

treatment attendance on graduation outcomes. As expected, participants who attend 

treatment sessions are more likely (1 1.3 times) to graduate fkom drug court. A total of 

24% of the variance in program graduation is explained in this model. 

Turning to an kxamination of the Creek County drug court, we find 3 variables 

sigmfkant in predicting the likelihood of graduation. As in the case of the St. Mary 

Parish drug court, treatment attendance has a strong positive impact upon graduation. 

The more treatment sessions attended, the more likely the participant will graduate. 

Participants who had received prior substance abuse treatment are less likely to graduate 

than those receiving treatment for the first time. Participants who never received any 

prior treatment are 2.55 (inverse of -391) times more likely to graduate. Those 

participants who had an educational level equivalent to a minimum of a high school 

diploma or GED are 2.9 times more likely to graduate than those who had less thanma 

high school education. Overall, this model explains 25% of the variance in graduation at 

the Creek Counky Drug Court. 

With respect to the Bakersfield program, several program compliance measures 

and participant characteristics are sigdicant in predicting the likelihood of graduation. 

Turning to compliance measures, participants in the Bakersfield Drug Court who attend 

treatment sessions are also more likely to graduate. Participants with one or more inprogram arrests are 13.9 (inverse of .072) times less likely to graduate than those who 

had no arrests during program participation. Similar findings pertain to those 

participants arrested for Failure to Appear. These participants are nearly 10 times less 

likely to graduate. Interestingly, participants with “low” percent positive tests are 2.7 

times more likely to graduate than participants with no positive drug screens. 

Characteristics of participants at entry to the program are also related to program 

completion. First, participants who had ever used opiates are 1.8 (inverse of .56) times 

less likely to graduate than participants with no prior history of opiate use. Similar to the 

Creek County drug court, participants having had prior substance abuse treatment has a 

negative effect. Participants with no prior treatment are 3.9 times (inverse of 254) more 

likely to graduate than participants who had prior substance abuse treatment. Third, 

participants with three or more prior arrests are over 2 times (inverse of .473) less likely 

to graduate than those participants with no prior arrests. The last demographic variable 

pertains to life-time history of cracklcocaine use which has a positive effect on the 

likelihood of graduation. Participants with a prior history of crackkocaine use are 

slightly over one and a halftimes more likely to graduate than those participants with no 

history of crackkocaine use. Overall, 36% of the variance in graduation at the 

Bakersfield Drug Court is explained. 

The Jackson County drug court program has seven variables significant in 

predicting the likelihood of graduation. First, non-white participants are 1.6 (inverse of 

-620) times less likely to graduate fiom the program than white participants. Second, 

8-19 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 0 

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participants with three or more prior arrests are 2.04 (inverse of .489) times less likely to 

graduate than participants with no prior arrests. Also similar to the Bakersfield drug 

court, participants with positive drug screens are 3.88 times more likely to graduate than 

those participants that had no positive drug screens. This positive effect is reversed, 

however, for participants who had positive urinalyses. As expected, these participants 

are nearly 1 1 times less likely to graduate than participants with no positive drug screens. 

And lastly, participants with one or more in-program arrests or one or more arrests for 

Failure to Appear are 5.1 times (inverse of -196) and 9.2 times (inverse of .109) less 

likely to graduate than those who had no arrests during program participation 

respectively. Unfortunately, due to missing cases, the percent treatment attendance 

variable is omitted fiom this model. However, the model is fairly robust with 33% of the 

variance in discharge outcomes explained. 

Summary 

This chapter focused on how key components of the drug court model and how 

compliance with the performance expectations of the drug court are associated with 

discharge outcomes. The chapter also addressed several issues about the integrity of the 

drug court model by comparing program protocols with actual drug court operations. In 

order to assess whether the drug court program was delivered as intended, program 

protocols were compared with actual drug court operations at each of the four sites. Some 

gaps were found between drug court programs as designed and actual program operations 

that pose a challenge to the integrity of these programs. 

Although the overall mean length of attendance in drug court was within 98% of 

the scheduled length of the program, the amount of time some participants were in drug 

court exceeded the program's intended length. In each of these four drug courts, the 

length of the drug court program was extended. For example, about 25% of the 

participants were discharged fiom the program after attending more than 125% of 

scheduled program length. They represent 38% of the graduates and 185 of the 

terminated participants. While it appears that these drug courts are attempting to be 

flexible in tailoring program requirements to their clients, given the absence of data, it is 

unclear what criteria are used in making individual case decisions that override program 

requirements. 

Actual compliance with drug testing protocols and compliance with treatment 

session attendance requirements also varies considerably among the four drug courts. 

Moreover, lack of compliance with these requirements is directly related to program 

completion. Offenders who did not provide the requisite number of drug tests or failed to 

appear for treatment sessions are more likely to be unsuccesshlly terminated fiom the 

program. Regarding treatment attendance, most of the offenders whose cases result in 

termination were Sequent attendees of treatment sessions. 

This chapter also examined whether compliance with the program requirements of 

the drug court program was associated with program completion. Adherence to program 

requirements should be expected and were found to be related to program completion. Inprogram arrests and positive drug tests were negatively related to program completion. 

Overall, 76% of the participants tested positive for drug use one or more times and 33% 

8-20 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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were arrested during their participation in drug court. As expected, positive drug tests and 

in-program arrests are both associated with being terminated fiom the program. A total 

of 15% of those with in-program arrests and 30% with one or more in-program positive 

drug tests graduated fiom the program. Put differently, these drug court programs expect 

adherence to program requirements as a condition of remahhg in the program 

Participants terminated fiom the program are two to three times more likely to test 

positive for drug use and four to five time more likely to be arrested during their 

participation than those who successfilly complete the program through gradpation. 

The findings reported here are similar to those reported by Goldkamp et. al. 

(2001) as they are mixed and site specific. Although not designed to assess the “success” 

or impact of drug court programs, the findings indicate that both key components of the 

drug court model and characteristics of participants were associated with program 

4 graduation and termination. Overall, results of the regression analyses indicate that 

compliance with program protocols (attendance at treatment, no drug use and no new 

criminal conduct) are the most important factors associated with program graduation. 

We these results are largely expected, there are a several patterns that emerge from 

these analyses that may bear hrther exploration. At two sites (Bakersfield and Creek 

County), it was found that participants with a history of prior substance abuse treatment 

are less likely to graduate than participants who are receiving treatment for the first time. 

The second pattern that emerges concerns participants serious criminal histories. At the 

two urbab locations (Jackson County and Bakersfield), it was found that these 

participants are also less likely to succeed in drug court. Combined, these patterns 

suggest that some drug court programs may have dficulty in dealing with participants 

presenting more severe drug using and criminal behaviors. 

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8-2 I 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 9 

Cross-site Comparisons of Rates of Post-Program Recidivism 

Overview 

The major goal of drug court programs is to reduce the recidivism of drug involved 

offenders by changing' their drug using habits. This chapter provides information about 

rates of post-program recidivism at each of the four drug courts and identses factors 

associated with new criminal activity. Although a growing body of research literature 

consistently indicates positive results for drug courts across studies, questions remain as to 

what outcomes are most important and which factors affect those outcomes (Belenko, 

2001; Peters, et. al 1999; Goldkamp, et. al. 2001). 

In 1997, the U.S. General Accounting Offices (GAO) suggested that fbture research 

on drug courts should be designed to include comparisons between recidivism rates of drug 

court participants with those of a control group of offenders. As of 2001, Belenko reported 

that only six of the 37 studies he reviewed provided such information and only three studies 

distinguished between in-program versus post-program recidivism. More recent 

evaluations reporting such information include: Chester County, Pennsylvania (Brewster, 

2001); Multnomah County, Oregon (Goldkamp et. al. 2001); Clark County, Nevada 

(Goldkamp et. al. 2001); Baltimore City, (Gottfiedson, 2003); and, Ohio (Latessa et. al. 

2002). While hdings reported by these studies vary, the literature consistently indicates 

that recidivism rates for drug court participants are lower than comparison groups during 

the same follow-up period. 

with recidivism (Harrell, et. al. 1998; Peters, 1999; Goldkamp, 2001 ; and, Latessa, 2002). 

They found both program and participant characteristics were related to recidivism. 

Participant characteristics include: prior criminal record, prior treatment history, age, ' . 

ethnicity, gender, and marital and employment status. Lower rates of recidivism were 

found among participants who were married, Caucasians, and participants with minor arrest 

histories. Factors associated with higher rates of recidivism include: participants whose 

primary substance abuse problem is cocaine, younger participants, and African Americans. 

Program characteristics found to be associated with recidivism include sanctions, 

drug testing outcomes, and treatment attendance (Goldkamp, et. al. 2001). Lower rates of 

recidivism were found among program graduates and participants with higher rates of 

treatment attendance. As expected, higher rates of recidivism were found among 

participants with in-program arrests, higher in-program drug tests and among those 

terminated. 

rates of recidivism for participants with certain characteristics, who participate in treatment 

and who successfblly complete the drug court program. These studies, however, are 

limited both in scope and consistency. For example, there are variations in how recidivism 

is defined as some studies do not distinguish between in-program and post-program 

I 

Several studies have used multi-variate techniques to examine factors associated 

Consequently, the picture that seems to emerge is that drug courts result in lower 

. 

9- I 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

recidivism. And, time-fiames during which recidivism is measured varies across studies. 

Further, the use of experimental or quasi-experimental designs is the exception rather than 

the rule. As a result, the findings reported by these’studies are generally mixed and site 

specific. They have been unable to address questions of program impact. Although such 

problems may reflect constraints imposed on research projects and requirements of finding 

agencies, they do limit the generalizability of the findings and the ability to demonstrate 

whether drug courts arq an effective tool to reduce recidivism. 

As discussed in Chapter 2, the current study was not designed to assess whether 

drug court programs are more successhl than traditional adjudication or other programs 

with the efficacy of the treatment delivery system as it pertains tQ drug courts. This study 

does, however, allow us to examine how some of the key components of drug court 

programs are related to post-program recidivism. It distinguishes between in-program 

versus post-program arrests and incorporates a fixed twelve month post-program follow-up ’ 

to examine rearrest activity. Other studies have failed to make even these distinctions 

(Belenko, 2001). 

activity among drug court participants at four drug court sites. By using bivariate and 

multivariate techniques, the goal of the chapter is to assess how variatiohs in recidivism 

rates are related to differences among participant characteristics, various program 

compliance requirements such as drug use and treatment attendance, as well as program 

completion status. 

Overall, findings in this chapter indicate that program completion status is one of 

the most important factors associated with post-program recidivism For three drug 

courts in this study, program “success” (graduation) in drug court is related to “success” 

(no arrests) in the twelve month post-program follow-up. Interestingly, at the one site 

where completion status was not a significant predictor of recidivism, the low overall rate 

of recidivism found there was related to the high overall rate of treatment attendance. 

The chapter is organized as follows. The next section discusses methods and the, 

time-fiame of the analysis. This is followed by a comparison of overall recidivism rates at 

each of the four sites. This includes a discussion of the timing to first arrest as well as the 

types of arrest offenses that occurred. By using bi-variate cross-tabular analyses, the third 

section examines factors associated with new criminal conduct. Multivariate logistic 

regression and structured equation models are introduced in the final sections of the chapter 

so as to identi@ to the most salient factors related to recidivism at each site. 

and hence, did not utdze comparison or control groups. The current study is concerned 4, 4 

This chapter, then, provides an opportunity to examine some rare data about,rearrest 

Methods 

As descriid in Chapter 2, arrest data was obtained fiom NCIC for 2357 

participants discharged between January 1,1997 and December 3 1,2000. Data was 

collected for each participant who either graduated or was terminated and had at least 

twelve months time-at-risk beyond their date of program discharge. A fixed time-fiame of 

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I 9-2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
twelve months post-program follow-up is used to describe rates of post-program arrests’5. 

For example, a participant discharged on January 1, 1998 was tracked for 12 months until 

December 3 1, 1998 to identif) whether an arrest had occurred. 

Stepwise logistic regression models are employed to test the impact of participant 

and program characteristics on post-program recidivism at each of the four sites. Postprogram arrest serves as the dependent variable of interest. Those not arrested are coded 

“0” and participants who were arrested one or more times after program discharge are 

coded “1 .” The regression models predict the odds of arrest vs. no arrest at each site. 

The last section of the report also provides structured equation models for each drug 

court program. Here, the research integrates all of the previous findings (factors associated 

with drug court graduation and post-program recidivism), in order to provide a more 

complete, holistic picture of sigdcant relationships by simultaneously considering the 

explanatory effects of multiple variables. 

90.0 - 

80.0 - 

70.0 - 

Fixed 12-Mon th Follow-Up Post-Program First Arrests 

60.0 - 

Overall, findings indicate that 3 1% of the 2357 participants had one or more arrests 

during the twelve month post-program follow-up. Recidivism information is presented for 

each of the sites in the study in Figure 9.1 and Table 9.1. Findings indicate cross-site 

variations in the percent of participants rearrested. Recidivism rates range from a low of 

17% at St. Mary Parish to a high of 39% at Bakersfield. 

Figure 9.1 12-Month Fixed Follow-up Post-Program Arrests Outcomes 

53.4 

St MaryParish Creekcounty Bakersfield Jackson County TOM 

t3 Graduated E4 Terminated m Overdl 

~ ~ ~~ 

’’ The actual amount of time between participant discharge and the collection of recidivism data is of course variable 

and ranged between I2 months and 63 months. 

9-3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
These recidivism rates are'consistent with those reported elsewhere and fall within 

the range of rearrest rates reported in those studies. For example, Belenko (2001) reports 

recidivism rates for four drug court programs range between 12% and 45% during a 24- 

month follow-up period. Post-program recidivism rates reported in this study, however, are 

lower than those reported by Latessa (2002). Latessa reports post-program recidivism rates 

of 41% for Ohio's felony drug courts and 32% for Ohio's misdemeanor drug courts. 

Recidivism rates for the programs in this study are also lower than reported for Baltimore 

City (see Chapter 1). 

NoArrests 

E 

The most significant factor associated with variations in recidivism rates in this 

study is program completion status16. Simply stated, only 73 of the 779 graduates from 

these drug court programs were involved in a criminal offense leading to an arrest within 

one year after graduation. And, program graduates have substantially lower rearrest 

I activity than terminated participants. Similar findings have been reported by Finnegan 

<,I 998), Peters (I 999) and Goldkamp (200 1). Referring to Figure 9.1, a greater percentage 

of terminated participants were rearrested during the post-program follow-up than 

graduates. Overall, 41% of terminated participants and 9% of graduates were rearrested. 

Differences by discharge status are statistically significant across all four sites. 

recidivism for both graduates (6%) and terminated participants (22%). Conversely, the 

Bakersfield drug court has the highest rate of recidivism for both program graduates (1 3%) 

and terminated participants (53%). Table 9.1 (below) reports recidivism rates by 

completion status. Of the 722 arrested participants, 90% of those arrested were terminated 

and 10% were program graduates. Arrested program graduates range fiom a low of 7% at 

the Jackson County drug court to a high of 20% at Creek County. These findings indicate 

that participants who were terminated are more than four times more likely to be rearrested 

than participants who complete the program through graduation. 

In comparison with other sites, the St. Mary Parish drug court has the lowest rate of 

St. Mary Creek Bakersfield Jackson Total 

Parish County County 

% N TOG % N %G % N %G % N %G % N %G 

83.2 183 36 74.5 143 58 61.3 443 51 70.9 866 38 69.4 1635 43 

OneorMore 16.8 37 11 25.5 49 20 38.7 280 12 29.1 356 7 30.6 722 10 

Arrests I 

100 220 32 100 192 48 100 723 36 100 1222 29 I00 2357 33 

3.1.'. 4.8*" I 1.7*** 1 1.4*** 16.6.. 

~.05; two-tailed tests 

G=Gfaduated 

I 

I 

i 

c 

l6 The finding that program completers are less likely than those expelled fiom the program to be arrested in the 

twelve month follow-up is an important substantive finding of some significance. Other possible findings in this regard 

- such as more graduates being arrested than those who were expelled -would seriously challenge the ''SUCC~SS" of 

drug courts for participants. While the finding that propun graduates have fewer arrests than unsuccessll 

completers is important, the interpretation of the meaning of this finding in terms ofoverall program success is debated 

in the literature. For example, Goldkamp (2001 32) argues that in the absence of an experimental design such findings 

merely indicate that the UsucCesses succeed and the failures hi]". 

9-4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 Length of Time to First Arrest 

Median 

Mean 

St.Dev. 

Range 

Several studies report findings that suggest the Zength of time to first post-program 

arrest is important in the assessment of recidivism as an outcome measure (Goldkamp et. 

al. 2001). Table 9.2 presents cross-site comparisons of the average length of time to first 

arrest within the twelve month fixed time-frame. Overall, findings indicate that the 

majority of participants were arrested within the first six months after program discharge. 

The median length of time to first arrest is 4 months with a mean of 4.8 months. The tirne 

of first arrest ranges from 1 day to 12 months after program discharge. 1 

4.0 4.0 4.0 8.5 4.0 5.0 8.0 3.0 3.0 6.0 4.0 4.0 6.0 3.0 4.0 

4.5 4.5 4.5 7.6 4.6 5.3 6.9 4.2 4.5 6.3 4.7 4.0 6.6 4.5 4.7 

1.0 3.14 2.98 3.97 3.04 3.43 3.56 3.66 3.74 3.42 3.49 3.5 3.49 3.51 3.57 

N4 33 37 10 39 49 34 246 280 25 331 356 73 649 722 

44 .13-11 .13-11 .07-12 .23-11 .07-12 .20-12 .03-12 .03-12 .43-12 .03-12 .03-12 .07-12 .03-12 .03-12 

Length of time to first arrest varies by program completion status as the timing of 

arrests for graduates occurs later than it does for participants who were terminated fiom the 

program. Referring to Table 9.2, the median length of time to first arrest for terminated 

participants is 4.0 months in comparison to 6.5 months for graduates. This difference holds 

for three of the four drug courts in the study. The exception is the St. Mary Parish drug court 

where there are essentially no differences in the length of time to first arrest between 

terminated participants and graduates. The greatest difference in the median length of time 

to first arrest between graduates and terminates is at the Bakersfield drug court (5 months). 

I 

I 

I 

Table 9.2 Length of Time to First Post-Program Arrest By Discharge Status 

Months I St. Mary Creek Bakersfield Jackson Total 

i 

Parish County County 

G T 0 G T 0 G T 0 G 'T 0 G T 0 

P 

1 

Overall, findings presented in this section of the chapter indicate that signiscantly 

fewer graduates were rearrested in the post-program follow-up and the timing of the 

arrests occurs later than it does for participants who were expelled fiom these programs. 

- 

In-Program and Post-Program Recidivism 

In Chapter 8, we reported that participants who were arrested during drug court 

(in-program arrests) were less likely than those with no in-program arrests to graduate 

from the program. Belenko (2001) reports that few programs have examined the 

relationship between in-program and post-program recidivism. Are participants with inprogram arrests more likely to recidivate? Cross-site comparisons about the relationship 

between in-program and post-program recidivism are presented in Table 9.3, controlling 

for program completion status. The cell values represent the percent of participants 

arrested. 

I 

I 

9-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

Noh-Program 

Arrest 

InProgram 

Arrest 

chi-:quare 

u 

0 

8 

Table 9.3 Relationship Between In-Program and Post-Program Recidivism 

~ St. Mary Creek Bakersjield Jackson Total 

Parish County County 

G T 0 G T 0 G T 0 G T 0 GT 0 

6.3 24.4 18.3 9.6 31.3 20.2 12.0 52.0 27.2 6.4 29.8 21.6 8.6 32.2 22.3 

0 8.7 6.9 20.0 73.7 55.2 16.7 53.9 48.7 11.6 55.1 49.4 14.2 53.4 47.7 

11.6*** 15.8*** 35.2". 52.0*** 89.9"' 71.04***158.2*** 

I 

Treatment Attendance and Post-Program Recidivism 

Several studies have examined the relationship between treatment attendance and 

post program recidivism. For example, Goldkamp et. al. (2001:53) found that the 

frequency of treatment sessions attended was inversely related to the recidivism rates for 

Las Vegas drug court participants. In this study, treatment attendance information was 

obtained for 1219 drug court participants. Table 9.4 examines the relationship between 

treatment attendance and recidivism, controlling for program completion status. It will be 

recalled from Chapter 8 that a treatment attendance standard of 70% of the minimum 

expected number of sessions was computed for each participant controlling for the length 

of time of drug court participation. The cell values represent the percent of participants 

arrested. 

The findings in this study are consistent with those reported by Goldkamp (2001). 

Controlling for discharge status, Table 9.4 indicates that treatment attendance is inversely 

associated with post-program recidivism. That is, at three of the four sites terminated 

participants who attended less than 70% of the expected treatment sessions were more 

likely to be arrested than terminated participants completing more than the 70% standard. 

Table 9.4 Relationship Between Treatment Attendance and Percent of Post-Program Arrests 

c 

I' 

1 

m 

St. Mary Creek Bakersfield Jackson Total 

Parish Counry County 

G T 0 G T 0 G T 0 G T 0 G T 0 

Lessthan7WhTx 

7WhTxorMorc 

Chi-square 

0 28.3 27.9 0 42.6 34.2 12.6 52.7 41.4 0 39.4 37.8 9.8 43.6 38.3 

5.9 18.8 13.1 12.2 34.2 19.6 10.3 55.8 31.8 13.8 33.3 24.6 10.0 32.2 21.1 

6.7" 5.1' 4.1. 7.2** 37.8'** 

9-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Cba'racteristics of Participants Associated With Post-Program Arrests 

Cross-site comparisons of the relationship between demographic characteristics of 

participants and post-program recidivism are presented in Table 9.5. The cell values I 

represent the percent of participants arrested. Overall, there are few statistically significant 

differences among the four sites in the relationship between participant characteristics and 

the occurrence of new c-al conduct. Significant differences are largely found in the 

Jackson Coun drug court across gender, race, age, marital status and employment 

characteristic8. Other findings are mixed and site specsc. For example, the Creek County 

drug court is the only site where we find that high school graduates are less likely to be 

arrested than non-high school graduates. And fo'r those paiticipants at the Bakersfield and 

Creek County sites, participants with a prior treatment experience are less likely to be 

rearrested than participwts engaging m treatment for the first time. 

Table 9.5 Characteristics of Arrkted Participants I 

Gender 

Male 

Female 

Chi-square 

Nonwhite 

White 

Race 

chi-square 

Agc 

Under 30 

30 and Older 

Chi-square 

Less than HS 

Hs Grad 

Education 

Chi-square 

Not Employed 

Employed 

Chi-square 

Not Married 

Manied 

Chi-square 

No Dependent 

Dependents 

Employment 

Marital Status 

Dependents 

chi-square 

Prior Tx 

No Prior Tx 

Prior Tx 

St. Maw Creek Bakersfield Jackson Total 

Parish' County County 

G T 0 G T 0 G T 0 G T OtG T 0 

5.6 

6.3 

9.1 

6.5 

5. I 

7.0 

3.7 

4.8 

7. I 

6.7 

10.3 

2.9 

8.6 

1, 

21.3 

25.0, 

23.7 

20.3 

22.8 

21.1 

20.4 

25.0 

20.8 

25.0 

21.6 

27.3 

21.9 

22.2 

26.6 

16.9 

16.5 12.7 39.7 26.8 10.5 56.9 41.0 

18.2 5.3 38.1 22.5 14.9 50.0 36.7 

17.6 5.6 54.5 32.5 16.2 52.9 41.0 

16.1 12.0 35.1 23.7 11.7 53.6 37.7 

18.2 12.5 40.4 29.1 17.0 56.3 41.7 

15.5 9.8 38.5 23.0 10.7 51.8 37.1 

16.3 16.7 42.6 33.8 13.6 52.2 38.5 

17.7 8.7 36.5 20.7 10.2 59.7 39.7 

4.1. 

16.2 6.7 29.3 19.7 12.5 50.9 40.7 

18.1 12.7 46.6 28.9 13.8 53.4 33.5 

17.1 11.4 42.9 27.9 12.9 52.8 37.9 

14.3 8.7 23.8 15.9 13.2 55.7 42.9 

18.5 10.5 39.0 25.3 11.7 53.1 38.8 

14.1 10.9 39.7 25.7 26.1 63.6 38.2 

3.8. 

19.3 9.5 33.3 20.7 12.4 51.8 36.4 

.*. Chi-2quare 

G=Graduate T=Terminated o=overall 

F.001, F.01, 

14.2 15.8 51.5 38.5 17.2 59.0 49.5 

6.3** 7.8 

6.05; two-tailed tests 

9.0 

3.3 

3.8' 

10.1 

3.6 

5.7' 

8.6 

5.6 

6.7 

8.6 

6.8 

5 .O 

6.0 

8.0 

3.0 

7.2 

5.6 

,40.9 ,, 32.4 9.5 41.8 31.9 

30.2 20.8 9.2 39.6 28.3 

7.9.. 16.1*** 

39.3 32.7 10.5 40.7 33.0 

34.8 21.7 8.7 41.7 28.2 

15.6*** 6.2.' 

46.1 35.2 11.1 45.5 35.2 

27.9 20.8 8.1 36.9 26.6 

30.0*** 35.1*** 11.9*** 20.2*** 

39.0 30.1 9.8 41.7 31.9 

33.1 24.1 8.4 38.7 26.0 

6.7.. 

42.4 34.6 9.7 44.2 34.0 

27.9 18.8,,, 10.2 38.2 25.7 

6.9" 14.3 12.1'- 

38.7 29.7 10.2 42.3 31.2 

20.0 83. 7.6 44.4 29.5 

7.5 

39.9 30.6 9.8 43.1 32.5 

31.v 23.: 8.0 32.3 23.2 

4.6 5.2 1 1.6*** 15.3*** 

36.6 27.5 10.2 43.4 30.7 

38.1 29.3 10.9 41.5 32.9 

Chi-square tests of significance not performed due to low cell counts. 

" Differences at the Jackson County drug court should be considered carefully, however, given the large percentage of 

missing cases described in Chapter 2. 

9-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Post-Program Arrest Offenses 

Few studies report specific arrest charges of drug court participants who are 

arrested. Overall, information about 47 different post-program arrests offenses 

representing the most serious arrest charge in the arrest event was collected fiom NCIC. 

Table 9.6 present cross-site information on 21 ofthe most fiequently occurrhg arrest 

charges for the 649 temated and 73 graduates who were arrested. The cell values 

represent the percent of participants arrested. Arrest offenses are arrayed by overall 

frequency of occurrence and appear in descending order by arrest type. The findings , 

presented in Tables 9.6 and 9.7 indicate that participants with post-program arrests were 

charged with a variety of offenses ranging fiom drug related offenses to property offenses 

and assauk. 

The most fiequknt rearrests occur for drug related offenses with over sixty percent 

of the participants charged for drug related crimes. In this regard there were few 

differences between graduates (66%) and terminated participants (61%). Twenty percent 

of the participants who were arrested were charged with property crimes (receiving stolen 

property, burglary, burglary of a motor vehicle and theft). A higher percent of terminated 

participants (2 1 %) than graduates (1 1 %) were arrested for these offenses. There are few 

differences by program discharge status in the percent arrested for crimes against a 

person (robbery: felony assault, assault, and criminal threatening). A total of 8% of 

participants who were arrested were charged for these crimes. 

I 

Table 9.6 Comparisons of Post-Program Arrest Charges by Discharge Status for Those 

Possession of Scheduled Drugs 

Under the Muence 

DWWI 

Habitual DWDWI 

Possession of Drug 

Paraphernalia 

Distribution of Scheduled Drug 

Possession with Intent 

TrafFcking in Scheduled Drugs 

Sub-totuf of Drug Arrests 

Burglary of a Motor Vehicle 

Theft 

Burglary 

Receiving Stolen Property 

Passing Bad Checks 

Forgery 

Assault 

Child Welfare Endangerment 

Felony Assault 

Robbery 

Prostitution 

Weapons Violations 

Other. 

Total 

G 

50.0 

50.0 

50.0 

1 OO?? 

T 

42.5 

3 .O 

45.5 

3.0 

9. I 

6. I 

6. I 

3.0 

3.0 

9.1 

3.0 

9. I 

3 .O 

100% 

G 

10.0 

20.0 

20.0 

50.0 

10.0 

20.0 

10.0 

10.0 

- 

100% 

T 

28.2 

5.1 

10.3 

5.1 

12.8 

61.5 

15.4 

2.6 

5. I 

5.1 

2.6 

7.7 

IW? 

G 

26.7 

17.6 

8.8 

2.9 

2.9 

2.9 

8.8 

70.6 

2.9 

5.9 

5.9 

14.7 

I OO?? 

Arrested 

St. Mary Creek Bakersfield Jackson Total 

Parish County County 

0 -.- T G 

19.1 

32.6 

7.3 

4.9 

8.1 

1.2 

0.8 

73.9 

0.8 

3.7 

2.0 

2.4 

0.8 

0.4 

0.8 

3.3 

0.4 

2.4 

8.9 

1W? 

G 

44.0 

12.0 

4.0 

4.0 

4.0 

68.0 

12.0 

4.0 

4.0 

4.0 

4.0 

4.0 

I OOO? 

~ 

T 

36.0 

2.4 

1.8 

- 

7.9 

0.3 

4.2 

52.6 

14.8 

3.9 

6.9 

0.6 

1.5 

0.9 

1.8 

I .2 

2.7 

3.3 

0.3 

2.1 

7.3 

I 00% 

31.6 

8.2 

11.0 

4.1 

2.7 

2.7 

4.1 

1.4 

65.8 

5.5 

2.7 

2.7 

5.5 

4. I 

1.4 

1.4 

11.0 

1 OW? 

1 

29.4 

12.3 

4.3 

‘3.4 

3.1 

4.5 

1.4 

2.5 

60.9 

8.0 

4.8 

4.8 

1.8 

I .2 

0.8 

2.0 

2.0 

2.0 

1.8 

1.1 

1.1 

7.7 

IOOO? 

29.6 

11.9 

5.0 

3.5 

3.0 

4.3 

1.7 

2.4 

61.4 

7.8 

4.6 

4.3 

1.7 

1.1 

1.0 

2.4 

2.2 

1.9 

1.7 

I .o 

1.1 

8.0 

100% 

(4) (33) (10) (39) (34) (246) (25) (331) (73) (649) (722)’ 

9-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 9.7 Categorized Post-Program Arrest Offenses by Discharge Status 

I St. Mary Creek Bakersfield Jackson Total 

Parish County County 

G T G T G T G T G T 0 

Crimes Against a Person 

Property Offenses 

Drugoffenses 

Weapons Violation 

Prostitution 

other. 

Total 

21.2 20.0 7.7 11.8 4.5 8.0 9.1 11.0 7.9 8.2 

30.3 30.0 23.1 2.9 10.2 16.0 28.7 11.0 21.4 20.4 

50.0 45.5 50.0 61.5 70.6 74.0 68.0 52.6 65.8 60.9 61.4 

4.0 2.1 , 1.4 1.1 1.1 

2.4 0.3 1.1 1 .O 

50.0 3.0 7.7 14.7 8.9 4.0 7.3 11.0 7.7 8.0 

100% 100% loo?! 100% 1000/0 lW!o 1W? 1ooo/. loo?? 1ooo/. 100% 

(4) (33) (10) (39) (34) (246) (25) (331) (73) (649) (722) 

Table 9.6 also presents cross-site comparisons of offense charges. Other than 

charges for drug possession, charges for theft and habitual DUI/DWI represent the 

majority of arrests in Creek County. At Bakersfield, most participants were arrested on 

charges for ‘‘Under the Influence of Controlled Substances” representing 34% of 

terminated and 18% of graduates who were arrested. Other than drug related charges, 

Jackson County has more participants charged with motor vehicle burglary than any other 

site. Other than arrests for drug related offenses (50%), post-program arrest charges at St. 

Mary Parish are widely dispersed. 

Logistic Regressions 

Stepwise logistic regression models are employed to examine the relationship 

among participant characteristics, program compliance measures and completion status 

on post-program recidivism. The high degree of collinearity among many of the 

independent variables necessitates the use of the stepwise method. These multivariate 

models complement the preceding bivariate analyses by assessing the salience of each 

factor among control variables. Separate models are estimated for each site as variations 

in missing cases prohibit the inclusion of all variables at all four sites. 

program recidivism at each of the four sites. Beginning with the St. Mary Parish 

program, we find one variable significantly predicting the likelihood of post-program 

recidivism - treatment attendance. In the St. Mary Parish drug court, participants who 

attend a greater percentage of treatment sessions are statistically 

Table 9.8 presents the step-wise logistic regression results for the odds of postlikely to be arrested 

+ Other arrest offenses include: Operating After Suspension (6); Manufacturing Scheduled Drugs (6); 

Violation of Protection Order (5); Failure to Give Correct Information to an OEcer (5); Criminal 

Threatening (3); Fraud (3); Disorderly Conduct (3); Unauthorized Use of Property (2); Vandalism (2); 

Escape (2); Contempt of Court (2); Obstructing an Officer (2); Forging Prescription Drugs (2); Gross 

Sexual Assault (2); Trafficking in Prison Contraband (2); Arson (1); Stalking (1); Hindering Prosecution 

(1); Criminal Restraint (1); Sew1 Abuse of a Minor (1); Criminal Mischief (1); Driving without a License 

(1); Leaving Scene of an Accident (1); Vehicle Registration Violation (1); Furnishing Alcohol to Restricted 

Persons (1). 

9-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
after program discharge. This is an important finding as it suggests that treatment 

attendance may have an overall net positive effect for both graduates and terminated 

participants. Given the absence of any other predictive variables, the model is weak with 

only 6% of the variance in recidivism explained. 

Turning to the Creek County drug court, five variables were found to si&cantly 

contribute to the likelihood of post-program recidivism. Those who were arrested during 

drug court participation are 6.3 times more likely to be arrested after program discharge. 

And, discharge status is also significant. Those who graduated fiom the drug court are 

less likely to be rearrested. In comparison with the other three drug courts, the effect of 

discharge status is strongest in Creek County. The inverse of the odds ratio (.09) 

indicates that those who are terminated are nearly 11 tknes more likely to be rearrested in 

the twelve month follow-up than program graduates. The three remaining variables of 

4 significance pose some dficulty in interpretation. First, the data suggests that those that 

w,ere employed at the time of their admission to the drug court are 3.1 times more likely 

to recidivate than those who were not employed. Second, those participants who had lifetime use of alcohol are nearly 3 times less likely (inverse of -338) to recidivate than those 

participants with no life-time use of alcohol. Finally, those participants with percent 

positive drug tests (29% to 100%) are 4 times less likely to be rearrested than those with 

no positive drug tests. Unlike the model for St. Mary Parish., this model is more robust 

with 23% of the variance in post-program recidivism explained. 

With respect to the Bakersfield drug court, only two variables contribute to the 

variance in recidivism. As with the Creek County drug court, discharge status is 

significant at the Bakersfield site. Those terminated are 7.2 times (inverse of .139) 

likely to be arrested than program graduates. One history variable is significant. As the 

participant’s age at first arrest increases, the likelihood of being arrested after program 

discharge decreases. Overall, 17.2% of the variance in recidivism is explained by this 

model. 

County drug court. In-program arrests are significant. Participants with an in-program 

arrest are 2.66 times more likely to have a subsequent arrest after program discharge. As 

in the case of both the Creek County and Bakersfield programs, discharge status is also 

sigruficant. Graduates in Jackson County are less likely to be arrested than those that 

were terminated. Those terminated are 5.15 times (inverse of. 194) more likely to be 

arrested than the program graduates. Unlike the other three sites, participants having 

positive drug tests are 2 times and 1.5 times less likely to be arrested than participants 

with no positive drug tests respectively. Female participants are 1.42 (inverse of .70) 

times less likely to be arrested than male participants. Finally, as in the case of the 

Bakersfield drug court, as the participant’s age is inversely related to the likelihood of 

being arrested after program discharge. Overall, 17.3% of the variance in recidivism is 

explained by this model. 

Six variables are significant in predicting the odds of rearrest at the Jackson 

9-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Table 9.8 Odds Ratios from the Stepwise Logistic Regression of 12 Month Post Pr&- 

Recidivism on Participant Characteristics and Compliance Measures' 

DelIlOEZITiDhit3 

Female (male * 0) \ 

Race (white = 0) 

Age 20 - 29 (Less than 20 = 0) 

Age 30- 39 (Less than 20= 0) 

Age 40 + (Less than 20 = 0) 

On or More Dependents (None = 0) 

High School Graduate (Leis than High School = 0) 

Employed at Admission (Not Employed = 0) 

Marital Status (Not Manied = 0) 

' 

Ever used Alcohol (No Use = 0) 

Ever used Marijuana (No Use = 0) 

Ever used Crack/Cocaine (No Use = 0) 

Ever used Methamphetamines (No Use = 0) 

Ever used Opiates (No Use = 0) 

Ever used Other Substances (No Use = 0) 

Received Prior Treatment (No Prior Tx = 0) 

One or Two Prior Arrests (No Arrest = 0) 

Three or More Prior Arrests (No Arrest = 0) 

Age at First Arrest (Log) 

Age at First Use 

Comdiance 

Failure to Appear (No = 0) 

Drug Court Arrest (No = 0) 

Percent Positive UA .01 thru .08 (None = 0) 

Percent Positive UA .09 thru .28 (None = 0) 

Percent Positive UA .29 thru I .O (None = 0) 

Percent Tx Attendance (ActuaVExpected Minimum) 

Status (Graduate =I) 

Constant 

Cox & Snell R2 

N .*' 6.001. "6.01. *t%.05: two-tailed tests 

county county 

- OR - OR - OR OR 

ns 

ns 

ns 

*, 

b 

ns 

ns 

ns 

b 

llS 

b 

ns 

b 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

b 

b 

ns 

ns 

.244"* 

ns 

ns 

.726 

.OS8 

219 

ns 

ns 

m 

ns 

11s 

ns 

ns 

3.10*' 

ns 

.338' 

b 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

b 

6.28"' 

b 

ns 

.248*'* 

ns 

.091'*' 

1.08 

.23 1 

191 

ns 

ns 

ns 

11s 

ns 

C 

C 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

ns 

.320*'* 

ns 

C 

ns 

ns 

ns 

ns 

ns 

ns 

.139"* 

40.67'*' 

.172 

723 

-70' 

115 

ns 

lls 

lls 

C 

a 

IC 

C 

C 

C 

C 

C 

C 

C 

C 

ns 

.356'** 

11s 

C 

lls 

2.66.- 

.485*** 

,683.' 

C 

.194"* 

13.92"' 

.I73 

I221 

'Uktand&d:lzed cbe'fficients and standard errors available fiom author upon request. Only the main effect terms tested in the models are 

'Variables not tested in model due to low cell counts. 

ns-Not Significant 

resented, the insignificant interaction terms are omitted to conserve space. 

Variables not tested due to high percentage of missing cases. 

9-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
As we can see, the results of the regression analyses indicate that program 

completion status is the most consistent factor associated with recidivism. In three of the 

four drug courts it was demonstrated that drug court “success” (graduation) leads to 

“success” (no arrests) in the twelve month post-program follow-up. However, it is 

interesting to note that the drug court where discharge status is not significant, St. Mary 

Parish, that greater exposure to treatment has a negative impact on the incidence of 

recidivism regardless of whether participants successhlly completed the program or not. 

Path Analysis 

Throughout the course of analyzing participant level data, findings have been 

presented about three dependent variables. First, we examined the relationship between 

I participant characteristics, program compliance measures and in-program recidivism. 

Second, we examined factors related to program completion (graduation). Finally, the 

recidivism analysis assessed the relationships between background factors, program 

compliance, and drug court completion status on post-program recidivism. 

This analysis attempts to synthesize these findings in order to provide a more 

complete, holistic and explicit interpretation of the operant factors at each drug court that 

are associated with rates of post-program recidivism. This requires the use of a particular 

statistical method known as path analysis’*. Path analysis ‘is a “multivariate” approach 

that simultaneously considers the explanatory effects of multiple factors. Path analysis is 

unique in allowing not only independent (cause) and dependent (effect) variables, but 

also intervening or mediating variables. Intervening variables simultaneously measure 

the effects of some variables and the causes of others. In short, path analysis enables the 

construction of complex models that more accurately reflect social reality. 

The findings from the logistic regressions in this chapter as well as in Chapter 8 

informed the variable selection for the analysis that follows. Each path model includes 

only those variables that were statistically significant in previous analyses. Logical 

causal relationships were specified and the models were estimated. Given the 

exploratory nature of this project, modification indices offered by the statistical software 

were employed. Modification indices identitj, which relationships could be specified and 

which relationships could be eliminated in order to strengthen and improve the overall 

“fit” of the model. Each model presented is the single best-fitting model and all of the 

relationships included are statistically sigrdicant. It will be expected that these models 

will closely resemble earlier findings. However, this modeling is expected to produce 

new effects (and diminish some of the previous ones) as it incorporates all of the 

variables simultaneously. 

specified to be correlated in the models. Therefore, these relations are controlled for by 

allowing particular independent variables to covary with one another. These covariances, 

usually represented by curved, double-headed arrows, are not presented in the diagrams 

Given the problem of multi-collinearity, many of the independent variables are 

I* See O.D. Duncan, 1960. “Path Analysis: Sociological Examples”. American Journal of Sociology. Vol 

72. #I. pp.1-19. 

9-12 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
in order to conserve space and maximize clarity. A list of the model covariations are 

available fiom the authors upon request. 

St. Mary’s Parish 

Figure 9.2 presents the best-fitting path model for the St. Mary Parish drug court. 

Overall sulll~llziry statistics suggest that the model is a “good fit” (refer to the high 

goodness-ogfit statistic, low root mean square residual, low Chi-square statistic, and high 

probability value). Overall, the model reflects little departure fiom sndimgs presented 

above. Participants with positive drug tests are less likely to graduate. And, attendance 

at a greater percentage of treatment sessions has a positive effect on graduation and a 

negative effect on post-program recidivism One new relationship was formed, however, 

1 as participants with “low” percent positive tests are more likely to attend a higher 

percentage of treatment ses~ions’~. Again, it is interesting to note that unlike the other 

drug courts in this study, drug court graduation is not associated with post-program 

recidivism at the St. Mary Parish program. 

in the amount of the variance explained in the dependent variables in this model. More 

variance in recidivism is explained here (1 3% compared to 6%). Whereas, the variance 

explained in drug court graduation is diminished fiom a previous 24% to 16%. 

As expected, compared to the earlier regression analyses, there are some changes 

Figure 9.2 St. Mary Parish Path Model 

Moderate % 

Low % Drug Court 

Positive Tests Graduation 

Treatment -.I6 4 Post-Program 1 1 Attendance Arrest 1 I I I 

GFI = .992; FWSR = .006; Chi-square = 4.18; df = 4; prob. = .383; N = 219 

Notes. Standardized path coeEcients are located near the head of the arrows and the variance explained for 

each intervening and dependent variable is in bold, outside of the upper-right hand corner of the boxes. All 

paths are significant @<.OS; two-tailed tests). 

It is important to note here that this is a relationship that could not be considered in previous regression 

analyses (that is, how compliance measures may effect one another). Naturally, many of these relations 

may also be reciprocal (or “dialectical”) despite being identified as unidirectional in the diagram. 

9-13 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Creek County 

Figure 9.3 presents the best-fitting path model for the Creek County drug court. 

As we found in St. Mary Parish, the summary statistics for this model can also be 

characterized as a “good fit”. This model, however, reflects several departures fiom 

earlier regression analyses. Previous hdings suggest a positive relationship between 

high school graduates and drug court graduation. In this model, the relationship is further 

specified with high school graduates being less likely to have positive drug tests. This 

model also speciiies two new relationships in this regard with those having positive drug 

tests being less likely to graduate and less likely to attend a greater percentage of 

treatment sessions. Further, previous findings indicate a relationship between life-time 

use of amphetamines and in-program arrests and relationships between employment and 

life-time use of alcohol on post-program recidivism. These relationships are no longer 

significant in this model. I 

Similar to previous hdings, participants with a prior substance abuse treatment 

experience are less likely to graduate and interestingly, those with “high” percent positive 

tests are less likely to be arrested in the post-program follow-upzo. Other signiscant 

determinants of recidivism presented in this model include the positive effect of drug, 

court graduation and the negative effect of in-program arrests. As expected, there are 

some changes hi the amount of variance explained in the dependent variables in this path 

model (compared to the earlier regression analyses). Less variance in post-program 

recidivism is explained here (15% compared to 23%) as well as drug court graduation 

(25% to 15%). 

Figure 9.3 Creek County Path Model 

-.20 

Treatment 

Attendance Graduation 

b 

Hig’ -‘ 

PWitiVl 

GFl = .978; RMSR= -01 1; Chi-square = 15.62; df = 12; prob. = .209; N = 191 

Notes. Standardized path coefficients are located near the head of the arrows and the variance explained for 

each intervening and dependent variable is in bold, outside of the upper-right hand corner of the boxes. All 

paths are significant w.05; two-tailed tests). 

*’ Information pertaining to incarceration status at time of program discharge was not available and may 

account for this finding. 

9-14 

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This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 4 

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Bakersfield 

Age at First -22 Post-Program Arrest Arrest 

Figure 9.4 presents the best-fitting path model for the Bakersfield drug court 

which can also be characterized as a “good fit”. As in the case of the Creek County drug 

court, this model also reflects numerous departures fiom findings in earlier regression 

analyses. In this model, all but one participant characteristic remains significant among 

the two dependent variables pertaining to in-program and post-program recidivism As 

age at first arrest increases, the likelihood of in-program and post-program recidivism 

decreases. And, age at first arrest also emerged producing a positive effect on the 

likelihood of graduation 

graduation and negatively associated with in-program recidivism. And, participants 

arrested for FTA or other charges are also less likely to graduate. Lastly, as in the case of 

Creek County, drug court graduation decreases the likelihood of recidivism. More 

variance in post-program recidivism (20% versus 14%) and in-program recidivism (24% 

versus 12%) is explained in this model. Conversely, the amount of variance explained in 

drug court graduation is diminished fiom a previous 36% to 15%. 

, 0, 

Similar to previous findings, treatment attendance is positively associated with 

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Figure 9.4 Bakersfield Path Model - Failure to Appear 

GFI = -998; RMSR = .001; Chi-square = 4.71; df = 6; prob. = .581; N = 723 

Notes. Standardized path coefficients are located near the head of the arrows and the variance explained fa 

each intervening and dependent variable is in bold, outside of the upper-right hand corner of the boxes. All 

paths are significant *.OS; two-tailed tests). 

9-15 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Jackson County 

Figure 9.5 presents the best-fitting path model for the Jackson County drug court. 

Much like the Bakersfield path model, age at fkst arrest remains significant among the 

two dependent variables pertaining to in-program and post-program recidivism. As age 

at first arrest increases, the likelihood of both in-program and post-program recidivism 

decreases. And, age at first arrest emerged producing a positive effect on the likelihood 

of graduation. One other participant characteristic, non-whites are more likely to 

recidivate in the post-program follow-up. And, as discussed in previous analysis, nonwhites are also less likely to graduate. Contrary to previous findings, only one 

compliance measure remains significant in this analysis. Those arrested during program 

participation are less likely to graduate and more likely to recidivate in the post-program 

follow-up. Lastly, as in the case of Creek County and Bakersfield, drug court graduation 

decreases the likelihood of post-program recidivism. Less variance in post-program 

recidivism (1 7% versus 19%) and drug court graduation (1 9% versus 33%) is explained 

in this model. Conversely, the amount of variance explained in during-program 

recidivism is enhanced fiom a previous 3% to 19%. 

Figure 9.5 Jackson County Path Model 

I 

Age at 

First Arrest 

GFI = 1.0; RMSR= 0.0; Chi-square = .026; df = 1; prob. = -871; N = 1221 

Notes. Standardized path coefficients are located near the head of the arrows and the variance explained for 

each intervening and dependent variable is in bold, outside of the upper-right hand corner of the boxes. All 

paths are significant @<.05; two-tailed tests). 

One benefit of these path models is the ability to spec^ previously identified 

causal relationships in the presence of multiple dependent variables. At each site, one or 

more new relationships were identified and for three of the four sites, some previously 

identified relationships were diminished. 

9-16 

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This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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i Similar to the findings presented in earlier regression analyses, overall results of 

the path analyses confirm, with the exception of the St. Mary Parish program, that 

program completion status remains the most common predictor of post-program 

recidivism. At each of the three other sites, drug court graduates are between 2 and 4 

times less likely to recidivate than those terminated. The negative effect of treatment 

attendance on recidivism was identified at the St. Mary Parish program, whereas in two 

other sites (Bakersfield pd Creek County) treatment attendance is only indirectly related 

to recidivism insofar as it is positively related to program completion. 

Few participant characteristics remained si@cant in these analyses. No more 

than two participant cRaracteristics at any one Site were identified as having any causal 

relationship with any of the dependent or mediating variables. The most common, age at 

first arrest, was specified at both the Bakersfield and Jackson County drug courts. In 

both sites, as age at first arrest increases, the likelihood of in-program and post-program 

recidivism decreases and the likelihood of drug court graduation increases. At the two 

rural courts, new relationships between drug use and treatment attendance were 

identified. At the St. Mary Parish site, few positive drug tests are associated with 

increased treatment attendance whereas at the Creek County drug court, fiequent positive 

drug tests is associated with decreased treatment attendance. 

not appropriate to construct an overall path model combining the four sites. At each drug 

court program, a specific set of variables - primarily those related to program operations 

as distinct fiom participant characteristics - were salient. Operant factors directly 

affecting recidivism include: program completion (at three sites), in program arrest and 

age at first arrest (at two sites) and treatment attendance, positive drug tests and race (at 

one site each). 

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Since the findings pertaining to recidivism are mixed and site-depend&, it was 

Conclusions 

The overall “success” of drug court programs is dependent on whether offenders 

abstain fiom new criminal conduct after program discharge. This study examined some 

important data on how compliance and non-compliance with program requirements of the 

drug court are related to post-program recidivism at four drug court sites. Overall, 31% 

of the participants had one or more arrests during the 12-month follow-up period. Postprogram recidivism rates range from a low of 17% at St. Mary Parish to a high of 37% at 

the Bakersfield drug court. The recidivism rates reported here are consistent with those 

reported elsewhere and fall within the range of recidivism rates reported in those studies. 

This chapter examined how variations in recidivism are related to differences in program 

completion status, various program compliance requirements such as drug use and 

treatment attendance, as well as participant characteristics. 

Overall, program completion status is the most important factor associated with . 

recidivism. Offenders who “successfidly” complete the drug court program through 

graduation were at least three times & likely to be arrested in the post-program followup. A total of 44 % of the terminated participants and 9% of graduates were rearrested. 

9-1 7 

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This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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’ Other factors associated with recidivism at one or more sites include: age at brst 

arrest - as the participant’s age at first arrest increases, the likelihood of being arrested 

after program discharge decreases; in-program arrest - participants with an in-program 

arrest are more likely to have a subsequent arrest after program discharge. 

they suggest the possibility of a net ‘drug court effect’ that may be affecting outcomes. 

That is, participants whb comply with the performance expectations of drug court 

programs and attend treatment are less likely to recidivate than non-compliant 

participants. For example, at the St. Mary Parish drug court we found that completion 

status was not a sigdcant predictor of recidivism, the 10,w overall rate of recidivism 

found there was related to the high overall rate of treatment attendaqce regardless of 

whether participants graduated Erom the program or not. 

Although these findings are limited showing mixed results that are site dependent, 

Since the findings about recidivism are mixed and site dependent, there was no I 

one overall “best fitting” model. At each drug court program, a specific set of variables - 

primady related to program compliance requirements as distinct fiom participant 

characteristics - were operant. Operant factors affecting post-program recidivism at one 

or more sites revealed by the path analysis include: program completion, treatment , 

attendance, in-program arrest, positive drug tests, race, age, and prior treatment 4 

’ 

experience. , ,I ,I 

9-18 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Chapter 10 

Conclusions 

Overview 

Drug treatment courts have been heralded as one of the major justice reforms of 

the 20* century (Goldkamp: 2001). The drug treatment court provides an intkrmediate 

sanction that combines the coercive power of the criminal justice system with substance 

abuse treatment. As such, they represent a nexus between criminal justice and substance 

abuse treatment systems that is intended to reduce the recidivism of drug involved 

offenders by changing their drug using habits. The drug treatment court model includes 

treatment, drug testing, supervision, and compliance management with the specialized 

feature of the presiding judge overseeing the progress of the addicted offender’s 

rehabilitation. 

criminal justice policy by creating a multidisciplinary team to address the criminal 

behavior and drug addiction of offenders through integrated programming. The 

theoretical assumption is that drug treatment is tied to reduced criminal conduct and the 

provision of treatment services is the means to achieve that goal. Stated simply, drug 

courts recognize that treatment is one of the primary interventions to achieve justice goals 

and the role of the court is to ensure these services are delivered. 

Nationally, there is a great deal of diversity in how drug treatment courts have 

been implemented. There are also broad variations in the structure and operations of 

drug courts included in this study. Examining four well-established drug court programs, 

their respective treatment programs, and participant completion and rearrest activity, this 

study afforded an opportunity to examine some important data on drug court and 

treatment operations, program integrity, and the relationship between participation in 

these programs and recidivism. Here, we summarize those findings. 

In many ways, the concept of the ‘drug treatment court’ is intended to reshape 

Chapter Summaries 

Chapter 1 posed a dilemma. Despite a decade of research on drug treatment 

courts, we still lack critical information about the types and quality of treatment services 

delivered in the drug court model that may Wher our knowledge of factors affecting 

participant outcomes. To date, little is known about either the “black box’’ of treatment 

or the “black box” of drug court operations. The information we do have indicates 

variations in the development of key components of the drug court model - treatment, 

testing, and sanctions (Goldkamp, et. al. 2001). Moreover, there is a paucity of 

information about post-program outcomes in terms of drug use and recidivism. Despite a 

number of research limitations, the current study does provide important information 

about drug court operations, treatment delivery systems, and how participant compliance 

with drug treatment court requirements is related to program completion and recidivism 

10-1 

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expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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' Chapter 2 described a research design that combined an analysis of participant 

level data with information about current drug court and treatment operations at four drug 

court sites (St. Mary Parish, LA; Creek County, OK, Bakersfield, CA; and Jackson 

County, MO). Multiple sources of data include: interviews with court personnel and 

treatment administrators; surveys of treatment counselors; direct observations of 

treatment sessions; participant level data contained in individual treatment and drug court 

case files; and, NCIC data on in-program and post-program recidivism. 

Findings from this study should be interpreted carellly as there are a number of 

limitations in the overall research design. The analysis of participant level data did not 

include a control grou; with which to compare ,outcomes, The analysis was also 

hampered by an overall lack of consistency in the types of data elements available at the 

four sites. Overall, not one program demonstrated an ability to successllly centralize in 

automated form the necessary information required to conduct a thorough assessment 

(e.g.: none of the programs maintained information sukounding sanctions and 

incentives). The study is fbrther limited by the attempt to correlate current treatment 

practices with retrospective participant data. Information collected about treatment 

practices and participant data do not necessarily represent the same cohort of offendFs. 

Chapter 3 described each of the four drug treatment courts and provided B crosssite comparison Qf the structure and operations of those programs. Findings i& Chapter 3 

indicate that while there are basic elements common to each court, the four programs are 

diverse with respect to size, participant eligibility, program protocols, approaches, the 

nurnber and content of drug court phases, and treatment and drug testing requirements. 

I 

Each of the four drug treatment courts offer a program lasting approximately 

twelve months. However, they target different populations ranging fiom &st-the and 

second-time felony offenders at Jackson County and misdemeanant-only offenders at 

Bakersfield to both felony and misdemeanant offenders at the Creek County and St. Mary 

Parish sites. Three of the drug courts are post-plea whereas the Jackson County drug 

court is a pre-plea diversion court. All four programs offer a step-down phased system of 

requirements meaning that as participants progress through program phases, both 

treatment and court requirements decrease. Although step-down requirements vary by 

site, they are similar insofar as phases require attendance at treatment sessions, drug court 

status hearings, and participation in drug testing. Two sites have a four-phase program 

and two sites have a three-phase program. Treatment placement options also vary. Two 

of the programs offer a single track for all participants, two programs offer multiple 

treatment tracks. 

In Chapter 4, we descriid the types of treatment programs associated with each 

of the four drug courts, the treatment services delivered, as well as the availability and 

use of ancillary services. Treatment services at three sites were delivered by a dedicated 

treatment provider contracted by the drug court. Treatment services at the Bakersfield 

drug court were provided by an array of local providers. 

services provided and the content of those treatment services. Two of the direct 

treatment providers are fairly robust in the breadth of services they offer. In both the 

Jackson County and St. Mary Parish drug court progrw such services include 

Overall, there was substantial diversity in the nature and types of treatment 

1 0-2 

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expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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residential treatment, intensive outpatient, outpatient services, relapse prevention and a 

therapeutic community. The direct service provider at the St. Mary Parish drug court 

offered more types of services than any of the other three drug court programs. 

Each drug court in this study attempted to provide access to a continuum of 

alcohol, drug and other related treatment and rehabilitation services which is one of the 

Key Components (49 of drug courts. The research found several impediments to the 

delivery of this type of “bontmuum of care”, including the reliance on informal referral 

systems for the provision of ancillary services (those beyond substance abuse treatmeqt). 

In sum, treatment services at the four sites did not represent the standard of care with 

“highly individualized placements and lengths ‘of stay in one or more modality contingent 

on individual need”. At each site, when particular services were not directly provided, 

attempts were made to refer participants to other agencies for those services. However, 

there was no indication’at any site that direct providers were substantively involved in 

ensuring that participants received services for which they were referred. This lack of 

follow-up generally reflects the lack of policy development and other impediments to 

coordinate service delivery. Treatment programs differ across sites, though there were 

some commonalities. Three programs employ fiom one third to two thirds of staff , 

persons who were in recovery, There are variations in caseloads across sites, though 

three of the four sites had caseloads in the 25 to 35 client range. 

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In general, the form of the relationship that exists between the court and the 

substance abuse treatment agencies has an important impact on the nature and extent of 

service delivery (in terms of both substance abuse treatment and ancillary services). For 

example, at the Bakersfield drug court, the linkages between the court and the provider 

were largely informal. Treatment for the most part was “relied” upon, ifconvenient, 

instead of integrated into program protocols. This informality in some instances appears 

to translate into a lack of control over service delivery. Cancelled treatment sessions in 

the Bakersfield court program are the most notable example of this. On the other hand, 

the St. Mary Parish drug court developed a strong integrated model where the court and 

criminal justice players were knowledgeable about and relied upon treatment to address 

issues of continued drug use, noncompliance with supervision conditions, etc. 

suggest that some drug courts have difficulty providing ancillary services (especially fbr 

diverse client groups such as the visually impaired or Spanish speaking clients). In fact, 

only in Bakersfield were groups in Spanish available. Most programs offered a relatively 

standard set of outpatient and intensive outpatient services, with only limited capacity for 

residential services. Only about halfthe treatment programs reported providing any sort 

of aftercare treatment. 

Most programs reported offering ancillary services (education, vocational 

education, housing, etc) through a referral system without having direct placement 

capabilities. However, the actual availability of these services was diEcult to determine. 

These problem areas in service delivery likely provide substantial impediments to the 

provision of an appropriate continuum of care, as outlined in the Key Components of 

drug courts. 

Results fiom surveys of counselors and treatment program administrators also 

10-3 

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This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Additional attention is merited in terms 0.f the delivery of an effective continuum 

of care, particularly for clients whose needs go beyond substance abw. For example, 

additional educational and employment services, as well as ongoing aftercare are notably 

missing fiom these programs. Services for diverse populations are also missing (cultural 

and gender-specific issues were also hftequently addressed). Formalized cooperation 

between treatment providers and the courts is also lacking in some courts as is adequate 

oversight of treatment integrity by the courts. 

system differs fiom treatment services delivered to drug court participants. It was found 

in Chapter 5 that staffemployed by the treatment agencies for delivering services in the 

drug court context tended to have relatively low levels of education, but some had 

professional licensures or certifications and histories of overcoming substance abuse 

themselves. While many programs serve large proportions of minority clients, few 

minority counselors were employed. In terms of daily activities, most counselors 

reported conducting a single treatment group (about one hour long), as well as conducting 

one or two individual counseling sessions. 

It was also found that a substantial proportion of treatment stafftime was spent on 

admissions related duties. However, given the amount of time allocated to these duties, 

only a smad percentage of time was dedicated to conducting clinical assessments. while 

all programs reported using a structured screening instrument and developing individual 

treatment plans, most sites reported little involvement of either the client or drug court 

staff in the treatment planning process. 

expectations to clients. In some instances treatment stamembers were responsible 

while in others court staff performed these tasks. Use of written contracts was also 

inconsistent, with some programs reporting reliance on verbal communication of program 

criteria. Some treatment programs reported using behavior modification techniques, with 

the most common sanctions pertaining to loss of privileges, extra treatment or support 

meetings, or increased drug testing. Typical rewards included verbal praise fiom 

counselors or other clients, while other programs reduced treatment or drug testing 

requirements as well. All programs reported drug testing and sharing that information 

with court staff. 

responses were categorized into ten general models or theoretical perspectives. 

Counselors’ philosophies of the causes of and what constitutes effective treatment for 

substance abuse suggest they take a broad, eclectic approach to treatment, endorsing only 

portions of each of the various philosophical approaches. This finding suggests lack of a 

coherent, consistent approach in the manner in which counselors not only think about but 

also how they respond to clients’ drug abuse. 

Overall results fiom Chapter 5 suggest several areas for improvement. First, 

qualifications and training of counselors could be improved. The second area requiring 

attention lies in developing a programmatic focus that centers on specific therapeutic 

approaches (e.g. specific cognitive behavioral strategies that have been consistently 

supported as effective in past research). 

The research was not designed to compare how the local treatment delivery 

There was also variability in terms of who was responsible for communicating 

Treatment staff were surveyed regarding their philosophy of treatment and 

10-4 

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This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Findings in Chapter 6 focused on actual observations of treatment. The length of 

scheduled treatment sessions range fiom one hour and ten minutes to two hours with an 

average length ofjust under one and a halfhours. However, the duration of actual 

treatment sessions was shorter. The amount of treatment time actually delivered 

(scheduled time minus breaks etc.) across all sites represents approximately 75% of the 

total expected treatment time. 

Results fiom observations of treatment sessions themselves also indicate that drug 

treatment interventions being utilized can be characterized as an amalgamation of eclectic 

therapeutic approaches that result in delivering disparate treatment components in a 

superficial mer. In general, the observational results reveal a diverse pattern of 

approaches, including cognitive-behavioral techniques like trigger analysis and the 

examination of existing emotional processes coupled to a lesser extent with techniques 

derived fiom 12-steps programs @e., acceptance of powerlessness, reliance on a higher 

power). While the use of this broad-based approach to treatment may appear to be an 

effective intervention style, potentially addressing multiple client needs, these Sndings 

suggest that the actual result was a relatively small amount of the being spent on any 

specitic treatment item or approach. In addition, some of these approaches are inherently 

inconsistent, in that they derive fiom distinct and conflicting theoretical assumptions 

about the underlying nature of addiction. These Snding may indicate incoherent 

treatment modalities are being applied. 

As previously discussed, programs addressing multiple client needs are in fact 

preferred in that they may be more effective in reducing substance abuse and criminal 

behavior, however this does not mean that treatment approaches based on incompatible 

philosophical positions should be incorporated together. In general these programs are 

more likely to deliver effective treatment ifthey coordinate a coherent treatment 

approach that can tackle multiple client needs in a consistent manner. The treatment 

literature suggests that cognitive-behavioral approaches are effective for offender 

populations. As such, this group of programs may benefit fiom solid- their use of 

these types of techniques rather than attempting to utilize them in conjunction with so 

many other divergent approaches. 

the program that specifically target substance abuse issues is the need for programs to 

include additional services to address clients’ multiple needs. In this case we are 

referring to ancillary services such as vocational education, parenting skills, and more 

consistent preparation for and use of aftercare treatment in the community. As a group 

these treatment programs were generally lacking in each of these areas, though the extent 

to which these services are adequately delivered through referrals to outside agencies is 

unknown. 

Finally, none of the programs seemed to have an aftercare program that was 

widely attended by graduates. And, none of the programs appear to provide differentiated 

programming such as gender or culturally specific treatment, as evidenced in the low 

fiequency with which these topics were observed in treatment groups. Again, the 

provision of specially tailored services might improve the efficacy of treatment for these 

specific subgroups of clients. While white and male clients tend to dominate treatment 

groups in most sites, there were still substantial minority and female populations in each 

Related to the need to implement a coordinated strategy within those portions of 

10-5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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jdiction who may benefit from services specifically tailored to their Unique sets of 

needs. Culturally sensitive treatment would also be facilitated by the use of a more 

diverse group of counselors. 

In general, the broad-based nature of the treatment provided seem to result in 

little time being spent on any particular approach to treatment, the delivery of sometimes 

incompatible approaches to treatment, and the inability to provide what might be more 

effective interventions (;.e., adequate attention to issues such as relapse prevention, 

educational needs, aftercare planning, and gender and cultural issues). 

integration of treatment and criminal justice sehces remains an open question, in general 

the overall qualay of treatment appeared to be somewhat higher in those courts that were 

more directly affiliated with their treatment providers (i-e., the courts or local 

governments were more directly responsible for the operation of the treatment services 

employed by the court). Courts making use of existing treatment services in the 

community appear to have several issues regarding accountability and therapeutic 

integrity to overcome ifthey are to deliver high qdty treatment services to their 

participants. We return to this issue in the discussion of treatment and court integration 

relative to the results of Chapter 7. 

Chapter 7 provided a discussion of integration of court and treatment operations. 

At the heart of the drug court is an attempt to achieve a new working relationship 

between treatment providers and the courts (Goldkamp, 1999: 170). This requires a level 

of integration between treatment and the courts that has not previously existed. Bringing 

treatment and criminal justice together in an attempt to create this “seamless system” 

highlights differences and conflicts in values, goals, and methods between the courts and 

treatment profession (See Taxman, 2000 and Goldkamp, 1999: 170). 

Results fiom surveys of treatment staff reveal that in general they believe 

communication with the drug court was slightly better than average in terms of 

effectiveness and that this communication was generally bilateral. Most felt that there 

were formalized lines of communication between the two parties in terms of drug testing 

information. Treatment staff commonly reported that drug court personnel attended 

treatment planning meetings, but also reported that court staffwere less frequently 

involved in the actual treatment planning process. Court staff generally reported only a 

passing familiarity with the goals and techniques of substance abuse treatment, but in 

some instances did not appear to have specific knowledge of the process, variations and 

limitations of substance abuse treatment. Few court stareport having attended any 

treatment sessions. Additional cross-training for staffmay improve this level of 

familiarity and further improve levels of communication and cross-program integration. 

context seem to be addressed through several common mechanisms: 1) Program 

integration occurs by combining court and treatment requirements for participants in the 

phase system; 2) Institutionalized lines of communication between court and treatment 

operations occur through weekly pre-court meetings where court and treatment staff meet 

and discuss client progress; 3) Drug courts in this study also integrate staffby placing 

Whether these‘difKculties might be meliorated by improvements in the 

I 

Integration issues between treatment and court operations in the drug court 

. 10-6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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representatives fiom both treatment and court staffon drug court steering committees and 

other decision making and policy making bodies. 

Integration is not, however, simply a matter of cooperation and cross-program 

familiarity by sta it involves different levels of system integration- philosophical, 

policy, and operations. Moreover, the types of integration that are best for drug courts 

have yet to be demonstrated. By design, various components of criminal justice and 

substance abuse treatment systems are intended to work together as part of the drug court 

model to combine the coercive power of the court with what is hopefully effective and 

scientifically based treatment practices (Belenko, 1998:6). We know very little about the 

impediments to forming this level of integration. Future research might consider 

addressing these issues: formal linkages in terms of treatment delivery (especially to 

ensure delivery of ancillary services that clients are referred); oversight mechanisms to 

reduce the number of cancelled meetings; and continued development of policy-level 

htegration so that joint decision making roles are spelled out in terms of clinical and 

legal assessments, program advancement, and program discharge. 

Results fiom participant data analyzed in Chapters 8 and 9 addressed how 

compliance with program requirements of drug treatment courts were related to program 

compliance and post-program recidivism The sampling fiarne consists of 2357 

participants who were enrolled one or more days between January 1' 1997 and December 

3 la 2000, that were either terminated or graduated, for whom both a minimum amount of 

follow-up time (12 months) had elapsed since discharge, and for whom NCIC criminal 

history information was available. 

during their program participation (i.e., drug testing, treatment, and graduation) and 

rearrest data was gathered for the 12-month post-program period. The data set that was 

compiled across the four sites includes program information (e.g., drug court program 

start and end dates, number of treatment sessions attended, number of drug tests 

administered and number of positive tests), characteristics of participants (e.g., age, 

gender, ethnicity, marital status, substance abuse histories, drugs of choice, etc.), type of 

graduation (ie., graduatedterminates, exceeded program timefiame), and rearrests during 

and after program participation. For the most part, more complete information was 

maintained by the treatment providers (as compared to the courts) and therefore the 

analysis of participant data tends to over-represent those drug court participants who 

actually attend their mandated drug treatment services. Rearrest data was gathered fiom 

the National Crime Information Center (NCIC) for each site. 

reported nationwide. A total of 779 (33%) of the 2357 participants graduated fiom these 

programs and 1578 (67%) were tenninated. Program completion rates range fiom a low 

of 29% to a high of 48%. 

and minority groups being less likely than white non-Hispanics to graduate fiom drug 

court. Since this is a retrospective study, it is not known how these findings articulate 

with the lack of diversity found among treatment staff and lack of culturally specific 

programming discussed in Chapter 5. However, such a connection is being made 

Information about offender behavior and program participation was collected both 

Rates of program completion reported in this study are somewhat lower than 

Overall, there were race and ethnic differences in program completion with race 

10-7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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between gaps in treatment programming and ‘’unsuccessfbl” program outcomes among 

minority participants. Such findings bear further research. 

issues: 1) Examining the integrity of drug court by comparing program protocols against 

actual operations; 2) Examining participant compliance With drug court requirements; 3) 

Identifjring how various participant characteristics and functional components of the drug 

court program are assodiated with progr& completion; 4) Ident-g how these factors 

are associated with post-program recidivism. 

chronic nature of addiction through drug testing, sanctioh, fiequent status hearings and 

substance abuse treatment. This study assessed a number of issues about the “black box” 

of the drug court model by assessing the integrity of several core components of drug 

court programs. The protocols of important componknts of the drug court model were 

compared with actual drug court operations. In an analysis of length of program 

participation, drug testing, and treatment attendance, the findings in this study indicate 

that there are gaps between drug court program protocols and actual drug court 

operations. 

Findings in the four areas of program participation, treatment attendance, drug 

testing, and in-program recidivism are worth noting in this regard. Although the overall 

mean length of attendance in drug court was within 98% of the scheduled length of the 

program, the amount of time some clients participated in drug court exceeded the 

program’s intended length suggesting that the twelve month time fi.ame is generally too 

short for some offenders. For example, more than 24% of participants were discharged 

from the program (or about 18% of the expelled participants and 38% of graduates) after 

attending the program for more than 125% its scheduled length. While one advantage of 

the drug court program is to allow some flexibility for offenders who are making progress 

by extending their participation, it is unclear about the criteria being used to make these 

individual cases decisions and override program requirements. Since 18% of those who 

completed more than 125% of the program were subsequently expelled &om the 

program, there may be a further problem of net-widening effects. Given that 53% of the 

graduates participated in the program past the expected program length, this suggests that 

the 12 month time fiame may be too short to address the relapsing nature of addiction. 

Participant level data analyzed in Chapters 8 and 9 are concerned with three 

Ideally, the drhg court model provide3 an integrated program to address the 

I 

. 

There were also gaps between program treatment attendance requirements and 

actual attendance at treatment sessions. Overall, 64% of the participants did not attend a 

minimum number (70%) of the required treatment sessions. These findings also indicate 

that more than a third of the participants (36.5Y0) graduate fiom drug court programs 

without having completed the minimum number of treatment sessions called for by 

program protocols. Conversely, a number of participants (1 0%) who were expelled fiom 

drug court actually attended more than 100% of the treatment sessions required by the 

program’s treatment protocol. 

In addition, the study found gaps between drug testing requirements and actual 

drug testing practices. More than half of the participants (54%) did not receive a 

minimum (70%) number of drug tests called for by the program’s drug testing 

10-8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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requirements. A total of 33% of the graduates and 64% of terminated participants Med 

to receive 70% of the scheduled drug tests. 

As expected, the majority of drug court participants were not in compliance with 

one or more program requirements. More importantly, fajlure to comply with these 

requirements is related to unsuccessll completion of the program A total of 59% of the 

expelled clients participated in less than half of the drug court program; 76% did not 

attend the minimum number of treatment sessions; and, 64% of the expelled participants 

did not receive the minimum number of drug tests. 

Since the major goals of drug court programs are to reduce submce abuse and 

criminal offending behaviors, drug court programs require that participants comply with 

certain performance expectations including not engaging in new criminal conduct and 

abstinence from the use of alcohol and drugs. This study examined how in-program 

qcidivism and positive drug tests were related to program completion. Overall, the 

findings in this study indicate that 17% of the participants were arrested once and 16% 

were arrested two or more times (in-program arrests) during their participation in drug 

court. In addition, 76% of participants tested positive for drug use one or more times and 

61% tested positive two or more times during program participation. 

As expected, positive drug tests and in-program arrests are both negatively 

associated with program completion. A total of 85% of those with in-program arrests and 

50% of the participants with one or more positive drug tests were terminated fiom the 

program. Put dserently, participants terminated fiom the program are two to three times 

more likely to test positive for drug use and four to five times more likely to be arrested 

during drug court program participation than those who graduated. 

The overall “success” of drug court programs is dependent on whether defendants 

commit more crimes after program completion. Rearrest data was obtained for all of the 

2357 offenders for 12 months past the date of discharge fkom the drug court program. As 

a result, this study was able to examine some rare data on the relationship between 

compliance with program requirements on post-program recidivism 

one or more post-program arrests during the twelve month follow-up. Rearrest rates range 

from a low of 17% to a high of 37%. Chapter 9 examined how variations in recidivism is 

related to differences among participant demographic characteristics, various program 

compliance requirements such as drug use and treatment attendance, and program 

completion status. 

The most significant factor associated with recidivism is program completion status. 

Simply stated, only 73 of the 779 graduates from the drug court programs were involved in 

a criminal offense leading to an arrest within one year after graduation. And, program 

graduates have substantially lower rearrests than those expelled. Overall, 41% of the 

terminated participants and 9% of the graduates were arrested. This means that of the 722 

arrested participants in the post-program follow-up, a total of 90 % were expelled. Similar 

findings have been reported by Finnegan (1998), Peters (1999) and Goldkamp et. al.(2001). 

As shown in Figure 10.1, findings indicate that 3 1% of the 2357 Participants had 

10-9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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90.0 - 

80.0 - 

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Figure 10.1 12-Month Fixed Follow-up Post-Program Arrests Outcomes 

100.0 1 

I 

53.4 

0, 

50.0 

40.0 

30.0 

20.0 

10.0 

0.0 

n 

I 

St MaryPatish creekcwnty BakersfW Jackson County Total 

El Graduated Terminated Ovwall , 

As shown in Figure 10.1, the rate of post-program recidivism is consistently higher 

for terminated participants than graduates across all four sites: Moreover, terminated 

participants were arrested in a shorter period of time. Terminated participants who were 

arrested took an average of 4.5 months until they were arrested whereas those graduates 

who were arrested took about 6.6 months. 

status is the most consistent variable associated with post-program recidivism. In other 

words, offenders who “successfully” complete the drug court program through 

graduation are three times less likely to be arrested in the post-program follow-up than 

terminated participants. And, drug court graduates who were arrested took a longer 

period of time before they were arrested. In sum, if these drug court programs are 

reducing recidivism, it would appear they are having their greatest effect on those 

individuals who successhlly completed the program, 

Other factors associated with post-program recidivism at one or more sites include: 

treatment attendance - with participants with low attendance at treatment sessions having a 

greater likelihood of being arrested after program discharge; racdethnicity - with race and 

ethnic minorities being more likely than white non-Hispanics to be arrested; age at first 

arrest - with Participants having prior arrests at younger ages being more likely to be 

rearrested; gender - with males being more likely to have a post-program arrest; and, 

participants with arrests during their participation in drug court. Overall, participants with 

in-program arrests were twice as likely to have a subsequent post-program arrest. Among 

the 1581 participants with no in-program arrests 23% were arreged after program 

discharge. And, a total of 48% of the 776 participants with in-program arrests were also 

arrested in the twelve month follow-up. 

Like other studies, the findings in this study indicate that program completion 

10-10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
The results of a series of logistic regression models confirm that program 

“succeqes” in terms of graduation are also “successfbl’’ post-program in terms of 

recidivism whereas program “failures” (participants terminated from the program) do not 

do as well after program discharge. The results of a series of path analyses support this 

finding. They indicate that participant compliance with key components of the drug court 

model operate through program completion thereby affecting post-program recidivism, 

However, as reiterated throughout, these findings are limited as they show mixed results 

and are site specific. 

Nevertheless, the fact that program graduates are less likely to be arrested is a 

substantive finding of some significance. Overall¶ the findings in this research confirm 

what has been found in other studies - namely that drug court graduates “succeed” and 

terminated participants “fail“ - have policy implications. Nationally, it suggests that 

’ improvements in program retention and program completion should remain focal points of 

hg court programs (See also Bavon, 2001). Such a recommendation is justified given the 

relatively high rate of unsuccessll terminations reported m this study and throughout the 

literature. 

drug courts have the potential to become an effective modality to reduce substance abuse 

and recidivism by providing offenders drug treatment services, providing the leverage 

necessary to insure their participation in drug treatment and achieve abstinence, providing 

swift and certain negative sanctions for negative behavior, and providing the addictoffender with time to adjust to treatment, testing and sanctions. Is it possible for drug 

treatment courts to achieve these goals? 

The fmdings of this and other major studies of drug court programs have not 

identified theoretical flaws in the ‘drug court’ model. Continued enthusiasm for drug 

treatment courts is warranted. However, it is possible that the drug court model may Mter 

in implementation. In fact, an examination of program integrity and actual drug court 

operations indicates a number of ways that drug court programs may actually be fhhg 

their clients. Addressing such issues in the hture will improve program outcomes. 

At the onset of this discussion, we described the promise of the drug court - that 

10-1 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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position or policies of the U.S. Department of Justice.
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expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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1992 

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This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Appendix A 

, Treatment Administrator's Mail Survey ' , 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Drug Court Treatment Implementation Study 

Treatment Administrator's Mail Survey 

Name: 

Position: 

Agency: 

The following questions refer to the drug treatment program that you oversee. The information 

is being requested in reference to the drug treatmentprogram that serves the adult diwg court in 

your jurisdiction. This information is being requested in advance of our scheduled interview 

with%jou, so that you may have enough time to collect any information you may not have readily 

available during that interview. Please complete this survey and return it to us when we arrive 

at your agency to conduct our in-person interview. Ifyou have any questions, please call Jefs 

Bouflard at (301) 403-4414. 

I 

A) Promam Administration 

1) Organizational Structure 

1. Please all check those that apply to your drug treatmentprogram. 

Independent (not part of a larger parent agency) 

Part of a hospital or larger healthcare facility 

Part of a university or school 

Part of a prison or other criminal justice program 

Part of a tribal government 

Part of a community-based organization 

Part of a municipavlocal mental health agency 

Part of a municipaVlocal substance abuse agency 

Part of a state mental health agency 

Part of a state substance abuse agency 

Part of a non-profit cornunify service agency 

2. If your program is part of a larger, parent agency, how many units does this agency include? 

3. Who runs the parent agency? 

CEO 

Medical Director 

Other 

Appointed Officers 

Elected Officers 

BGR University of Maryland 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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2) Program Funding 

1. What is your drug treatment program's approximate total operating budget for the current fiscal 

year? (Check one) 

Less than $45,000 per year 

-$45,100 - $90,000 per year 

$90,100 - $250,000 per year 

$250,100 - $500,000 per year 

$500,'100 - $1 million per yea 

More than $1 million per year , t, 

2. Please provide appi-oximate whole dollar amounts for those hding sources that your 

drug treatment program utilized over the past fiscal year. l 

a. Federal Sources: 

$ Medicare 

$ ' Veterans Administration 

$ 

$ SAMSHA Funds 

$ 

$ 

$ Other Federal Funds (spec*) 

Center for Substance Abuse Treatment Funds 

U.S. Dept. of Justice (BJA, BJS, NIJ, etc) 

National Institute of Health Funds 

b. State Sources: 

$ State General Funds 

$ 

$ Other State Agency (spec*) 

$ Medicaid 

State Criminal Justice Agency (spec%) 

$ Other (spec%) 

c. Local Sources: 

$ County Court Funds 

$ 

$ City Court Funds 

Other County Government Funds (spec*) 

$ 

$ Other Local Funds (spec%) 

Other City Government Funds (spec%) 

BGR University of Maryland 2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Prhate Sources: 

$ Health Insurance 

$ Client Fees 

$ Foundations or Corporations 

$ Religious Organizations 

$ Self-supporting Income 

$ Other Private Sources (specify) 

What % of the overall agency’s budget does your program’s budget represent? 

Please 311 in the amounts that represent the percent of the drug treatment program’s (not 

the overall agency’s) budget allocated for each of the following: 

Program Activity 

Individual Treatment Services 

Group Treatment Services 

Treatment Adjuncts (e.g., voc. ed., other 

social services, etc) 

Case Management 

Drug Testing 

Program Administration 

Program Physical PlanWacilitiedRent 

StafFTraining 

Training Materials 

Other 

BGR University of Maryland 

% of Overall Drug Treatment Program 

Budpet 

3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
5. If your program were able to secure more funding, rank order your preference for 

spending the money on each of the following (1 =thing you would most like to spend it 

on). 

Ranked Preference to SDend Additional 

Promam Activitv - Funds 

Individual Treatment Services 

Group Treatment Serviceq 

Treatment Adjuncts (e.g., voc. ed., other 

social services, etc) 

Case Management 

Drug Testing 

Program Administration 

Program Physical Plant/Facilities/Rent 

Staff‘Training 

Training Materials 

Other 

3) General Staffing and Personnel Questions 

1. Please provide the number of stafffunded specifically for the drug treatment program. 

Staff TvDe 

Contractual (not 

{+35h rs/week) {-35/hrs/week) aeencv/Droeram) 

Full Time Part Time directly employed by 

ManagerdSupervisors 

Clinical (Therapists, 

Counselors, etc) 

Medical Staff 

Security Staff 

Clerical Staff 

Case Managers 

Total 

2. Please indicate the number of staff involved in treatment provision, assessment, case 

management, or clinical supervision, who hold each of these as their highest degree: 

MD or DO: 

PA or NP: 

RN/LPN: 

Ph.D.: 

Master’s: 

Bachelor’s: 

HS diploma or less: 

BGR University of Maryland 4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Substance abuse treatment certificatiodlicensure: 

3. Please indicate the number of clinical staff who are recovering alcoholics. 

, 

4. Please indicate the number of clinical staff who are recovering substance abusers. 

B) Treatment Propram (s) ‘Cham c teris tics 

1) Nature of Treatment Services 

I. Indicate the “expected” duration of each phase of the programs offered by your agency (e.g., 

fa client completed each phase of the program, how long would this tak?). Include all services 

offered by your agency. 

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Promam Tv~es 

Detoxification 

Residential 

Out-patient Drug-Free 

Expected Duration in Weeks 

Phase 1 Phase 2 Phase 3 Phase 4 

(I ,I 

Intensive Outpatient (+6 hrdweek of Tx) 

Jail-Based 

Methadone Maintenance 

Women w/CMdren Promam Y 

Self-Help Program 

Dual Diagnosis Program . 

Criminal Justice Population Program 

Other (please specifl) 

3. Please indicate the average number of clients assigned to each counselor in each 

program ype. 

Propram Tmes Averape # of ClientsKounselor 

Detoxification 

Residential ~ 

Out-patient Drug-fiee 

Intensive Outpatient (+6 hrdweek of Tx) 

Jail-Based 

Methadone Maintenance 

Women w/Children Program 

Self-Help Program 

Dual Diagnosis Program 

Criminal Justice Population Program 

Other (please specitj) 

BGR University of Maryland 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
'I 

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3. If there is currently a.waiting list for any of your treatment programs, please identifi the 

program by providing the estimated wait time (in days] and number of clients on that list. 

Check here ifyou do not keep a wait list I I 

Promam Twes 

Detoscation 

Residential 

Out-patient Drug-fiee 

Intensive Outpatient (+6 hrdweek of Tx) 

Methadone Maintenance 

Women w/Childrea Program 

Self-Help Program 

Dual Diagnosis Program 

Criminal Justice Population Program 

Other (please speclfj) 

Jail-Bmd 

Estimated Wait Number of Clients 

Time (days) on Wait List 

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4. Please indicate the approximate number of hours each week @er counselor) that your 

counselors spend per$orming the following activities. 

Counselor Activities HoursWeek 

AdmissionsAnt ake 

Assessments 

Discharge duties 

Group Therapy 

Individual Counseling 

Case Management Duties 

Other Administrative Duties 

Other Duties spec^) 

BGR University of Maryland 6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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5. Please indicate, by program type, the level of participation your program desires that 

clients spend in group, individual and “other types” of treatment activities: 

Promam TvDes 

Detoxitication 

HoursNeek in HoursRVeek in Hours/Week in 

Grow Individual Other Services 

Residential 

Out-patient Drug-fiee 

Intensive Outpatient 

(+6 hrdweek of Tx) 

Jail-Based 

Methadone 

Maintenance 

Women w/Children 

Program 

Self-Help Program 

Dual Diagnosis 

Program 

Criminal Justice 

Population Program 

Other (please spec@) 

6. Does your program make use of “closed groups” of clients or can individual clients begin 

the program at any time (“open groups)? Open Closed (Circle one) 

7. Does your program make use of any formal, written or pre-packaged curricula (e.g. social 

skill building curricula)? Yes No (Circle one) 

If so, name the curriculum: 

Please provide us with a copy of the curriculum, ifpossible. 

BGR University of Maryland 7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
C) Client Information 

I. Please indicate the percentage of your clients from each of the following categories, 

served by your program(s) over the past fiscal year: 

Cateeorv Overall From the D~UP Court 

\ 

Total Clients 

% Clients employed full- , 

time 4 I 

% Males 

% Females 

% Clients w/dependent I 

children under their care 

2. Please indicate the percentage of clients in your program(s) from each referral source 

over the pqst fiscal year: 

a. What percent of clients are referred fiom Drug Court? 

b. What percent of clients are referred fkom other Courts? 

c. What percent of clients are referred fiom other Criminal Justice Agencies? 

d. What percent of clients are self-referred? 

e. What percent of clients are referred fiom other sources? 

f. Please descni these other referral sources. 

I 

3. Please indicate the percentage of clients, overall and from the drug court that your 

program@) serves from each of these ethnic backgroundr over the past fiscal year: 

'YO of Clients in Programs % of Clients from Drug 

RaceLEthnic Grow Overall - court 

Whit e/Caucasian 

African American 

Asian 

Hispanic 

Native American 

Other 

BGR University of Maryland 8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, , 

4. Please indicate the percentage of clients, overall andfiom the drug court, your 

program@) serves from each of the following categories: 

Categorv 

Vietnam Veterans 

Clients with HIV 

Clients with AIDS 

% of Clients in Programs % of Clients from Drug 

Overall - court 

Other (specltjr) 4 

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5. Please indicate the percentage of clientsi overall and from the drug court, your 

program(s) servesfrom each of the following age groups: 

Ape Category 

Under 18 years 

18-29 

3 0-3 9 

40-49 

50-59 

Over 60 

BGR University of Maryland 

YO of Clients in Programs YO of Clients from Drug 

Overall - court 

9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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6. Please indicate the percent of clients, overall andfiom the drug court, your program(s) 

serves whose primary drug of abuse is each of the following: 

Primary Drug of Abuse 

CatePoly 

Heroh 

Non-Crack Cocaine 

Crack 

Amphetamine 

BarbiturateflranqukB 

Marijudashish 

LSD 

PCP 

Inhalants 

Over the counter drugs 

Alcohol 

Other 

YO of Clients in Programs YO of Clients from Drug 

Overall - court 

7. Please indicate the percent of clients, overall and from the drug court, who left your 

program for each of the following reasons over the past fiscal year: 

Reason Clients Left 

Promm(s) 

CompletedGraduated 

Left AMA 

Returned to Prison 

Returned to Jail 

Removed for Rule 

Violations 

Referred to Another Level 

of Care 

Deaths 

Other 

I BGR University of Maryland 

% of Clients in Programs % of Clients from Drug 

Overall court 

10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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D) Provision of Specific Services 

Please indicate if any of the following services are included as part of your drug treatment 

program(s); either provided directly or by referral (check all that apply). 

1) Substance Abuse Services 

Service 

Provided Directly by Your Provided By Referral to 

Agency Other Oreanhation 

Individual Counseling 

Group Therapy 

General Substance Abuse 

Relapse Prevention 

Social & Coping Skills 

12 Step or Other SelfHelp 

Life Skills 

Vocational Skills 

Anger Management 

Family Sessions 

Follow-up Counseling 

Case Management 

Family Counseling 

Other (Specify) 

2) Medical Services 

Service 

Adult Primary Care 

Pediatric Care 

Prenatal Care 

Post-Partum care 

Physicals 

TB Testing 

STDND Testing 

HIV Testing 

Medical Detoxification 

Methadone Treatment 

Prescribed Medications 

Birth Control 

Acupuncture 

Other (Spec*) 

BGR University of Maryland 

Provided Directly by Your 

APencv Provided by Referral 

11 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
3) Educational and Vocational Services 

Service 

Academic (Tutor, GED) 

Job Training (Voc Ed) 

Career Counseling I 

Job Placement 

Other Career Services 

Provided Directly by Your 

Agency Provided Bv Referral 

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4) Additional Social Services 

Provided Directly by Your 

Service 

Locating Housing 

Transportation 

Legal Assistance 

Childcare Services 

Services in Spanish 

Services for Sight Impaired 

Services for Hearhg 

Impaired 

Other (Spec*): 

Other (Specify): 

Other (Specify): 

Provided BY Referra! 

5) Continuing Drug Treatment Services 

1. Services provided after clients leave your program(s): 

Service 

Provided Directly by Your 

Agencv Provided Bv Referral 

Intensive outpatient 

Out-patient Drug-Free 

Residential 

12 StepdSupport Group 

Vocational Education 

Other (Specify): 

BGR University of Maryland 12 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Appendix B 

Treatment Administrator Interview Protocol 

BGR University of Maryland 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Drug Court Treatment Implementation Study 

Treatment Administrator Interview 

Staff Code Number: 

Agency: 4 

A) Assessment & EliPibility 

1. What are the explicit eligibility criteria for drug court clients to enter your program? 

2. Which agency makes the determination of a drug court client’s eligibility for your 

program? 

3. What specific criteria do you use to exclude clients fiom your program? 

4. Can drug court clients enter the program(s) without meeting eligibility criteria? 

5. What intake tool does your program use to screen incoming drug court clients? 

BGR University of Maryland 2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
6. Do the personnel who perform the assessment of incoming drug court clients have 

particular training in substance abuse needs assessment? If so, please explain this 

training. 

7. Please describe any personalized treatment plans developed and maintained for each 

of your clientddrug court clients. (Ask -Can we get a copy of a treatment plan?) 

8. How are drug court clients matched to appropriate treatment services based on the 

results of their initial assessment? 

9. Who is primarily responsible for updating the treatment plans of drug court clients? 

(Primary counselor, special clinical staff, drug court staff person, etc.. .) 

B) Drug TestinP and Contingency Management 

‘1. Please describe the process (e.g., urinalysis) used to monitor clients’ drug use 

during progrddmg court participation. 

2. What is the frequency with which drug tests are required from your clients? 

BGR University of Maryland 3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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3. What are the typical procedures (behavior modification techniques) employed in , 

response to a positive drug test by one of your clients. 

4. How does your p&gm use therapeutic coqsequenceq and incentives to reinforce 

client behavior in a manner consistent with treatment objectives (e.g., contingency 

management procedures, token economies)? 

5. What are the sanctions imposed by the drug court for client's misbehavior? What 8 

incentives are given for appropriate behavior used by the drug courts? I, c< 

6. Describe the behavioral contract used with clients participating in your program. 

C) Aftercare Procedures 

1. Please describe the process used in your program for aftercare treatment coordination 

or pre-release planning and case management? Who in your program is responsible 

for this? 

2. Does your program have designated aftercare treatment slots available in the 

community for program graduates? If so, please describe the number and type of these 

slots. 

BGR University of Maryland 4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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3. Please describe the funding process for program graduates who are placed in afierczm. 

4. Please describe the assessment and intake process for program graduates who we 

placed in aftercare. 

D) CommunicatiodInformation SharinP with the Dmp Court 

,,, , 1. Please describe the means of communication between your program and member of 

the drug court. With whom and how fiequently do you have contacts? 

2. Please describe your program's communication with crkinal justice supervision 

agents other than court personnel (e.g., Probation or Parole officers). With whom and 

how fiequently do you have contacts? 

3. What information is shared with the drug court regarding clients' attendance at 

treatment meetings? 

4. How are drug court or CJ supervision staff involved in the treatment planning process 

for your clients? 

5. Do drug court/CJ supervision staff attend treatment staff meetings? 

BGR University of Maryland 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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6. Do treatment staff regularly attend drug court hearings? If so, who attends these 

hearings and what role do they play there? 

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7. Describe the mechanisms by which information is shared between the Drug Court or 

supervision agents and your treatment program. I 

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8. Do you feel this process bilateral? 

9. In your opipion, how effective is this communication between your progra~ and the 

drug cow? 

E. Program Monitorine/Evaluation/Certification 

1. Please describe any performance measures your program may have in place. 

2. Please describe the MIS systems your program uses to maintain client data. 

3. Please describe the type of reporting requirements your program has. 

BGR University of Maryland 6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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4. Please describe your program's training and other certification requirements. 

5. From what accrediting bodies does your program hold certifications? 

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BGR University of Maryland 7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Appendix C 

Treatment Provider Survey 

BGR University of Maryland 1 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Drug Court Treatment Implementation Study 

Treatment Providek Survey 

Code Number: 

\ 

The following questions refer to the drug treatment program that you work in. Please a 

complete each of the, following questions to the best of your knowledge. This information 

is being requested so that we may better understand the drug treatment delivered to 

clients referred from the local drug court. Please complete this survey and return it to us 

in the stamped envelope we have attached. Once we receive your completed survey, we 

will forward the $25 stipend to you for your time in helping us collect this information. 

If you have any questions, please call Jeff Bouffard at (301) 403-4414. 

Please provide your name and mailing address on this sheet only. We will separate this 

sheet from your answers once we receive the survey fi-om you, in order to protect the 

confidentiality of your answers. Only you and the researchers at the University of 

Maryland will know which code number matches with your name. 4 

Name and Address: 

Agency Name: 

BGR University of Maryland 2 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Code Number: 

Use “N/A ”for “Not Applicable” and “Unknown” ifyou don’t know an 

answer. 

A. Staff Characteristics: 

1. What is your job title? 

2. What are your primary responsibilities? 

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Counselor , 

Case Manager 

-Court Liaison 

Intake SIjecialist 

Other (Speci~) 

3. What is the highest academic degree you hold? (please put a check mark). 

MD or DO: 

PA or NP: 

RNLPN: 

Ph.D.: 

Master’s: 

Bachelor’s: 

HS diploma or less: 

4. What professional credentials/certifications/licenses do you hold? 

5. How many hours do you work per week at this program? 

6. Are you a recovering alcoholic or other substance abuser? Yes No (circle one) 

7. How many clients are currently assigned to you? 

8. How would you describe yourself! (check all that apply) 

Ethnic Background: 

Caucasian 

Afiican-American 

Asian 

Hispanic 

Native American 

Other 

9. What is your age? 

BGR University of Maryland 3 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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10. How long have you worked at this program? yrs. months 

1 1. How long have you proyided drug treatment? yrs. 

12. How long have you provided social services generally? yrs. 

months 

months 

13. How long have you worked with offender populations? yrs. months 

B) Staff Activities: 

1. How many group sessions do you provide per week? 

2. What is the average number of clients in each of these groups? 

3. How many individual sessions do you provide per week? 

4. Does your program use an intake tool for all incoming clients? Yes No (circle one) 

, 

If so, state which one. (e.g., ASI, SAS). 

5. Do you feel this intake tool is useful for making treatment plans? Yes No (circle one) 

6. How many assessments do you perform in a week? 

7. Briefly describe the training you received in the assessment of incoming clients. 

8. Are individualized treatment plans developed for each of your clients? ’ 

Yes No (circle one) 

9. How often are these treatment plans updated? 

-Weekly or more often 

Monthly 

Less than once/month 

As needed 

They are not updated 

-Other (Specify): 

10. Who is primarily responsible for creating and/or updating the treatment plans? 

BGR University of Maryland 4 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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1 1. How much time do you personally spend on treatment planning per week? 

12. Please indicate the approximate number of hours each week that you spend 

performing the following activities: 

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Program Activity 

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Hourstweek 

I 

Admissions 

Assessments 

Discharge duties f 

Group Therapy Sessions 

Individual Counseling 

Case Management Duties 

Family Counseling I 

Other Administrative Duties 

Other Duties (Specifjt) 

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C) Program Characteristics: ,, ,I 

1. How long are clients supposed to stay in your program? (By design, how long should 

clients be participating in treatment?) 

2. mat is the average length of time clients actually stay in ybur program? 

3. Please check the types of drug treatment services available in your agency (check 

those that are available): 

Procram Twes 

Detoxification 

Residential 

Out-Patient Drug Free 

Intensive Outpatient 

Jail-Based 

Methadone Maintenance 

Other (please specify) 

BGR University of Maryland 

4 If Available 

5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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4. Please indicate the duration of each of t,ese services (e.g., -ow long is the program 

designed to last?). If duration of the program is’based on client need and behavior, 

include the average number of weeks a “successful” client would spend in each , 

programb 

Program Types Expected Program Duration 

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Detoxification 

Residential 

Non-Residential (DAg Free) I 

Intensive Outpatient 

Jail-Based 

Methadone Maintenance 

Other (please speci@) 4 I 

5. Does your program make use of any formal, written or pre-packaged curricula (e.g. 

social skill building curricula)? Yes No (Circle one) I 

,I tf 

If so, please provide the name of the curriculum: 

6. Please describe the specific training you received in the use of these pre-packaged 

curricula? 

7. Please describe your experience using these curricula? (check all that apply). 

They are effectivehseful 

-They are clearhnderstandable to the clients 

They are too structured for the clients to use 

-They are too complicated for the clients to use 

They are too longhime consuming for the clients to use 

-They are not relevant to client’s real problems 

They are too basiclrudimentary for clients to use 

8. Please indicate whether your program makes use of any of the following treatment 

materials (check all that apply): 

- Video tapes 

- Audio tapes 

-Workbooks/Worksheets 

- Other (please describe) 

JournalsDiaries 

BGR University of Maryland 6 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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9. If there is currently a waiting list for some or all of your treatment programs/services; 

please identify the program, estimated wait time and number of clients on that list. 

10. Does your program use urinalysis to verify a client's drug use? 

Yes No (circle one) 

1 1. If so, check how often are drug tests required fiom your clients? 

Daily 

Weekly 

Monthly 

Randomly (Specifjl usual frequency of tests): 

Other (specify) 

12. Does drug-testing frequency vary based on the clients phase in the treatment 

program? Yes No (circle one) 

13. If drug-testing frequency varies with treatment phase, please provide the frequency 

for each phase on the lines provided below: 

Phase 1- Name: Frequency: 

Phase 2- Name: Frequency: 

Phase 3- Name: Frequency: 

Phase 4- Name: Frequency: 

14. Please make a check for who is responsible for conducting the drug tests? 

Treatment staff 

Drugcourtstaff 

Probation officers 

Outside agency 

-Other (specify) 

15. Are reports of drug testing behavior generated by the agency responsible for the 

testing? Yes No (circle one) 

16. If so, are these reports shared between your treatment program and the criminal 

justice (Drug court) agencies? Yes No (circle one) 

BGR University of Maryland 7 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
17. Please describe the typical procedures and sanctions employed by the treatment 

program in response to a positive drug test by one of your clients? 

18. How do these procedures differ from those employed by the drug court? I 

19. Does your program have an established set of behavior modification techniques to ($7 shape client behavior in a manner consistent with treatment objectives (clear rules and 

a list of possible consequences, rewards or sanctions)? 

Yes No (circle one) 

20. If so, please briefly describe these techniques or policies. 

D) ContinPencv ManaPement Procedures: 

1. Is a written behavioral contract provided to clients as part of their drug court 

participation? Yes No (circleone) 

2. Are restricted behaviors and their associated sanctions made known to clients? 

Yes No (circle one) 

3. What sanctions are used for negative behaviors? 

Loss of privileges 

Require to attend extra treatment sessions 

Require to attend extra support (e.g., MA) sessions 

-Homework 

Increased Drug testing 

Financial Consequences (e.g., fee not waived) 

Removal of Tokens, Credits, or Points (redeemable for some privilege or 

goods?) 

-Other (specify) 

BGR University of Maryland 8 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
I 

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4. Are rewards also used in response to appropriate/desirable behaviors? 

Yes No (circle one) 

5. What rewards are used for positive behaviors? 

Verbal Praise from counselor 

Verbal Praise from other clients 

Reduce Treatment Sessions 

-Reduce'Drug Testing Frequency 

Financial (e.g., waive testing fees) 

Vouchers, Tokens, Credits, or Points (redeemable for some privilege or 

goods) 

Certificate issued 

Token Economy 

Other (specify) 

6. Please estimate the approximate ratio of rewards to sanctions used (e.g., 4: 1). ; 

7. Who decides upon the imposition of any sanctions or rewards? . 81 

Judge 

Probation oficer 

Treatment Counselor 

Other (specify) 

8. What type of infractions would lead to a client being removed from your treatment 

program? 

9. If you are dissatisfied with a client's progress does the drug court judge usually 

(check only one): 

Heed your advice about how to respond 

Ignore your recommendations 

Warn the client 

Other (specify) 

10. Please describe the criteria for program graduation. 

BGR University of Maryland 9 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 

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1 1. How are these criteria made clear to participants at intake? 

(check the most common method) 

- Written Behavioral Contract 

- Verbal Explanation 

Other (speciq) 

12. Does your program have designated aftercare treatment slots in the community for 

program graduates? Yes No (circle one) 

13. If so, please indicate the number of each of these type of treatment slots. 

Detox Slots 

- Out-Patient Drug Free Program Slots 

Intensive Outpatient (+6 hrdweek) Slots 

Self-Help or Support (MA) Slots 

Other (specify) 

4 Residential Treatment Slots 

1,- , 

14. Please describe the assessment and intake process for program graduates who are 

placed in community-based aftercare drug treatment. 

E) Interaction with the Drup Court: 

1. Do you have regular contact with members of the Drug Court? Yes No (circle one) 

2. If so, please check the box for the approximate fiequency of contact with each of the 

following personnel: 

Less than 

Court Personnel Daily Weekly Monthly Monthly 

Judge 

Court Liaison 

Other (specify) 

3. Do you have regular contact with supervision agents (Probatioflarole Officers)? 

Yes No (circle one) 

BGR University of Maryland 10 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
4. If so, please check the box marking the approximate frequency of contact with each of 

the following personnel: 

Supervision Less than 

Personnel Daily Weekly Monthly Monthly 

Probation Officer 

Parole Officer 

Other (specie) 

5. Are Drug Court/Supervision staff involved in treatment planning for your clients? 

Yes No (circle one) 

'"I 

4. Do Drug Court/Supervision staff attend treatment staff meetings? 

Yes No (circle one) 

5. Do treatment staff regularly attend court hearings? 

, Yes No (circle one) 

6. What mechanisms are used to share information between you and the drug 

cowtlsupervision agents. (check all that apply) 

Staff meetings 

Written Reports 

Telephone calls 

Other (specify) 

7. Is the information shaiing process bilateral? (does info flow in both directions?) 

Yes No (circle one) 

8. In your opinion, how effective is the communication between the drug court and your 

treatment agency? (circle a number) 

Very Effective 

1 2 3 

BGR University of Maryland 

4 

Not at all Effective 

5 

11 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Drug Abuse Treatment Philosophy -Causation Scales 

- 

Respond to each of the following statements using this scale. Please fill out both sides of each page 

1 .The causes of drug use vary by gender. 

1 2 3 4 5 

Amee Disagree 

Strongly Strongly 

1 2 3 4 5 

2.Drug abuse by females is caused in part by gender discrimination. 1 2 3 4 5 

3.The causes of drug abuse vary by ethnicity. 1 2 3 4 5 

4.The causes of drug abuse vary by race. 1 2 3 4 5 

5. Drug abusers tend to associate with other drug abusers because their 1 2 3 4 5 

communities generally reject them. 

6. Negative reactions to a person’s drug use by the criminal justice system 1 

increase his or her likelihood of drug abuse. 

7.When a person is labeled as a dkg abuser this determines how individuals 1 

and social institutions respond to him or her. 

8. Drug abusers lack respect and affection of significant others. 1 2 3 

4 5 

4 5 

4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
. .. 

9. Drug abusers do not calculate the conse4uences of their behavior. 

10. Drug abusers do not cope well with htration. 

1 1. Drug abusers are risk prone and thrill seekers. 

12. Drug abusers have few long-term ambitions or aspirations. 

13. Drug abusers have little respect for social rules or conventions. 

1 2 3 4 5 

Strongly Strongly 

Apree Disagree 

1 2 3 4 5 

1 2 3 4 5 

2 3 4 5 

2 3 4 5 

2 3 4 5 

14. Drug abuse is concentrated in communities characterized by physical and 

economic decline, social disorder, and population instability. 1 2 3 4 5 

15. Drug abuse is a product of social disruption. 1 2 3 4 5 

1 2 3 4 5 

1 2 3 4 5 

16. Drug abuse results from generational and culture conflicts. - e 

17. Drug abuse occurs in communities that lack social organization. 

18. Declining neighborhoods cause drug abuse. 

19. Poverty causes drug abuse. 

20. Drug abuse is a product of substandard schools. 

rnmm-==u 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
2 1. Drug abuse is a product of substandard housing. 

-1 2 3 4 5 

Strongly Strongly 

Amee Disagree 

1 2 3 4 5 

22. Drug use is a learned behavior. 

23. Learning drug use is no different than leaming other behaviors or skills. 1 

1 2 3 4 5 

2 3 4 5 

24. The longer one is exposed to stressful life events, the greater the likelihood 

of drug abuse. 1 

25. Drug abuse is a response to the failure to achieve positively valued goals 

(e.g., a good job, education rewards). 1 

26. Drug abusers are generally people who turn to drugs because they lack 

access to or have failed to achieve success using legitimate opportunities. 1 

27.The greater number of stressful life events, the greater the 

chances of drug abuse. 1 

28. Drug abuse is a response to negative life events or conditions (e.g., physical 

abuse or living in a crime-ridden neighborhood). 1 

2 3 4 5 

2 

29. Drug abuse is a response to the loss of something positively valued (e.g., a 

job or breakup of a romantic relationship). 1 2 

i 

30. The more recent the stressll life event, the greater the chance of drug abuse. 1 2 

3 4 5 

3 4 5 

3 4 5 

3 4 5 

3 4 5 

3 4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 2 3 4 5 

Strongly . Strongly 

Agree Disagree 

3 1. Drug abusers generally lack a set of pro-social values. - 1 2 3 4 5 

32. Drug abusers generally lack effective coping skills for dealing 

with stresses in life. 1 2 3 4 5 

33. Drug abusers generally lack social skills that would help them 

1 2 3 4 5 

1 2 3 4 5 

manage their lives. 

34. Drug abusers generally lack lifeskills that would help them 

manage their lives. 

35. Drug abusers generally have a set of thought processes that facilitate 

their drug use (rationalizations,-denial, minimizing, blaming others, etc.). 1 2 3 4 5 

36. Drug abusers generally have a set of anti-social attitudes that facilitate 

their drug use. 1 2 3 4 5 

37. Drug abusers generally lack the ability to feel empathy for other people. 1 2 3 4 5 

38. Drug abusers are generally only concerned with themselves and do not 

think of the consequences of their actions for other people. 1 2 3 4 5 - 

39. Drug abusers generally consider only things in the present, ignoring the 

future consequences of their actions. 1 2 3 4 5 

40. Drug abusers sometimes relapse or continue to engage in drug use because 

they think “going straight” is too boring and unexciting. 1 2 3 4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 2 3 4 5 

Strongly Strongly 

Agree Disagree 

4 1. Drug abusers often fail to see the relationship between their past patterns 

and current behaviors. 1 2 3 4 5 

42. Drug abusers often relapse or continue to use drugs because they are 

unaware of the things that trigger their cravings for drugs. 1 2 3 4 5 

43. Drug abuse is caused by the fact that the drug abuser’s environment - 

provides reinforcement for such behaviors. 1 2 3 4 5 

44. Drug abusers use drugs because they do not have any alternative, 

pro-social leisure time activities to participate in. 1 2 3 4 5 

-45. Drug abusers generally lack emotional skills needed to cope with their lives. 1 2 3 4 5 

46. Drug abusers generally lack problem solving skills needed to function 

effectively in life. 1 2 3 4 5 

47. Drug abusers often relapse be6ause they fail to acknowledge their 

powerlessness over the disease of addiction. 1 

48. Drug abusers often relapse because they fail to accept their need for a 

. higher power. 1 

2 

2 

4 5 

4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Drug Abuse Treatment Philosophy -Intervention Scales 

Respond to each of the following statements by circling the most accurate to your belief. 

1 2 3 4 5 

Strongly Strongly 

Agree Disagree 

1. It is important ta encourage clients to develop strategies for coping 

with racism. 

2. It is important to encourage clients to deal with any relevant racial issues. 

3. It is important to encourage clients to talk about issues related to their 

ethnic or cultural identity. 

4. Therapy should focus on encouraging clients to develop strategies for 

coping with prejudice and institutional discrimination. 

5. An important part of drug treatment is to address the negative 

self-concept of the drug abuser. 

6. Drug treatment should include concrete strategies for reintegrating 

the drug abuser back into the “conforming” community. 

7. Successful treatment helps clients learn how to use leisure time in more 

social activities (e.g., hobbies, family responsibilities, and so forth). 

8.Successful treatment gets clients more involved in constructive activities. 

9. A goal of therapy is to help the client develop a more positive self-concept. 

i 

1 2 3 4 5 

1 2 3 4 5 

1 2 3 4 5 

1 

1 

1’ 

1 

1 

1 2 

4 5 

4 5 

4 5 

4 5 

4 5 

4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
- 1 2 3 4 5 

Strongly Strongly 

Awee Disapree 

1 2 3 4 5 

10. Counselors should encourage clients to take a more active part in community 

organizations. _- 

11. Drug treatment will be most effective when community problems such as 

1 2 3 4 5 joblessness, limited education, and poverty are also examined. 

12. It is important to help clients solve daily life-management problems. 1 2 3 4 5 

13. Client progress will usually be undermined by social problems such 

as violence, racism, and unemployment. 1 2 3 4 5 

14. Treatment is most effective when it combines counseling with providing 

concrete services (e.g., housing, vocational, etc.). 1 2 3 4 5 

15. The success of drug treatment depends on the client making an association 

between drugs and negative outcomes. 1 2 3 4 5 

16. It is important to helpclients substitute healthy rewards (for example, 

socializing in a drug fiee 6nvironment) for unhealthy rewards 

(for example, drugs and alcohol). 1 

17. It is important to teach clients cognitive and behavioral skills to avoid 

drug use situations. 1 

2 3 4 5 

2 3 4 5 

18. It is important to assist clients in role-playing cognitive and behavioral 

skills to avoid drug use. 1 2 3 4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
- 1 2 3 4 5 

Strongly Strongly 

Apree DisaPree 

1. 2 3 4 5 

19. It is important to aid clients in identifying cognitive and behavioral - strategies that have been successful in avoiding drug abuse. 

20. It is important to teach clients behavioral skills to avoid drug use situations. 1 2 3 4 5 

2 1. It is important to aid clients in identifling behavioral strategies that 

have been successful .1 2 3 4 5 in avoiding drug use. 

22. A key part of successful drug treatment focuses on helping the client develop 

behavioral ways of reducing stress (e.g., walking away from confrontations). 1 2 3 4 5 

23. A key part of successll drug treatment focuses on helping the client 

develop emotional ways of reducing stress (e.g., seeking counseling). 1 2 3 4 5 

24. It is important for clients to understand the link between anger 

and drug abuse. 1 2 3 4 5 

25. A key part of successhl drug treatment fmuses on helping clients develop 

cognitive ways of reducing stress (e.g., learning to accept failures 

and move forward). 1 

26. Stress management is an essential part of successhl treatment. 1 

27. Drug treatment should generally include helping clients develop a set 

of pro-social values. 1 

2 3 

2 3 

2 3 

4 5 

4 5 

4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
1 2 3 4 5 

Apree Disagree 

- Strongly Strongly 

- 28.brug treatment should generally include clients learning about effective 

1 2 3 4 5 

1 2 3 4 5 

coping skills for dealing with stresses in life. 

29. It is important that drug abusers learn social skills that would help 

them manage their lives. 

30. Effective drug treatment should focus on life skills that would help 

1 2 3 4 5 them manage their lives. 

3 1. Drug treatment should have focus on the clients’ thought processes that 

facilitate their drug use (rationalizations, denial, minimizing, 

blaming others, etc.) 1 

32. It is important that drug treatmeit help clients reduce the anti-social 

attitudes that facilitate their drug use. 1 

33. Successful drug treatment generally focuses on the client’s inability to 

feel empathy for other people. 1 

34. Drug treatment should teach clients to be concerned with other people 

and think of the consequeiices of their actions for other people. 1 

35. Drug abuse treatment should help clients focus on the future consequences 

of their actions and stop focusing on only things in the present. 1 

36. Mective drug treatment helps clients avoid relapses or continued 

engagement in drug use by helping them see the benefits 

of “going straight”. 1 

2 

2 

2 

2 

2 

2 

3 

3 

3 

3 

4 5 

4 5 

4 5 

4 5 

4 5 

4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
37. Drug abuse treatment should focw on the clients need to see the 

relationship between their past pattern and current behaviors. 

38. It is important for drug treatment to help clients understand the things 

that trigger their cravings for drugs, to avoid relapse or 

continued drug use. 

39. Drug abuse treatment should focus on the fact that the drug abuser’s 

environment provides reinforcement for such behaviors. - 

40. Successful drug treatment should focus on helping clients develop 

alternative, prosocial leisure time activities. 

1 2 3 4 5 

Strongly Strongly 

APree Disagree 

1 2 3 4 5 

4 1. Drug abuse treatment should generally include a focus on clients’ lack 

of emotional skills needed to cope with their lives. 1 

42. Effective drug treatment involves helping clients to develop 

problem-solving skills needed to function effectively in life. 1 

43. Drug treatment should help clients acknowledge their powerlessness 

over the disease of addiction. 1 

44. It is important that drug treatment help clients avoid relapse by teaching 

them to accept their need for a higher power. 1 

f 

2 

2 

3 4 5 

3 4 5 

3 4 5 

3 4 5 

3 4 5 

3 4 5 

3 4 5 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Appendix D 

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, Treatment Observation Instrument 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
) Structurec 

Drug Court Treatment Process Evaluation 

Observation Code Sheet for Group Treatmen. Activities 

Site: Observer: 

Datenimes: Counselor: 

Meeting Type: No. Participants: 

Timeperiod ! 1: 2: 3: 4~ 5: 6( 7: 81 93 1: 1: 1 

O!O! O! O! O! Of O! O! O!O( 1: 2 

Treatment Item O!O! 0 

I 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Self-Acceptance (RET) 

Other 1 

Other 2 

Other 3 

*SSS Notes: 

# EcWoc Notes: 

Other 1 Notes: 

Other 2 Notes: 

Other 3 Notes: 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Summary Ratings of the Observed Activity 

i 

1) Treatment Format 

Was the activity you just observed part of a sequence of treatment activities? Yes No 

Was the activity you just observed part of a specific treatment phase? Yes No 

If so, what phase of treatment is this activity part of? 

Check all that apply to the activity you just observed. If more than one, rank them in the order 

they occurred. 

- Staff LecturePresentation 

- Client Lectureh'resentation 

- Staff Lead Discussion 

Outside Staff LecturePresentation 

Client Lead Discussion 

Outside Staff Lead Discussion 

- Open Group DiscussionPeer Interaction 

Other (Specify: ) 

2) Treatment Purpose 

Was a specific purpose/objective of this activity clearly related to the group? Yes No 

Check all that apply to the activity you just observed. If more than one, rank them in the order 

they occurred. - Educational (Academic or Vocational) 

-Treatment 

Clinical Education (Treatment readiness) 

- Ceremony (Grad, B-day, Discharge, etc.) 

Other (Specify: ) 

3) Treatment Style 

Circle the number that best describes the entire activity you just observed. 

Informal Formal 

1 2 3 4 5 

1 2 3 4 5 

1 2 3 4 5 

Not Confiontational Confiontational 

Not Analytic Analytic (e.g., Freudian, Psycho-Dynamic) 

I 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
4) Treatment Grow 

Circle the number that best describes your overall impression of the treatment client@) you just 

observed. 

Reserved open 

1 2 3 4 5 

Not Involved Very Involved 

1 2 3 4 5 

1 2 3 4 5 

Not Knowledgeable Knowledgeable 

5) Treatment Processes 

Circle the number that best describes the overall treatment process you just observed 

I Unstructured structured 

1 2 3 4 5 h’ 4 

Was the activity you just observed Scheduled Impromptu 

Was the activity you just observed: Co-ed All Male All Female 

Did the activity you just observed include any formal peer role models? Yes 

(e.g., formalized roles, such as “Facilitator‘‘ or “Coordinator”) 

No 

Narrative Comments: 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
, 

Site: Datemime: 

Describe the Physical Sefflng. 

t . 

Describe the climate. 

Offenders 

IC Staff 

Materials Distributed. 

Describe Any Distractions. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
NIJ Drug Court Study 

Treatment Observation Instrument Dictionary 

Introduce New Client(s): Introducing new clients to the group. 

Check-In: Usually in the beginning of a group meeting; clients take turns expressing 

how they are feeling today, what they want to work on, etc. 

Community Management: Discussion of issues related to the daily hctioning or 

operating procedures for the group or living unit (residential) (e.g., “ground rules” 

for participating in the group discussion, etc) 

Group/Community Issues: Discussion of therapeutic issues related to the group, such as 

previous conflicts between members, the need to share or keep information confidential. , 

Community Building Activity: Any activity designed to get members to work together, 

to trust one mother, or other wise improve the cooperation and sense of unity 

among group members. 

Physical Exercise: Any physical activity, often done as a way to start a group, such as 

stretching: calisthenics, Tai Chi, etc. 

Relaxation Training: Any activity designed to teach clients to relax without the use of 

substances, such as breathing exercises, meditation training, Zen, yoga, etc. 

Treatment Readiness: Any activity designed to build clients’ readiness for treatment, 

such as helping the client see the benefits of sobriety, or the costs of continued 

use. 

Motivation Building: Any activity designed to improve clients motivation for treatment 

or continued treatment, such as reassurances, boosting clients’ sense of selfefficacy, point out past successes or strengths. 

Alternative Activities: Teaching clients to develop a set of pro-social leisure activities 

(hobbies, time with kids, reading, etc), other than substance abuse or related 

activities (hustling, etc). 

Alternative Goals: helping clients to develop pro-social goals, to move beyond seeking 

drugs and getting high, to aspire to pro-social educational, occupational, 

interpersonal and/or familial goals. 

Alternative Values: helping clients to develop pro-social values, to move beyond 

valuing anti-social values such as hustling or “looking out for number one”. 

Pull-Ups/Sanctions: Staff or other group members calling members out for inappropriate 

behaviors, values, thinking patterns, and so on, during a formal activity. Formal 

imposition of therapeutic sarictions on the member in front of the group, such as a 

wearing a sign or sitting outside the group. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Rewards/Positive Recognition: Recognizing milestones in the treatment program 

(graduation, movement to new phase, accomplishment of a therapeutic task, in 

front of ,the group, granting new privileges, etc. , 

Trigger Analysis/Awareness: Any activity designed to teach clients to recognize the 

factors that put them at risk for relapse or re-offense, such as a particular risb 

situation, former associate, or emotional state (depression, anger). 

Relapse Prevention Pldnning: Planning for hoy the client will react when a “trigger” is 

encountered in the “real world”, developing an escape plan or other alternative 

coping method, other than using substances again. 

Parenting Skills: Any activity designed to teach clients improved techniques for caring 

for (nutrition, cleaning, etc), monitoring, supervising, or disciplining their 

children. 

Academic Education: Any activity designed to improve the client’s educational 

achievement in a specific academic topic area (e.g., math class, English class, 4 

’ 

etc). Not building motivation for clients to participate in some academic education 

activity at ‘a later date (code this as Alternative Goals). 

Vocational Education: Any activity designed to improve the client’s vocational 

preparedness in a specific occupational area (e.g., auto mechanic’s class, 

carpenter’s apprenticeship, etc). Not building motivation for clients to participate 

in some vocational education activity at a later date (code this as Alternative 

Goals), 

Job Skills Training: Any activity designed to improve the clients’ ability to search, 

apply and/or interview for a job, or to improve the client’s ability to keep the job, once it 

is obtained (e.g.,.work ethics, timeliness, time management, etc) 

Aftercare Service Planning: Any activity designed to develop a plan for the clients’ 

return to the community (or graduation from this program), including plans for locating 

and accessing other needed social services after leaving the current program. Planning 

for follow-up substance abuse treatment is scored as Aftercare Treatment Planning, see 

below. 

Aftercare Treatment Planning: Any activity designed to develop a plan for the clients’ 

return to the community (or graduation from this program), including plans for 

locating and accessing subsequent drug treatment or substance abuse support 

networks (ANNA). Planning for other social services is scored as Aftercare Service 

Planning, see below. 

Feelingsflhoughts-Behaviors: Clients discuss the relationship between their feelings or 

thought and their subsequent behaviors; to teach them that they have control over 

their thoughts and/or feelings, and thus the behavior that arises from these. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Attitudes: Clients discuss their attitudes and opinions (“view of the world”); particularly 

those that relate to their dealings with people, perspectives on crime and drug use (and 

the harms associated with these), and related antisocial behaviors (hustling for drugs, 

etc). 

Expectancies: Clients discuss what they expect in specific situations (when confronted 

by police, when buying drugs) or from certain people (family, fiends) or types of 

people (other addicts, police, counselors, etc). Also what clients expect from 

themselves in how they deal with situations and people (e.g., self-efficacy, feeling able to 

deal with things effectively). 

Appraisals: Client discuss how they perceive or evaluate themselves, or other situations 

and people (e.g., maybe they always see people in terms of power differentials 

and evaluate others in terms of their relative power or evaluate people in terms of 

their usefulness to the addict). ’ ’ 

Attributions: Clients discuss what they typically attribute to themselves, or other people; 

such as how they speculate on what other people’s motives might be (e.g., do they 

see other people as trustworthy, do they attribute their failures in life to 

themselves or others?) 

New Cognitive Skills: Clients learn new cognitive skills, such as to be aware of or 

monitor their own thoughts, to restrain themselves from acting when they are 

angry (such as recognizing anger and counting to 10 before reacting). 

New Emotional Skills: Client learn new emotional skills, such as ways of coping with 

feelings of depression or worthlessness when they have a lapse (e.g., by training 

themselves to remember something positive or by acknowledging that lapses are part of 

the recovery process). 

Structured Social Skills*: Clients use a Structured social skills program (usually using 

formalized written materials, workbooks, or videos) to learn new, pro-social ways 

of interacting with other people (e.g., how to effectively and politely enter a conversation 

with someone you don’t know, how to resolve a dispute without becoming aggressive, 

how to make and hold eye contact). Make a note of the name of the curriculum in the 

“Notes” section. 

Problem SolveKoping Skills: Clients learn how to analyze a problem, develop potential 

solutions, choose from among the possible solutions based on their likely outcomes, and 

implement the solutions. Clients learn ways of handling stressful life events other than 

through the use of substances (such as visualizing something pleasant, being assertive, 

without aggression, or walking away from a confrontation) 

Healing-Nurturing Activities: Clients discuss experiences or relationships that have 

helped them recover from difficult prior psychological or emotional events. Clients 

discuss the traumatic event or discuss something they did or that someone else did for 

them, that helped them put the trauma behind them and grow from it. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Physical Safety Issues: Clients discuss the need for feelings of physical safety within the 

therapeutic environment (free from threats or actual violent actions of others). 

Psychological Safety Issues: Clients discuss the need for feelings of psychological 

safety within the therapeutic environment (free from taunting, teasing, demeaning or 

disrespectful language from other members, or restrictions on the discussion of treatment 

topics outside of the group). 

Past Personal Experiences: Clients discuss personal experiences that lead them to drug ’ 

use and crime, dith the intent of helping ,one anothersee possible patterns in their own 

lives, past experiences, thoughts, feelings, values, and behaviors. 

Past Family Experiences: Similar to above, but clients review experiences specifically ’ 

within the family that provide relevant, therapeutic examples for others in the group. 

Past Street Experiences: Similar to above, but clients review experiences specifically 

from their “life on the street” that provide relevant therapeutic examples for others in the 

group. 

Past Other Experiences: Similar to above, but clients review experiences from atdomain . other than‘one described in the other “past experiences” items (maybe from a work or 

school environment) that provide relevant therapeutic examples for others in the group. 

Recent Incidents: Clients discuss recent events, either within the ,treatment group, living 

unit (if residential program), drug court, or in the wider community that are related to 

their recovery, the court, their criminal behavior or substance abuse. won-therapeutic 

“chit-chat” is not scored here). 

Review Diary/Journals: Clients discuss diary or journal entries that have been 

previously assigned as “homework” or which they may have completed on their own as 

part of the recovery process. 

Review Letters: Clients discuss letters they may have written or received (to or from 

family, friends, etc) as part of the therapeutic process. This category can also be 

used if clients discuss things like “goodbye to drugs” letters or a “letter to myself five 

years from now”, that are often used a treatment components. 

Use of Defense Mechanisms: Clients discuss the use of defense mechanisms, such as 

denial (it didn’t happen), minimization (I just used once, or no one got hurt, so it doesn’t 

count), rationalization (if I hadn’t used those drugs someone else would have) which 

impede their recovery. 

Acceptance of Powerlessness: Clients discuss their need to accept that fact that they can 

no longer control their lives and that they are helpless over their addiction. 

Spiritualityrnigher Power: Clients discuss their need to turn their lives over to a 

“Higher power”, or that they need to develop a sense of “spirituality” in their lives to help 

them with their recovery. 

, 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Moral Inventory (12 Steps): Clients discuss the process of recognizing “all those they 

have harmed” and “become willing to make amends to them”. Clients make a list of their 

shortcomings and the others they have harmed and ready themselves to make amends and 

accept their faults. 

Making Amends (12 Steps): Client discuss or prepare for the process of actively making 

“direct amends to such people whenever possible, except when to do so would injure 

them or others”. t 

Confrontation by Counselor: Clients are confronted by staff members, about their 

antisocial or drug-use-related thoughts, values, emotions, beliefs, or behaviors 

informally, during the course of a group. (Formal, structured confrontation duririg an 

activity designed specifically for that purpose would be scored as a “Pull-up or Sanction” 

above). 

Confrontation by Peers: Clients are confronted by other clients, about their antisocial or 

drug-use-related thoughts, values, emotions, beliefs, or behaviors informally, during the 

course of a group. (Formal, structured confrontation during an activity designed ’ 

specifically for that purpose would be scored as a “Pull-up or Sanction” above). 

Vishalization: Clients learn to visualize either a pleasant past event (as a means of 

relaxation) or to visualize themselves if they were successful in recovery (“what would 

you be like if you changed the things you wandneed to change in your life?”, as a means 

to build motivation for treatment). 

Emotion Managemqnt (RET): Clients are taught to moderate, but not eliminate their 

experience of emotions, with the idea that extreme emotions (extreme depression or rage) 

interfere with effective functioning, while moderate amounts of emotion can be healthy 

(e.g., some discomfort helps motivate us to improve our lives). 

Disputing (RET): Clients are taught to recognize and change those parts of their 

thinking that are not sensible, accurate or usehl. Clients thought processes which 

are irrational and stand in the way of their recovery are pointed out as such, so that clients 

can begin to recognize and change them. 

Self-Acceptance (RET): Clients are taught to give up the unrealistic expectations they 

have for themselves (and others) in order to lessen their feelings of guilt, shame and 

failure (or frustration with others), which can lead them to continued substance abuse. 

Other 1: Track the amount of time spent on other activities that do not appear to fit one 

of these categories and write a detailed description’of what the activity involved, so that 

we can determine how to code it back in the office. 

Other 2: Track the amount of time spent on other activities that do not appear to fit one 

of these categories and write a detailed description of what the activity involved, so that 

we can determine how to code it back in the oflice. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Other 3: TmcR the amount of time spent on other activities that do not appear to fit one 

of these categories and write a detailed description of what the activity involved, so that 

we can determine how to code it back in the office. 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Appendix E 

Drug Court Staff Interview Protocol 

, 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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Court Staff Name: 

Site: 

Interviewer: 

Role: (Describe tasks): ’ 

Drug Court Personnel Interview 

Title: 

Date: 

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Philosophical Beliefs 

How are substance abuse and crime related? (Probe: khat do you believe to be the nature and/or 

cause of substance abuse and crime? Do you believe that this is a causal relationship?) 

+ 

Which one comes first? 

Do you think that yok drug court participants would succeed if they were only participating in drug 

treatment? (Probe: What does the drug court piece add to the mix?) 

What do you believe is needed to improve this drug court program? I 

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Admission and ScreeninP Criteria 

How are clients referred to the drug court? How are clients legally screened? 

How are clients screened by treatment? 

What specific screening instruments are utilized by the drug court? 

who is responsible for conducting clinical assessments of clients’ substance abuse and other 

treatment or service needs? 

I 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
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What are the explicit eligibility criteria? 

Is information fiom these assessments used to determine eligibility requirements? 

Is this information used simply used to make decisions about care? 

Service Delivery - Drug Court 

Do clients have a contract with the court? If so, is it individualized or standard? 

What are the criteria for graduation? 

How do people get expelled from the drug court program? 

What kinds of sanctions and rewards are routinely issued in the drug court? 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Does the drug court team meet prior to regularly scheduled status hearings to review and discuss the 

progress of the clients? 

How do other activities of the drug court (e.g.: supervision, sanctionshewards, court schedule 

support drug treatment as a primary goal or do other goals take precedence over drug treatment 

services? (Probe: To what extent is treatment a primary goal?) 

Substance Abuse Treatment Structure and Operations 

How many and what type of servicehreatment providers does the drug court utilize? 

How long have these providers been serving you? 

What are the three most important goals of treatment in the drug court? 

Aftercare 

Is there an aftercare program? When does it occur? (Probe: Before or after graduation.) Who is 

responsible for working with clients to develop their aftercare plans? What role does the client play 

in developing this plan? 

Do you offer an aftercare treatment plan as part of the drug court? If so, what does it typically 

involve? 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.
Service Deliverv - Treatment 

Are personalized treatment plans developed and maintained for each of your clients? 

Have you ever gone to observe a treatment episode? 

Drug Testing 

Do you think that dnig te$ting is important? Why? 

Is information about drug testing results shared? How and with whom? 

What is the frequency of drug testing? Is it randomized? Is it observed? 

Overall, how well do you feel treatment personnel and criminal justice personnel get along? (Probe 

on the nature and types of conflicts.) 

I 

This document is a research report submitted to the U.S. Department of Justice.

This report has not been published by the Department. Opinions or points of view

expressed are those of the author(s) and do not necessarily reflect the official

position or policies of the U.S. Department of Justice.