MONOGRAPH


U.S. Department of Justice 

Office of Justice Programs 

Bureau of Justice Assistance 

Family Dependency Treatment 

Courts: Addressing Child 

Abuse and Neglect Cases 

Using the Drug Court Model 

D ECEMBER 2004 

Bureau of 

Justice Assistance 
U.S. Department of Justice

Office of Justice Programs 

810 Seventh Street NW. 

Washington, DC 20531 

John Ashcroft 

Attorney General 

Deborah J. Daniels 

Assistant Attorney General 

Domingo S. Herraiz 

Director, Bureau of Justice Assistance 

Office of Justice Programs 

Partnerships for Safer Communities 

www.ojp.usdoj.gov 

Bureau of Justice Assistance 

www.ojp.usdoj.gov/BJA 

NCJ 206809 

This document was prepared by the National Drug Court Institute and Center for Substance 

Abuse Treatment, under the Drug Court Training and Technical Assistance Program, under 

contract number 282–98–0023, funded by the Center for Substance Abuse Treatment.The 

opinions, findings, and conclusions or recommendations expressed in this document are 

those of the authors and do not necessarily represent the official position or policies of 

the U.S. Department of Justice. 

The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also 

includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile 

Justice and Delinquency Prevention, and the Office for Victims of Crime. 
Family Dependency Treatment Courts: Addressing Child Abuse and Neglect Cases Using 

the Drug Court Model 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services Administration 

U.S. Department of Health and Human Services 

Bureau of Justice Assistance 

Office of Justice Programs 

U.S. Department of Justice 

Prepared by 

National Drug Court Institute and Center for Substance Abuse Treatment 

Reviewed and Revised by 

Center for Substance Abuse Treatment, Bureau of Justice Assistance, National Drug Court 

Institute, National Council of Juvenile and Family Court Judges, and 

Permanency Planning for Children Division 

Disclaimer 

The opinions expressed herein reflect the views of a focus group conducted by the 

above-mentioned organizations and do not reflect the official position of the Bureau of Justice 

Assistance (BJA), the Office of Justice Programs (OJP), the U.S. Department of Justice (DOJ); 

the Center for Substance Abuse Treatment (CSAT), the Substance Abuse and Mental Health 

Services Administration (SAMHSA), the U.S. Department of Health and Human Services 

(DHHS); or the National Drug Court Institute (NDCI). BJA, OJP, DOJ, CSAT, SAMHSA, 

DHHS, and NDCI express no official support or endorsement of these opinions or of particular 

approaches described in this document. Any guidelines on substance abuse treatment presented 

in this document should not be considered substitutes for individualized patient care and 

treatment decisions. 

December 2004 

1 

2

Acknowledgments 

This monograph, Family Dependency Treatment Courts: Addressing Child Abuse and Neglect 

Cases Using the Drug Court Model, was produced under contract number 282–98–0023, funded 

by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health 

Services Administration, U.S. Department of Health and Human Services, 5600 Fishers Lane, 

Rockwall II, Suite 621, Rockville, Maryland, 20857, telephone 301–443–5052. The contractees 

were the National Drug Court Institute (NDCI) and ROW Sciences, Inc. Bruce Fry, J.D., served 

as the CSAT government project officer. Betsy Earp, ROW Sciences, Inc., wrote this 

monograph, and Kathleen R. Snavely, NDCI, served as managing editor. NDCI and CSAT 

would also like to acknowledge the hard work of Susan Weinstein and Rita Trapani of the 

National Association of Drug Court Professionals for their invaluable editorial assistance and 

massaging of the text. 

Appreciation is also extended to the field reviewers of this publication: 

Andrea Murphy 

Nancy K. Young, Ph.D. 

Marilyn McCoy Roberts 

The Honorable Charles M. McGee 

Cynthia Lu, J.D. 

Penny Howell, LMSW 

Kathleen Phillips, Esq. 

The Honorable Nicolette Pach 

Meghan Wheeler, NDCI, and Nancy Tribble, National Council of Juvenile and Family Court 

Judges, served as the review and revision team. Susan Yeres served as the team’s writer and 

editor. Bruce Fry, CSAT, and Jennifer Columbel, formerly of the Bureau of Justice Assistance, 

served as final reviewers. 
3

Contents 

Introduction

Chapter 1 Background: History, Definition, Mission, and Goals of the Family Dependency 

Treatment Court

Chapter 2 How the Family Dependency Treatment Court Fits Into the Justice System

Chapter 3 Common Characteristics of Four Early Family Dependency Treatment Courts

Chapter 4 Varying Approaches

Chapter 5 Community Stakeholders

Chapter 6 Permanency and Safety for Children: Implications of the Adoption and Safe 

Families Act of 1997

Chapter 7 Recommendations of the Focus Group

Chapter 8 Current Initiatives

Appendix A: Focus Group Participant FDTC Program Descriptions

Appendix B. Adoption and Safe Families Act Timeline

Appendix C: Recommendations for Research and Evaluation

Appendix D: Family Intervention Programs

Appendix E: Strengths, Challenges, Opportunities, and Threats

Appendix F: Focus Group Participants

Appendix G: Other CSAT Resources

Notes

References
4

Introduction 

What Is a Family Dependency Treatment Court? 

A family dependency treatment court is a court devoted to cases of child abuse and neglect that 

involve substance abuse by the child’s parents or other caregivers. Its purpose is to protect the 

safety and welfare of children while giving parents the tools they need to become sober, 

responsible caregivers. To accomplish this, the court draws together an interdisciplinary team 

that works collaboratively to assess the family’s situation and to devise a comprehensive case 

plan that addresses the needs of both the children and the parents. In this way, the court team 

provides children with quick access to permanency and offers parents a viable chance to achieve 

sobriety, provide a safe and nurturing home, and hold their families together. 

The first family dependency treatment court (FDTC) opened in 1994 in Reno, Nevada, marking 

the beginning of a movement that has since taken hold in cities and counties across the United 

States. The ideas presented in this monograph are rooted in a 1999 gathering of teams from some 

of the most well-established FDTCs: Kansas City, Missouri; Reno, Nevada; San Diego, 

California; and Suffolk County, New York. This 2-day focus group was convened by the 

National Association of Drug Court Professionals (NADCP), the National Drug Court Institute 

(NDCI), and the Center for Substance Abuse Treatment (CSAT). Its purpose was to provide a 

forum where practitioners from this emerging field could share their experiences in planning and 

implementing FDTCs. 

 

The focus group explored the pros and cons of various approaches to the development and 

operation of FDTCs, formulated a mission and overall goals for the court, and took the first steps 

toward devising a national strategy for advancing the FDTC concept. The group also considered 

a broader perspective on FDTCs, exploring their place within the American justice system as a 

whole. It compared the FDTC structure to both the adult drug court model and to the traditional 

family (dependency) court model, clarifying the FDTC’s roots, special characteristics, and 

unique role. 

Following the 1999 focus group, a number of projects—including training, technical assistance, 

and evaluation—were initiated to help other jurisdictions develop and implement family 

dependency treatment courts. Chapter 8 describes the specific resources offered to jurisdictions 

through these projects. 

The Purpose of This Publication 

This publication documents the ideas, discussions, and conclusions of the 1999 focus group. We 

caution, however, that because the FDTC is a model-in-progress, this document is not intended 

as a blueprint or “how-to” guide for establishing an FDTC. Nor is it meant to comprehensively 

address each area that is discussed. Instead, it is hoped that by consolidating the early 

experiences of the first courts, the stage will be set for other communities to make their own 

contributions to this exciting new collaboration among the judicial, child protection, and 

treatment fields. 
5

Chapter 1 

Background: History, Definition, Mission, and Goals of the Family Dependency Treatment 

Court 

Why Family Dependency Treatment Courts? 

Since the mid-1980s, a dramatic rise in cases of child abuse and neglect has overwhelmed the 

nation’s courts and child welfare agencies. Each year, more than 1 million cases of child abuse 

and neglect are filed and substantiated; as of April 2001, the foster care system was responsible 

for more than 588,000 children (U.S. Department of Health and Human Services, 2001). 

Many factors may account for the escalation in abuse and neglect, including poverty, domestic 

violence, and an increasing personal mobility that results in the loss of family support systems. 

However, the primary cause is clear: substance abuse and addiction. According to Linking Child 

Welfare and Substance Abuse Treatment: A Guide for Legislators (National Conference of State 

Legislatures, 2000), “a large percentage of parents who abuse, neglect, or abandon their children 

have drug and alcohol problems. . . . Although national data are incomplete, it is estimated that 

substance abuse is a factor in three-fourths of all foster care placements.” Also, Kelleher et al. 

(1994) write that “children whose parents abuse drugs and alcohol are nearly three times more 

likely to be abused and more than four times likely to be neglected than children of parents who 

are not substance abusers.” 

It is not surprising that substance abuse and addiction are so frequently associated with the 

neglect and abuse of children. Parents battling substance abuse often put the needs created by 

their own alcohol or drug dependency ahead of the welfare of their families. At the same time, 

they—and their children—often have complicating physical or mental health problems. Unable 

to maintain employment or provide a stable and nurturing home environment, they are unable to 

care for their children. 

The rapid increase of abuse and neglect cases due to parental substance abuse poses an immense 

challenge for dependency courts, child welfare systems, and treatment providers. Attaining 

treatment for families—especially treatment that is timely, accessible, and appropriate—has 

always been difficult. But with the burgeoning number of parents in need of treatment, courts 

and providers have been strained to capacity. Also, without a coordinated effort among them, 

these systems are not equipped to handle the specialized issues that permeate cases of abuse and 

neglect that stem from parental substance abuse. As a result, parents are likely to continue their 

addiction as their children, unable to return home, languish in foster care. 

Recognizing that the complex web of problems affecting these families could be adequately 

addressed only through a coordinated approach to breaking the cycle of substance abuse and 

child maltreatment, a number of practitioners in juvenile dependency courts, child protective 

services, and substance abuse treatment systems began experimenting with a more holistic 

approach to intervention. In doing this, they looked to an earlier experiment in the coordination 

of judicial and treatment services—the adult drug court. 
6

Adult Drug Courts: An Example To Follow 

As far back as the 1950s, drug and alcohol abuse weighed heavily on the nation’s court systems. 

By the 1980s, the burden was overwhelming. Offenders cycled in and out of court, their 

substance abuse problems either overlooked or left untreated—at times simply because the court 

lacked cooperative working relationships with providers. Those who entered treatment were 

often unmotivated and unmonitored, and they frequently dropped out unnoticed. 

Because the adversarial nature of the justice system was failing to break the cycle of substance 

abuse, some jurisdictions began to reexamine the relationship between criminal justice 

processing and treatment services. It became apparent that treatment providers and criminal 

justice practitioners shared two common goals: stopping the use and abuse of addictive 

substances, and reducing crime. In 1989, Dade County, Florida used that realization to its 

advantage, opening the nation’s first modern drug court. For more than a decade since then, adult 

drug courts have helped criminal offenders achieve sobriety and break the cycle of addiction and 

criminal behavior. These successes can be attributed to a set of key practices that include 

integrating treatment with justice case processing, a nonadversarial approach, early intervention, 

access to a continuum of services, frequent drug testing, use of a coordinated strategy to address 

behavioral change, ongoing judicial interactions, monitoring and evaluation of goals and 

outcomes, cross-disciplinary training, and partnerships among community organizations and 

agencies that generate support and enhance programming (National Association of Drug Court 

Professionals Drug Court Standards Committee, 1997). 

The success of the adult drug court provided inspiration for professionals struggling with the 

onslaught of child abuse and neglect resulting from substance abuse by parents. They drew on 

the concept of collaboration between the criminal justice and drug treatment fields and combined 

this with the best aspects of family and juvenile court practices. What emerged were the family 

dependency treatment courts. 

Four Early Family Dependency Treatment Courts 

In September 1994, the Second Judicial District Court of Washoe County (Reno), Nevada, 

convened the first session of an FDTC. When the 1999 focus group met, 10 FDTCs were 

operating around the country, with approximately 10 more in the planning stages. 

Like the adult drug courts that inspired them, the first FDTCs took a collaborative approach to 

therapeutic jurisprudence, building teams that included judges, treatment providers, child welfare 

specialists, attorneys (including the prosecution as well as those representing the protection 

agencies, the parents, and the child), and other key service providers. Together, these 

practitioners operated a formal program of early intervention and treatment based on a 

comprehensive needs assessment and case plan. Frequent court appearances held both the 

parents and the systems accountable for compliance and outcomes. 
7

Definition, Mission, and Goals of the FDTC

As defined in Juvenile and Family Drug Courts: An Overview (Drug Court Clearinghouse and 

Technical Assistance Project at the American University, 1998), an FDTC is “a court that deals 

with cases involving parental rights, in which an adult is the party litigant, which come before 

the court through either the criminal or civil process, which arise out of the substance abuse of a 

parent.” 

An alternate definition crafted by the 1999 focus group emphasized the process through which 

the court responds to these cases: 

A family dependency treatment court is a collaborative effort in which court, treatment, 

and child welfare practitioners come together in a nonadversarial setting to conduct 

comprehensive child and parent needs assessments. With these assessments as a base, the 

team builds workable case plans that give parents a viable chance to achieve sobriety, 

provide a safe nurturing home, become responsible for themselves and their children, and 

hold their families together. 

From its discussions, the focus group also developed the following mission and goals for the 

FDTC. 

Mission 

To protect children from abuse and neglect—precipitated by the substance abuse of a parent or 

caregiver—by addressing the comprehensive issues of both the parents and their children 

through an integrated, court-based collaboration among service providers who work as a team to 

achieve timely decisions, coordinated treatment and ancillary services, judicial oversight, and 

safe and permanent placements. 

Goals

• To provide appropriate, timely, and permanent placement of children in a safe healthy 

environment. 

• To stop the cycle of abuse and neglect in families. 

• To provide children and parents with the services and skills needed to live productively 

in the community and to establish a safe, healthy environment for their families. 

• To respond to family issues using a strength-based approach. 

• To provide a continuum of family-based treatment and ancillary services for children and 

parents affected by substance use, abuse, and dependence. 

• To provide continuing care and information that families need to access the services they 

may require to function responsibly. 
8

• To develop cost-effective programming and interventions using the ongoing allocation of 

resources to support parents and their children. 

• To provide gender-specific, culturally and developmentally appropriate treatment. 

• To avoid delays in case processing by ensuring parental compliance with court orders and 

ancillary services, and by facilitating the court’s ability to modify court orders as cases 

progress. 

• To foster collaborative relationships among the systems operating in the community so 

they can effectively manage cases involving the abuse and neglect of children. 

The next section examines FDTCs in the context of the broader justice system. 
9

Chapter 2 

How the Family Dependency Treatment Court Fits Into the Justice System 

The family dependency treatment court (FDTC) draws on a rich judicial history, blending drug 

court practices with those of traditional family dependency courts. To clarify its place within the 

justice system, the focus group identified key factors from adult drug courts, traditional 

dependency courts, and family dependency treatment courts for comparison. The results of their 

discussion are shown in table 1.

Table 1. Comparison of Drug Court Models 

Adult Drug Court 

Traditional 

Dependency Court 

Family Dependency 

Treatment Court

Client Adult or parent who is 

charged 

Children who have 

been abused and or 

neglected 

Both the adult and the 

children who are 

affected 

Gender of Adult or 

Parent 

Majority males Majority females Majority females 

Type of Proceeding 

(Civil or Criminal) 

Criminal Civil (Parent may face 

criminal charges in 

another court) 

All are civil, but some 

may also be criminal 

Comprehensive 

Assessment 

The treatment, 

skill-training, 

developmental, and 

health needs of the 

parent are assessed. 

The health, safety, 

and developmental 

needs of each child 

are assessed. 

The health, safety, 

and developmental 

needs of each child 

are assessed. The 

treatment, 

skill-training, 

developmental, and 

health needs of the 

parent are assessed. 

Family Involvement Nuclear and extended 

family members are 

often included in the 

case plan. 

Extended family helps 

provide care and 

supervision of 

children. 

The spouse, 

significant other, or 

father figure is often 

involved in the 

treatment process. 

Extended family is 

included in the case 

plan as appropriate. 
10

Adult Drug Court 

Traditional 

Dependency Court 

Family Dependency 

Treatment Court

Treatment Parent- or adultfocused 

Children are provided 

treatment if 

appropriate. 

Treatment of parent 

may be required by 

the court but 

occasionally is not 

provided through nor 

supervised by the 

court. 

Treatment focuses on 

the parent but is also 

extended to the 

children, who are at 

risk for substance 

abuse, mental illness, 

developmental 

disabilities. Treatment 

may be provided to 

the family as a unit. 

Services Parent-/adult-focused; 

family unit may also 

be referred for 

services. 

Children receive 

services. Parent may 

be referred to 

services. 

The family unit 

receives a full range 

of services. Services 

for the parent and 

children are 

comprehensive and 

include areas such as 

parenting skills, 

domestic violence 

counseling, health 

care, and 

developmentally 

appropriate services. 

Sanctions Parent-/adult-focused Not applicable. The 

child is not 

sanctioned. 

Accountability is 

focused on the parent. 

Accountability is 

focused on the parent. 

The court must 

consider the impact of 

a parent sanction on 

the children and 

family as a unit. 
11

Adult Drug Court 

Traditional 

Dependency Court 

Family Dependency 

Treatment Court

Role of the Judge Leader of a team; 

therapeutic 

Determine best 

interest of the 

children; leader of a 

team 

Leader of a team; 

nurturing with 

children; therapeutic 

Objectives Adult sobriety and 

reduced recidivism 

A safe and permanent 

placement for the 

children 

A safe and permanent 

placement for children 

through parent 

sobriety and the 

development of the 

skills and knowledge 

needed to become 

mature, responsible 

parents who can meet 

their children’s 

developmental needs. 

 

Role of Agencies and 

Organizations 

Team members who 

represent criminal 

justice and treatment 

services who are 

empowered with 

increased 

accountability 

Representatives of 

various entities (in 

traditional roles) 

Team members who 

represent social 

services, treatment, 

and justice (criminal 

or civil) who are 

empowered with 

increased 

accountability and 

decisionmaking 

capacity 

Time Constraints Length of the program 

and treatment protocol

Movement toward 

safety and 

permanency as 

mandated by the 

Adoption and Safe 

Families Act (ASFA) 

Movement toward 

safety and 

permanency as 

mandated by ASFA 

Review Hearings Frequent and 

regularly scheduled 

(varies from monthly 

to weekly) 

As scheduled on court 

docket, mandated by 

state or federal 

statutes, or as needed 

in emergency 

situations 

Frequent and 

regularly scheduled 

(varies from monthly 

to weekly) 

Drug Testing Frequent and random 

drug testing of parents 

Drug testing done as 

ordered 

Frequent and random 

drug testing of parents 
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Chapter 3 

Common Characteristics of Four Early Family Dependency Treatment Courts 

As discussions progressed during the 2-day focus group, participants identified characteristics 

shared by their programs. These are described below with notes about how each characteristic 

manifests itself in the progression from planning, through implementation, to the ongoing 

operation of the FDTC. Some descriptions are accompanied by program examples. 

The first family dependency treatment drug courts— 

• Integrated a focus on the permanency, safety, and welfare of abused and neglected 

children with the needs of the parents. 

• Intervened early to involve parents in developmentally appropriate, comprehensive 

services with increased judicial supervision.

• Adopted a holistic approach to strengthening family function. 

• Used individualized case planning based on comprehensive assessment. 

• Ensured legal rights, advocacy, and confidentiality for parents and children. 

• Scheduled regular staffings and judicial court reviews 

• Implemented a system of graduated sanctions and incentives. 

• Operated within the mandates of the Adoption and Safe Families Act (ASFA) of 1997 

and the Indian Child Welfare Act of 1979. 

• Relied on judicial leadership for both planning and implementing the court. 

• Made a commitment to measuring program outcomes. 

• Planned for program sustainability. 

• Strived to work as a collaborative, nonadversarial team supported by cross training. 

• Integrated a focus on the permanency, safety, and welfare of abused and neglected 

children and the needs of their parents. 

For most substance abuse programs, the adult is considered the primary client. Treatment 

providers focus on the adult in their therapeutic activities and although they may engage 

the family in the treatment process, treatment providers do not consider the interests of 

the children as a primary concern. 
13

In contrast, the child is the primary focus of the intervention for the child welfare agency. 

Although the entire family may be “before the court,” the child welfare specialist is 

required to put the child’s need for safety and permanency first when a choice must be 

made in balancing children’s needs and parents’ needs.

A family dependency treatment court integrates the needs of both children and parents, 

encompassing the entire family as the client. Although decisions are always made in the 

best interest of the child, the court maintains a parallel focus on the interests of the 

parent. The operating procedures and decisions of the court reflect this dual focus. The 

court provides parents with an opportunity to address the issues in their lives—primarily 

substance abuse, sobriety, and recovery—and clears the way for them to establish a 

permanent, safe, and nurturing home environment. Family reunification is contingent on 

the parents’ demonstrated ability to provide for the child’s health, safety, and well-being. 

Timelines mandated by ASFA must be recognized and adhered to by the team throughout 

the life of a case. 

• Intervened early to involve parents in developmentally appropriate, comprehensive 

services with increased judicial supervision. 

To meet the needs of parents, all of the first FDTCs intervened early to place parents in 

structured programs that included substance abuse treatment (often for 12 months), 

frequent court appearances, and drug testing; and training, education, counseling, and 

other ancillary services selected to meet each parent’s specific developmental needs. 

The focus group identified two major challenges in providing these services to parents. 

First, the chronic shortage of treatment services—especially those for women and 

children—is a significant issue for all family dependency treatment courts. Participants 

noted that the shortage may get worse with the emergence of managed care. Because

access to immediate treatment is a core tenet of FDTC, each court represented at the 

focus group had found a way to ensure that this treatment was available to its parents. 

(See sidebar for specific examples of how this was accomplished.) 

The second issue noted by the focus group was the conflict in timelines between 

substance abuse treatment programs and state and federal statutory mandates related to 

child welfare. Because relapse is common for a substance abusing parent, the long-term 

timeframes needed for recovery may not mesh with the shorter timelines mandated by 

statute and used by child welfare agencies to make child placement decisions. As a result, 

the child’s needs for a permanent, safe home may conflict with the parent’s need for 

extended treatment. It may be difficult for the child welfare professional to determine 

whether a parent is making appropriate progress in treatment. 

To reconcile these conflicting timelines, the FDTC coordinates treatment for parents with 

the deadlines for decisions about the placement of children. Through close ongoing 

communication among service providers, the court assesses the parent’s response to 

treatment and ancillary services to make timely decisions in the best interest of the child. 
14

Treatment for Parents: Examples From the First FDTC Programs 

San Diego, California 

To give its clients more immediate access to treatment, the FDTC in San Diego contracted 

for priority slots in San Diego County’s network of alcohol and drug treatment providers. 

This initiative was funded through the San Diego County Board of Supervisors and the 

Alcohol and Drug Services Division of San Diego’s Health and Human Services Agency. 

Reno, Nevada 

The Reno court has both an outpatient track and an inpatient track in which parents 

sometimes live with their children. Outpatient services are funded through a contract with 

the department of social services in addition to grants and donations. Inpatient services are 

funded through fees charged to participants on a sliding scale and supplemented by grants 

and donations. 

Suffolk County, New York 

The Suffolk County court uses existing community-based nonprofit and for-profit treatment 

facilities licensed by the New York State Office of Alcohol and Substance Services. 

Treatment modalities include an array of services: detoxification, short-term inpatient, 

long-term residential, day treatment, intensive outpatient, and outpatient. Treatment is 

provided by approximately 30 nonprofit agencies under contracts managed by the Suffolk 

County Department of Health, the Division of Community Mental Hygiene, Alcohol and 

Substance Abuse Services. This managing agency also serves as liaison between the 

treatment community and the family treatment court. 

Kansas City, Missouri 

The Kansas City program is specifically geared toward mothers and infants who have been 

exposed to drugs. Treatment, both residential and outpatient, is provided through an agency 

specializing in the services needed by this group. Funding may come through Medicaid, 

private insurance, or self payment on a sliding fee scale; it can be Community-Backed AntiDrug Tax (COMBAT)-assisted; or it may be provided by the Missouri Department of 

Mental Health. The provider, a C-Star model for comprehensive services, has a 

noncompetitive contract but must offer an informal bid that binds it to the level of 

participation and collaboration required by the court. All needed services must be available 

to any participant accepted into the program. 
15

• Adopted a holistic approach to strengthening family function. 

Many children and parents have specialized needs that affect their ability to thrive in an 

FDTC program. For example: 

o Children and parents with developmental disabilities may need the support of team 

members who are trained to work with the specific challenges of these conditions. 

o Children and parents with co-occurring mental health, substance abuse, and 

developmental disorders will need appropriate services to succeed in the program. 

o Women with histories of sexual abuse may be more comfortable in court if they can 

talk to a female judicial officer. 

o Parents diagnosed with HIV need additional medical services, and their children need 

a long-term permanency plan as well as a short-term plan. 

Domestic violence, in particular, presents numerous challenges to FDTCs. Many women 

and children coming into the courts are the victims of domestic violence—or have a 

significant other who is also involved with alcohol or drugs. In response, many courts 

have the authority to hold a significant other accountable. In some courts, this 

accountability is achieved through a signed contract requiring that the significant other 

comply with the court’s conditions. Other courts may make a significant other’s contact 

with the children contingent on program participation. 

In many cases, the FDTC’s ability to respond to a family’s special needs can mean the 

difference between success and failure. Unfortunately, the appropriate services are not 

always available. To implement a holistic approach to strengthening the family, the team 

must actively seek out resources to respond to these needs. 

“As a caseworker for the family dependency treatment court, you move furniture, take 

people to appointments, do whatever needs to be done. You work harder and provide 

more intensive services, but it’s more rewarding because you’re seeing success. You’re 

more invested and have more information to work with because of communication with 

the team. The more contact you have with the family, the more success you see.” 

—Child Welfare Specialist 

Family Dependency Treatment Court 

Reno, Nevada 
16

• Used individualized case planning based on a comprehensive assessment. 

Both the children and the parents of each family entering an FDTC receive a 

comprehensive assessment to determine their developmental, mental, and physical health 

needs and their treatment. With this information, the team customizes a case plan to meet 

the family’s needs, drawing on relevant disciplines and specialties. 

Program Example: Kansas City 

The Jackson County Family Dependency Treatment Court, which is designed to serve 

women with infants who have been exposed to drugs, intervenes after birth while mothers 

are still in the hospital. A social worker with a background in substance abuse conducts a 

crisis assessment of both mothers and newborns who have been identified by hospital staff 

as substance dependent. This immediate assessment helps the team determine how the case 

should be handled. By collaborating with hospital staff to develop the protocols for testing 

mothers and their newborns, the program has fostered good working relationships with 

staff members and heightened their concern for drug-exposed infants. Team members 

report that children clearly benefit from this cooperative, early intervention approach. 

The Jackson County program has the backing of the Metropolitan Task Force on 

Drug-Exposed Infants. The task force is a long-standing workgroup that has met monthly 

for 10 years in Kansas City. This multidisciplinary team routinely reviews local issues and 

has spearheaded local and state system reforms.

The focus group devoted special attention to two components of an effective case plan: 

parenting programs and aftercare. 

Parenting programs. Many types of parenting programs (sometimes called 

family-strengthening programs) are available to address a range of problems. Since 1990, 

the U.S. Department of Justice has funded efforts to synthesize research and practice 

information on these programs for wider use in the field. After reviewing 500 nominated 

programs, researchers selected the top 25 on the basis of evaluation results and ease of 

dissemination (Office of Juvenile Justice and Delinquency Prevention, 1994). (Several 

interventions that may fit within the FDTC model are described in appendix D.) 

Typically, parenting programs define family as the constellation of adults or siblings who 

care for a child. Nontraditional family arrangements include single-parent families, 

divorced families with joint custody of the child, children living with extended family 

members, adoptive parents, protective custody (such as temporary or permanent foster 

homes), and stepparents (sometimes in blended families with children from two or more 

prior relationships). 
17

Program Example: Miami 

The Miami Dependency Drug Court, Family Dependency Treatment Court Initiative, 

implemented a family-strengthening curriculum that combines two proven family-focused 

interventions: Ages and Stages, which assesses children ages 0 to 4 for developmental 

delays; and Strengthening Families, which uses an adult/child/family systems approach for 

responding to family problems and improving chances for reunification. (A description can 

be found in appendix D.) 

Aftercare. Aftercare is a complex issue when substance abuse treatment is provided in a 

civil justice setting—and even more complex when child abuse and neglect enter the 

picture. The FDTC team needs to devise strategies to prevent relapse, and they need to 

plan for child safety if relapse occurs. Because the risk of relapse is most likely during 

the first 3 months following treatment, it is recommended that child welfare officials 

continue monitoring families for at least 3 months after a parent leaves treatment and 

regains custody of the children. Although many child welfare officials say they cannot 

afford such support, it has been noted that they are already providing this followup by 

repeatedly reopening cases that have closed. Given the chronic nature of substance abuse, 

this cycle is likely to repeat itself many times if effective aftercare is not provided 

(National Center on Addiction and Substance Abuse, 1999). 

Aftercare is a critical component of FDTC programs because there is always a danger 

that a parent will relapse and jeopardize the well-being of the child. Many parents are 

aware of their need for ongoing support. In fact, personal communication with a judge 

revealed that parents sometimes intentionally sabotage their graduation so they will not 

be left without services. 

Providing for aftercare can be a challenge to the FDTC team, especially as time passes 

and the parents are no longer under the jurisdiction of the court. To ensure that resources 

are in place by the time of graduation, planning for aftercare should begin when the 

family first enters the program. The parent will need routine access to self-help groups, 

counseling sessions, and possibly other resources such as alumni events, support groups, 

and social functions. 

The aftercare plan should also maintain services for children who may have been 

maltreated for a substantial period of time. When the plan addresses the needs of both the 

parent and the child, aftercare contributes to a healthy reunification process, growth of 

the family, and a permanent placement for the child. 

• Ensured legal rights, advocacy, and confidentiality for parents and children. 

Each member of the FDTC team must ensure that advocacy, confidentiality, and due 

process are maintained by advising the parents, children, and their representatives of the 

guidelines for participating in the drug court. Because parents are subject to sanctions by 

the court, it is essential that they be oriented to the conditions of participation. Some 
18

judges use the jail sanction in an FDTC. In this situation, it is important that parents be 

notified upon entering the program that a jail sanction could be levied, and that they 

agree, in writing, to accept such a sanction. 

The court should orient and provide written materials to participants and their families 

advising them of their rights and resources for advocacy. 

Program Example: Suffolk County, New York 

In Suffolk County, the obligation to be drug free is stated in a court order. Based on the 

facts of a particular event, the judge may find that the order was violated and then impose 

the jail sanction. The parent has an opportunity to know what the evidence is—usually a 

positive urinalysis—and to give an explanation before the judge makes a decision. 

• Scheduled regular staffings and judicial court review. 

FDTC teams hold frequent staffings to review the progress of each child and parent and 

to update family case plans. 

Victims of child abuse and neglect come before juvenile and family court judges for 

protection from further harm and for timely decisionmaking for their future. In response, 

judges make critical legal decisions and oversee social service efforts to rehabilitate and 

maintain families, or to provide permanent alternative care for child victims. Frequent 

judicial review of cases in the FDTC—preceded by a team meeting (often called a 

staffing)—is an important component of the court’s process. This is the opportunity for 

team members to give the judge vital information that will ensure that his or her 

decisions are based both on up-to-date assessments of the progress of parents and on the 

well-being and safety of their children. 

In the past, it has not been a standard requirement for a judge to build partnerships with 

other service providers or to develop nurturing relationships with the people who come 

into the court system. However, the FDTC’s team approach changes those relationships. 

Participating judges, child welfare and substance abuse treatment systems, social service 

agencies, attorneys, law enforcement officials, and community groups all must become 

familiar with program policies and procedures, treatment procedures and issues, judicial 

system processes, and the mandates and legal issues affecting parents and children. Many 

issues must be resolved among the various disciplines to conduct effective meetings and 

make key decisions in response to parental compliance with court-ordered case plans. In 

some FDTCs, decisions about visitation and services for children are made during 

staffing hearings; in other courts, these decisions are made in separate child protection 

proceedings. If separate dependency proceedings occur, close coordination with the 

FDTC should take place. 
19

Frequent judicial oversight of parents’ progress in substance abuse treatment, compliance 

with conditions of court orders, and relationship and interaction with their children is a 

necessity to the FDTC process. Although the judge is considered the leader in the 

process, it is imperative that team members recognize that their knowledge and expertise 

can enhance the judge’s ability to manage families in FDTC through staffing and court 

hearings. 

Some courts allow children in the courtroom. The effort to create an atmosphere in the 

court that is welcoming to children is integral. The judges participating in the focus group 

described child-friendly courtrooms that include benches just for children. The children 

can work on puzzles, color with crayons, and play on the floor, or a court clerk may have 

a candy drawer with treats for the children. In this type of setting, children see the 

courtroom not as a scary place, but as a place that can help their families. 

• Implemented graduated sanctions and incentives. 

FDTCs hold parents accountable through a graduated system of sanctions and incentives. 

Sanctions are used as a consequence for parents who miss a hearing date, test positive for 

drugs, skip a treatment session, or are otherwise noncompliant. Incentives are used to 

reward parents who achieve program milestones or perform admirably in the program. 

Practitioners generally agree that both sanctions and incentives have a therapeutic impact 

on parents and help them accept responsibility for their actions. 

Sanctions and incentives are also the key elements of the adult drug court model. In the 

adult court, the primary focus is on the adult offender. Therefore, when issuing sanctions, 

the judge needs to consider only the appropriateness of the sanction to the action and any 

written guidelines of the court. 

FDTC sanctions might include verbal admonitions from the judge, therapeutic essay 

writing, community service, fines, and increased frequency of urine testing. For 

significant acts of noncompliance, a judge may order an offender to jail for 2 days, a 

week, or longer. However, when considering a jail sentence for the parent, the FDTC first 

considers how this sanction might affect the safety and welfare of the children; every 

effort is made to avoid adverse effects. Jail time should not conflict with the parent's time 

with the child, even if the child is in foster care. 

The effect a parent’s jail time has on children is just one of the serious issues this 

sanction raises for FDTCs. The other is due process. In the adult drug court, defendants 

must sign a contract—as a condition of entry to the program—acknowledging that jail is 

one of the sanctions for violating the program requirements. In doing so, defendants 

waive their right to advance notice and a full hearing prior to being jailed. This 

mechanism enables the judge to swiftly impose the sanction when necessary. Although 

this practice has been challenged, it still is the way most adult drug courts operate. 
20

The Use of Jail as a Sanction: Focus Group’s Perspectives 

Focus group participants expressed varying opinions about the value of jail time as an 

FDTC sanction. 

The Reno team reported that its judge sees a 48-hour jail stay as very motivating. In San 

Diego, jail time is used for parents who show a pattern of noncompliance over time. (In both 

jurisdictions, the incarcerated parent continues to receive treatment while in jail.) 

Both the Reno and San Diego teams argued that jail time gets the attention of the parent 

very quickly—an advantage given the stringent time constraints of ASFA. Jail time also 

makes clear the seriousness of illegal drug use and forces parents to consider its detrimental 

effects on their children. Finally, they argued that parents in the courtroom who see another 

noncompliant parent go to jail are forewarned and may, in turn, take their responsibilities 

more seriously. 

The majority of focus group participants agreed that there may be times when jail is an 

appropriate sanction. They pointed out that not all children are hurt by the sanction, and 

many parents learn a valuable lesson. The group concluded, however, that the welfare of the 

child should always be considered before a jail sanction is issued. 

A dissenting opinion was voiced by participants from the Jackson County program. There, 

jail time is seen as demeaning to women in the program and detrimental to children who, 

when they see a parent being taken away, may perceive that they, the children, are being 

punished. 

Program Example: Suffolk County Sanctions and Incentives—Levels and Phases of 

Dependency 

Treatment courts often have written guidelines to govern the judge’s issuance of sanctions 

and incentives. The guidelines shown in table 2 are used by the Suffolk County, New York, 

family court. The most serious infractions—Levels A and B—require an immediate court 

appearance, reevaluation of contact with children, and reassessment of the treatment level. 

In some cases, Level C infractions may result in more severe sanctions. 

 
21

Table 2. Consequences and Rewards for FDTC Parents in Suffolk County, New York 

Infraction Sanction 

Level A 

Leaving treatment with involuntary return 

to court 

Reduction in phase 

Violating a protection order Termination from program 

Filing of a new petition Up to 6 months in jail 

Level B 

Leaving treatment with voluntary return to 

court 

Reduction in phase 

Tampering with urine Up to 2 full days in court, termination from 

program, up to 6 months in jail 

Level C 

Testing positive or missing drug test Reprimand from court 

Missing treatment appointment Therapeutic essay 

Missing visit with child Increased court appearances 

Missing appointment for services One or more full days in jail 

Failing to keep recertification appointments

 

Increased case management contacts 

Arriving late to court, breaking treatment 

program rules 

Increased case management contacts 

Achievements Incentives 

30 days clean Acknowledgment by judge 

Complying with court order Reduced court appearances, case called 

early in court, small gift (book, keychain) 

Completion of Phase I Phase Advancement Reward 

4 months clean Acknowledgment by judge 

Complying with court order Case called early in court, small gift

 

Completion of Phase II 

 

Phase Advancement Reward 

4 to 6 months clean Acknowledgment by judge, case called 

early in court, small gift 

Completion of Phase III Graduation Ceremony 

6 months clean Certificate of completion 
22

• Operated within the federal mandates of the Adoption and Safe Families Act and Indian 

Child Welfare Act. 

The Adoption and Safe Families Act of 1997 (Public Law 105-89) was passed in 

response to the overwhelming number of children in the foster care system without 

permanent stable families and the pressing need to change how families that abuse or 

neglect their children are dealt with. The Indian Child Welfare Act of 1979 specifies 

procedures for state courts to follow in custody proceedings for Native American 

children identified as abused or neglected. 

Adults and children experience the passage of time very differently—physically, 

developmentally, and emotionally. An adult may be equipped to wait for an uncertain 

situation to resolve itself sometime in the future; however, a child’s time is now. In 

recognition of the child’s differing sense of time, ASFA reduces the deadline for 

permanency placement hearings for children in foster care from 18 months to 12 months. 

In dependency cases involving parental substance abuse, ASFA has made evident both 

the lack of access to treatment for substance abusing parents and the disconnects among 

courts, caseworkers, and treatment services—problems that often result in children 

continuing to live in unsafe conditions or in foster care placements for protracted periods 

of time. In some cases, this lack of service access and coordination for substance abusing 

parents has contributed to the termination of their parental rights. 

For the FDTC, the shortened timelines under ASFA mean that parents with substance 

abuse problems have much less time to enroll and participate in treatment and to 

demonstrate their capacity to provide a safe home for their children. The FDTC must 

operate within these constraints. 

The FDTC team—which includes many professional disciplines—brings a unique 

perspective to the issues surrounding the implementation of ASFA. FDTCs offer valuable 

insight regarding the protection of children and ideas to more effectively move the 

dependency court population through the FDTC process. The provisions of ASFA—and 

their full implications for the family dependency treatment court—are explored in greater 

depth in chapter 6. 

• Relied on judicial leadership for both the planning and implementation of the court. 

The judge plays a key leadership role in the planning and implementation of an FDTC, 

encouraging team members to collaborate as they express their professional opinions. To 

be prepared for this leadership role, judges need training on the nature of substance abuse 

and recovery. They may also need orientation to the team approach—that is, the ways 

collaboration with other service systems can result in recovery for parents, reunification 

of families, and timely placements for children. The role of the judge is described further 

in chapter 5. 
23

• Made a commitment to measuring outcomes of the FDTC program. 

Focus group participants agreed that ongoing evaluation is essential to FDTC success 

because it helps jurisdictions answer questions such as: 

o Is the program accomplishing what it intended to do? Is it meeting its goals and 

objectives? 

o Which components are effective? Which are not? 

o Is the program reaching its target audience? 

o Which services are most appropriate and useful for participants? 

o Is there a need to hire more staff? 

By documenting the positive outcomes for children and families, evaluation results can 

be used to gain support for FDTCs from policymakers and elected officials, and to 

change laws and policies to enable the expansion of FDTCs to and increase their 

acceptance in the community. 

The first step in planning an evaluation is to define success by asking “What is a 

successful outcome?” or “How will we recognize success?” The answer differs 

depending on the perspective of the practitioner. From the perspective of substance abuse 

treatment, successful outcomes are measured, in part, by the cessation of alcohol and 

drug use, decreased criminal behavior, and decreased need for health services. However, 

from the perspective of the child welfare agency, the child’s safety and the permanency 

of the child's successful placement in the home define success. At times these definitions 

may be difficult to reconcile because, even when the parent’s treatment goals have been 

met, child safety issues may remain. 

At the inception of the FDTC program, the team needs to develop a common definition of 

success. Using this as a starting point, it then should identify the variables to be studied 

and establish procedures to ensure the efficient and timely gathering of data. The 

evaluation should also be tailored to answer the questions of stakeholders who have 

decisionmaking power. When external evaluators are used, practitioners should become 

involved in the research design and methodology by providing information about the 

program’s content and background (Tauber and Snavely, 1999). 

Beyond its benefits to individual programs, the accumulation of evaluation findings also 

benefits the field as a whole. In a review of FDTCs, the Urban Institute (1999) 

recommended a number of areas in which preliminary research is both needed and 

feasible in existing FDTCs. Those recommendations are presented in appendix C. 

Preliminary studies, such as those recommended by the Urban Institute, will lay the 

groundwork for more sophisticated studies on the larger impact of FDTCs. Future studies 
24

should assess the long-term effects of the FDTC approach on child well-being and parent 

functioning in a range of life domains. Impact evaluations also need to be conducted to 

determine the effectiveness of specific service components and to identify the 

characteristics of cases most likely to benefit from the FDTC approach. 

• Planned for program sustainability. 

Funding sources for FDTCs are limited. In some jurisdictions, a “tough-on-crime” stance 

narrows access to the available sources. In others, managed care constraints limit certain 

types of services. (In Jackson County, for example, inpatient days are severely curtailed.) 

However, focus group participants pointed out that FDTCs are not limited to moneys 

raised within the community. Program support can also come through nonmonetary 

resources and the reallocation of resources within communities. In addition, the group 

noted several important opportunities for states and local communities to expand 

treatment services for parents through the child welfare system. The following strategies 

were identified during the focus group meeting: 

o The Substance Abuse Prevention and Treatment Block Grant, managed by 

SAMHSA, is the largest source of treatment funding. This block grant to states 

provides funds for substance-abuse prevention and treatment services. 

o When treatment capacity is insufficient for a particular population (such as 

women and children), state and local agencies can apply for discretionary funds 

from SAMHSA’s Targeted Capacity Expansion Program. 

o A number of states have expanded the provision of substance abuse treatment 

services through Medicaid in recent years. Additional states may want to consider 

this option as a way of expanding treatment capacity. Many child welfare parents 

are already eligible for Medicaid. 

o Some substance-abuse services can be paid for under Temporary Assistance for 

Needy Families (TANF) and welfare-to-work programs. Many families in the 

child welfare system with substance abuse problems receive welfare benefits. If 

parents’ substance abuse interferes with their ability to care for their children, it 

may also interfere with their ability to work. States and counties can incorporate 

substance abuse treatment services as part of their parents’ employment plans. 

Under these circumstances, TANF and welfare-to-work funds can be used for 

nonmedical aspects of substance abuse treatment if it is not otherwise available. 1

o The Administration for Children and Families is the lead agency in the U.S. 

Department of Health and Human Services for programs that promote the 

economic and social well-being of families, children, individuals, and 

communities. Different types of funding include the Court Improvement Program 

(a grant program to help state courts improve their handling of proceedings 

related to foster care and adoption), child abuse and neglect programs (a grant 
25

program to help states improve and increase prevention and treatment activities), 

community service block grants (a grant program that provides states, territories, 

and Indian tribes with a flexible source of funding to help reduce poverty and 

address employment, education, housing assistance, energy, and health services), 

individual development accounts (a new program that empowers low-income 

individuals to save money for a home), social services research, and the LowIncome Home Energy Assistance Program. 

o Title XX of the Social Security Act, also called the Social Services Block Grant, 

is a capped entitlement program. Block grant funds are given to states to help 

them achieve a wide range of social policy goals. Funds are allocated on the basis 

of population. 

These resources may help FDTCs expand treatment capacity at the state and local levels. 

At the same time, programs can educate state and local leaders about the value of FDTC 

programs and urge them to expand resources to address the needs of children and parents 

involved in the child welfare system. 

• Strived to work as a collaborative, nonadversarial team supported by cross training. 

Substance abusing parents are more likely to succeed when services are provided in a 

seamless, well-coordinated continuum. To achieve this, the FDTC teams represented at 

the focus group all strived to establish a nonadversarial, team-oriented environment. 

Teamwork enabled them to communicate with parents in one voice, thereby eliminating 

the confusion of contradictory messages, strengthening the relationship between the court 

and the family, and fostering the parent’s motivation to change. 

However, the operation of an FDTC requires the efforts of individuals from a number of 

agencies—many of which have a history of unresolved turf issues and difficulties 

working in collaborative ventures. To create the nonadversarial, collaborative 

environment that is the foundation of effective teamwork, the FDTC must address the 

different philosophies and approaches that have traditionally separated the fields of 

substance abuse treatment, child welfare, and the judiciary. Every party in the FDTC 

system must step outside his or her traditional role, assume additional responsibilities, 

work harder and faster, and embrace perspectives he or she may not have considered 

previously. Some of the difficulties encountered in making these changes include: 

o Judges who reject the FDTC philosophy because they do not want to take on 

responsibilities that have traditionally been viewed as beyond the scope of 

judicial authority. 

o Substance abuse treatment providers who fear that parents will be taken out of 

treatment against their wishes and put in jail. 

o Child protective services caseworkers who are overwhelmed by additional 

demands and the close scrutiny of the multisystemic team
26

o Members of the substance abuse treatment community who see ASFA timelines 

as a threat and who need a better understanding of the FDTC system. 

o Parent advocates and defense attorneys who fear the parents are not granted due 

process and who may encourage the parents not to cooperate. 

o Child attorneys or representatives who worry that decisionmaking will focus more 

on the parent than on the child, that reunification will be rushed, and that 

visitation will be used as a sanction or incentive. 

Although all these fields share the vision of permanent recovery for parents and 

permanent placement for children, safety for children, and healthy, functioning families, 

their differences have the potential to create misunderstandings, engender mistrust, and 

undermine cooperation. Each field has its own definition of who the client is, what 

outcomes are expected, what the timeline should be, and the appropriate response to 

setbacks. In addition, the legal and policy environments in which the agencies operate 

also affect their ability and willingness to work together. These environments are shaped 

by state and federal laws on child abuse and neglect, the sense of crisis under which 

many child welfare agencies work, the chronic shortages of substance abuse treatment 

services, and the confidentiality requirements that may prevent sharing information 

(Administration for Children and Families and the Substance Abuse and Mental Health 

Services Administration, 1999). 

Focus group participants agreed that one of the best ways to bridge the gaps among those 

involved in the FDTC is to implement cross-system training. Their experience is 

supported by a paper from the National Center on Addiction and Substance Abuse (1999) 

at Columbia University, which recommends that certification and licensing of child 

welfare officials include training in the nature and detection of substance abuse and what 

to do when it is found. The report also states that judges and child welfare directors need 

to accept responsibility for training themselves and their staffs about the substance abuse 

problems that are driving their caseloads and about confidentiality laws for persons 

receiving treatment. 

Cross training is also critical for substance abuse treatment providers. For many of these 

providers, participating in the legal arena may be a new experience. They need training in 

the court process, especially concerning open communication and frequent contact with 

the court. They must also become versed in the court’s legal mandates—from both ASFA 

and the Indian Child Welfare Act. They also need orientation to the perspective of “the 

family as the client” with the best interest of the child as the paramount concern—a 

perspective that is not the traditional view of the treatment provider. 
27

But cross training does more than impart information. It also helps build relationships 

and trust among team members. As a supplement to regular staffings, it allows time to 

discuss program procedures, identify gaps in service, consider how to improve outcomes 

for families in the program, and resolve problems as they develop. 

Program Examples: Suffolk County, Reno, San Diego 

 

Suffolk County, New York 

To bridge the systemic barriers between substance abuse treatment and child welfare, the 

Suffolk county family treatment court develops a comprehensive service plan for each case, 

with input from both substance abuse treatment providers and child welfare representatives. 

The plan includes specific goals to meet the treatment needs of the parents and the service 

needs of the children. The team ensures speedy alcohol and drug assessment of the parents 

and identifies barriers to treatment. The members of child protective services conduct a risk 

assessment. A court-appointed special advocate is appointed for each child. The entire team 

reviews the service plan for consistency. The primary goal is preserving or reuniting the 

family and developing a permanency plan for the children. 

Reno, Nevada 

In Reno, substance abuse treatment efforts have improved because of the FDTC, where the 

individual issues of parents and their children are taken into consideration. The children 

benefit from the services received by their parents, such as intensified parenting classes, 

referrals to domestic violence centers, and sexual abuse treatment. Efforts are made to 

provide a variety of services in one location (one-stop shopping) to make it easier for the 

mothers. Rather than focusing only on getting the mother off drugs, the court also ensures 

that the needs of the children are met. 

San Diego, California 

In the San Diego court, the substance abuse treatment plan becomes part of the reunification 

plan, and representatives of all systems work toward the same goals. The social workers 

have a significant role in ensuring that services are delivered, and they work closely with the 

county-contracted Substance Abuse Recovery Management System (SARMS) recovery 

specialists (i.e., parents’ substance abuse case managers who work with the treatment 

program under contract with the county). 

Despite significant barriers to collaborative teamwork, many opportunities to more effectively 

serve families result from the shift in roles. Professionals in all systems have the opportunity to 

learn from one another and resolve turf issues. Therefore, it is necessary to train practitioners in 

ways that help them carry out these new responsibilities. 
28

Chapter 4 

Varying Approaches 

Among jurisdictions across the country, the family dependency treatment court approach varies 

in a number of ways. The differences may result from a number of factors: the statutory 

framework within the state and local jurisdiction, the availability of resources, the degree of 

community support, the infrastructure of the local jurisdiction, and the ease of collaboration 

among systems. Below are five examples of how FDTCs may vary in their approach: 

• Type of case. Most FDTCs accept only clients with civil cases. A few handle clients with 

both civil and criminal cases. 

• Court of jurisdiction. FDTCs may operate under the jurisdiction of the family court, the 

juvenile court, or the general jurisdiction court. 

• Infrastructure of the local judicial jurisdiction. Some FDTCs use a “one family, one 

judge” approach; all pending cases involving any member of the family are consolidated 

under the oversight of the FDTC judge. In other programs, families may deal with 

multiple judges—from the dependency court, the FDTC, and other criminal and civil 

courts in which family members may have matters pending. 

• Integrated or supplemental program. Some FDTCs are fully integrated within 

dependency court. Other programs supplement the dependency court case process and 

step in at a particular point in the process to review parental compliance with court 

orders. 

• Target population. Some programs focus on specific populations, such as mothers of 

drug-exposed infants. Others have a much wider focus and will consider any dependency 

case in which the initial investigation determines that parental substance abuse 

contributes to the abuse or neglect of children. 

Each of the FDTCs represented at the focus group has its own individual approach, which is 

illustrated in the following overviews. For detailed descriptions of the focus group courts, see 

appendix A. 

Suffolk County, New York 

New York’s Suffolk County Family Treatment Court enhances child protective services by 

providing case processing within civil family court proceedings and accepting cases of child 

neglect (but not child abuse) resulting from parental substance abuse. The family treatment court 

was developed in response to the escalating number of neglect cases involving parental 

substance abuse and the need to better integrate and coordinate services for children and 

families. The enhanced services offered by the program support the efforts of the department of 

social services by developing comprehensive service plans, facilitating access to treatment and 

ancillary services, and providing increased judicial monitoring of cases. The family treatment 
29

court is designed to integrate chemical dependency and child welfare services for drug-addicted 

parents and their children. 

The judge hears family treatment court cases on a separate docket—two mornings and three 

afternoons a week—and is assisted with monitoring and review by the treatment court team. 

Court staff members work jointly with members of a multidisciplinary case management team 

consisting of case managers, a court-appointed special advocate, drug and alcohol abuse 

specialists, and a liaison from the department of social services. The program provides a wide 

range of services to families, including parenting skills, mental health services, counseling on 

domestic violence issues, public health nursing services, and substance abuse treatment. 

Reno, Nevada 

The Reno court is an example of a program that works with both cases involving criminally 

charged parents and cases of child removal due to abuse or neglect. Respondents who appear 

before the family dependency treatment court judge are mostly women with substance abuse 

problems. The program provides for a minimum of 1 year of substance abuse treatment, linkage 

to social services, and a drug court team consisting of the judge, his or her staff, a case manager, 

the treatment provider, and a child welfare caseworker. Other team members may include the 

prosecutor, defense counsel, and probation officer. The program has uniquely used foster 

grandparents in a number of cases to provide support for the children and parent during their 

participation. 

Jackson County (Kansas City), Missouri 

The family dependency treatment court in the Sixteenth Judicial Circuit Court of Jackson 

County, Missouri, handles child abuse and neglect and other child endangerment cases. The 

court works directly with hospitals that identify new mothers who are substance abusers, and the 

program attempts to keep new mothers with their babies to ensure the critical early bonding of 

the newborns can take hold. Program proponents believe that the unique needs of each stage of 

child development must be met to protect the emotional stability of the child. Therefore, courts 

must move quickly to provide either a safe home with the parent or a stable and permanent living 

environment outside the parent’s home. Delays in permanency decisions or frequent changes in 

placement can cause irreparable psychological damage to the child. To achieve these goals, the 

court works to stop substance abuse by parents when the substance abuse threatens the safety 

and welfare of their children. The court provides supervision and specialized treatment to parents 

who are abusing substances, led by a team that specializes in dependency cases. 

San Diego County, California 

The two-tiered approach used in the Dependency Court Recovery Project in San Diego County 

provides court supervision and substance abuse treatment through seven traditional dependency 

courts and three dependency drug courts. The dependency drug courts provide intensive 

supervision for parents who fail to comply with the requirements of the traditional dependency 

court. All parents who come before the traditional dependency court with evidence of an alcohol 

or drug abuse problem are screened and assessed for substance abuse. Any resulting treatment 
30

plan becomes part of a court order, and violation of the court order results in escalating 

sanctions. The third occurrence of noncompliance may result in transfer to the dependency drug 

court, an intensified three-phase program of treatment with heightened supervision and judicial 

monitoring (each phase lasts 90 days). If the parent still does not meet treatment goals, a hearing 

to terminate his or her parental rights may be held. San Diego’s program was developed in 

response to the estimated 80 to 90 percent of parents who come before the dependency court 

with substance abuse problems. 
31

Chapter 5 

Community Stakeholders 

“Stakeholders have a vested interest in the success of the family dependency 

treatment court and are likely to include parents, abused and neglected children, 

extended family members, judges, other members of the judiciary, prosecutors, 

defense attorneys, police and probation officers, jail administrators, public health 

practitioners, ancillary service providers, child protective service providers, 

school officials, transportation and daycare providers, employment and training 

specialists, welfare-to-work program specialists, local labor department officials, 

faith community leaders, county council members, State legislators, health care 

professionals, and the media.” 

 —Focus Group

Good processes and viable programs are important to the success of an FDTC. Equally important 

are the people who plan the processes and programs, support them, and participate in them. The 

focus group identified three groups of stakeholders who are critical to the success of their courts: 

• Members of the steering committee. 

• FDTC team members. 

• Families appearing before the court. 

This section specifies the key people and entities that need to be engaged in the work of an 

FDTC and describes the roles of principal team members. It also discusses the identification of a 

target population and offers a profile of the parent most often seen in an FDTC. 

Steering Committee 

Each of the focus group court teams identified a committee of key stakeholders, often organized 

at the inception of the project, as a steering committee. All the teams indicated that the support 

of their steering committee significantly contributed to their success. The list of key 

decisionmakers and community stakeholders is likely to vary from one community to another. 

Common to most of the lists are top-level officials and decisionmakers, treatment and ancillary 

service providers, policymakers, and community members. 

The steering committee facilitates support for the drug court concept among high-level 

policymakers (e.g., elected prosecutor, presiding judge, and chief public defender) and 

commitment to supporting successful outcomes. In this manner, the planning team, which may 

include nonexecutive-level personnel, will be confident that the head of each participating 

agency has made the FDTC a priority, and has delegated to the team the authority to make 

implementation decisions. The steering committee should have as its clear purpose the support 
32

and operation of the FDTC. It should meet regularly and establish a procedure for ongoing 

communication with the planning team to provide oversight and support. 

The steering committee should comprise executive-level personnel from each agency involved in 

or affected by the FDTC. Members from noncourt-related community entities should also be 

considered. These members should be selected for the political support or potential resources 

that they may offer in support of the FDTC’s planning process and operation. Potential members 

should reflect a broad cross section of the community. In this regard, members may include 

representatives of civic clubs (e.g., the Rotary Club or Lions Club), health agencies, local media 

outlets, vocational and educational services, the faith community, and private foundations. 

At least two focus group teams noted that their steering committees have disbanded, and they 

urged other teams not to allow this to happen. Another court team supported this statement, 

pointing out that it has kept its steering committee in place and active throughout the life of the 

program, and that the committee has remained supportive and resourceful. 

The FDTC Team 

The purpose of the FDTC team is to ensure that every child’s and parent’s needs are met and that 

each receives every opportunity to be successful. Although each member of the FDTC team is 

accountable for his or her individual performance, team members work collectively, share 

critical information, and make collaborative decisions about every case before the court. Teams 

meet regularly—usually weekly—to share information regarding the children’s and parents’ 

progress, attendance at hearings, and participation in treatment. At these meetings, team 

members serve as sounding boards and listen closely to one another. Because the team is 

working together, no individual carries the entire burden for decisions that affect the family. 

Team members often develop relationships with the parents and their children and observe every 

aspect of their lives. Therefore, each team member’s insight and observations are important in 

making decisions. The entire team (depending on the jurisdiction) is usually present at court 

hearings. This is important for the presentation of a consistent message, which prevents parents 

from manipulating individual team members and ensures parent accountability. 

Although the makeup of the FDTC teams represented at the focus group varied slightly, some 

positions were considered essential. Descriptions of the key members of an FDTC team follow: 

Judicial officer. The primary role of the judge in abuse and neglect cases is to ensure the child’s 

safety, permanency, and well-being. The judge oversees the progress of family members in 

treatment and serves as the team leader in bringing together various components of the 

program—including those within the family court system, the substance abuse treatment 

community, the child welfare system, mental health services, and other community 

organizations. The judge is also the central figure in the treatment and recovery of the 

participants, serving as a role model and authority figure to whom participants look for guidance 

and support. The judge provides leadership, and is in a position to influence related reform 

efforts and keep his or her colleagues and the community informed about the FDTC. 
33

The judge is also obligated to educate team members and FDTC participants about courtroom 

policies, procedures, and the judge’s role. He or she should remain open to learning from other 

team members about their systems. It is especially important for the judge to understand the 

cycle of substance abuse and relapse in addition to the various treatment options available. 

Judges also need specialized knowledge of child development, family violence, and other child 

welfare-related issues, including services for children and families available in the community. 

Coordinator. The FDTC coordinator is the “hub of the wheel.” He or she maintains the ongoing 

operation of program activities and ensures that the team works efficiently to provide services 

for the family. The coordinator is responsible for the overall monitoring services, ongoing 

scheduling of cases, maintenance of files, identifying and allocating resources, budgeting, and 

evaluating performance. The coordinator position may vary greatly from one jurisdiction to 

another. The scope of this position will be determined by the overall needs of the FDTC. 

Substance abuse treatment providers. Treatment providers are critical to the success of the 

program and should be included in the program planning stage to help establish common goals, 

learn to “speak the language” of the child welfare and dependency court systems, and provide 

mechanisms for communicating the results of drug testing and other relevant information. It is 

the responsibility of the substance abuse professional to determine the appropriate substance 

abuse treatment and continuum of care for the parent and to educate the team on relevant issues 

regarding treatment modalities, relapse, and substances of abuse specific to their jurisdiction. In 

addition, treatment providers attend and participate in staffing and court sessions to offer 

information about the progress of FDTC participants. 

Child welfare representative. Child welfare representatives are responsible primarily for the 

well-being of the children and are a key part of successful collaboration. Child welfare agencies 

and practitioners are responsible for protecting children’s health and safety, advocating on behalf 

of the children’s best interests, and ensuring that children and their parents receive necessary 

services in addition to substance abuse treatment. They, too, must learn to speak the language of 

the other team professionals, especially of substance abuse treatment providers, and understand 

substance abuse and the cycle of relapse and recovery. 

Representative of supervision agencies. Those who function in a supervisory role, such as 

those in child protective services probation and parole officers, and treatment alternative to street 

crime (TASC) case managers maintain ongoing contact with the parents or offenders and provide 

frequent reports on their progress. This function is especially critical in linking offenders with 

community supervision, treatment, and law enforcement services. 

Child attorney/representative (i.e. court-appointed special advocate and guardian ad 

litem). These separate legal representatives for children bring a necessary dynamic to the drug 

court team. They provide a voice for the children during the staffing hearing that might be absent 

in the general discussion. These attorneys often bring attention and focus to the needs of the 

children. 
34

Parent attorney. The parent attorney ensures that the FDTC gives consideration to the parent's 

interests while at the same time guarding the welfare and safety of the child. This team member 

informs the parent about court procedures, makes the parent aware of the benefits of the 

program, and encourages the parent to participate. During team discussions of possible sanctions 

and incentives, the parent attorney may remind team members that in a family court setting, 

sanctions that separate a parent from a child are not always the answer. The parent attorney may 

also handle any related criminal charges against the parent. 

 

Agency attorney/prosecuting attorney. The attorney responsible for bringing the case forward 

is integral in the identification of cases eligible for participation in the FDTC. The attorney 

attends all required hearings and files the motions and petitions necessary to initiate the parents’ 

involvement in the FDTC. In addition, the agency attorney attends and participates in the staffing 

and court hearings to ensure ASFA timelines are met and the safety and best interest of the child 

are maintained. The attorney monitors the dependency court case, regardless of whether the 

family dependency court is fully integrated within, or is separate from, the family dependency 

treatment court. 

“Treatment providers have always been skeptical of how the court system treats 

clients. [It] has been focused on punitive measures that are intended to force people 

into socially appropriate behavior. As the treatment provider for the Kansas City 

Juvenile and Family Dependency Treatment Court, my perception has dramatically 

changed. We are witness to a system of attorneys, judges, and case managers who 

are passionately concerned about the welfare of our children. What makes this 

system so successful is a collaborative working relationship between the provider 

and the court. We are grateful for the opportunity to affect so many lives in a 

strength-based continuum of care.” 

—Carla Ingram, CSACII, LCSW

Program Manager

North Star Recovery

Kansas City, Missouri

Family Members 

The children, parents, and other family members are also stakeholders in the FDTC. In the 

FDTC setting, parents have more opportunities to advocate for services to meet the needs of their 

children. They have the opportunity to bring their concerns before the court or to speak 

individually to team members. Children have a voice through their social worker, parents, or 

representatives, or they may speak directly to the court regarding their own safety, well-being, 

and permanency. 
35

Program Example: Reno, Nevada 

In Reno’s family dependency treatment court, participants are encouraged to call 

staff members or the judge at any time. Frequent hearings in a more relaxed court 

atmosphere and face-to-face meetings with team members encourage parent 

participation in the process. Although some parents initially are not very 

communicative, they eventually begin to feel less threatened and speak openly about 

their views if they are listened to and treated with respect. 

Program Example: San Diego, California 

As part of a pilot project, the San Diego County dependency court sometimes uses 

family group conferences, which recognize the value of allowing families to 

participate in the decisionmaking process when the well-being of children is 

concerned. The conference includes parents, members of the extended family, and 

individuals who the family considers supportive or able to provide resources (e.g., 

neighbors, clergy, or tribal elders). The goal is to jointly develop an action plan in 

the best interest of the child. This approach actively engages the family and 

capitalizes on family strengths, allowing for an expression of culturally appropriate 

processes and solutions. 

Families may have varying needs and interests depending on how the court defines its target 

population and, in particular, whether the court serves families struggling with more than 

substance abuse. The focus group broadly characterized the FDTC target population as substance 

abusing parents who are at risk of losing their children. When asked to consider the possibility of 

establishing more specific criteria, the focus group first examined the applicability of the 

dependency treatment court model to persons with problems other than alcohol or drug abuse 

and arrested maturity. The possibility of serving individuals with co-occurring disorders or those 

who are mentally impaired raised questions about the court’s capacity to serve a broad 

population. The group agreed that the FDTC model probably could be applied to persons with 

special needs. The participants noted, however, that individual courts may want to explore the 

appropriateness of extending services to specific groups. Among the numerous factors to 

consider when making such a decision are the availability of resources and local services and the 

court’s experience level. 

With the exception of the Jackson County court, the courts participating in the focus group place 

no restrictions on cases in terms of gender or age. Nevertheless, they agreed that the parents they 

are most likely to see are females who are raising children alone (or with minimal support from 

the children’s father or father figures). The typical parent’s emotional and psychological 

maturation is likely to be arrested, and there is a good chance he or she will lack the skills to 

hold a steady job. The parent is also likely to need parenting training and may have mental or 

physical health issues. It is quite possible that the parent grew up in a dysfunctional family 

environment, is the product of multigenerational abuse and neglect, and is currently a victim of 

domestic violence. 
36

Chapter 6 

Permanency and Safety for Children: Implications of the Adoption and Safe Families Act 

of 1997 

Historically, child welfare workers and the courts have struggled to provide substance abuse 

treatment that enables parents to retain or resume child custody without jeopardizing the safety 

of their children. Cases have often lingered in the courts for years, with no permanent resolution, 

as the parents cycled in and out of treatment. Their children were left in foster care for months or 

even years—a condition often called foster care drift. Since the 1997 passage of the Adoption 

and Safe Families Act (ASFA), a renewed emphasis on establishing permanency for children 

within federally mandated timeframes has accelerated the need to find effective responses to 

substance abuse and child maltreatment within families. The passage of ASFA is forcing courts 

and related services to take innovative approaches to helping substance abusing parents stabilize 

their lives and maintain their families. 

Although ASFA may present challenges to FDTCs, its intent—to prevent foster care drift—is in 

line with the goals and operation of FDTC programs. Family dependency treatment courts, with 

their early and intensive delivery of services, have great potential to help meet ASFA goals. The 

common characteristics of the FDTC—immediately available services, collaboration among 

stakeholders, and frequent court reviews—are essential to the successful implementation of 

ASFA. The accelerated timeframes; the accountability by the parent, service providers, and the 

court; and the reduced duplication of services that are characteristic of FDTCs all further the 

goal of safely returning children to their families or finding permanent placements for children 

who cannot return home. 

This chapter discusses the implications of ASFA for family dependency treatment courts. 

A Summary of the Adoption and Safe Families Act of 1997 

 

In 1997, President Clinton signed into law the Adoption and Safe Families Act2

 (Public Law 

105-89). ASFA shortens the time children spend in foster care and specifies permanency options 

that lead to permanency, safety, and well-being for children. It calls on the nation’s courts and 

social service agencies to make the health and safety of children the paramount concern in 

placement and permanency decisions. 

Congress’ intent in passing ASFA was to prevent foster care drift by moving children out of 

foster care and into safe and permanent placements as quickly as possible. ASFA places 

stringent requirements on the courts and the child welfare systems, holding them accountable for 

both the protection and permanent placement of children and for assistance with families—

especially those in which substance abuse and addiction exist. 
37

For the first time legislation, through ASFA, clearly states that the safety and welfare of children 

is paramount. Family dependency treatment courts adhere to this principle and are well 

positioned to work within the constraints of ASFA to provide parents with the tools they need to 

become nurturing, responsible adults who are ready to reunite with their children and able to 

provide them with a safe home environment. 

Reasonable Efforts 

ASFA mandates that child welfare agencies make “reasonable efforts” to preserve or reunite 

families. Specifically, the agencies must make reasonable efforts to: 

• Prevent the initial removal of a child from his or her home (this applies only when 

keeping the family together does not endanger the health and safety of the child). 

• Make it possible for a child who has been taken from the home to reunite with his or her 

parents (such efforts may occur during only the 12 months from the date the child entered 

foster care unless compelling reasons exist to extend the limit). 

If reuniting a child with his or her parents is no longer the goal, the child welfare agency must 

place the child in a permanent, safe, and nurturing home. 

When No Reasonable Efforts Are Required 

To prevent children from languishing in the foster care system for extended periods of time, 

ASFA includes exceptions to the reasonable efforts requirement (National Council of Juvenile 

and Family Court Judges, 1998). The act acknowledges certain circumstances in which no efforts 

to preserve or reunite a family could be deemed reasonable. Specifically, reasonable efforts to 

preserve or reunite the family are not needed when any of the following circumstances exist: 

• A child has been subjected to “aggravated circumstances” as defined by state law (e.g., 

abandonment, torture, chronic abuse, or sexual abuse). 

• A parent has aided or abetted, attempted, conspired, solicited, or committed the murder or 

voluntary manslaughter of another of his or her children. 

• A parent has committed a felony assault resulting in serious bodily injury to the child or 

to another of his or her children. 

• A parent’s rights to another child have been involuntarily terminated. 

Permanency Hearings 

ASFA requires that a permanency hearing to determine a child’s permanent placement be held 

12 months after a child enters foster care (starting from the date of adjudication or 60 days from 

the child’s removal from the home, whichever is earlier) or within 30 days of a determination 

that no reasonable efforts are required.3

 At most, this leaves 14 months for a parent to succeed 
38

under an established case plan before a permanency plan must be determined. (For an outline of 

the timelines required by ASFA, see appendix B.) 

The permanency hearing involves significantly more than a review or an extension of placement. 

The hearing must determine the permanency plan for the child. Under federal regulations, the 

court must determine whether and when the child will be: 

• Returned to the parent. 

• Placed for adoption, with the agency filing a termination of parental rights (TPR) 

petition. 

• Placed permanently with a fit and willing relative. 

• Referred for legal guardianship. 

• Placed in another planned permanent living arrangement (this final option is to be taken 

only in cases in which the agency has documented a compelling reason that none of the 

first four options would be in the child’s best interest). 

Termination of Parental Rights Requirement 

ASFA requires that a child protection agency file or join a TPR petition when a child under its 

protection has been in foster care for 15 of the past 22 months; the court determines that the child 

has been abandoned; or the court, following ASFA guidelines, determines that no reasonable 

efforts to preserve or reunite the family are required. There are three exceptions to the TPR 

requirements: 

• The child is being cared for by a relative. 

• The agency has documented compelling reasons that TPR would not be in the best 

interest of the child. 

• The agency has not provided necessary services in a period consistent with the case plan 

(in cases where reasonable efforts are required). 

The Reasonable Efforts Provision: Implications for the FDTC 

 At various points in the court proceedings, the judge must decide whether the agency has in fact 

made reasonable efforts—in light of a child’s current and future health and safety needs—to 

prevent removal, provide adequate services to reunite the family, or to diligently locate and 

secure an alternate permanent placement for the child. According to the National Council of 

Juvenile and Family Court Judges et al. (1987), reasonable efforts may consist of providing 

direct services, financial or in-kind benefits, or counseling assistance. 

The FDTC model, with frequent and regularly scheduled hearings, is well positioned to ensure 

these efforts are made and to provide the judge with frequent opportunities to make a 

determination. Yet, making this determination is no small challenge. According to a 1999 

analysis of data on child abuse and neglect—which included a survey of 916 professionals in the 

field and numerous indepth interviews with those on the front lines of child welfare— 
39

Determining whether “reasonable efforts” have been exerted is practically and 

emotionally very difficult. Parents almost always oppose efforts to terminate 

rights to their children. Child welfare officials, many of them trained in social 

work and focused on “helping families,” are generally reluctant to recommend 

breaking up families. With an uncoordinated and often inconsistent delivery of 

services from various agencies and providers to assist families, family court 

judges often find defining “reasonable efforts” an elusive goal, especially since 

substance abuse is a factor in most cases and most child welfare workers and 

juvenile dependency court judges have little or no understanding of the nature of 

substance abuse or addiction, or the process of treatment and recovery (National 

Center on Addiction and Substance Abuse, 1999).

The challenge of defining “reasonable efforts” is potentially diminished in the FDTC due to the 

coordinated service delivery plan and a team approach to case management. 

When No Reasonable Efforts Are Required: Implications for the FDTC 

It is the court’s responsibility to inquire at each hearing whether any of the reasonable effort 

conditions outlined in ASFA apply. If so, and the judge agrees that no reasonable efforts are 

required, the court must hold a permanency hearing within 30 days. The agency must make 

reasonable efforts to place the child in accordance with the new permanency plan, including 

placing the child for adoption or with a legal guardian. 

In the FDTC model a number of questions emerge: Is past history of failed drug treatment a 

circumstance in which no reasonable efforts should be required? Should a parent whose rights to 

a child previously were involuntarily terminated as a result of an inability to achieve sobriety 

while in treatment—which was inadequate or inconsistent—be prevented from participating in 

the FDTC’s program? 

Anecdotal evidence from existing FDTCs suggests that even parents who might otherwise be 

considered a poor risk are able to succeed in a program of early and intensive treatment, and can 

reunite with their children. However, ASFA mandates that the child’s health and safety always 

be considered paramount. These and other questions will be answered as the research on 

successful graduates informs the field about identifying appropriate FDTC parents. 

Permanency Hearings: Implications for FDTCs 

For parents battling substance abuse—as well as the courts and substance abuse treatment 

providers—the 12-month timeframe for the permanency hearing has important implications. 

Even parents who are committed to achieving sobriety often require more than 12 months in 

substance abuse treatment before making significant progress, and one or more relapses during 

treatment are common. Responding to concerns from the field, the U.S. Department of Health 

and Human Services (HHS) entered the following commentary into the federal regulations: 
40

“[P]arents dealing with substance abuse issues may require more than 12 months 

to resolve those issues. However, a parent must be complying with the established 

case plan, making significant measurable progress toward achieving the goals 

established in the case plan, and diligently working toward reunification in order 

to maintain the goal of a permanency plan at the permanency hearing. Moreover, 

the state and court must expect reunification to occur within a timeframe that is 

consistent with the child’s developmental needs.”4 

For an FDTC parent or participant, reunification may continue to be the goal of the permanency 

plan if the parent meets these HHS conditions. However, the child’s safety must remain 

paramount. Although drug treatment services may be required for more than 12 months, this 

need should not be used to justify extending reunification efforts. Rather, reunification should be 

safely accomplished within the 12 months, with drug treatment continuing after reunification. 

It is also essential that agencies promptly provide substance abuse treatment services. 

Historically, treatment service providers have lacked sufficient capacity to help parents who seek 

it—but the short timeframe imposed by ASFA increases the need for court systems to ensure 

close judicial supervision of, and coordination and accountability among, service providers. 

FDTCs are model programs that incorporate these vital components for meeting ASFA’s 

mandates. 

Termination of Parental Rights Requirement: Implications for the FDTC 

A substance abusing parent who complies with and makes substantial progress toward the goals 

in his or her case plan, and who diligently works toward reunification, may fall under the 

“compelling reasons” exception to ASFA’s TPR requirements. If the agency believes this is the 

case, the caseworker should document the specific reasons that make the parent’s progress a 

compelling reason not to file a TPR petition. 

Because FDTCs are designed to provide early and intensive services, the third exception—when 

the agency has not provided necessary services in a period consistent with the case plan (in cases 

where reasonable efforts are required)—should not apply to alcohol and drug treatment services. 
41

Chapter 7 

Recommendations of the Focus Group 

Family dependency treatment courts remain a new concept, but initial reports from the field 

indicate that the justice, child welfare, and substance abuse treatment systems are finding 

effective ways to collaborate. As a result, many allegedly abusive and neglectful parents who 

have substance abuse problems are receiving the services they need to make safe and stable 

homes for their children. 

Although FDTCs currently exist in a limited number of jurisdictions, this new breed of family 

court has shown significant potential. To facilitate the efforts of court planners and to ensure that 

new court teams benefit from the experience of the first courts, the focus group proposes the 

following elements as a national strategy for validating and advancing the FDTC movement: 

• Set minimum standards for family dependency treatment courts by which they can 

be defined and judged. As the field gains experience and research findings become 

available, these standards should be codified to guide the development and refinement of 

FDTCs. 

• Develop gender-specific treatment and longer treatment programs. The lack of 

treatment programs that are longer and specifically designed for women is a serious 

concern in a court setting in which most parents are women. 

• Develop effective aftercare programs that will keep graduates on their recovery and 

growth paths. Program graduates need a transitional link from the courts to the 

community that will provide the continued support and treatment they need. Aftercare 

should be available following graduation and, ideally, should be supplemented with a 

mentoring program or alumni association for long-term support, recovery, and ongoing 

healthy child development. 

• Secure ongoing support from policymakers, community leaders, and the public. 

Support is necessary at every level of government, from the local community to state and 

federal representatives. Education and awareness among the general public are also 

needed so communities can appreciate FDTC efforts to promote child safety and parents’ 

recovery from substance abuse. Media attention can play a significant role in this 

process. 

• Foster a clear understanding of the purpose of the family drug treatment court and 

the roles of the FDTC team among team members and other court and agency 

personnel. This is especially important for court personnel, for it is only through 

understanding that they will support the FDTC movement. 

• Provide interdisciplinary cross training for FDTC team members on a local level. 

To sustain and improve on the efforts of existing FDTCs, the cross training of 

practitioners must be widely implemented. Sharing knowledge and skills across systems 

is necessary not only for optimizing the day-to-day operations of the court but for 
42

establishing trusting relationships. Training must be ongoing, with representatives of 

FDTC organizations continually building their understanding of the team’s components 

and the strength that is possible through collaboration. 

• Realign resources for service delivery, education, and outreach. Collaboration is an 

essential component of effective FDTC programs. Agencies and organizations must 

coordinate their efforts to frontload services, maximize resources, and build program 

capacity and sustainability. 

• Identify funding sources and means to raise funds without breaching ethical 

standards. In each jurisdiction, it will be necessary to investigate the financial resources 

available through local, state, and federal avenues. 

• Identify venues for education and training, and use them to increase understanding 

among stakeholders, legislators, the judiciary, the bar, and the public of the FDTC 

mission, goals, and process. A public information campaign is needed to educate the 

public and stakeholders about the promise and vision of FDTCs. Current leaders in the 

field need to use national and state conferences, forums, newsletters, and publications to 

mobilize decisionmakers and communities. 

• Form collaborations of national organizations around dependency issues. Such 

organizations include, but are not limited to, the National Association of Drug Court 

Professionals, the National Drug Court Institute, the American Bar Association, the 

National Council of Juvenile and Family Court Judges, the Child Welfare League of 

America, and the National Association of the State Alcohol and Drug Abuse Directors. 

• Establish measurements and basic data elements to evaluate FDTCs. The research 

community needs to establish the effectiveness of FDTCs. Programs need to incorporate 

evaluation components from the outset, develop uniform data elements, and demonstrate 

effective outcomes. The complexity of the FDTC approach makes it difficult to 

determine the type of data that should be measured. As evaluation procedures and models 

are developed, the field must collaborate effectively to share approaches to research and 

evaluation. 

• Expand substance abuse treatment capacity and allocate resources for early 

intervention and treatment. Each community needs to develop a full continuum of 

resources. These services might include residential care, outpatient services, day 

treatment, individual and group counseling, and education. 

• Recognize the distinctions between civil and criminal FDTCs in establishing 

program plans. Each program should be aligned with the legal and statutory 

requirements for its jurisdiction. Procedures and processes must account for the limits 

and authority of the court. 
43

• Break down barriers. When barriers to collaboration exist between the court system, the 

child welfare system, and the substance abuse treatment community, they can prevent 

effective service delivery to families. Although federal agencies recognize and address 

these barriers and provide funding for some initiatives that attempt to break down 

barriers, much of the work necessary to change established systems must be done on state

and local levels. New roles must be taken on at all levels—by social workers, treatment 

counselors, agency administrators, political leaders, and judges. Although the challenges 

are substantial, the potential rewards are even greater. 
44

Chapter 8 

Current Initiatives 

Training for Family Dependency Treatment Courts 

Training is critical to the implementation of an FDTC. However, because the FDTC differs 

significantly from the adult criminal and juvenile delinquency drug court models, a new 

approach to training is needed. 

Responding to this need, in 2001 the Drug Court Planning Initiative (DCPI) began to offer 

training for jurisdictions planning a family dependency treatment court. During the first year, 42 

jurisdictions participated in a two-part training. They first visited at least two host family 

dependency treatment courts and then attended a 4-day conference workshop. The workshop 

addressed the unique characteristics of FDTCs; provided substantive, topic-specific information 

in a practitioner-focused manner; and guided participants through the development of an 

implementation plan. 

By 2002, the DCPI had refined and expanded the initial training conference into a series of three 

programs: introductory training, skills-based training, and operations training. Each program 

builds on the preceding program in the series. Together the programs lead participants through 

the process of designing and planning a family dependency treatment court, paying particular 

attention to implementation and institutionalization. A total of 68 jurisdictions participated in the 

training program in its first 2 years. 

To ensure the planning teams that attend training represent the critical disciplines involved in 

FDTCs, each participating team is required to include a: 

• Judicial officer. 

• Child protective service or welfare service representative. 

• Substance abuse treatment provider. 

• Drug court or planning coordinator. 

• Parent attorney. 

• Agency attorney. 

• Child attorney, guardian ad litem, or child representative. 

• Evaluator. 

• Management information systems specialist. 
45

The DCPI training program is interactive, and it provides opportunities for teams to discuss, 

analyze, and plan for an FDTC. Specifically, jurisdictions are encouraged to examine issues that 

will affect the design of their FDTC, identify how the key leaders will address those issues, and 

work as a team to ensure the integrity and efficiency of the planning process. 

The following description is excerpted from the training program series announcement:

Introductory Program 

Purpose 

To identify leadership roles in the planning process, to provide a foundation of 

information about how to apply the drug court concept within a dependency court 

practice, and to assist participants as they begin to plan for an FDTC. 

Goal 

To introduce the drug court concept and build common knowledge of its 

application in a dependency court setting, and to further develop the leadership 

skills essential to effectively implement an FDTC plan, particularly the skills of 

the judicial officer, child welfare representative, and coordinator. 

Characteristics 

• First in the series. 

• Three-day training for judicial officer, child welfare representative, and 

coordinator. 

• Observations offered by the host FDTC based on its experience (both the court 

staffing and courtroom). 

• Substantive topics include: 

o Implementation of ASFA. 

o Implementation of the National Council of Juvenile and Family Court 

Judges’ Resource Guidelines (1995) and Adoption and Permanency 

Guidelines (2002). 

o Family dependency treatment court characteristics. 

o Sustainability and community resources. 

o Responsibility to children and the evolution and promise of FDTCs. 

o Judicial and team leadership responsibilities. 
46

Skills-Based Program 

Purpose 

To educate the planning team about issues, practices, and processes unique to 

FDTCs; to assist team members from each discipline as they examine the impact 

of the FDTC on their roles and responsibilities. 

Goal 

To begin drafting an FDTC policy-and-procedures manual by applying the 

knowledge and insight acquired as a result of the presentations; to determine how 

team members will collaborate to plan the FDTC. 

Characteristics 

• Second in the series. 

• Four-day training for entire planning team. 

• Observations offered by the host FDTC based on its experience (both the court 

staffing and courtroom). 

• Substantive topics include: 

o ASFA. 

o Indian Child Welfare Act. 

o Cultural competency. 

o Team building. 

o Intergenerational issues in substance use, abuse, and dependence. 

o Development of an FDTC mission statement. 

o Basics of substance abuse and dependence. 

o Management of information. 

o Targeting and eligibility. 

o Screening and assessment. 

o Management information systems. 

o Evaluation. 

Operations Program 

Purpose 

To create the framework and policy for the FDTC, defining specific roles within 

the team and the jurisdiction. 
47

Goal 

To define treatment services and continuing care models, develop a program 

structure, identify sanctions and incentives, examine community resources, 

formulate an action plan, and finalize a policy and procedure manual. 

Characteristics 

• Third and final program in the series. 

• Three-day training for entire planning team. 

• Substantive topics include: 

o Assessment and treatment services. 

o Definition of your treatment services and continuing care models. 

o Case management, process and structure. 

o Management of participant behavior through incentives and sanctions. 

o Quality assurance and sustainability. 

o Ethics and confidentiality. 

o Ensuring team consensus. 

o Intergenerational issues related to substance use, abuse, and dependence. 

Family Dependency Treatment Court National Cross-Site Evaluation Project 

A significant project sponsored by the Center for Substance Abuse Treatment is now underway. 

This evaluation comprises five FDTCs. It examines whether the revised procedures, intense 

supervision, and early treatment interventions are instrumental in achieving the courts’ desired 

outcomes. 

Funding for FYs 2002 and 2003 

Funding streams and grants have changed since the focus group meeting in 1999. As noted in 

program sustainability, FDTCs are not limited to the actual dollars raised within the community. 

Program support can also come through nonmonetary resources and the reallocation of resources 

within communities. The following items identify potential funding opportunities for FDTCs: 

• Fiscal Year (FY) 2002 appropriations for the Substance Abuse Prevention and Treatment 

Block Grant increased by $60 million from the FY 2001 funding level. It was estimated 

that FY 2003 appropriations would again be increased over FY 2002. This block grant to 

states provides funds for substance abuse prevention and treatment services. 

• When treatment capacity is insufficient for a particular population (such as women and 

children), state and local agencies can apply for discretionary funds from SAMHSA’s 

Targeted Capacity Expansion Program. 

• SAMHSA’s drug treatment court grant in FY 2002 provided more than $10 million in 

funding for 28 community drug treatment courts to provide substance abuse treatment for 
48

juveniles, parents charged with abuse and neglect of their minor children, and substance 

abusing adults charged with criminal offenses. These grants will expand these courts—

which provide targeted treatment services to break the cycle of child abuse, criminal 

behavior, alcohol or drug abuse, and incarceration—by funding alcohol and drug 

treatment and additional services that support substance abuse treatment. The grants, 

which are part of the SAMHSA drug courts initiative, will allow SAMHSA to support 

the goals of the Adoption and Safe Families Act. ASFA sets strict timelines for courts 

that have jurisdiction over parents who have neglected or abused their children. 

• A number of states have expanded the substance abuse treatment services available 

through Medicaid in recent years. States may fund substance abuse treatment in many 

forms through the mandatory benefits required by the Health Care Financing 

Administration and may wish to consider this as an option for expanding treatment 

capacity. Many parents involved in the child welfare system are already eligible for 

Medicaid. 

• Some substance abuse services can be paid for under Temporary Assistance for Needy 

Families (TANF) and welfare-to-work programs. Many families in the child welfare 

system that also have substance abuse problems receive welfare benefits. If parents’ 

substance abuse is interfering with their ability to care for their children, it may also be 

interfering with their ability to work. States and counties can incorporate substance abuse 

treatment services as part of their parents’ employment plans. Under these circumstances, 

TANF and welfare-to-work funds could be used for nonmedical aspects of substance 

abuse treatment if the treatment is not otherwise available. 4

• The Administration for Children and Families (ACF) is the lead HHS agency responsible 

for programs that promote the economic and social well-being of families, children, 

individuals, and communities. The FY 2002 budget requested $44.4 billion, a net 

increase of $1.2 billion, or 2.9 percent, from the FY 2001 funding level. Of these funds, 

$12.6 billion was allocated for discretionary programs, and $31.8 billion was earmarked 

for entitlements. The programs covered with this money include the Court Improvement 

Program (a grant program to help state courts improve how they handle foster care and 

adoption proceedings), child abuse and neglect programs (grants for states to improve 

and increase prevention and treatment activities), Community Service Block Grants (a 

program that provides states, territories, and Indian tribes with a flexible source of 

funding to help reduce poverty and address employment, education, housing assistance, 

energy, and health services), individual development accounts (a new program that 

empowers low-income individuals to save for a home), social services research, 

developmental disabilities, entitlement programs (TANF), childcare, and the LowIncome Home Energy Assistance Program. 
49

• Title XX of the Social Security Act, also referred to as the Social Services Block Grant, 

is an entitlement program with funds capped at $2.8 billion. Block grant funds are given 

to states to help them achieve a wide range of social policy goals. Funds are allocated on 

the basis of population. 

These resources may help FDTCs expand treatment capacity at the state and local levels. At the 

same time, FDTC programs can educate state and local leaders about the value of FDTCs and 

urge decisionmakers to expand resources that address the needs of children and parents involved 

in the child welfare system. 
50

Appendix A: Focus Group Participant FDTC Program Descriptions 

Family Treatment Court, Suffolk County, New York 

In Suffolk County, New York, the number of child abuse and neglect cases continues to escalate. 

Parental substance abuse is believed to contribute to the majority of cases, placing children at 

substantial risk for out-of-home care. Despite the prevalence of cases involving substance abuse, 

neither the child welfare system nor the dependency system has been able to effectively meet the 

multifaceted needs of chemically dependent parents and their children. This has resulted in the 

fragmentation of services and poor coordination among service delivery systems. The Honorable 

Nicolette M. Pach, a family court judge in Suffolk County, responded to this need by researching 

the connection between substance abuse and child maltreatment. She assembled key stakeholders 

to further explore the problem and formulate a plan to address the needs of children and families. 

Implementation of the Family Treatment Court 

With the support of the Office of Court Administration and the Suffolk County District 

Administrative Judge, a steering committee composed of key court personnel, county leaders, 

and representatives from numerous county and community-based agencies was developed to 

explore resources, funding sources, policy concerns, and implementation issues. After a yearlong 

planning period, the Suffolk County Family Treatment Court (FTC) became operational on 

December 10, 1997. 

The multidisciplinary, interagency effort integrates chemical dependency and child welfare 

services for alcohol- or drug-addicted parents and their children. The overall purpose of the 

program is to ensure the safety and well-being of children, to facilitate reunification efforts, and 

to expedite permanency planning. The program uses a comprehensive and integrated case 

management approach to meet the needs of chemically dependent parents and their children, 

including the developmental and health care needs of children. The program was the state’s first 

family drug court and initially relied on county and state funding, as well as in-kind 

contributions from participating agencies. The court later received a grant from the State 

Division of Criminal Justice Services and an additional grant from the Robert Wood Johnson 

Foundation. 

Eligibility 

FTC identifies substance abusing parents who have neglected their children by screening all of 

the original neglect petitions filed by the Department of Social Services (DSS) through local 

child protective services agencies. Parents who are alleged to have neglected or abused their 

children, who abuse alcohol or drugs, and who meet the established criteria will have their cases 

heard before the designated treatment court judge. Eligible parents are notified of the program 

and its requirements during their initial court appearance and are offered the opportunity to meet 

with staff to further discuss the program. Parents who are willing to admit neglect due to their 

substance abuse and who voluntarily opt to participate in the program sign an agreement and are 

scheduled to meet with members of the court-based case management team for an alcohol and 

drug family assessment. 
51

Court Procedures and Operations 

FTC emphasizes early intervention through the immediate assessment and referral to appropriate 

treatment and ancillary services of substance abusing parents who are charged with child abuse 

or neglect. Within 2 to 3 weeks of their initial court appearance, eligible parents are assessed and 

referred to the appropriate treatment, which includes an intake appointment with a treatment 

provider. This provider addresses the parent’s specific needs, including transportation and 

daycare services. Approximately 6 weeks following the parent’s initial court appearance, a 

dispositional order based on the service plan is entered. This order details the specific services 

designed to address the needs of the family. The goal of the court is to develop a comprehensive 

service plan that meets the needs of both the parents and the children. 

Intensive case monitoring and frequent status reviews before the judge keep the court apprised of 

safety issues pertaining to the children, the parents’ progress in treatment, and progress toward 

permanency planning goals. This monitoring, which continues throughout the duration of the 

court order, enables the court to make informed decisions regarding placement issues. 

FTC places increased emphasis on accountability. Parents are rewarded for progress in treatment 

and for meeting the requirements of the drug court. Conversely, they are sanctioned for 

noncompliance or failing to meet the needs of their children. Onsite alcohol and drug testing 

provides an effective measure of abstinence. Positive drug tests result in the reevaluation of 

treatment levels and other therapeutic interventions, as well as increased monitoring by the court. 

Willful contempt of court orders may result in up to 6 months’ incarceration. Progress is 

acknowledged through the three phases of the program, each of which addresses specific 

recovery and child welfare issues. Graduation is achieved after a minimum of 1 year of 

participation in the program, including 6 consecutive months of sobriety and a court-approved 

permanency plan. Aftercare services include ongoing supervision by child protective services. 

Case Management, Treatment, and Related Services 

Through its team approach to case management, FTC integrates chemical dependency and child 

welfare services, ensuring the delivery of coordinated services for the entire family. Court-based 

case management services enhance the efforts of DSS, and frequent case conferencing ensures 

that critical information is exchanged among service delivery providers. The development of a 

comprehensive plan that addresses the needs of the entire family is one of the foundations of the 

family treatment court. The strong assessment components leading to the development of this 

plan are also critical to ensuring that permanency planning efforts begin early in the process. 

The enhanced assessment components of FTC are also integrated with the risk assessment 

conducted by DSS. This results in a more comprehensive and coordinated plan and a more 

inclusive court order. For example, in addition to placement and visitation issues, service plans 

frequently include services to address alcohol and drug issues, domestic violence, the mental 

health issues of parents, and the developmental and health care needs of children. Intensive 

monitoring of the service plan is key to the family treatment court. The team also serves as a 

resource for linkages to public assistance, housing, transportation, and other ancillary services. 
52

As of late 2000, FTC was held 3 half-days per week before one judge. There are approximately 

46–60 active cases at any time. 

Preliminary Findings 

FTC recently began evaluation efforts; however, some benefits of the program can already be 

seen. Parents have been able to access appropriate treatment in an expedited manner. Intensive 

monitoring is identifying family needs and problems early so that assistance can be provided and 

the safety of children can be ensured. The court receives comprehensive status reports, enabling 

informed decisions concerning the placement of children. Also as a result of integrating services, 

new relationships are developing among treatment providers, child welfare professionals, and the 

court. 

Contact Information 

Christine L. Olsen, C.S.W. 

Project Director 

Telephone: 631–853–4482 

Fax: 631–853–7616 

E-mail: colsen@courts.state.ny.us 

Dependency Court Recovery Project, San Diego, California 

San Diego County receives approximately 90,000 reports of suspected child abuse or neglect 

each year. Of these cases, approximately 2,400 come under the jurisdiction of the dependency 

court. In such cases, the court may remove supervisory authority or custody of the child from the 

family and transfer custody to the county child protection agency (there are approximately 9,000 

children in the county’s dependency system). In San Diego County, the Superior Court Juvenile 

Division’s seven dependency courts and the Health and Human Services' Children’s Services 

Division handle the cases. 

Before 1997, San Diego County’s dependency system had tremendous difficulty making timely 

permanent placement decisions for children. A review of the case files indicates that 80 percent 

of dependency cases involved alcohol or drug abuse by one or both parents. However, many 

parents in the court system were not receiving prompt and effective substance abuse treatment, 

which forced the dates for reunification plans and placement decisions to be extended. As a 

result, the county was not able to resolve cases within the state’s statutory guidelines. In 1994, 

case resolution averaged 34 months. Children spent significant time in foster care, often with 

three changes in placement, which led to further trauma and psychological problems among 

these children. 
53

A Systems Approach 

In response to this situation, the presiding judge of the juvenile court, the Honorable James R. 

Milliken, brought together a team of key stakeholders in the dependency system to 

collaboratively implement a series of rapid reforms designed to achieve either family 

reunification or the timely and permanent placement of children outside the home. Stakeholders 

included the San Diego County Board of Supervisors, judges, court and county administrators, 

attorneys, social workers, foster parents, substance abuse treatment providers, parents, and 

juveniles. A policy group was also established to provide a forum for the discussion and 

development of policies on how dependency cases should be handled from beginning to end. 

The resulting Dependency Court Recovery Project emphasizes compliance with statutory 

timelines for decisionmaking in all dependency cases. Eight major court-reform measures 

address both the general court reforms and the specific alcohol and drug concerns. Directly 

addressing these concerns is a two-tiered system of court supervision and substance abuse 

treatment. 

The First Tier: Dependency Court 

Within the dependency court, each parent against whom an abuse or neglect petition is filed is 

subject to the requirements of the dependency court. If alcohol or drugs are an issue, the parent is 

also subject to the requirements of the Substance Abuse Recovery Management System 

(SARMS). Through SARMS, Mental Health Systems, Inc. (a nonprofit organization under 

contract with the county) provides case management services to help parents address their 

substance abuse problems and encourages sobriety. The SARMS recovery specialist conducts 

the substance abuse assessment, enrollment, alcohol and drug testing, and progress monitoring 

and reporting. He or she also works with the participant to prepare a Recovery Services Plan that 

identifies the required treatment. Dependency parents attend counseling, therapy, education 

sessions, and recovery support groups through community-based treatment programs and submit 

to frequent alcohol and drug tests. SARMS reports to the court and Children’s Services Division 

on a twice-monthly basis regarding parents’ progress in treatment and the results of the alcohol 

and drug tests. In addition to the normal dependency review hearing schedule, 30- and 60-day 

SARMS review hearings are required, and the parent is encouraged to seek treatment before the 

30-day hearing. 

A social worker from the Children’s Services Division remains the principal case manager and is 

responsible for the overall dependency case management. The addition of the SARMS recovery 

specialist provides case management for the parents’ substance abuse issue only. 

SARMS recovery specialists initially work actively with participants toward compliance with 

their recovery services plans, which are an automatic condition of the court order. Violation of 

the order results in sanctions of increasing severity: first, a reprimand from the judge; second, 

jail time and/or a fine; third, jail time and/or a fine or referral to the dependency drug court. 
54

The Second Tier: Dependency Drug Court 

The dependency drug court, a major component of the Recovery Project, is designed for 

dependency court parents who fail to meet the SARMS recovery services plan treatment goals. 

The dependency drug court operates an intensified three-phase program of treatment and 

heightened supervision, with each phase lasting 90 days. In Phase 1, a court appearance is 

required once a week. In Phase 2, a court appearance is required every 2 weeks. In Phase 3, a 

court appearance is required once a month. The parent is expected to cooperate fully with the 

conditions of the recovery services plan and to submit to random alcohol and drug tests in 

conjunction with dependency drug court appearances. If the parent is uncooperative and 

repeatedly fails to meet the recovery service plan goals, a permanency hearing to terminate 

parental rights may ensue. 

Case Management, Treatment, and Related Services 

SARMS is an extensive case management system that uses a broad range of treatment options to 

address the needs of parents in both tiers of the dependency court system. Through funding from 

the San Diego County Board of Supervisors and activities of the Health and Human Services 

Agency’s Alcohol and Drug Services, the county network of contract treatment providers has 

been expanded to serve the immediate needs of the dependency population. The recovery 

services plan developed by the SARMS recovery specialist may include counseling, therapy, 

education sessions, and attendance in support groups. In addition to traditional inpatient and 

outpatient services, programs that can house parents (usually mothers) with their children are 

sought. Such facilities provide a “SAFE (sober and friendly environment) house” for the care 

and well-being of the family as parents progress through the recovery process. When possible, 

necessary services, such as parent-skills training, employment, and mental health and medical 

treatment, are within walking distance. The expectation is that a continuum of services and early 

intervention will strengthen the family and result in increased chances for success. However, the 

best interest of the child always remains the paramount consideration, and dedicated foster 

parents are valued for their role in making the dependency system work when the child cannot 

safely stay with the parent. 

Dependency courts sometimes use family group conferences to allow families to participate in 

the decisionmaking process concerning the protection and safety of their children. This process 

involves parents as well as members of the extended family. With the guidance of the Children’s 

Services Family Unit, meeting staff who are trained as family group conference facilitators, 

family members, and the participating support groups meet to formulate a plan for the child, 

which is then presented to the Health and Human Services Agency. This approach capitalizes on 

family strengths, allows for the expression of culturally appropriate solutions, and engages the 

whole family in accepting responsibility for the children. 

As of late 2000, the dependency drug court was in session 3 days a week before one judge. 

Approximately 60 cases are active at a given time. 
55

Preliminary Findings 

The majority of clients are responding well to the program. Preliminary progress reports reflect 

an 81 percent compliance rate with the recovery services plan. More than 1,200 parents have 

received SARMS case management services. 

Contact Information 

The Honorable James R. Milliken 

Presiding Judge of the Juvenile Court 

Telephone: 858–694–4543 

Andrea Murphy 

Superior Court Special Projects Manager 

Telephone: 619–515–8678 

Caroline Rodlex 

Director of Juvenile Court 

Telephone: 858–694–4211 

Family Drug Court, Jackson County (Kansas City), Missouri 

The family drug court was established in the Sixteenth Judicial Circuit Court of Jackson County, 

Missouri, in 1998 to address an increasing number of problems associated with alcohol and 

drugs. The court’s goals are to stop parental substance abuse that threatens the safety and 

permanency of their children and to stop substance abuse by delinquent juveniles or their parents 

that places the juveniles at risk of further delinquent behavior. The overall mission of the court is 

“to provide judicially managed, community-based, close supervision and specialized treatment to 

parents and juveniles whose substance abuse places their children or themselves at risk of 

substantially increased intervention by the justice system.” The court was initially a participant 

in a pilot project under the auspices of CSAT and, in October 1998, received an implementation 

grant from the U.S. Department of Justice’s Drug Court Programs Office. 

Eligibility 

Eligibility is based on established written criteria, and eligible clients are identified immediately 

after charges are filed. Clients are promptly advised about family drug court requirements and 

the merits of participating. Eligible individuals are screened both for substance abuse problems 

and their suitability for treatment by trained professionals, must appear promptly before the drug 

court judiciary, and are enrolled in a treatment program. Jackson County has a combined court 

system that facilitates case processing in cases when both abuse or neglect issues and juvenile 

delinquency exist. However, the focus of this description is on cases related to child dependency 

or child endangerment, including: 
56

• Child dependency cases, defined as abuse or neglect civil cases, including any case filed 

pursuant to child abuse or neglect statutes when parental substance abuse is the primary 

or underlying cause for the neglect or abuse of the child. 

• Child endangerment or criminal cases (diversion), including criminally filed child 

endangerment cases in which the defendant or mother has had at least one drug-exposed 

child with a subsequent baby testing positive for any abused substance at the child’s 

birth, or a criminal defendant eligible for the adult drug court who also has a child who is 

the subject of a dependency proceeding in the family court. 

Court Procedures and Operations

To address these civil and criminal child dependency cases, the family drug court uses a team 

approach, which includes the family drug court commissioner, the family drug court manager, 

the attorney for the juvenile officer, the defense attorney, the adult prosecutor, the guardian ad 

litem, treatment providers, social service providers, family members, and other interested parties. 

The court has also established relationships with private and public community-based 

organizations, public criminal justice agencies, law enforcement, and substance abuse treatment 

delivery systems that can provide linkages to education, housing, vocational rehabilitation, and 

other services. These relationships have expanded the continuum of services available to clients 

and helped educate the community about family drug court concepts. 

In this approach, the roles of the child dependency/juvenile justice practitioners and substance 

abuse treatment providers are very different from those in a traditional court. The judge is the 

central figure on the team, focusing on sobriety, lawful behavior, accountability, and engaging 

clients in treatment. The court’s focus remains on the best interest of the child. Treatment 

providers keep the court informed of each client’s progress so that incentives and sanctions can 

be appropriately applied. The court operates a coordinated, systemic approach to the substance 

abuser through comprehensive planning that includes a method for data collection and program 

evaluation. 

Case Management, Treatment, and Related Services 

The period immediately after charges are filed is a critical window of opportunity for 

intervention, and the value of substance abuse treatment is emphasized during this time. It is 

critical that the referral to the family drug court be immediately followed by a court appearance 

for the intervention to be effective. Treatment is unique to the individual, taking into account his 

or her biopsychosocial and cultural needs. The model uses a holistic approach to the client and 

family treatment plan and incorporates medical and mental health needs, financial issues, 

housing, vocational needs, and family and legal issues. Comprehensive services include 

individual and group counseling, relapse prevention, self-help groups, preventive and primary 

medical care, general health and nutrition education, parenting skill training, domestic violence 

education, and treatment for the long-term effects of childhood physical and sexual abuse. Case 

management ensures an uninterrupted continuum of care and monitoring of client progress. 
57

Abstinence is monitored by frequent urinalysis. Sanctions are imposed for continued substance 

abuse, and the severity of sanctions increases for continued noncompliance. The overriding focus 

is always the best interest of the child. 

The family drug court is in session three afternoons a week and has approximately 60 active 

cases at any given time. 

North Star Recovery Services 

North Star Recovery Services provides a range of program and treatment services for women, 

men, and children. It is the family drug court’s partner for the provision of services for mothers 

or babies who test positive for drugs. North Star offers residential, day outpatient, intensive 

outpatient, and continuing care treatment services. A multidisciplinary team includes counselors, 

community support workers, a family therapist, a child therapist, nurses, psychiatrists, child 

development teachers, and vocational counselors. A great emphasis is placed on empowering 

women as they rebuild their self-esteem and develop healthy relationships. Through the 

program’s child development center, mothers can develop the skills to foster healthy, nurturing 

relationships with their children. 

Contact Information 

The Honorable Molly M. Merrigan 

Commissioner, Family Drug Court 

Telephone: 816–435–8033 

Pamela D. Johnson 

Family Court Management Analyst 

Telephone: 816–435–4775 

David Kierst, Jr. 

Juvenile Officer/Family Court Administrator 

Telephone: 816–435–4850 

Penny Howell 

Program Manager 

Telephone: 816–435–4757 

North Star Recovery Services 

General Information 

Telephone: 816–931–6500 
58

Family Drug Court, Reno, Nevada 

The family drug court in Reno, Nevada, began in 1995 in response to the rising number of child 

abuse and neglect cases involving parental substance abuse. Heavy caseloads prevented social 

service caseworkers from meeting with parents more than once a month, and because of a 

backlog in the judicial system, children languished for years in foster care. In addition, the same 

families often cycled repeatedly through criminal and family courts because of problems related 

to substance abuse. Judge Charles McGee of Washoe County, Nevada, became motivated to try a 

new approach to help children and parents with substance abuse problems. 

In 1995, Judge McGee, who had 17 years of experience as a general jurisdiction, juvenile court, 

and family court judge, designed the first family drug court. He used information about criminal 

drug courts obtained from a colleague to develop the court’s approach and launched the program 

with a budget of $15,000. The court now operates with funds from participating agencies, the 

overall county court administration budget, and a grant from a private foundation; it has also 

secured funds from the county child welfare agency to pay for substance abuse treatment. 

Eligibility 

Families are eligible for the program if their children are placed at risk by their parents’ 

involvement in substance abuse. They may be identified by criminal activity on the part of a 

parent or because children are being removed from the home as the result of abuse or neglect. 

The respondents who appear before the family drug court judge are mostly women with 

addiction problems. Many are victims of domestic violence, have histories of physical and 

sexual abuse, and are often in destructive relationships with men. The families are normally 

referred by child protective agencies or drug treatment programs. However, this is a voluntary 

program, and families may elect not to participate or to discontinue participation and have their 

cases revert back to the traditional court docket. 

Each parent must make a commitment to (1) refrain from alcohol and drug use, (2) meet with the 

judge twice a month for progress hearings, and (3) accept sanctions for failure to comply with 

any ordered obligations. In exchange, the program provides a minimum of 1 year of substance 

abuse treatment, increased social services, and a support system consisting of the judge, his staff, 

a case manager, the treatment provider, and a child welfare caseworker. On acceptance of these 

conditions, families enter into a yearlong program of intensive intervention with the goal of 

reuniting as a healthy, stable family unit. 

Court Procedures and Operations 

Parents must appear before the judge every other week for a hearing. Before this hearing, the 

judge confers with staff members involved in the case to discuss the parents’ progress and 

related issues. Staff members may include the treatment provider, child welfare caseworker, case 

manager, prosecutor, defense counsel, probation officer, and foster grandparents. All staff from 

each agency that has contact with the parents must attend the conference. At the hearing, success 

is reinforced through praise and encouragement, but parents are held strictly accountable for 

failed drug tests or missed treatment appointments. Failure to appear for a drug test or a positive 
59

test usually results in 2 days in jail. Caseworkers make arrangements for the care of the child. 

For participants further along in the program who relapse, community service may be allowed, 

or jail time may be deferred to the weekend to prevent employment conflicts. Other parent 

participants in the court program may sit in the gallery during these hearings. 

The Reno family drug court is a 12-month program, and the participant must be entirely sober 

and drug free for 3 consecutive months before graduation. The graduate may be required to 

attend 3 months of aftercare, which consists of attendance at monthly hearings and aftercare 

treatment. During this time, the graduate’s progress in recovery is monitored, and appropriate 

parenting of the children is ensured. The strength of the court is based on the fact that the judge, 

the court staff, the caseworkers, prosecutors, defense counsel, and the treatment professionals are 

personally involved with the families. 

Case Management, Treatment, and Related Services 

A comprehensive assessment is conducted immediately to identify family needs. Services 

provided include drug treatment, coping and life-skills development, parenting skills education, 

and integrated services case management. Participating agencies give their appraisal of the 

family and recommend a course of action. Each agency is asked to honor the goals of the others, 

work through turf issues, and identify gaps in service provision. Through this collaborative 

approach, an individualized plan with specific goals is developed. The judge in Reno hired a 

service coordinator, based in his court, to ensure that participants receive all necessary services. 

Two treatment programs provide assessment and treatment. One program, an inpatient track 

called Step II, is designed for women only. Step II allows children to live with their mothers; it 

also provides drug testing for women twice a week. The other track, an intensive outpatient 

program called CHOICES, is designed for both men and women, and all the couples in family 

drug court participate in this track. The outpatient track monitors clients by conducting drug tests 

three times a week. A nonprofit group, Tru Vista, can also provide family group conferencing 

services. Court staff members monitor the capacity of each program and accept new participants 

in the drug court only if treatment openings are immediately available. 

Family drug court is in session 1afternoon per week before a single judge. The program had 

approximately 60 participants as of late 2000. 

Preliminary Findings 

Although no formal evaluation has been done, 74 participants have graduated from the program 

since 1999. Screening for substance abuse has improved because of the social services 

caseworkers’ close involvement in the family drug court. Access to ancillary services has greatly 

improved because of the efforts of the service coordinator. Program staff members believe that 

the clear case plan and close monitoring of progress allow for informed decisions on the part of 

the judge concerning child custody and better quality of service for families. 
60

Contact Information 

Victoria (Tori) King 

Court Clerk 

Second Judicial District Court 

Department 2 

One South Sierra Street 

P.O. Box 30083 

Reno, NV 89520 

Telephone: 775–328–3144 
Appendix B. Adoption and Safe Families Act Timeline 

▲If the review hearing is held by the court, it must be held at least once every six months.○ The deter

mination that reasonable efforts to finalize the plan be made is often made at the per

manency hearing, although it can be made at another point in the proceedi

deadline is met.

† When calculating when to have the permanency hearing or the 15 of 22 months, use the earlier of the date of adjudication OR 60 days after the child is removed from th* Unless one of the following exceptions is documented: child is being cared for by a relative, agency has not provided services it has deemed necessary to rehabilitate thexists.Source: This timeline was originally prepared by Mimi Laver and published in ABA Child Law Practice, Vol. 17(8), p. 119. It was updated and amended by ©1998, American Bar Association. All rights reserved. Reprinted with permission from the ABA Center on Children and thD.C. For m

ore information about this publication or to receive a free sample issue, contact Lisa M. Waxler, Publications C

1743; e-mail: waxlerl@staff.abanet.org.

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62

Appendix C: Recommendations for Research and Evaluation 

In its Review of Specialized Family Drug Courts: Key Issues in Handling Child Abuse and 

Neglect Cases, the Urban Institute (1999) made the following recommendations regarding the 

research and evaluation of family drug treatment courts: 

Process evaluation. Studies need to document the policies and procedures developed by courts 

around the country. Issues that should be examined include confidentiality, staffing patterns, 

interagency collaboration, sanction and incentive practices, and advocates' concerns regarding 

civil rights of parents and children. 

Service needs of parents and children. These address substance abuse treatment, legal issues, 

health, employment, housing, domestic violence, and other areas. 

Outcomes for children. Short-term outcomes include the duration and number of foster care 

episodes and the final placement decision. Long-term outcomes for those placed with their 

parents include the percentage named in subsequent abuse or neglect petitions, and when 

parental rights are terminated, the percentage of children adopted. 

Outcomes for parents. Short-term outcomes include graduation or failure to graduate from 

treatment, participation in aftercare following case termination, perceptions of fairness of the 

court process, effects of the process on treatment motivation and retention, and assessment of the 

relationship between FDTC services and reduction in problems faced by parents. 

System impacts. For courts, these include the duration of cases, the number of hearings, the 

demands for resources, the net-widening effects of encouraging early intervention, the potential 

efficiencies of combining multiple petitions for multiple children in a family in a single case, and 

the potential for linking drug court cases with active cases in other courts. For other systems, 

these include the effect on demand for staff and services, requirements to change procedures, and 

barriers to participation based on agency mandates or funding. 

Direct expenditures and in-kind contributions. These include those paid for by existing 

agency funds, insurance, special government programs, private funds, and funding received from 

agencies and community groups. This information is needed for a comparison with the costs of 

existing procedures for handling these cases. 
63

Appendix D: Family Intervention Programs 

Contact information for each of these programs can be found at www.strengtheningfamilies.org. 

HOMEBUILDERS Program 

The HOMEBUILDERS Program is one of the best documented family preservation programs in 

the country. It is designed for the most seriously troubled families referred by child service 

agencies. Populations served include newborns to teenagers. The program is designed to break 

the cycle of family dysfunction by preventing foster care, residential, and other out-of-home 

placements, and to strengthen the family. Program goals include improving family functioning, 

increasing social support, increasing parenting skills, improving school and job attendance and 

performance, improving household living conditions, establishing daily routines, improving 

adult and child self-esteem, helping clients become self-directed, and enhancing motivation for 

change while decreasing family violence. 

The program includes 4 to 6 weeks of intensive in-home services to children and families. A 

practitioner provides counseling and other services, spending an average of 8 to 10 hours per 

week in direct contact with the family; the practitioner is on call 24 hours a day, 7 days a week 

for crisis intervention. Therapeutic processes used include skills building, behavioral 

intervention, motivational interviewing, relapse prevention, rational emotive therapy, and other 

cognitive strategies. 

HOMEBUILDERS has been evaluated both formally and informally since it began in 1974, and 

results have shown repeated positive findings on a variety of measures focusing on placement 

prevention and on child and family functioning. 

Strengthening Families Program 

The Strengthening Families Program (SFP) is a family-skills training program designed to 

reduce risk factors for substance use and other problem behaviors in high-risk children of 

substance abusers, including behavioral, emotional, academic, and social problems. SFP builds 

family relationships and parenting skills and improves the children’s social and life skills. It is 

designed for families with children 6 to 10 years old and has been modified for 

African-American families, Asian and Pacific Islanders in Utah and Hawaii, rural families, 

Hispanic families, and early teenagers in the Midwest. 

SFP participants attend 14 weekly meetings, each 2 hours long. SFP includes three separate 

courses: Parent Training, Children’s Skills Training, and Family Life Skills Training. Parents 

learn to increase desired behaviors in children by using attention and reinforcements, 

communication, substance use education, problem solving, limit setting, and maintenance. 

Children learn about communication, understanding feelings, social skills, problem solving, 

resisting peer pressure, and complying with parental rules. The meetings also include 

opportunities for questions and discussion about substance use. Families practice therapeutic 

child's play and conduct weekly family meetings to address issues, reinforce positive behaviors, 
64

and plan activities together. SFP uses creative strategies—such as providing transportation, child 

care, and family meals—to retain families in treatment. 

Positive outcomes have been found in a number of independent program evaluations. Parents 

reported significant decreases in drug use, depression, and use of corporal punishment, as well as 

increased parental efficacy. Children became less impulsive, improved their behavior at home, 

and exhibited fewer problem behaviors in general. Children also reported fewer intentions to use 

tobacco and alcohol. 

Treatment Foster Care 

Treatment Foster Care (TFC) is a parent training program that works with foster parents to 

provide 6-month placements for 12- to 18-year-old adolescents referred to the program because 

of chronic delinquency. The teenagers’ biological parents or guardians are involved intensively 

both during the placement period and a 12-month aftercare period. Youth are referred by the 

juvenile justice system. 

The treatment goals for the referred youth’s parents are to increase their parenting skills, 

particularly the ability to supervise and use effective discipline strategies, to increase their level 

of involvement with their child, and to help them engage in prosocial activities in the 

community. Treatment goals for the referred youth are to reduce criminal behavior and substance 

use, improve school attendance and grades, reduce association with delinquent peers, and 

become better able to live successfully in a family setting. 

After intensive preservice training, TFC parents are contacted daily to monitor their children’s 

progress and problems, and they attend a weekly meeting to receive supervision and support. 

TFC parents implement a daily behavior management program that is individualized for each 

TFC adolescent. Each day, youth participants have the opportunity to earn and lose points that 

translate into long- and short-term privileges. As they progress through the program, the level of 

supervision and control over their activities is reduced. Youth also participate in weekly, 

skills-focused individual therapy. The youth attend public schools, where their attendance and 

performance are tracked on a daily basis. Twenty-four-hour-a-day, 7-day-a-week on-call support 

is provided to TFC parents and parents or guardians during home visits and in aftercare. 

The effectiveness of the TFC program has been demonstrated in several studies. TFC boys 

reported significantly fewer psychiatric symptoms, had better school adjustment, returned to 

their family homes after treatment more often, and rated their lives as being happier than boys in 

group care placements. This model is now being adapted for adolescent girls who are referred by 

the juvenile justice system but who have serious mental health problems. 
65

Functional Family Therapy 

Functional Family Therapy’s (FFT) primary goal is to improve family communication and 

supportiveness while decreasing the intense conflicts so often characteristic of troubled families. 

Other goals include helping family members identify what they desire from each other, 

identifying possible solutions to family problems, and developing powerful behavior change 

strategies. 

The program is conducted by family therapists working with each individual family in a clinical 

setting, which is standard for most family therapy programs. More recent programs with 

multiproblem families involve in-home treatment. The model includes four phases: 

introduction/impression, motivation (therapy), behavior change, and generalization (more 

multisystem focused). Each phase includes assessment, specific techniques of intervention, and 

therapy goals. The intervention involves a strong cognitive/attributional component that is 

integrated into systemic skills training in family communication, parenting skills, and conflict 

management skills. The FFT model has been evaluated many times since its inception in 1971, 

and its effectiveness has been repeatedly demonstrated. 

Effective Black Parenting 

Effective Black Parenting (EBP) is a cognitive behavioral program created to meet the specific 

needs of African-American parents. It facilitates efforts to combat child abuse, substance abuse, 

juvenile delinquency, gang violence, learning disorders, behavior problems, and emotional 

disturbances. It seeks to foster effective family communication, a healthy sense of 

African-American identity, and healthy self-esteem. The program emphasizes the importance of 

extended family values and provides information on child growth and development. It is 

grounded in basic parenting strategies and offers information appropriate for all socioeconomic 

levels, but it is especially effective for parents of children 2 to 12 years old. 

The program is taught in two formats. In one format, program participants attend 15 3-hour 

training sessions that emphasize role playing and home behavior projects. The second format is a 

1-day seminar version for large groups of parents. Black educators and mental health 

professionals teach a series of basic child-management skills using African proverbs and 

African-American linguistic forms and emphasize African-American achievement and 

competence. In addition, the interactive groups address respectful and rulebreaking behaviors, 

traditional and modern discipline, black pride, black self-disparagement, coping with racism, 

African-origin family values, preventing drug use, and single parenting. Two companion parent 

training programs are also available: Confident Parenting, for the general parent population, and 

Los Niños Bien Educados, for Latino parents. 

Evaluations of the program have shown a significant decrease in parental rejection, an increase 

in the quality of family relationships, and improved child behavior outcomes. Both formats have 

been well received in African-American communities nationwide, and 2,000 instructors have 

already been trained and are using the program in schools, community agencies, churches, 

mosques, and Urban League affiliates. 
66

Nurturing Parenting 

The Nurturing Parenting programs are family-centered programs designed to build nurturing 

skills as alternatives to abusive parenting and child-rearing attitudes and practices. The ultimate 

desired outcomes are to stop the generational cycle of child abuse by building nurturing 

parenting skills; reducing the rates of recidivism, juvenile delinquency, and alcohol abuse; and 

lowering the rate of teenage pregnancies. 

Nurturing Parenting is based on a reparenting philosophy. Parents and children attend separate 

groups that meet concurrently, with cognitive and affective activities designed to build 

self-awareness, positive self-esteem, and empathy. The program teaches alternatives to shouting 

and hitting and enhances family communication and awareness of individual needs. It attempts 

to replace abusive behaviors with nurturing ones, promote healthy physical and emotional 

development, and teach appropriate role and developmental expectations. 

Thirteen different programs address specific age groups (infants, preschool through middle 

school age, and teenagers), cultures (Hispanic, Southeast Asian, African-American), and needs 

(special learning needs, families in alcohol recovery). Programs can be implemented in group or 

home sites from 2 to 3 hours a week for 12 to 45 weeks. The program includes parenting skills, 

self-nurturing activities, home practice exercises, family nurturing time, and infant, toddler, and 

preschool activities. The program has been adapted for Hmong, Hispanic, and African-American 

families. The initial Nurturing Program for Parents and Children 4 to 12 Years has been field 

tested extensively, and significant positive increases were found in parenting attitudes and the 

personality characteristics in parents, children, and family interaction patterns. 

Health Start Partnership and CARES Parenting Program 

The Health Start Partnership and CARES Parenting Program are promising parenting programs 

that grew out of one agency’s prenatal and pediatric services unit. The overall goal is to foster 

secure mother-infant attachments by encouraging responsive parenting. This is accomplished 

through by helping new or expectant mothers understand child development, form realistic 

expectations, learn to respond to infant cues, gain perspective on their own childhood issues and 

roles as a parent, and find and learn to use social supports. It is rooted in attachment theory and 

includes three essential components: home visits, support and education groups, and medical 

care. Risk factors that indicate a need for project services include a personal history of 

maltreatment or out-of-home placement; conflicts, including abuse by a partner or spouse; 

negative feelings about the pregnancy; limited support; social isolation; economic stress; unmet 

personal needs; and chaotic family systems. 

Women are enrolled in late pregnancy or as early in the postpartum period as possible. The 

partnership program is designed for a group of 8 to 12 women with infants born within a few 

months of each other. Clients meet every other week, with home visits on alternate weeks, for 

about 2 years. The CARES group is always open to new members. Enrolled children range in 

age from newborn to 5 years, and families graduate when the last drug-exposed child is enrolled 
67

in kindergarten. CARES provides regular home visits and weekly support groups, with medical 

care and lunch provided onsite. Transportation is provided for all groups. 

Evaluation data for this program indicate a decline in abuse and neglect rates. In addition, all 

children who remained with the project until its completion were fully immunized by 30 months 

of age or were up to date on immunizations when the project ended. 

Multisystemic Therapy 

Multisystemic Therapy’s (MST) primary goals are to reduce out-of-home placements and 

antisocial behavior in adolescents, and empower families to resolve future difficulties. MST is an 

intensive family-based treatment addressing the known determinants of serious antisocial 

behavior in adolescents and their families. On a highly individualized basis, treatment goals are 

developed in collaboration with the family, and family strengths are used as levers for 

therapeutic change. MST treats factors in the youth’s environment that contribute to behavior 

problems. Such factors might pertain to individual youth characteristics (e.g., poor 

problem-solving skills), family relations (e.g., inept discipline), peer relations (e.g., association 

with deviant peers), and school performance (e.g., academic difficulties). Specific MST 

interventions are based on the best empirically validated treatment approaches, such as cognitive 

behavior therapy and pragmatic family therapies. 

Several programmatic features are crucial to the success of MST. First, the use of the family 

preservation model of service delivery (i.e., low caseloads, home-based services, time-limited 

duration of treatment) removes barriers to access to care and provides the high level of intensity 

needed to successfully treat both youth who present serious clinical problems and their 

multineed families. Second, the philosophy of MST holds service providers accountable for 

engaging the family in treatment and for removing barriers to successful outcomes. Such 

accountability clearly promotes retention in treatment and attainment of the treatment goals. 

Third, outcomes are evaluated continuously, and the overriding goal of supervision is to 

facilitate clinician attempts to attain favorable outcomes. Fourth, MST programs place great 

emphasis on maintaining treatment integrity so considerable resources are devoted to therapist 

training, ongoing clinical consultation, and service system consultation. Rigorous evaluation that 

demonstrates the program’s effectiveness is a hallmark of MST. 

Brief Structural/Strategic Family Therapy 

Brief Structural/Strategic Family Therapy (BSFT)5 evolved from a program involving 

Cuban-American families with youth who abused drugs and exhibited behavior problems. It is 

currently applied to families from other Hispanic-American groups and to African-American 

families. Therapy is tailored for and delivered to individual families, sometimes in their homes. 

A basic premise of BSFT is that families’ maladaptive ways of relating are an important factor in 

the development of problems such as substance abuse. Therapists seek to change these 

maladaptive interaction patterns by choreographing family interactions during therapy sessions 

and creating the opportunity for new, more functional interactions to emerge. Therapists are 

trained to assess and facilitate healthy family interactions based on the cultural norms of the 
68

family being helped. Structural Ecosystems Therapy, a variation of BSFT, is currently being 

applied and tested in the families of HIV-positive African-American women, caregivers of 

patients with Alzheimer’s disease, and drug-abusing youth. 

BSFT has been rigorously evaluated in a number of studies. The approaches have been found to 

be an effective means to improve family relationships, improve youth behavior, and reduce 

recidivism among youthful offenders. 

Center for Development, Education, and Nutrition 

The Center for Development, Education, and Nutrition (CEDEN) provides comprehensive 

services that promote and strengthen families in need of prenatal, early childhood, and parenting 

education. The agency’s programs seek to improve the outcomes of pregnancies among 

adolescents and at-risk women by providing information on reducing the incidence of premature 

and low-birthweight babies. The agency also provides services to prevent and reverse 

developmental delays, increase positive parenting behaviors, reduce injuries, and ensure timely 

immunizations. CEDEN serves primarily low socioeconomic families and parents with children 

0 to 5 years old who have developmental delays or are at risk of becoming developmentally 

delayed. 

CEDEN’s home-based programs accommodate family needs by working with children at 

childcare centers, relatives’ homes, shelters for homeless or battered women, and other 

community shelters. The frequency of home visits is based on the family’s needs and may range 

from weekly to monthly. Parent educators deliver a series of educational materials, including 

early childhood stimulation activities, age-appropriate activities, basic health and nutrition care, 

home safety, and a profamily curriculum focusing on child development, behavior, and skills 

building. 

Program evaluations demonstrate CEDEN’s ability to improve the status of young children with 

developmental delays. Children participating in the program maintain up-to-date immunizations 

at a higher-than-average level for the community. Parents report satisfaction in learning and 

using alternative disciplinary methods; they also feel they understand their children better after 

participating in CEDEN’s programs. In addition, parenting classes and support groups help 

reduce the social isolation of mothers by facilitating friendships and boosting self-esteem. 

Home-Based Behavioral Systems Family Therapy 

Home-Based Behavioral Systems Family Therapy is based on the Functional Family Therapy 

model but targets families with lower educational levels and higher levels of pathology than the 

original model. Intermediate objectives include decreased family conflict and increased 

cohesion; improved family communication; improved parental monitoring, discipline, and 

support of appropriate child behavior; improved problem-solving abilities and parent-school 

communication; improved school attendance and grades; and improved child adjustment. 

Long-range objectives include reductions in the child’s involvement in the juvenile justice 
69

system, self-reported delinquency, teen pregnancy, and special class placement, along with 

increased graduation rates and employment. 

The program is delivered in five phases: introduction/credibility, assessment, therapy, education, 

and generalization/termination. In the program’s early phases, therapists are less directive and 

more supportive and empathic than in the later phases—when the family’s cooperation and 

lowered resistance allow for increased therapist directiveness. 

Evaluations have indicated robust treatment effects that are not the result of chance. 
70

Appendix E: Strengths, Challenges, Opportunities, and Threats 

In a series of exercises designed to both assess the state of family drug treatment courts and build 

a strategy for the future, the focus group identified the courts’ perceived strengths and the 

challenges, opportunities, and threats facing them. 

Strengths 

• Early assessment and service plans. 

• Judicial leadership (albeit a challenge to keep everyone on the bench in step with 

change). 

• Courtroom style—proactive judicial involvement in the case. 

• Collaboration among service providers and a nonadversarial approach. 

• Careful documentation of activity, leaving no doubt as to whether reasonable efforts (as 

defined by the Adoption and Safe Families Act of 1997) have been made. 

• Frequent contact with parents, regular meetings, and routine hearings. 

• Ability to avoid being in violation of ASFA requirements by providing services early and 

achieving a positive outcome. 

• Ability to identify truly abandoned children early on. 

• Coordination and integration of services. 

• More efficient case management over long periods of time. 

• Motivated clients. 

• Early identification of clients who are likely to succeed and those who are not likely to 

succeed. 

• Clients with similar characteristics (screening criteria). 

• Ability to identify inconsistencies in the child welfare system. 

• Policy of treating clients with dignity and respect. 

• Dedicated staff, which leads to consistency in approach and indepth understanding of 

clients. 

• Clients’ positive perception of legal system. 

• Family drug treatment court parents who help each other succeed. 

Challenges 

• Tendency to associate a court with the personality of a particular judge; incumbent on 

judge and team to groom their replacements. 

• Fragility of clients in the first 30 to 90 days. 

• Tendency to objectify all standards for admission into FDTC (intuition must play a part 

in determining whether someone is ready). 

• Immediate aftermath of an arrest or a child’s removal from the home. 

• Limited number of spots in the program. 

• Territoriality issues among the collaborators. 

• Limited time for inpatient treatment due to managed care rules. 
71

• Decline in Medicaid patients (as clients lose children, they lose access to Medicaid, and it 

happens more quickly under ASFA). 

• Obtaining buy-in from other members of the judiciary. 

• Locating housing for parents (after children are removed). 

• Limited treatment capacity; the need to work with the treatment community to increase 

sensitivity to the needs of this population. 

• Getting systems to work with one another and to treat the client as one person, not 

several individual parts. 

• HIV-positive clients. 

• Ex parte nature of some communications in other forums (e.g., divorce cases). 

• Resistance among parents’ attorneys (though this is beginning to change as attorneys 

begin to understand the court); need to educate attorneys about FDTC. 

• Confidentiality. 

• Ethical issues. 

• Due process issues. 

• Deferring to the skills and knowledge of other team members. 

Opportunities 

• To use ASFA as a motivational tool. 

• To provide cross training or multidisciplinary training. 

• To work together to find ways to help parents and families and keep children safe. 

• To learn the important roles that other people play in the lives of recovering families and 

to recognize court professionals’ own limitations. 

• To initiate reforms in related areas. 

• To learn how other people perceive our clients. 

• To learn from collaborating professionals at staffings. 

• To give healthy, safe, clean, and sober parents back to their kids. 

• To expose the underfunding of child welfare systems and the need to redirect money into 

those efforts. 

• To learn how a client’s arrest creates opportunity out of crisis. 

Threats (External) 

• Damaged relationship with foster care community due to time limits imposed by ASFA. 

• Threats by parent advocates who maintain that parents should not cooperate with FDTCs 

(i.e., parent advocates, not a parents’ attorney). 

• Placement of a child in kinship care as an excuse not to go forward with a permanency 

plan. (This is akin to placing kids in a black hole and forces us to focus only on kids in 

paid foster care. Parents are in and out of their lives; nothing changes for them.) 

• Political risk of taking persons with questionable backgrounds, such as drug dealers, into 

the program. 

• Lack of understanding of FDTCs and the accountability that is essential to their success. 
72

• Potential for issues to become political. 

• Funding (funding is often subject to the political climate). 

• Lack of education about FDTCs among professionals and the community at large. 

• Perceived lack of good outcome data. 
73

Appendix F: Focus Group Participants 

Participating Family Drug Treatment Court Practitioners 

Jackson County Family Court 

Kansas City, Missouri 

Judge 

The Honorable Molly M. Merrigan 

Commissioner 

Jackson County Family Drug Court 

Treatment Specialist 

Carla Ingram 

Program Manager 

North Star Women and Children 

Child Welfare Specialist 

Penny Howell 

Drug Court Program Manager 

Jackson County Family Drug Court 

Guardian Ad Litem 

Kyla Grove 

Jackson County Family Drug Court 

San Diego County 

Superior Court 

Juvenile Court Division 

San Diego, California 

Judge 

The Honorable James R. Milliken 

Presiding Judge, Juvenile Division 

San Diego Superior Court 

Treatment Specialist 

Kimberly Bond 

Chief Operating Officer 

Mental Health Systems, Inc. 

Deputy Alternate Public Defender 
74

Rosalind Gibson 

Alternate Public Defender’s Office 

Project Manager 

Andrea Murphy 

San Diego Superior Court 

Second Judicial District Court 

Reno, Nevada 

Judge 

The Honorable Charles M. McGee 

Judge 

Second Judicial District Court 

Treatment Specialist 

Kristen O’Gorman 

Director of Administration and Counselor 

CHOICES 

Child Welfare Specialist 

Elise Henriques 

Social Services Practitioner 

Washoe County Social Services 

Deputy Public Defender 

Cynthia Lu, Esq. 

Washoe County Public Defender’s Office 

Suffolk County Family Treatment Court 

Central Islip, New York 

Judge 

The Honorable Nicolette Pach 

Family Court Judge 

Suffolk County Family Treatment Court 

Treatment Specialist 

Eileen Davies 

Case Manager 

EAC 

Child Welfare Specialist 
75

Christine L. Olsen 

Project Director 

Suffolk County Family Treatment Court 

Attorney 

Kathy Phillips, Esq. 

Legal Aid Society 

Other Participants 

Lolita R. Curtis 

Vice President 

National Association of Drug Court Professionals 

Bruce Fry, J.D. 

Social Science Analyst 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services Administration 

Robin Kimbrough, J.D. 

Research Associate/Professor 

Institute on Family and Neighborhood 

Clemson University 

Eva Klain, J.D. 

Director 

Court Improvement Project 

American Bar Association 

Marilyn Roberts 

Former Director 

U.S. Department of Justice 

Office of Justice Programs 

Drug Courts Program Office (now part of BJA) 

Kathleen R. Snavely 

Director of Research 

National Drug Court Institute 

Consultant 
76

Betsy Earp 

Consultant/Writer 

ROW Sciences, Inc. 

Deborah Kaufman 

Research Associate 

ROW Sciences, Inc. 

Ali Manwar, Ph.D. 

Social Science Analyst 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services Administration 

Shirley Rhodus 

Division Manager 

El Paso County Department of Human Services 

Colorado Springs, Colorado 

Steve Zentz, Esq. 

Colorado Springs, Colorado 
77

Appendix G: Other CSAT Resources 

The following documents include other CSAT publications (treatment improvement protocols 

and companion products based on them) that may be of help to FDTCs. These documents can be 

obtained from the Substance Abuse and Mental Health Services Administration’s National 

Clearinghouse for Alcohol and Drug Information (NCADI) at 800–729–6686 (TDD 800–487–

4889) or from CSAT’s Web site at www.csat.samhsa.gov. The NCADI publication number is 

provided. 

TIP 12, Combining Substance Abuse Treatment With Intermediate Sanctions for Adults in the 

Criminal Justice System, BKD144 

• Quick Guide for Clinicians Based on TIP 12, QGCT12 

• KAP Keys Based on TIP 12, KAPT12 

TIP 17, Planning for Alcohol and Other Drug Abuse Treatment for Adults in the Criminal 

Justice System, BKD165 

• Quick Guide for Clinicians Based on TIP 17, QGCT17 

• KAP Keys Based on TIP 17, KAPT17 

TIP 21, Combining Alcohol and Other Drug Abuse Treatment With Diversion for Juveniles in 

the Justice System, BKD169 

• Quick Guide for Clinicians and Administrators Based on TIP 21, QGCA21 

TIP 23, Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case 

Processing, BKD205 

• Quick Guide for Administrators Based on TIP 23, QGAT23 

TIP 25, Substance Abuse Treatment and Domestic Violence, BKD239 

• Quick Guide for Clinicians Based on TIP 25, QGCT25 

• KAP Keys Based on TIP 25, KAPT25 

TIP 30, Continuity of Offender Treatment for Substance Use Disorders From Institution to 

Community, BKD304 

• Quick Guide for Clinicians Based on TIP 30, QGCT30 

• KAP Keys Based on TIP 30, KAPT30 

TIP 36: Substance Abuse Treatment for Persons With Child Abuse and Neglect Issues, BKD343 

Quick Guide for Clinicians Based on TIP 36, QGCT36 

KAP Keys Based on TIP 36, KAPT36 

 
78

Notes 

1 Nonmedical services are performed by those not in the medical profession, such as counselors 

or social workers, and include services not provided by a hospital or clinic. The welfare-to-work 

program specifically targets individuals who require substance abuse treatment for employment 

and allows nonmedical substance abuse treatment as an activity under job retention and support 

services. 

2 P.L. 105-89, signed into law on November 19, 1997, amending Titles IV–B and IV–E of the 

Social Security Act. 

3

 The DHHS document Permanency for Children: Guidelines for State Legislation (in 

development) recommends that the deadline be clarified in state statute as 12 months from the 

date of adjudication. 

4

Commentary to Section 1355.20, Federal Register, vol. 63, no. 181, September 18, 1998, p. 

50072. 

5

One Person Family Therapy, Family Effectiveness Training, Bicultural Effectiveness Training, 

Structural Ecosystems Therapy, and Structural Ecosystems Prevention have all been developed 

based on the BSFT model. 
79

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Drug Court Clearinghouse and Technical Assistance Project at the American University. 1998. 

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Kelleher, K., M. Chaffin, J. Hollenberg, and E. Fischer. 1994. “Alcohol and Drug Disorders 

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