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Family Treatment Drug Court National Evaluation Overview & Phase I Preliminary Results. Beth L. Green, Ph.D. Sonia Worcel, M.A., M.P.A. Michael W. Finigan, Ph.D. www.npcresearch.com. Presentation Overview. What are Family Treatment Drug Courts (FTDCs)?
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Family Treatment Drug Court National EvaluationOverview & Phase I Preliminary Results Beth L. Green, Ph.D. Sonia Worcel, M.A., M.P.A. Michael W. Finigan, Ph.D. www.npcresearch.com
Presentation Overview • What are Family Treatment Drug Courts (FTDCs)? • Overview of National FTDC Evaluation • Preliminary Phase I Results • What Makes Drug Courts Work? • Implications for Practice NPC Research
What are Family Treatment Drug Courts? • AKA: Family Drug Courts, Family Treatment Court, Family Dependency Drug Courts, etc. • Family Treatment Drug Courts address the needs of substance-abusing parents involved with the child welfare system • Goal is to increase positive treatment outcomes and therefore increase probability of successful reunification • Maintaining safety and well-being of the child NPC Research
Key Service Components • Similar to Adult Drug Court: • Increased judicial oversight • Supportive but structured environment • Integrated drug court team provides support & wraparound services • Accessible, appropriate treatment resources • Relapse support • Differences from Adult Drug Court: • Predominantly women (85% or more) • “Threat” is different – termination of parental rights • Addresses family issues and child safety concerns • Successful treatment doesn’t necessarily mean successful reunification NPC Research
Reasons for the FTDC Evaluation • Despite the huge increase in number of FTDCs, very little research to date on FTDCs and their effectiveness • In 2006, 151 current FTDCs, many more being planned • Little is known about whether and how FTDCs work • With increased funding earmarked for FTDCs, federal government is interested in the outcomes produced by these courts • Also interested in how FTDCs work, and • Are FTDCs cost-beneficial? NPC Research
What is the FTDC National Evaluation? • A national evaluation funded by the Center for Substance Abuse Treatment, conducted by NPC Research, Portland, OR • Four FTDCs in the study: Santa Clara, CA; San Diego, CA; Reno, NV; Suffolk, NY • Two primary phases • Phase I: Historical (retrospective) administrative data; comparison group largely “pre” FTDC • Phase II: Larger study (n=2000), administrative and interview data (on subset); comparison group mostly from same time period of “unserved eligibles” NPC Research
Four Sites With Different FTDC Models • San Diego: System-wide reform; FTDC for non-compliant parents • Washoe: Traditional drug court model; screens out severe MH, abuse allegations • Suffolk: Neglect cases only, many children not in out-of-home placements • Santa Clara: Started as traditional drug court model; changed to a system-wide model NPC Research
Phase1 Study Overview • 50 drug court and 50 comparison cases from each site (plus 50 SARMS cases in San Diego) – total 450 families • Some cases (primarily San Diego) were pre-ASFA • Data gathered from child welfare, treatment, and court records • Cases followed 5 years post-petition NPC Research
How Similar Were FTDC and Comparison Group Participants? • No differences on most demographic and risk-related variables • FTDC participants less likely to be: • Married, employed • FTDC participants more likely to have: • Previous A & D treatment • Infant children • Children with more risk factors NPC Research
Expected Treatment & Child Welfare System Outcomes • Treatment: Participants in FTDCs will have: • Decreased time to treatment entry • Increased time spent in treatment • Increased treatment completion • Child Welfare: Participants in FTDCs will have: • Decreased time to permanent placement • Increased % reunified with parents • Decreased child welfare recidivism NPC Research
Treatment Outcomes Results based on regression models controlling for demographic, risk and site variables. Sample sizes vary due to missing data (n=334-397). NPC Research
Child Welfare Outcomes Results based on regression models controlling for demographic, risk and site variables. Sample sizes vary due to missing data (n=334-397). NPC Research
Summary of Site Differences • Treatment Results: • 3 of 4 sites had consistently positive treatment results, especially for treatment duration and treatment completion • Child Welfare Results: • Time to permanent placement only different for site with pre-ASFA comparison group • Reunification results positive for two sites using more “traditional” FTDC models NPC Research
Research Question #1 • What characteristics of the family drug court process make a difference for court, treatment and child welfare outcomes? • Time to enter FTDC • Time spent in FTDC • Graduation status NPC Research
Do Families Who Enter FTDC More Quickly Have Different Outcomes? • YES: Enter treatment more quickly. • YES: Enter permanent placement more quickly. • YES: Cas closure more quickly. • BUT: How fast they enter FTDC not related to: • time spent in treatment, • treatment completion, or • type of permanent placement. NPC Research
Do Families Who Remain in FTDC Longer Have Different Outcomes? • YES: More time spent in treatment • YES: More likely to complete treatment. • YES: Take longer to enter permanent placements. • BUT: Not related to time to case closure or likelihood of reunification. NPC Research
How are Graduates Different From Non-Graduates? • Graduates (n=126); Non-Grads (n=63) • Not different in: • demographic or risk characteristics, • How long it took them to begin FTDC or Tx • Treatment predicts graduation: Parents with longer treatment stays and who completed treatment were more likely to graduate. NPC Research
Do Families Who Graduate From FTDC Have Different CW Outcomes Than Those Who Don’t? • YES: Graduates: • more likely to be reunified • less likely to have parental rights terminated, • 80% of graduates reunified • 21% of non-graduates reunified • 44% of comparisons reunified • BUT: Not related to time to case closure or time to permanent placement NPC Research
Research Question #2 • What characteristics of the treatment process make a difference for child welfare outcomes? • Time to enter treatment • Time spent in treatment • Completing treatment NPC Research
Correlations Between Child Welfare and Treatment Outcomes *Significant at p<.05 **Significant at p<.01 NPC Research
Summary Regression Results: Relationship of Treatment Experience to CW Outcomes • Parents entering TX faster: • Stay longer in treatment • More likely to complete treatment • Enter permanent placement more quickly & reach case closure more quickly • Parents remaining in TX longer: • More likely to complete treatment • Take longer to reach case closure. • Parent completing TX • More likely to graduate from FTDC • Take longer to reach permanency, • Have longer cases, BUT • Are more likely to be reunified with parents. NPC Research
Is There a “Value Added” for FTDC in Supporting Child Welfare Outcomes? • Clustered families with similar treatment experiences to create “successful” and “unsuccessful” groups • Analyzed whether child welfare results were different for these groups of families depending on whether they were FTDC or Comparison NPC Research
Treatment Experiences & FTDC Status Predict % of Children Reunified NPC Research
Key Practice Issues for FTDCs • Data Suggest: • Identification and referral to FTDC quickly after petition • Helping parents access treatment quickly • Supporting successful Tx completion • Retaining parents until success is clear • Observations and Interviews suggest: • Judicial monitoring and check-ins important • Quality of relationship with judge important • Quality of collaboration between child welfare, courts, and treatment is critical -- communication • Wrap around services critical • Family connections & peer support • Post-graduation support or connection • Key issue: How to ensure stability in placements post-FTDC NPC Research