Effective Drug Court Treatment: Methods, Modalities and More Terrence D Walton, MSW, ICADC

ProcessPractice Effective Treatment

AssessPlaceTreat

EBT Manuals Best Practice OutcomesScience

OUTIN EfficacyOutcomesEvidenceAnecdotesInstincts

Integrate alcohol and other drug treatment services with justice system case processing

1. Treatment representatives attend and are actively involve in pre-court staffing decision making 2. Treatment representative present for Drug Court hearings 3. Law enforcement and supervision officers supporting abstinence goals when on patrol or during home visits

4. Treatment providers supporting supervision goals during treatment sessions 5. Release conditions, probation/parole terms, and sentencing stipulations that support treatment participation 6. Mutual appreciation for the differing philosophy, perspective and priorities of treatment and criminal justice

ObstaclesSolutions

Drug Courts provide access to a continuum of alcohol, drug, and other related treatment rehabilitation services

Level III or IV Residential Inpatient Level II Intensive OPDay Treatment Level 0.5 or I Early InterventionOutpatient

Level lll.5 High Intensity Clinically Managed Level III.3 Medium IntensityClinically Managed Level III.1 Low IntensityClinically Managed

Opioid Maintenance Therapy Methadone/LAAM Buprenorphine Level IV (inpatient) High IntensityMedically Managed Level III.7 (residential) High IntensityMedically Monitored

Combine IOP with halfway house, sober living facility, or transitional housing when residential is not available. Utilize home confinement, curfews, and electronic monitoring in conjunction with IOP when residential is not available. Combine outpatient services with frequent support group participation when IOP is not available.

Fully engage the volunteer recovery community—e.g. sponsors, recovery coaches, on-line resources—to augment professional treatment services. Maximize internal resources to build expertise to deliver some treatment services in-house. Limit your services to those who can be safely treated with your available resources

Don’t use punitive sanctions for those who fail to respond when treated at a level appreciably below the level they are assessed to require.

 Qualified practitioners  Intensity sufficient to treat safely with a reasonable likelihood of success  Accurate assessment  Realistic, real-time, relevant treatment planning

 Culturally-appropriate evidenced based treatment practices  Practitioners trained and coached in manual-guided delivery  Strong linkages with the community-based recovery networks  Quality assurance/control  Evaluation and impact assessment

Cognitive Behavioral Treatment Motivation Enhance- ment Relapse Prevention Medication Assisted Treatment Co- Occurring Disorders

National Registry of Evidenced- based Programs and Practices:

1. Deliver the same level, length, intensity, modality, and type of treatment to everyone. 2. Assume that my program or population is the exception to what research shows works for others 3. Use treatment as a sanction and be sure to describe it to participants that way. Also, use residential treatment to get “criminals off the street”.

4. Use incarceration to achieve clinical or social service objectives, such as to obtain access to detoxification services or sober living quarters. 5. Don’t worry about having treatment representatives on the Drug Court team as long as you get a thorough, written report from them.

6. Automatically exclude from your program any and all with co- occurring disorders or who needs medication-assisted treatment. 7. Use treatment practitioners without treatment credentials, or use those with treatment credentials who have no experience with offenders and defendants.

Mandate 12 Step group participation without providing secular alternative to those who object to the religious or spiritual content.

Effective Drug Court Treatment: Methods, Modalities and More

This project was supported by Grant No DC- BX-K004 awarded by the Bureau of Justice Assistance. 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, the SMART Office, and the Office for Victims of Crime. Points of view or opinions in this document are those of the author and do not represent the official position or policies of the United States Department of Justice.