1. Treatment for Court- Involved Clients Peter Baker, District Administrator, Durham Drug Treatment Courts

2. Why Treatment? Statistics have proven that most (as high as 80%) of court-involved individuals have Substance-abuse related challenges. Treatment addresses these challenges, therefore reducing future incidents of court involvement.

3. Treatment in North Carolina Mental Health Reform has netted Local Management Entities (LME’s)- much like Managed Care ideology These county agencies, formally known as local Mental Health Agencies offer treatment primarily to indigent persons and Medicaid recipients. In their new role they: manage contractual services, monitor compliance of service providers, evaluate services, and can authorize services for providers.

4. What Treatment Services are Available in the Community Medical and Social Setting Detoxification Crisis Stabilization Units/Transitional facilities Inpatient Treatment (I.e. John Umstead, Black Mountain) Outpatient/Intensive Outpatient Treatment Case Management Services Structured Halfway Houses ¾ Houses: Oxford Houses, local client -managed facilities Therapeutic Communities ( I.e. TROSA) 12-step Recovery meetings

5. Detoxification To counteract or destroy the toxic properties of substance used Usually medically supervised for physically addicting drugs- alcohol, heroin, opiates, prescription drugs Social setting detox- cocaine, hallucinogenics, etc. Persons with suicidal/homicidal ideations

6. Crisis Stabilization/ Transitional Facility Post-detox hospitalization, and/or observation, for specified days to ensure mental and medical stability Three to ten days duration (Crisis) Two-four weeks (Transitional) May or may not include medical supervision

7. Inpatient Treatment Not as widely used Minimized by insurance coverage (including lifetime coverage limits) Theory of the least intrusive treatment Most are 14 to 30 days durations

8. Outpatient Treatment <9 hours considered outpatient 9-20 hours considered Intensive Outpatient (3 days/wk.) Includes: group therapy, psycho- educational classes, disease theory,pharmacology, individual therapy, life-skills,etc.

9. Halfway Houses Highly structured housing with paid staff Daily routines Resident participation with chores Includes on-site Outpatient classes Can includes services such as employment training, education planning, community volunteering

10. ¾ Houses Usually no paid staff Client ran, w/ internal structure Uniform rental amounts Oxford Houses (national organization)

11. Therapeutic Community (TC’s) Long-term (2+ years) Highly-structured Minimal contact with outside world On-site business structure Permanency housing planning Employment training/apprenticeship TROSA

12. 12-step Community Fellowship/society of recovering individuals who meet regularly to help each other stay clean and sober Based on spiritual principles of recovery 12-steps for personal application 12-traditions for group cohesiveness Voluntary with no dues or fees NA and AA are most popular

13. Court –Order Access TASC- treatment alternatives to street crimes- acts as a case-management referral to treatment entity Criminal Justice Partnerships - offers Outpatient Treatment to Probationers DRUG TREATMENT COURTS-Family, Adult, and Juvenile courts that are highly monitored and case managed. Referral services. System of Incentives/sanctions.

14. Therapeutic Jurisprudence The process of involving the courts and treatment in a collaboration that acknowledges the connection between crime/court involvement, and the need for treatment.

15. DUKE BLUE DEVILS Upcoming 2006 ACC CHAMPS #1 SEED IN NCAA’S COACH OF THE YEAR- Coach K PLAYER OF THE YEAR- JJ Reddick TEAM OF THE DECADE GO DUKE, GO DUKE, GO DUKE!!!