1. Evidence-Based Practices in Adult Drug Court Melissa Labriola, Ph.D. Center for Court Innovation (labriolam@courtinnovation.org)labriolam@courtinnovation.org

2. Questions About Drug Courts? Do Drug Courts Work? For Whom do Drug Courts Work? Why do Drug Courts Work? Evidence-Based Practices

3. Do Drug Courts Work? Documented Results Recidivism:  Almost 100 evaluations of adult criminal drug courts  Most reduce recidivism (about 4 of every 5 programs)  Average recidivism reduction = 8-12 percentage points Drug Use:  All evaluations (five) show reductions in drug use  Several studies show larger effects on serious drug use (e.g., heroin or cocaine) than on marijuana use Cost Savings: Multi-site studies all show savings, mainly from reductions in recidivism and incarceration

4. Reduced Recidivism Source: Rossman et al. (2011)

5. Why Do Drug Courts Work? Evidence-Based Principles Treatment Deterrence Procedural Justice Staff/Collaboration Positive Outcomes Reduced Recidivism Reduced Drug Use Cost Savings Target Population Risk Level Leverage Treatment Need

6. Target Population  Risk Level (higher-risk)  Leverage (higher-leverage)  Addiction Severity (“Clinical Need”): Larger effect with primary drug other than marijuana Clinical need may influence type/intensity of treatment  Demographics: Age, sex, and race/ethnicity  Motivation: Offenders who present with greater interest or readiness-to-change at baseline

7. Why Do Drug Courts Work? Evidence-Based Principles Treatment Deterrence Procedural Justice Staff/Collaboration Positive Outcomes Reduced Recidivism Reduced Drug Use Cost Savings Target Population Risk Level Leverage Treatment Need

8. Risk Need Responsivity (RNR) 1. Risk Principle: Who to Treat? Medium- to High-Risk 2. Need Principle: What to Treat? C riminogenic needs (and problematic non-criminogenic needs, e.g., trauma) 3. Responsivity Principle: How to Treat? Cognitive- behavioral therapy (CBT) tailored to the needs, learning style, motivation, and other attributes of the offender.

9. The “Central Eight” Factors 1. History of criminal behavior 2. Antisocial personality/temperment 3. Antisocial peers/associates 4. Criminal thinking 5. Family or marital problems 6. School or work problems 7. Lack of pro-social leisure/recreational activities 8. Substance abuse The “Big Four”

10. What About Other Needs? Non-Criminogenic Needs  Examples: Trauma history Depression, anxiety, and other mental health disorders Low self-esteem Medical needs  Why Assess and Treat: Ethical reasons (affect individual well-being) Can interfere with treatment for criminogenic needs (trauma especially should be treated simultaneously) Low Collective Efficacy (Neighborhood-based)

11. Treatment Implementation Treatment Group Size (ideally < 12 per group) Sensitivity to Risk Level (separate groups by risk) Dosage (100 hours medium-risk, 200+ hours high-risk) Manualized Curricula (written lesson plans) Fidelity to Curricula:  Frequent staff training and retraining (e.g., on CBT)  Regular staff observation/debriefing/supervision

12. Why Do Drug Courts Work? Evidence-Based Principles Treatment Deterrence Procedural Justice Staff/Collaboration Positive Outcomes Reduced Recidivism Reduced Drug Use Cost Savings Target Population Risk Level Leverage Treatment Need

13. Leverage: Drug Court Results High-leverage target population (felony) Policies to maximize leverage:  Post-plea model (10% effect size)  Jail/prison alternative set in advance AND alternative always imposed on those who fail (10% effect size) Practices to maximize perceptions of leverage:  More staff note consequence of failing  More staff note that consequence of failing will be severe  More times that participants must promise to comply Clear reminders given early and often!!!

14. Sanctions: 86-Site Findings High level of certainty (imposed in every case) Certainty more important than severity (use of jail for first infraction did not improve outcomes) Formal sanctions schedule (aids expectations) Source: Cissner et al. (2013)

15. Positive Incentives/Rewards General Themes:  Incentives should be certain and frequent (like sanctions)  Consider developing an incentives schedule Fishbowl Method:  Bowl with incentives, some certificates and some cash value (e.g., gift certificates, movie tickets, etc.)  Call up participants to dip into bowl for set milestones  Okay for many/most incentives to be non cash value

16. Why Do Drug Courts Work? Evidence-Based Principles Treatment Deterrence Procedural Justice Staff/Collaboration Positive Outcomes Reduced Recidivism Reduced Drug Use Cost Savings Target Population Risk Level Leverage Treatment Need

17. Procedural Justice: Examples Voice:  You felt you had the opportunity to express your views in the court.  People in the court spoke up on your behalf. Respect:  You felt pushed around in the court case by people with more power.  You feel that you were treated with respect in the court. Neutrality:  All sides had a fair chance to bring out the facts in court.  You were disadvantaged…because of your age, income, sex, race… Understandin g  You understood what was going on in the court.  You understood…your rights were during the processing of the case.

18. Research Findings Compliance: Increases compliance with court orders and reduces future crime (e.g., Lind et al. 1993; Tyler and Huo 2002) Procedure v. Outcomes: More influential than perceptions of the outcome (win or lose) (Tyler 1990; Tyler & Huo 2002) Aid to Deterrence: Complements deterrence by reducing perceptions of unfair consequences Rectifies Inequality: Effect is greater among those with negative views at baseline (e.g., black offenders) Role of the Judge: Greatest influence on overall perceptions (Abuwala and Farole 2008; Lee et al. 2013; Frazer 2006; Rossman et al. 2011)

19. The Judge: Drug Court Results Offender Perceptions: Perceptions of judge were a key factor in reducing crime and drug use (Rossman et al. 2011) Observed Judicial Demeanor: Drug courts produced greater crime and drug use reductions when the judge was rated as more respectful, fair, attentive, consistent, caring, and knowledgeable (Rossman et al. 2011) Role of Time: Significantly greater impact when judge averaged > 3 minutes/hearing (Carey et al. 2012) Conclusion: It’s not just about having judicial status hearings but their content (see also Goldkamp et al. 2001; Cissner and Farole 2005)

20. Additional Content Tips Time: Target > 3 minutes/hearing (average & median) Session Participation: Mostly judge and participant Response to Compliant Report: Target = praise Judicial Interaction:  Judge talked directly to defendant (not via attorney)  Judge asked non-probing questions  Judge asked probing questions  Judge imparted instructions or advice  Judge explained consequences of future compliance  Judge explained consequences of noncompliance

21. Why Do Drug Courts Work? Evidence-Based Principles Treatment Deterrence Procedural Justice Staff/Collaboration Positive Outcomes Reduced Recidivism Reduced Drug Use Cost Savings Target Population Risk Level Leverage Treatment Need

22. Staff/Collaboration: Research Staff Skills: :  Experience (1+ year working with criminal population)  Stability (2+ years in position)  Supervision (receive regular supervision)  Buy-in (opportunity for input into program policies) Operational Leadership: Program has convener and respected and knowledgeable leader. Collaboration:  Treatment attends team meetings and court (Carey et al. 2012)  Prosecutor and defense attorney participate (Cissner et al. 2012)

23. Resources: Web Sites National Institute of Justice: http://www.nij.gov/nij/topics/courts/drug-courts/welcome.htmhttp://www.nij.gov/nij/topics/courts/drug-courts/welcome.htm Research to Practice (R2P) Project: http://www.research2practice.org/index.htmlhttp://www.research2practice.org/index.html National Association of Drug Court Professionals:  General Page: http://www.nadcp.org/ http://www.nadcp.org/  Evidence-Based Standards: http://www.nadcp.org/Standards http://www.nadcp.org/Standards Drug Court Clearinghouse at American University: http://www.american.edu/spa/jpo/drug-court-clearinghouse.cfm http://www.american.edu/spa/jpo/drug-court-clearinghouse.cfm Center for Court Innovation:  General Drug Court Page: http://www.courtinnovation.org/topic/drug-court http://www.courtinnovation.org/topic/drug-court  Training and Technical Assistance: http://www.nadcp.org/ http://www.nadcp.org/