1.  Juvenile Drug Courts (Part I): Creating a Phase Structure that Makes Sense for Youth and Families Sandra J. Altshuler, Ph.D., L.I.C.S.W. Spokane County Behavioral Health Therapeutic Courts With thanks to Jacqueline van Wormer, Ph.D. Washington State University and NATIONAL COUNCIL OF JUVENILE AND FAMILY COURT JUDGES

2. This I Believe I believe juvenile drug court teams and professionals are strengthened, enlightened, and reinvigorated when I provide valuable training, technical assistance, and resources, which improves their knowledge level and ability to maintain fidelity to the preferred model, which, in turn, may increase positive outcomes for youth and families in their community.

3. Learning Objectives  Participants will review briefly the need for diversion programs for juveniles and the research on Juvenile Drug Courts (JDCs).  Participants will review and discuss proper phase structures in JDCs.  Participants will learn about JDC Incentives and Sanctions that DO and DO NOT work to promote positive behavior change in youth.  Participants will learn about contingency management (CM) and its use in JDCs for adolescent’s substance abuse and use.  Participants will learn how to develop behavior and activity contracts.

4.  Overview Juvenile Drug Courts: Why and How

5. Why We Want to Use Alternatives Probation/court monitoring, group homes, and correctional facilities have, at best, only modest favorable effects on subsequent recidivism. Some studies show negative effects (Lipsey and Cullen, 2007; Petrosino, Turpin-Petrosino, and Guckenburg, 2010). Deterrence-oriented programs that focus on discipline, surveillance, or threat of punitive consequences (e.g., prison visitation Scared Straight–type programs, boot camps, and intensive probation supervision) have no effect on recidivism and may actually increase it (Lipsey, 2009).

6. Because… “Therapeutic” programs oriented toward facilitating constructive behavior change have shown very positive effects—even for serious offenders (Lipsey, 2009; Lipsey and Cullen, 2007; Lipsey and Wilson, 1998).

7. Are juvenile drug courts effective? 7 Yes! But not always…. Depends on how (and if) they implement the model

8. Are juvenile drug courts effective?  Early research:  Small samples and poor designs.  Negative effects found by Hartmann & Rhineberger (2003);  No effects on recidivism found by Wright and Clymer (2001); Anspach et al., (2003)  Positive Findings:  Lutze & Mason (2007); Latessa et al (2002), Rodriguez & Webb (2004), Shaffer et al., (2008) Hickert (2010), Hennegeler (2006, 2012), NPC Research (2006, 2010)  Latessa report (2013)  Meta-Analysis:  Null-findings for both Wilson et al (2006); Shaffer (2006)  Small effect size – Mitchell et al (2012)

9. National Academy of Science (2012) Juvenile justice programs are more likely to have a positive impact when they:  Focus on high-risk offenders  Connect sound risk/needs assessment with the treatment approach taken  Use a clearly specific program rooted in a theory of how adolescents change  Are tailored to the particular offender, demonstrate program integrity,  Involve the adolescent’s family, and take into account community context

10. New Key Findings  To strengthen outcomes:  Engage families  Attend court & active involvement  Support group method  Engage entire family in services if able  Adopt evidence-based treatment practices  Utilize contingency-management procedures  Evaluate and continually monitor team for adherence to 16 Strategies in Practice. Follow the model!!

11.  Creating a Responsive Phase Structure: Making it Make Sense

12. Can We Strengthen Our Court Sessions to Bring About Stronger Behavior Change?  What do youth behaviors look like during phase one?  How do you want them to look by phase four?

13. The Teenage Brain

14. It begins with the phase structure Phase One Phase Two Phase Three Phase requirements for youth and family should start out small, increase, and then decrease again after the youth work through treatment and court related goals.

15. Phase I: setting the stage Phase II: learning skills Phase III: maintaining the change Readiness and engagementInvolvement, stabilizationReflection, enrichment Focus on complianceBeyond complianceMaintain drug testing, court appearance High level of structureSkill developmentExpanded development activities Clarifying expectations, building trust Completing assignmentsEnriching community connections Phase Structure Source: Betty Gurnell

16. The Four Steps in Addressing Problem Behaviors  Identify (define) the targeted behavior  Identify (define) the current behavior  Identify (define) the desired behavior  Use small, achievable increments

17. Decision Matrix – Phase I BehaviorIncentivesSanctions Attend school at least ?? out of 20 days Teacher signs attendance card each day present and acknowledges Small prize or coupon for each week with no absences After school study hall for each day absent over the limit to make up all missed work

18. Decision Matrix – Phase II BehaviorIncentivesSanctions Attend regularly Complete all assignments Select a book, notebook, pen after two weeks of success Praise from teacher, family, court Grades improve After school study hall to complete assignments (with help as needed)

19. Decision Matrix – Phase III BehaviorIncentivesSanctions Attend regularly Complete all assignments Improve grades Praise from teacher, family, court for improvement Certificate of achievement Select school related gift: tuition, book Determine if tutor is needed Attend extra class or session for help Tighten curfew

20. What do we mean by individual responses? Comprehensive Treatment Planning Developmentally Appropriate Services Gender-Appropriate Services Cultural Competence Focus on Strengths Educational Linkages Family Engagement Goal-Oriented Incentives and Sanctions

21. 7 (Easy) Steps to Individualizing Your Juvenile Drug Court Start with… 1. Screening and assessment And 2. Use the results to drive case planning So we can… 3. Emphasize individualized responses over generic, pre-determined requirements Which should help us… 4. Work with youth and families to provide input into the process (and get more buy-in) And 5. Focus on strengths And 6. Create lasting educational linkages And 7. Develop individualized incentives and sanctions

22. Example of a Predetermined Phase One Court Appearance Requirements Expected Duration Phase I 1 per week  3 Individual sessions per week (one of which will be substituted for a family session – one per month)  2 Group sessions per week  3 AA meetings per week  Random urinalysis, 2-3 per week  Attend school daily / no referrals / active participation  Abide by court-ordered curfew  Start a Journal For advancement to Phase II – completion of all Phase I assignments and 60 days of consecutive, CLEAN urinalysis testing. 2 Months

23. Develop a structure that promotes individualized case planning. Court Appearance Requirements Expected Duration Orientation 1 per week  Youth/caregiver and team work to set goals and develop a treatment and case plan (based on the assessment) before the youth moves into Phase II (Engagement)  As measured by # / % treatment / case plans developed  Follow a random urinalysis, 2-3 per week  As measured by # / % followed UA schedule  Youth/caregiver and team work to set attainable school/work related goals  As measured by # / % attainable goals set Based on completion of case plans and goals

24. Develop a structure that promotes individualized case planning. Court Appearance Requirements Expected Duration Engagement 1 per week  Engage in treatment and case plan. Demonstrate progress, as measured by:  # / % behavior contracts completed based on treatment, case, and school plans  Engage in providing negative UAs according to the UA schedule As measured by: # / % followed UA schedule # / % dropping clean UAs  Engage in pro-social activities as approved by the JTDC team and self-selected by youth/caregivers.  As measured by:  # / % pro-social activities attended Consider using points or a token economy to measure progress, rather than a fixed duration of time.

25. Albuquerque, New Mexico  One of 12 Learning Collaborative sites funded by NCJFJC/OJJDP  Engaged in full application of 16 Strategies, use of data to drive program and adoption of standardized screening.  Entails intensive support to restructure program to align with best practices

26. Albuquerque, New Mexico  1 st step: Surveyed youth re: what they wanted from the JDC

28.  2 nd step: To restructure phases to be more responsive to youth and families  Removed the “checklist” system and flipped to a reward system.  Youth earn points for various activities and earn their way out of a phase.

29. Example

30.  Points needed to phase:  Move to Phase 2: 100 points  Move to Phase 3: 70 points  Move to Aftercare: 70 points  Graduate from program: 40 points

31. Contact Information Sandra J. Altshuler, Ph.D., L.I.C.S.W. Spokane County Superior Court 1116 W. Broadway Spokane WA 99203 (509) 477 6355 saltshuler@spokanecounty.org sandyaltshuler@gmail.com Ncjfcj.org