1. 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

2. June 22, 2006 - NADCP NPC Research2 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

3. June 22, 2006 - NADCP NPC Research3 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

4. June 22, 2006 - NADCP NPC Research4 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

5. June 22, 2006 - NADCP NPC Research5 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?

6. June 22, 2006 - NADCP NPC Research6 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 ”

7. June 22, 2006 - NADCP NPC Research7 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

8. June 22, 2006 - NADCP NPC Research8 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

9. June 22, 2006 - NADCP NPC Research9 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

10. June 22, 2006 - NADCP NPC Research10 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

11. June 22, 2006 - NADCP NPC Research11 Treatment Outcomes OutcomeFTDCComparisonSignificant? (p<.01) Time to enter Tx 73 days181 daysYES Days in Tx302184YES % Tx episodes completed 45%34%YES Results based on regression models controlling for demographic, risk and site variables. Sample sizes vary due to missing data (n=334-397).

12. June 22, 2006 - NADCP NPC Research12 Child Welfare Outcomes OutcomeFTDCComparisonSignificant? (p<.01) Days to permanency 360 days435 daysYES % Reunified52%41%YES % Subsequent placements 10%5%NO Results based on regression models controlling for demographic, risk and site variables. Sample sizes vary due to missing data (n=334-397).

13. June 22, 2006 - NADCP NPC Research13 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

14. What Makes FTDCs Work? Unpacking the “Black Box”

15. June 22, 2006 - NADCP NPC Research15 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

16. June 22, 2006 - NADCP NPC Research16 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.

17. June 22, 2006 - NADCP NPC Research17 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.

18. June 22, 2006 - NADCP NPC Research18 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.

19. June 22, 2006 - NADCP NPC Research19 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

20. June 22, 2006 - NADCP NPC Research20 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

21. June 22, 2006 - NADCP NPC Research21 Correlations Between Child Welfare and Treatment Outcomes Days to Permanency % ReunifiedSubsequent Placements Time to Tx.20**-.12*.04 Days in Tx.24**.18**.01 Completed Tx.01.30**.04 *Significant at p<.05 **Significant at p<.01

22. June 22, 2006 - NADCP NPC Research22 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.

23. June 22, 2006 - NADCP NPC Research23 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

24. June 22, 2006 - NADCP NPC Research24 Treatment Experiences & FTDC Status Predict % of Children Reunified

26. June 22, 2006 - NADCP NPC Research26 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