family treatment drug court national evaluation overview & phase i preliminary results beth l....

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

June 22, 2006 - NADCP

NPC Research 2

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


NPC Research 3

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


NPC Research 4

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


NPC Research 5

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?


NPC Research 6

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”


NPC Research 7

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


NPC Research 8

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


NPC Research 9

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


NPC Research 10

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


NPC Research 11

Treatment Outcomes

Outcome FTDC Comparison Significant?

(p<.01)

Time to enter Tx

73 days 181 days YES

Days in Tx 302 184 YES

% 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).


NPC Research 12

Child Welfare Outcomes

Outcome FTDC Comparison Significant?

(p<.01)

Days to permanency

360 days 435 days YES

% Reunified 52% 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).


NPC Research 13

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

What Makes FTDCs Work?

Unpacking the “Black Box”


NPC Research 15

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


NPC Research 16

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.


NPC Research 17

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.


NPC Research 18

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.


NPC Research 19

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


NPC Research 20

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


NPC Research 21

Correlations Between Child Welfare and Treatment Outcomes

Days to Permanency

% Reunified Subsequent 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


NPC Research 22

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.


NPC Research 23

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


NPC Research 24

Treatment Experiences & FTDC Status Predict % of Children Reunified

86%

10%

63%

40%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Successful Tx Unsuccessful Tx

% c

hild

ren

reun

ifie

d

FTDCComparison

More days inFTDC, Tx

More likelyto complete

Tx

More likelyto graduate

FTDC

More likelyto be

reunifiedwith children

For some,shorter cases,

fasterpermanency

Thus, longercases, longer

times topermancy

Timely entryinto FTDC, Tx


NPC Research 26

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

family treatment drug court national evaluation overview & phase i preliminary results beth l....

Documents

family treatment court

family drug courts

adult drug court

family dependency drug

drug courts work

number of ftdcs

orfour ftdcs

current ftdcs