MakingPermanency Permanent: Dependency Drug Court is for the Whole FamilyAdrienne Miller, Ph.D. – COffice of the State Courts Administrator

Dr. Brittany Peters, LCSWCenter for Wellness & Clinical Development

Session Objectives

As a result of this presentation, participants

will be able to:

• � Describe how the dependency drug court

model differs from traditional dependency court

and adult drug court

• � Recall clinical interventions that work best

under this model

• � List the potential benefits to permanency when

dependency drug courts are utilized in

accordance with best practices

Substance Use affects the whole

family

Parental Substance use

Children grow up with untreated trauma and use substances

Bills don’t get paid; support family members get shut out

Children develop ACES

Children go to foster care

Dependency Drug Court

For at least one custodial parent with a substance usedisorder and a child in the dependency court system*

Researchers have found that when adhering to the evidence-based model, dependency drug courts performed better in the following areas compared to traditional dependency court (National Family Treatment Court Best Practice Standards, 2019):

� Getting people into treatment faster� Retaining people in treatment� Supporting completion of treatment� Reunifying families� Reducing children’s time in out-of-home care� Not having children return to care (re-occurrence of neglect or abuse)

Components of Dependency Drug Court

•Supportive Judicial Oversight

•Incentives, Sanctions, Therapeutic Adjustments

•Multidisciplinary Team

•Frequent Status Hearings

•Peer Supports

•Staffings

•MAT

MultidisciplinaryTeam:

• includes the judge, dependency drug court coordinator, attorneys, guardian ad litem representatives, dependency case manager, substance use disorder treatment provider, mental health treatment provider, and other providers serving the individualized needs of the families.

MultidisciplinaryTeam:

• Judge takes into account input from a team of experts

• Having the whole team at both the staffing and hearing is cost effective (National Family Treatment Court Best Practice Standards, 2019).

• A 2019 study(Gerber et al.) showed that parental attorney involvement in interdisciplinary teams allows for children to return home faster.

DependencyDrug Court

Specific

� Unified Family Court Model

� Dependency –Permanency Goals

� Family-Focus(Family Treatment Model)

� Parent-Child relationship strengthening interventions

ResearchBehind Dependency Drug Courts

Parents involved in FDTC began treatment quicker following the initiation of their child welfare case and spent more time in treatment compared to

parents who were not. FDTC parents (45%) completed treatment at a higher rate than the control group (34%). This was not found to be

significant.

Green et al. (2007)

FDTCs improve access to treatment and found a downward trend in relapse rates

Haack, Alemi, Nemes, and Cohen (2005)

In comparison to mothers who received IMCS, mothers who received EMP were more likely to decrease their alcohol use, although parents in both interventions decreased drug use

over time. The effects of both interventions, when compared, were not significant*.

Dakof and colleagues (2010)

Gifford and colleagues (2014) reviewed child welfare outcomes associated with FDTC participation and found heightened rates of reunification for children whose parents completed the program

as compared to those who did not.

Evidence-BasedClinical Interventions

The following are clinical interventions that have been used or studied within DDCs:

•Strengthening Families•Seeking Safety•Engaging Moms•Trauma-Focused CBT•Abuse-Focused CBT•Child Parent Psychotherapy

EngagingMoms Program (EMP)

Gold Standard Studies (Gayle A Dakof etal., 2010)-RCT

Permanency Outcomes • parents do better across a

wide range of outcomes such as improved parenting skills, reduced substance use, and reunification

Parent engagement and treatment retention

Trauma-focusedCognitive Behavioral Therapy (TF-CBT)

Training/Certification$600-1,200.00 per clinician

Components• parenting skills• relaxation skills• Managing emotions

through regulation

Highly effective• short term (8-25 sessions)• Can be done with child and

caregiver• PTSD diagnosis not required

Abuse-focused Cognitive BehavioralTherapy (AF-CBT)

Target PopulationPhysically abusive parents or parent who engage in coercive behavior

Pulls from several approaches• Family therapy• Cognitive therapy• Behavior Therapy

FocusInterpersonal skills are enhanced to reduce violent behavior and increase self-control

Common Clinical Concerns

Team may hear the following from counselors :

• Rapport building concerns with clients

• Resistant to therapist administering urine screens

• HIPPA concerns

• Hesitation in recommending sanctions

• Drafting court reports

Questions?