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Juvenile Drug Treatment Courts

Introduction

1) Designing Your Program

“Designing Your Program” is foundational and should be intentional. This is true for juvenile drug treatment court (JDTCs) teams that are in the planning stages of implementation. JDTCs are specifically designed courts that serve youth with substance use disorders. The treatment and services provided by a JDTC team are highly specialized; therefore, a great deal of strategic implementation and sustainability planning should be prioritized by all stakeholders involved. Use the tips, questions, answers, and resources found here to deliberately design, develop, and sustain an effective JDTC program. 

Operational JDTC programs should consider using the resources in this section to consider what is working in their JDTC and what may not be. For programs that have been operating for a number of years, there may be advances in the field that haven’t been incorporated into practice. This section lets those teams go back to basics.

Designing Your Program

Tips For Implementation

  • Watch virtual training on the JDTC Guidelines, via NCJFCJ’s YouTube channel, to further understand recommended practice.  
  • Begin by assembling a planning team to design the JDTC program in your community. The Starting a Juvenile Drug Court: A Planning Guide to collaboratively develop policies and procedures to run a juvenile drug treatment court. This guide can also be used by fully operational teams to implement enhancements. 
Designing Your Program

Frequently Asked Questions

How do we know we need a juvenile drug treatment court? 

  • First, consider the characteristics of youth who benefit the most from the services a JDTC can offer. Research has pointed to three characteristics – youth with a substance use disorder, youth who are at least 14 years old, and youth who have a moderate to high risk of reoffending. 
  • Second, take some time to collect local juvenile justice data related to those three characteristics. Use the worksheet entitled “Define the Problem” on pages 56-60 of Starting a Juvenile Drug Court: A Planning Guide for comprehensive guidance to fully understand the scope of the problem in your area.  

How should we convene a collaborative planning team to develop a JDTC program? 

Begin by assembling a planning team to design the JDTC program in your community. The Starting a Juvenile Drug Court: A Planning Guide suggests that conveners should “…look for individuals who can represent the goals and interests of both their agency and the population to be served. Look also for people who are flexible in how they discharge their responsibilities, who are in a position to influence their agency’s policies and decisions, and who are comfortable with assuming a non-adversarial role.”  

How do we assemble a steering committee and what is the committee’s main purpose? 

It’s likely that some of the stakeholders recruited to form the JDTC planning team will move to a formal steering committee once the JDTC becomes operational. Other members should include leaders from the community who can tap into important services and resources that the operational team will use to meet the needs of youth and families. Both planning and operational teams should work towards establishing a formal steering committee and making decisions around how the steering committee will support the team. 

Introduction

2) Working in a JDTC Team

Working as a multidisciplinary team in the juvenile justice system is more common than it was when JDTCs were first introduced as problem-solving courts; however, reaching a collaborative advantage as a team remains a challenge. JDTC team members are tasked with becoming experts in substance-use service delivery, adolescent development, behavior change, community outreach, trauma-informed practices, just to name a few of the topics members should be trained in. They also have to set aside agency agendas to meet the goals of the JDTC. All of this is easier said than done! Use the tips, questions, answers, and resources found here to reach a collaborative advantage as a team to better serve youth and families. 

Working in a JDTC Team

Tips for Implementation and Enhancement

  • Ensure that the core JDTC members are represented. According to the JDTC Guidelines, the core stakeholders of a fully formed JDTC team are a: judge, coordinator, clinical treatment supervisor or clinical treatment provider, juvenile probation officer (and/or a juvenile probation supervisor), public defender, prosecuting attorney, and school representative.
Working in a JDTC Team

Frequently Asked Questions

How can we engage a school liaison to serve on the JDTC team? 

JDTC teams experience many barriers when it comes to forming an effective partnership with local schools, so the best way to engage a school liaison is to be intentional and proactive. Use the strategies below to consider, develop, and implement strategies to enlist a school liaison: 

How can we effectively transition new members onto the team? 

This is an ongoing challenge for JDTC teams; however, addressing this challenge should be a fairly easy task. The JDTC coordinator should draft a formal transition policy/checklist to follow when a new team member is added to the JDTC team. 

How do we ensure the JDTC team is fully trained on an ongoing basis? 

It is common that training for the team occurs on an ad hoc basis, rather than in a strategic way that ensures the entire team attends effective training. For example, there may be some extra funding for three team members to attend a national conference one year but it isn’t consistent or reliable. The JDTC judge and/or JDTC coordinator should develop a policy that includes strategically planning for yearly training. This can be accomplished by designing a yearly training calendar. Consider designing your training calendar at the same time every year, for example – after the fiscal budget is ready, in December, as a close-out activity for the year, or after reviewing/analyzing programmatic data. The training calendar should include:  

  • State and national JDTC training events – add dates, location, funding source, team members attending. Also, strategically plan to attend these training events in an efficient way by using the “Strategically Training as a Team Technical Assistance Brief” guide to develop a training action plan prior to attending large-scale training events as a team (Note: this technical assistance brief is currently being approved by OJJDP, check back soon for the approved version). 
  • Monthly training topics – deliver information during a “lunch-and-learn” or other team meetings throughout the year. 
    • Use the worksheets entitled “Fundamental Topics: What You Need to Know for Planning Your JDC” on pages 17-53 of Starting a Juvenile Drug Court: A Planning Guide to cover important information that current and new JDTC team members should be well versed on. This section of the planning guide includes nine single subject worksheets that each have four main sections: 1) Why learning about this topic is essential; 2) What your team needs to know; 3) Recommended Resources; and 4) Questions for Discussion. The nine single subject worksheets include the following topics:  
      • Adolescent Development
      • Strengths-Based Approaches
      • Cultural Proficiency
      • Engaging the Family
      • Substance Abuse, Addiction, and Pharmacology
      • Treatment Approaches
      • Gender-Appropriate
      • Approaches
      • Trauma-Informed Care
      • Mental Health and Co-Occurring Disorders
    • Engage JDTC team members in delivering in-service training for the team. The team itself has subject matter expertise that can be shared to further understanding of agency rules, treatment standards/approaches, legal issues, etcetera. Take advantage of this expertise to build a robust training calendar. 
  • Other continuing education – add other non-JDTC specific training events that are available. For example, attorneys may have yearly continuing legal units that must be earned. This step allows the full team to understand where additional training is occurring and may lead to other in-service training opportunities. 
Introduction

3) Tailoring Responses for Youth

Juvenile Drug Treatment Court (JDTC) teams should individualize comprehensive case plans, incentives and sanctions, treatment approaches, and prosocial activities to help youth make lasting changes in their behavior. Conversely, JDTC teams should also ensure that service delivery is consistent and fair. These recommendations can seem contradictory, and JDTC teams struggle to develop policies and procedures that allow them to tailor responses for youth. Use the tips, questions, answers, and resources found here to effectively tailor responses for youth by developing comprehensive case plans, targeting incentives and sanctions, using adolescent-based treatment, and prioritizing prosocial activities. 

Tailoring Responses for Youth

Tips for Implementation

Developing Comprehensive Case Plans

  • Rethink the use of mandated requirements that are listed in phases structures. Instead, concentrate on identifying individualized, youth-specific behavior goals based on a validated risk needs assessment and coordinating service delivery to help the youth achieve goals. 
  • Implement a formal process for case plan development. This can be in the form of sophisticated online software or a pen/paper method, as long as the process is adhered to. 
  • Use validated risk/need assessments to drive case plan development. Use the results of the risk/needs assessment to focus on the potentially changeable criminogenic needs that the assessment identifies as top needs. 
  • Review “7 (Easy) Steps to Individualizing Your Juvenile Drug Court” in 7 Articles with 7 Easy Steps to Improving Your Juvenile Drug Court (pages 25-30) for more information on developing procedures that lead to individualization.  
  • Use the “Case Planning and Management” tips found on pages 2-4 of the Practical Tips to Help Juvenile Drug Treatment Court Teams Implement the JDTC Guidelines for information about how to use case plans as a team. 
  • Ensure that case plan goals are SMART. Use the table below as a guide to making goals specific, measurable, attainable, relevant, and timebound.  

SMART Goals

Specific

Address criminogenic needs with a specific intervention (e.g., substance use needs w/ adolescent-based treatment or values & beliefs w/ anger management course)

Help build a new skill by engaging in a prosocial activity

Ask youth to describe the types of skills they would like to learn

Measurable

Track attendance as a measure of compliance

Track certificates or final grades as a type of completion measure

Track the reduced criminogenic risk related to the intervention (i.e., reduced risk in the substance use domain after adolescent-based treatment has been completed)

Attainable

Ask targeted questions to determine if the goal is attainable:

Consider whether the youth has the capacity to fully participate in the intervention.

Consider if the youth is motivated to engage in the intervention or prosocial activity.

Determine if there might be any external factors that would be barriers to attending (i.e., transportation issues) and how the barriers could be addressed.

Relevant

Confirm that the intervention / prosocial activity:

Determine if an activity for a goal is related to an identified criminogenic risk factor, rather than a standard requirement that all youth have to do.

Include voice and choice from the youth and family; for example, selecting an activity to meet a goal, allow youth to choose from a variety of different prosocial activities.

Timebound

Discuss goal achievement expectations and due dates with youth by identifying a period of time to work on a specific goal.
Ensure that youth are able to work towards a distal goal (lower probability but higher value) by achieving smaller proximal goals (higher probability with less value) that are directly related to the distal goal. For example:
Improving school connectedness is a distal goal
Proximal goals related to that include – enrolling in school; completing an individual education plan; finishing a credit recovery courts; etc.

Targeting Incentives and Sanctions (Contingency Management)

Using Adolescent-Based Treatment

Prioritizing Prosocial Activities

  • Equalize the importance of participation in prosocial activities with substance use treatment by ensuring that the JDTC team has a wide variety of activities to refer to. Use the “Identify other service providers” (pages 183-187) and the “Explore enrichment opportunities” (pages 188-192) worksheets found in Starting a Juvenile Drug Court: A Planning Guide to identify possible community resources and opportunities for youth and families. 
  • Improve educational linkages by presenting a case study to the JDTC as an example of the barriers and solutions that JDTC teams face when working with schools. The case study “Educational Linkages” can be found in Practical Tips to Help Juvenile Drug Treatment Court Teams Implement the JDTC Guidelines (pages 27-29). 
  • Implement a structured mentoring program within your JDTC. Use Mentoring in Juvenile Treatment Drug Courts to better understand the key components of mentoring programs within a JDTC. 

 

Tailoring Responses for Youth

Frequently Asked Questions

Why doesn’t the JDTC Guidelines address phases? 

The main reason is that there isn’t any research to support the use of phases in JDTCs. The structure was adopted from the adult model. The use of pre-determined requirements is not informed by adolescent development or adolescent brain science so they may not serve juvenile drug treatment court programs as well as they serve adult drug court programs. Instead, comprehensive case plan development and management, driven by validated assessments, are much better at “…engag(ing) and retain(ing) clients whose circumstances make it difficult to follow a regimented program schedule.” This means that JDTC teams should rethink the use of phases entirely and consider revising JDTC program structure to focus on and align with effective case planning activities. Begin by: 

 

How can drug testing policies and procedures be trauma-informed and developmentally appropriate?  

JDTCs should ensure that drug-testing procedures are developmentally appropriate, trauma-informed, and fair, and drug testing services and locations are made accessible regardless of where in a community youth reside. NCJFCJ recommends: 

  • Staff who administer drug tests are trained on trauma, cultural humility, and implicit/institutional bias.
  • Staff who administer drug tests look like the youth they serve (in terms of race/ethnicity/sexual identity).
  • Drug testing processes and staff emphasize respect in interactions with youth and families.
  • Drug testing-related processes give youth voice and choice. 
  • Drug testing-related processes are transparent (i.e., state the why, how, what & who).
  • When youth have positive tests, they are referred to culturally appropriate treatment services and support.
  • When youth have negative tests, they receive meaningful and positive reinforcement.
  • Drug testing, when deemed necessary, is just one tool in the process for assessing and treating youth who have a substance use disorder.
  • Youth are not denied acceptance into JDTCs because drug testing or treatment services do not exist in their community or neighborhood.  

 

What does the research say about requiring a consecutive number of negative drug tests to advance from phase to phase OR graduate from a JDTC?

JDTCs commonly mandate a specific number of consecutive, negative drug test results for youth to advance from phase to phase or graduate; however, research does not exist that establishes a requirement of a specific number of consecutive or cumulative days of negative drug tests results is associated with higher graduation rate or a lower, post-program recidivism rate. The following is a summary of the available research/information regarding using drug test results to define remission or consistent non-use of substances:

 

APA’s DSM-5 defines remission as three months without “symptoms” (including craving) – but is noticeably silent on actual “use.” 

  • The DSM-5 may be the basis for specialty court rules that call for 90 days of consecutive sobriety for graduation. This is a questionable application of a clinical yardstick/concept to a court/legal mandate. Clinicians may look at physiological symptoms – like craving. Such symptoms/conditions do not exist as a phenomenon/concern in the realm of the law/courts. People cannot be arrested or locked up based on whether they have cravings. 
  • There is no research that states that 90 consecutive days are required for behavioral change of the sort that juvenile drug treatment courts are legitimately concerned with – not just taking drugs, but how the young person functions (or is not functioning) that shows recovery-related capacity. Youths could have 90 cumulative days (with a slip-up or two) and function in desired ways – like going to school, making progress in school, going to treatment, making progress in treatment, getting along better with parents, having positive peers, etc.
  • Treatment experts/clinicians might find behavior change proceeds better when young people have sustained sobriety (i.e., when they aren’t struggling with coping with cravings that may get in the way of these other capacities and growth). But there isn’t any definitive support in the treatment field that establishes that 90 consecutive days of sobriety is associated with lowered substance use, lowered illegal behavior, or increased prosocial activities, for adolescents.   
  • Statistically, the first big cut point comes from reducing use to less than one time a week (5/30 days or 13/ 90 days).

In sum, and as relevant to JDTCs, a set number of consecutive days of negative drug screen results are not required. For purposes of a JDTC program completion requirement, cumulative days are a sufficient standard, and with only minimal use within the period – for example, out of 30 days, only 5 with non-sobriety, and no more than 2 sequential ones. 

Introduction

4) Working with Families

According to the JDTC Guidelines, under Guidelines 1.5, “JDTCs should be deliberate about engaging parents or guardians throughout the court process, which includes addressing the specific barriers to their full engagement.” This is the guideline; however, JDTC teams should operationalize this recommendation so that working with and engaging families is an intentional aspect of the program. Use the tips, questions, answers, and resources found here to effectively engage and work with families to make certain that youth are successful.  

Working with Families

Tips for Implementation and Enhancement

  • Review current written documentation given to families that detail the program, rules, and procedures to determine accessibility. For example: 
    • Provide information in other languages to accommodate English as a second language speakers. 
    • Ensure that the readability is at a fifth-grade reading level, which is the recommended level of understanding for court users.
    • Limit the amount of information provided at one time and ensure it is relevant to the families so that families aren’t overwhelmed by internal team procedures and processes (e.g., referral/entry process). Consider building in separate orientations for each phase of the program. Use the worksheet entitled “Design an orientation for youth and families” on pages 170-173 of Starting a Juvenile Drug Court: A Planning Guide to develop a comprehensive orientation that engages families. 
  • Engage families during court hearings by making the focus of the hearing itself therapeutic and meaningful; avoid or minimize a focus on legal language and process that the family may not understand or may find alienating to one. Consider the short-term and long-term solutions suggested in “The Sin of the Missed Opportunity to Engage Participants – The Court Hearing” found in the Seven Deadly Sins Series: Juvenile Drug Court Practices that Can Lead to Poor Outcomes (page 4), which can help the team rethink judicial interactions, as well as the court atmosphere. 
Working with Families

Frequently Asked Questions

How can the JDTC team engage reluctant families or families that don’t see the value of intensive therapeutic services? 

  • First, present a case study to the full JDTC team as an example of a parent who is very frustrated with her son and is reluctant to participate in the JDTC, even though the services would be beneficial – The case study “Family Engagement” can be found in Practical Tips to Help Juvenile Drug Treatment Court Teams Implement the JDTC Guidelines (pages 30-32). 
  • Second, as a team, discuss the solution-focused tips that are included directly after the case study and create an action plan to implement 2-3 tips that will lead to increased family engagement. 

How can a JDTC team assess current practices to ensure that families are deliberately engaged in the process?  

As a team, use the “Family Engagement Practices Self-Assessment Tool” found in Engage, Involve, Empower: Family Engagement in Juvenile Drug Treatment Courts on pages 16-20. The key measures found in the tool provide an understanding of effective practice along a scale, which can then help the team identify gaps and plan enhancements or improvements. 

Introduction

5) Using Data and Sustaining Your Program

Of course, JDTC teams should monitor and track program completion and termination. However, JDTC teams should also routinely collect other data that can lead to ongoing program improvement and sustainability. For example, JDTC teams are encouraged to collect and aggregate data regarding family functioning, general recidivism, substance use, educational enrollment, sustained employment, involvement in prosocial activities, and youth-peer associations. Using data to inform service delivery can be referred to as continuous quality improvement (CQI). This is different from evaluative research. Evaluative research refers to having an outside entity examine your program and assess how well it achieves its goals and produces specific outcomes of interest. CQI, on the other hand, refers to the process of collecting, aggregating, and analyzing data early, often, and in multiple ways to determine whether or not service delivery and other program activities are occurring as intended. JDTC teams can use agreed-upon benchmarks to track and monitor data, make key improvements, and report progress on the JDTC mission. Use the tips, questions, answers, and resources found here to effectively use data for quality improvement and sustainability. 

Using Data and Sustaining Your Program

Tips for Implementation

Using Data

  • Review “7 (Easy) Steps to Measuring Performance of Juvenile Drug Courts” in 7 Articles with 7 Easy Steps to Improving Your Juvenile Drug Court (pages 7-13) for information about drawing on JDTC mission statements to draft operational objectives and performance measures that can inform continuous quality improvement.
  • Use the “Develop goals” (pages 98-102) and “Write objectives” (pages 198-201) worksheets found in the Starting a Juvenile Drug Court: A Planning Guide to draft mission-driven goals and operational objectives that JDTC teams can monitor to ensure successful service delivery. 
  • Draft a process to determine whether or not the JDTC team is achieving the proposed goals and objectives by using the “Build a system to monitor the program” (pages 202-205) found in the Starting a Juvenile Drug Court: A Planning Guide. 

Sustainability

Funding for JDTCs comes from many places. Some of these sources are stable (e.g., state supreme courts, administrative office of the courts, or county court systems). Others may be based on requests or applications (e.g., state block grants) to entities that select recipients and dollar amounts that vary, so the funding can’t be relied upon every year. Relying on funding requests or applications can put JDTCs in a precarious position and impact the services and interventions they are able to provide to youth and families. 

  • JDTC teams should tap into support from a steering committee to assist with mapping out funding sources and indicate which sources are stable and which sources are variable year to year or variable by monies awarded. This exercise may help the team strategically plan for augmenting funding sources that support treatment services, salaries, incentives, or pro-social activities. 
    • Even if your JDTC team is fully operational, use the “Develop a start-up budget” worksheets found in the Starting a Juvenile Drug Court: A Planning Guide to plan for specific budget categories like drug testing and transportation (pages 211-214). 
    • “Develop a five-year plan” using the worksheets found in the Starting a Juvenile Drug Court: A Planning Guide to help the team consider ways to institutionalize JDTCs in your state or community (e.g., advocating for legislation to fund JDTCs) (pages 215-217). 
  • JDTC teams should think about sustainability broadly, meaning it is more than finding funding to support salary and treatment services. Sustainability can include building strong community partnerships to provide services needed for youth and families. 
Using Data and Sustaining Your Program

Frequently Asked Questions

If we don’t have an evaluator on the team, how can we get help to collect and analyze our data?

Many teams do not have the funds or resources to engage an evaluator in their team planning or operations. Consider reaching out to a local college or university to see if there are graduate-level students in social science programs (e.g., criminal justice, social work) who need practical experience or internships. These students can provide ongoing data support to the JDTC team, even if they only work for a semester or two, as long as there are structured processes and procedures in place to follow. 

  • Use the Academic Partnerships technical assistance brief for specific guidance on working with local colleges and universities (Note: this technical assistance brief is currently being approved by OJJDP, check back soon for the approved version). 
  • Request specific technical assistance to collect and analyze JDTC programmatic data. There are many national providers that have federal funder to support this type of request – visit TTA360 to submit a formal request from a technical assistance provider funded by the Office of Juvenile Justice and Delinquency Prevention. 

How can we share aggregated data with our steering committee, community partners, and youth and families? 

Consider developing a process to draft a quarterly report to easily share aggregated data with stakeholders, partners, funders, and youth and families. Think of these quarterly reports as “JDTC Report Cards,” which can be compiled based on the data that are already collected and used for program improvement and decision-making. 

  • NCJFCJ recommends working as a team to follow the guidance found in Using Report Cards to Share Juvenile Drug Treatment Court Program Data: A Technical Assistance Brief, which provides steps to producing quarterly report cards and tips on data points to collect, as well as how to analyze the aggregated data (Note: this technical assistance brief is currently being approved by OJJDP, check back soon for the approved version).   

Collecting information on family functioning seems very subjective. How can JDTC teams best go about collecting this data in an objective way? 

Yes, “family functioning” can be very subjective, and it can be difficult to collect quantitative data regarding achieving a goal to improve family functioning. However, there are ways to collect and analyze quantitative data and qualitative data to determine whether or not the services/interventions provided in a JDTC are improving family functioning. Consider using the examples below to begin this analysis: 

Quantitative Data

  • Isolate the family-related domain in the risk/need assessment used during intake and again during reassessments to identify if improvements have been made in that domain. For example, the Youth Level of Service/Case Management Inventory (YLS/CMI) has 8 domains that predict a youth’s risk to re-offend. The second domain, Family/Parenting has a low (0-2), moderate (3-4), and high (5-6) range. This domain is dynamic, meaning it is potentially changeable if the right services or interventions are put in place to support positive outcomes (i.e., improved family functioning). Therefore, if a youth scores 7 (high) in the Family/Parenting domain at intake and evidence-based services that target family dynamics are provided through comprehensive case management, we can expect that score to go down at reassessment. This becomes a quantitative data point that can show improvements in family functioning. If reductions in that domain aren’t occurring as expected, this is a signal to figure out why – 1) meet with your treatment providers to determine if they are using evidence-based modalities with fidelity; 2) aggregate and review attendance data to determine if youth are consistently attending, or 3) conduct a survey or focus group with current and past participants to determine if they are engaging with treatment providers in an authentic way.

Qualitative Data

  • Work with your treatment provider to develop questions and a methodology to survey current and past participants regarding their experiences with the services/interventions. Consider developing several types of questions to better understand these experiences: 
    • Use scales that gauge agreement on certain performance measures, for example – On a scale of 1 – 5 (5 being total agreement), how much do you agree with this statement: “The treatment provider’s approach made me feel comfortable.” 
    • Include questions related directly to the skills and concepts that youth and families were practicing during treatment sessions to gauge increases in knowledge and skills.  
    • Ask one or two open-ended questions regarding participants’ thoughts and feedback about the services/interventions provided and then code/theme the data to draw some qualitative conclusions. This type of qualitative feedback is important to gathering and using youth and family voices for improvement purposes. 
      • Consider using qualitative software for this type of analysis to ensure accuracy and reliability (e.g., NVIVO, Tableau).