New Research on Juvenile Drug Courts: Yes, They Work

As of the mid-2000s, the research on the effectiveness of juvenile drug courts was unclear. Now, that's starting to change. In coming weeks, I'll post about new research from John Roman at the Urban Institute about what works and how juvenile drug courts should adjust their practices to be more effective.
 
Juvenile Drug Courts - How Do They Compare to Outpatient Treatment?

Today, I want to share with you a new quasi-experimental study I saw mentioned at JMATE 2010 that compares 1,120 youth in juvenile drug courts in multiple jurisdictions with 1,120 youth not in juvenile drug court, but who particiated in adolescent outpatient treatment. The goal was to see how the two groups differed in terms of services and in their treatment outcomes.
Bottom line? Juvenile drug courts appeared to do a better job (compared to treatment alone) of helping youth reduce symptoms of their emotional problems and cut their substance use, as measured six months post-intake. (This doesn't mean, of course, that every teen who needs drug or alcohol treatment should be in juvenile drug court--!) In general, youth in juvenile drug courts received -- unsurprisingly -- more family services, more wrap-around support, more urine tests, and more supervision.

There are limitations to the study and nuances I don't have the space to convey here, so I recommend that you review it in detail. Titled, "Needs, Services, And Outcomes Of Youths In Juvenile Treatment Drug Courts As Compared To Adolescent Outpatient Treatment," it was authored by by Melissa L. Ives, M.S.W., Ya-Fen Chan, Ph.D., Kathryn C. Modisette, M.A., and Michael L. Dennis, Ph.D. and appeared in a special issue of Drug Court Review devoted to juvenile drug courts just published by the National Drug Court Institute. (The rest of the issue looks meaty, too.) 
 
Some Highlights

A few key findings worth pointing out:

• Using evidence-based treatment matters.
• Juvenile drug court participants were less likely than youth in treatment-only to begin treatment within two weeks of intake. The authors note, "This is important because a recent study (Lennox, Dennis, & Modisette, under review) found that initiation of treatment within two weeks was a major protective factor against relapse and recidivism, and that delayed initiation was sometimes a source of health disparities by race or ethnicity. Enhanced coordination between the justice and substance abuse treatment systems could improve treatment initiation and, thereby, reduce the risk of relapse, recidivism, and health disparities" [emphasis added]. 
• The authors concluded that, "[c]ontrary to concerns about 'creaming' or 'net widening', this suggests that JTDC [juvenile treatment drug courts] are, in fact, one of several ways of getting significantly impaired youth into treatment and reliably achieving similar (and even slightly better) outcomes."

 
No Time to Read the Study? Check Out the PowerPoint

A great visual overview of the study can be found in this PowerPoint presentation, "History and Data on Juvenile Drug Courts," from Dr. Michael Dennis, Senior Research Psychologist at Chestnut Health Systems. 
In addition to discussing the study's findings, he lays the scientific groundwork for why it's critical to intervene early in adolescent drug and alcohol use and abuse, and -- among other things -- emphasizes the signal importance of properly implementing evidence-based interventions, and of addressing victimization in the youth we serve.
 
One in 19 Teens Get Treatment They Need

When we launched Reclaiming Futures ten years ago, about one in 10 teens got the treatment they needed for alcohol and drug use, according to federal data. Now, I see that number has dropped to one in 19 youth--!  (See slide 9 of Dr. Dennis' presentation.) I bet the ratio's lower in the juvenile justice system, but from a public health point of view, that number's quite troubling. 
 
Related Study

The Pathways to Desistance study also investigates the importance of substance abuse treatment and aftercare for youth in the juvenile justice system. The longitudinal study followed adolescent offenders into their early adulthood to identify pathways out of justice system involvement and describe the role of environmental factors in promoting desistance. Follow the link for more information about the study and its findings.
Photo: craftygoat.