Consumers’ Perspectives on Successful and Unsuccessful Experiences in a Drug Treatment Court

Abstract

This study focused on the program experiences of 190 men and women who chose to participate in a drug treatment court in lieu of incarceration in California. Participants had committed non-violent criminal offenses related to drug abuse. The program required 18 months of community-based treatment in conjunction with court supervision including frequent drug testing and 6 months of abstinence for successful program completion. Interviews were conducted in 2007/2008 with 94 participants who had successfully completed treatment and 96 who had not. Open-ended questions addressed reasons for entering and remaining in treatment and supports and obstacles to program completion. Responses were coded using ethnographic content analysis. Factors associated with successful program completion are discussed.

RÉSUMÉ

Cette étude a porté sur l’expérience de 190 hommes et femmes qui ont choisi de remplacer leur période d’incarcération par l’injonction thérapeutique de tribunal en Californie. Les participants avaient tous commis des infractions pénales non-violentes liées à l’abus de drogue. Le programme comptait 18 mois de traitement à caractère communautaire supervisé par un tribunal, et comprenait des analyses fréquentes de dépistage de drogue et 6 mois d’abstinence étaient nécessaires pour achever le programme avec réussite. Des entrevues de 94 participants ayant réussi ce programme et 96 autres ayant échoué ont été réalisées en 2007 et 2008. Les questions ont porté sur leur choix d’entrer en désintoxication, de rester en traitement, sur le soutien et les obstacles à la réussite du programme. Les réponses ont été codées à l’aide d’analyses du contenu de type ethnographique. Les facteurs associés à la réussite du programme sont discutés.

RESUMEN

Este estudio se enfoco en las experiencias del programa de 190 hombres y mujeres cuales decidieron participar en la corte de drogas envés de encarcelamiento en California. Los participantes habían cometido ofensas criminales no violentas relacionadas con abuso de drogas. Este programa requirió 18 meses de tratamiento comunitario en conjunto con supervisión de corte incluyendo exámenes de droga frecuentes y 6 meses de abstinencia para completar el programa exitosamente. Las entrevistas fueron realizadas en el 2007/2008 con 94 participantes cuales habían completado el programa de tratamiento exitosamente y con 96 participantes quienes no. Preguntas abiertas fueron echas sobre los razones de entrar y mantenerse en tratamiento y los apoyos y obstáculos para completar el programa. Las respuestas fueron codificadas usando análisis de contenido etnográfico. Factores asociados con el termino exitoso del programa son discutidos.

Keywords :

• Drug court
• treatment
• therapeutic jurisprudence
• consumer
• social support
• motivation

THE AUTHORS

Merith Cosden, Ph.D., is Chair and Professor of Counseling, Clinical and School Psychology at the University of California, Santa Barbara (UCSB), California, USA. She has been on the faculty there since 1988, conducting research and teaching graduate students. She has over 80 publications on assessment and treatment of adults and children with substance abuse and psychological disorders. She has conducted evaluation research on court-affiliated drug treatment programs for adult substance users and co-occurring substance use and mental health disorders; residential, trauma-informed, substance user treatment programs for pregnant and parenting women; and mandated psycho-educational programs for underage college students caught drinking on campus. She has also studied treatment for child abuse and neglect and risk and protective factors associated with learning disabilities and attention-deficit hyperactivity disorder. Finally, Dr. Cosden is a licensed psychologist who supervises graduate students at the Hosford Psychological Services Clinic at UCSB and has a small private practice.

Amber S. Baker, M.A., is a clinical psychology doctoral candidate in the Department of Counseling, Clinical, and School Psychology at the University of California, Santa Barbara, USA. She has engaged in research on the relationship of treatment motivation and social support to treatment outcomes for adults in Drug Courts. Additionally, she has conducted consumer surveys on program needs and satisfaction for pregnant and parenting women in substance user treatment. She has been employed by RAND Corporation, Santa Monica, USA, as an intervention facilitator and research assistant. Her research interests include motivation for substance user treatment, the role of social support in treatment outcomes, and the treatment of co-morbid PTSD and substance use among veterans and homeless adults.

Cristina M. Benki, M.A., is a clinical psychology graduate student in the Department of Counseling, Clinical, and School Psychology at the University of California, Santa Barbara, USA. She has evaluated outcomes for Santa Barbara County's Substance Abuse Treatment Courts and treatment provided under California's Substance Abuse and Crime Prevention Act. She has worked on several SAMHSA funded projects for substance user treatment for men and women, as well as an NIMH funded longitudinal study evaluating health among high school students. Her research interests include treatment outcomes for programs targeting offender populations, programs addressing co-occurring substance use and trauma, and the assessment and treatment of children and adults who have experienced neglect and/or abuse.

Sarah Patz, M.A., is a clinical psychology graduate student in the Department of Counseling, Clinical, and School Psychology at the University of California, Santa Barbara, USA. She has conducted research on factors associated with success and failure from Drug Courts and client and therapist perspectives on therapy for adults with ADHD. Her research interests include the effects of cognitive processing disorders, such as learning disabilities, ADHD, and traumatic brain injury, on the process and outcomes of adult psychotherapy and substance user treatment. Her clinical interests include the assessment and treatment of children and adults who have experienced neglect and/or abuse.

Sara Walker, M.A., is a clinical psychology graduate student in the Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, California, USA, and a predoctoral intern in the Neuropsychology Division of the Veterans Affairs Ann Arbor Healthcare System. She has worked with adult Substance Abuse Treatment Courts as well as with college campus alcohol and drug user treatment programs. Her recent clinical work includes the neuropsychological assessments of Operation Enduring Freedom/Operation Iraqi Freedom veterans with traumatic brain injury and geriatric veterans with co-morbid medical problems. Her clinical and research interests include neuropsychological and personality assessment of individuals with psychiatric disorders.

Kristen M. J. Sullivan, M.A., is a school psychology graduate student in the Department of Counseling, Clinical, and School Psychology at the University of California, Santa Barbara. USA. She is assisting with research on Santa Barbara County's Substance Abuse Treatment Courts and treatment provided under California's Substance Abuse and Crime Prevention Act. She was a Research Manager for Empirical Education Inc, in Palo Alto, California, USA. She was also employed by RAND Corporation, Santa Monica, California, USA, as an intervention facilitator and research assistant. Her research interests include assessment and treatment for at-risk adolescent populations, focusing on learning disabilities and substance use.

Notes

1 Proposition 36 Courts are not bound by the NADCP criteria and vary across the state of California in their intensity and the duration of treatment [see Hardy, Teruya, Longshore, and Hser (2005) for a review]. The Court in this study, however, followed the NADCP drug court model of treatment.