Examining the relationship between psychological functioning, childhood trauma, and types of perceived coercion among drug court enrollees: Results from a pilot study

Abstract

Background: Drug court interventions produce positive results—especially among mandated populations. Many criminal justice-involved persons, including drug court enrollees, have co-occurring substance abuse and childhood trauma disorders associated with psychological dysfunction. Given the coercive nature of mandated drug court treatment, it is important to understand whether childhood trauma and psychological functioning influence perceived coercion to enter treatment. Objectives: The purpose of this study was to describe the degree to which adverse childhood trauma and psychological functioning were associated with six domains of perceived coercion—self, family, legal, financial, health, and work—among a population of drug court enrollees. Methods: Data from 54 enrollees in a drug court pilot study were used to examine the relationship between childhood trauma, psychological functioning, and perceived coercion. Results: The pilot study data showed that psychological dysfunction and traumatic experiences in childhood were associated with higher perceived coercion to treatment, explaining 29% of the variance in coercion, controlling for gender and pre-arrest alcohol and drug use. Results indicated that the associations between psychological dysfunction and trauma were driven by non-legal types of coercion. In particular, childhood trauma was correlated with family (r = 0.32), financial (r = 0.32), and health (r = 0.47) types of coercion. Conclusions: Based on these preliminary findings, drug court practitioners are urged to assess perceived coercion, in addition to the behavioral health and childhood trauma of their clients, and to utilize non-legal types of coercion such as family, health, and financial impact to enhance treatment engagement.

Keywords:

• court-ordered
• PTSD
• mandated populations
• substance abuse
• trauma-informed practice

Public Interest Statement

Drug court is a popular intervention for criminal justice-involved individuals who abuse alcohol and drugs. Because drug court is often mandated as part of one’s sentencing, it has been critiqued as coercive. Given the high rates of childhood trauma among persons in the criminal justice system as well as the co-occurrence of substance abuse, it is important to examine whether drug court enrollees feel coerced to enter drug court, as perceived coercion may be linked to treatment outcomes. This article explores the roles of childhood trauma and psychological functioning, and is related to six types of perceived coercion (self, family, legal, financial, health, work) to enter drug court. Understanding one’s perceived coercion is key to better serving this population and tailoring motivational techniques to the needs of mandated clients.

Competing Interests

The authors declare no competing interest.

Additional information

Notes on contributors

Andrea N. Cimino

Andrea N. Cimino is a faculty research associate at the Johns Hopkins School of Nursing. Cimino’s research focuses on violence against women involved in the criminal justice system.

Natasha S. Mendoza

Natasha S. Mendoza is an assistant professor in the School of Social Work at Arizona State University whose research explores the ways in which identity and wellness are assets in recovery from substance use disorders.

Thomas H. Nochajski

Thomas H. Nochajski is a research professor at the University at Buffalo School of Social Work, an associate research scientist at the Research Institute on Addictions, and an associate research scientist at the Center for Health and Social Research. Nochajski’s work focuses on aspects of prevention of alcohol and drug problems (primary, secondary, and tertiary), as well as the impact of trauma.

Mark G. Farrell

Mark G. Farrell, a nationally recognized innovator in the practice of Therapeutic Justice, retired as the senior justice in the Amherst, New York Criminal and Civil Court.