Resource SPECIALIZED DOCKETS Targeting Drug Court Dockets Based on Risk/Need Assessment

Douglas B. Marlowe, J.D., Ph.D. Chief of Science, Law & Policy National Association of Drug Court Professionals

Objectives
Identify the appropriate population for the traditional drug court docket. Determine whether alternative dockets are appropriate for drug court. If so,
What are appropriate alternative dockets look like? How do you determine who is appropriate for alternative dockets? What services should be offered in each docket?

Alternative Dockets
Mental Health Court DWI Court Veterans Court Family/Juvenile Treatment Court Alternative Drug Court Tracks

Traditional Drug Court Ten Key Components

Eighty percent of offenders have substance involvement. One-half to one-third meet the criteria for substance abuse or dependence resulting in a seven-fold increase in continuing to engage in pattern of criminal offending. The goal is to match drug offenders to dispositions that balances cost, public safety and the welfare of the offender.

Traditional Drug Court

Research indicates which type of adult offenders are most in need of the full complement of services embodied in the Ten Key Components. However, many low need low risk offenders would have no alternative to incarceration if access to a drug court program is denied. As a result, it becomes important to design different tracks to accommodate the low risk low need offender.

Assessment of Risks and Needs

Three basic factors: Risk of Dangerousness Prognostic Risks Criminogenic Needs Predicts the most effective and cost-efficient disposition

Risk of Dangerousness
Goal: To protect citizens from violent or predatory offenders. Restrictive dispositions Eventually released back into the community Step-down for continued supervision Maxed out No authority to monitor and control behavior.

Prognostic Risks
Characteristics of offenders that predict poorer outcomes in standard rehabilitation programs: Risk: Not a risk for violence or dangerousness, rather a risk of failing to respond to standard interventions, and for continuing to engage in the same level of drug abuse and crime as in the past. The higher the risk More intense services

Prognostic Risk Factors

Younger age Male Early onset of substance abuse or delinquency Prior felony convictions Unsuccessful attempts at treatment or rehabilitation Co-existing of antisocial personality disorder Antisocial peers or affiliations

Criminogenic Needs
Clinical disorders or functional impairments that, if ameliorated, substantially reduce the likelihood of continued engagement in crime.

Criminogenic Needs
Substance Dependence or Addiction Bing Pattern Cravings or compulsion Withdrawal symptoms Abstinence is a distal goal

Criminogenic Needs
Substance Abuse o Compliance is a proximal goal

Shaping
Principle governing effective behavioral change Proximal Goals: Behaviors clients are already capable of engaging in and that are necessary for long term change. Distal Goals: Behaviors that are the behaviors that ultimately desired, but may take some time to accomplish.

Collateral needs o Dual diagnosis o Chronic medical conditions (HIV, diabetes) o Homelessness chronic unemployment

Responses
The magnitude or severity of the sanction should be higher for proximal behaviors and lower for distal behaviors. Low-level sanctions for failing to fulfill easy obligations can lead to habituation the offender becomes accustomed to being punished. Can make behavior worse.

Responses
High magnitude sanctions for failing to meet difficult demands that are beyond his capabilities can lead to hostility, depression and a disruption of the therapeutic relationship. Ceiling effect: Once options have been exhausted further efforts to improve behavior will be extremely challenging.

Quadrant One High Risk/High Need

Drug or alcohol dependence Severe mental illness Deficiencies in adaptive functioning Poor prognosis for success in standard treatment or rehabilitation

High Risk/High Need

Negative risk factors:
Early onset of delinquency or substance abuse Antisocial personality traits Previous failures in rehabilitation Preponderance of antisocial peers

High Risk/High Need

Status Calendar Intensive Treatment Ameliorate cravings and withdrawal symptoms Concrete skills to resist drugs and alcohol Coping strategies to deal with lifes stressors

High Risk/High Need

Compliance is proximal for basic supervision requirements: Showing up for treatment or UA Failing to appear for Court Tampering with urine samples Restrictive consequences: Most of these offenders have habituated to punishment and will engage in substance abuse despite negative consequences. Positive reinforcement can cultivate pro-social behaviors that can compete against substance abuse.

Responses
Positive Reinforcement: The offender can be expected to return to substance abuse unless has found a new job developed hobbies, cultivated healthy social relationships, or engaged in other pro-social activities. Put feeling aside and offer rewards for engaging in good behaviors that portend better longterm adjustment.

Responses
Agonist Medications
Allows addicted individual to function safely and effectively while performing daily chores and routines. Methadone Buprenorphine -

Quadrant Two Low Risk/High Need

Drug/Alcohol dependence Severe mental illness Poor adaptive skills Does not have negative risk factors that would predict a poor response to standard treatment.

Low Risk/High Need

Noncompliance Calendar:
They should focus energies on treatment. However, if they fail to attend treatment there should be a swift court consequence.

Intensive Treatment:
Treatment is proximal: Failing to attend treatment should trigger a noncompliance court appearances.

Clean drug tests are distal:

Early on dirty tests should be met with a more intense modality of care.

Low Risk/High Need

Positive reinforcement: This population has also experienced a ceiling effect or habituation to punishment. Therefore it is important to use positive reinforcement. Agonist Medications This population can perform adequately in probation-without-verdict dispositions.

Quadrant Three High Risk/Low Need

Does not have drug or alcohol dependence, severe mental illness or deficient adaptive skills. Has negative risk factors for failure in traditional correctional rehabilitation programs: Antisocial character traits Prior failures on supervision Deviant peer affiliations

High Risk/Low Need

Status Calendar Pro-social Rehabilitation: Focus on altering the offenders distorted perceptions, think before they act and consider the consequences of their actions and build empathy for others. Vocational preparation Education

High Risk/Low Need

Abstinence and compliance are proximal Low-level sanctions are merely the cost of doing business Higher magnitude sanctions should be administered at the outset to rapidly squelch substance abuse. Higher level of response for noncompliance with other basic requirements

High Risk/Low Need

Restrictive Consequences for failure to comply with supervision may require restrictive consequences to protect public safety. These responses may include in-home-detention, EMP Antagonist Medications: Block the effects of illicit drugs while providing no intoxication of their own. No treatment

Quadrant Four Low Risk/Low Need

Nave to criminal justice system and the substance abuse treatment system. Do not suffer from addictions or other impairments Do not have negative risk factions that would portend failure in standard interventions. Noncompliance docket Prevention services Abstinence is proximal

Adjusting Tracks
No assessment took is perfectly reliable and valid A participants subsequent performance in the program should serve as a guide for adjusting the conditions of the program. Adaptative Interventions: Pre-specified criteria for determining when and how to adjust services in response to participants performance.

Mental Health Court

Generally appropriate for the severely and persistently mentally ill offender. This population generally suffers from an Axis I disorder. These offenders are unable to maintain a stable life style without significant assistance, and therefore would be unable to complete the requirements of a traditional drug court docket.

Mental Health Court Eligibility

Who? Axis I? Personality disorders? Low functioning? Head injury? What resources do you have?

Program Requirements
Maintain stability in order to complete probation. Develop access to resources in order to maintain stable life after completing the program. Expectations may be tempered by a realization that this population may not be able to complete the requirements of traditional drug court. Individualization is critical.

DWI Court
The DWI offender often scores low on risk/need assessments, yet presents a significant public safety risk. Offenders generally do not have other involvement in the criminal justice system. This population seems to do better with stand alone treatment and court dockets.

Additional Dockets
Veterans Court Family Dependency Treatment Court Juvenile Drug Court

Breakout Session Group One

Traditional Drug Court: Quadrant One - High Risk/High Need Eligibility criteria. Program structure. Review responses to behaviors. (consider proximal and distal goals)

Breakout Session Group Two

Drug Court Alternative Track: Quadrant Two Low Risk/High Need Eligibility criteria. Program structure. Responses to behaviors. (consider proximal and distal goals)

Breakout session Group Three

Alternative Drug Court Track: Quadrant Three High Risk/Low Need Eligibility criteria. Program structure. Responses to behaviors. (consider proximal and distal goals)

Breakout Session Group Four

Alternative Drug Court Track: Quadrant Four Low Risk/Low Need Eligibility criteria. Program structure. Responses to behaviors. (consider proximal and distal goals)

Breakout Session Group Five

Additional tracks: Identify possible additional tracks, such as mental health court, DWI court. Will program requirements need to be adjusted? Will responses to behavior need to be adjusted? Are there requirements that should apply to all programs?

Breakout Session Group Six

Adaptive Interventions: Develop a set of guidelines that will trigger an adaptive intervention. For example, missing a pre-determine number of counseling sessions might trigger a reassignment to another docket. Consider alternate drug court tracks, and other options such as mental health court, DWI court.