SPECIALIZED DOCKETS

Targeting Drug CourtDockets Based onRisk/Need Assessment

Resource

Douglas B. Marlowe, J.D., Ph.D.

Chief of Science, Law & Policy

National Association of Drug Court Professionals

Objectives

Identify the appropriate population for thetraditional drug court docket.

Determine whether alternative dockets areappropriate for drug court.

If so,What are appropriate alternative dockets look like?How do you determine who is appropriate foralternative dockets?What services should be offered in each docket?

Alternative Dockets

Mental Health Court

DWI Court

Veteran’s Court

Family/Juvenile Treatment Court

Alternative Drug Court Tracks

Traditional Drug CourtTen Key Components

Eighty percent of offenders have substanceinvolvement.

One-half to one-third meet the criteria forsubstance abuse or dependence resulting in aseven-fold increase in continuing to engage inpattern of criminal offending.

The goal is to match drug offenders to dispositionsthat balances cost, public safety and the welfare ofthe offender.

Traditional Drug Court

Research indicates which type of adult offendersare most in need of the full complement ofservices embodied in the Ten Key Components.

However, many low need low risk offenders wouldhave no alternative to incarceration if access to adrug court program is denied.

As a result, it becomes important to designdifferent tracks to accommodate the low risk lowneed offender.

Assessment of Risks andNeeds

Three basic factors:Risk of DangerousnessPrognostic RisksCriminogenic Needs

Predicts the most effective and cost-efficientdisposition

Risk of Dangerousness

Goal: “To protect citizens from violent orpredatory offenders.”

Restrictive dispositions

Eventually released back into the community

Step-down for continued supervision

“Max’ed out” No authority to monitor andcontrol behavior.

Prognostic Risks

Characteristics of offenders that predict pooreroutcomes in standard rehabilitation programs:

Risk: Not a risk for violence or dangerousness,rather a risk of failing to respond to standardinterventions, and for continuing to engage in thesame level of drug abuse and crime as in the past.

The higher the risk – More intense services

Prognostic Risk FactorsYounger age

Male

Early onset of substance abuse or delinquency

Prior felony convictions

Unsuccessful attempts at treatment orrehabilitation

Co-existing of antisocial personality disorder

Antisocial peers or affiliations

Criminogenic Needs

Clinical disorders or functionalimpairments that, if ameliorated,substantially reduce the likelihood ofcontinued engagement in crime.

Criminogenic Needs

Substance Dependence or Addiction

Bing PatternCravings or compulsionWithdrawal symptoms

Abstinence is a distal goal

Criminogenic Needs

Substance Abuse

o Compliance is a proximal goal

Collateral needso Dual diagnosis

o Chronic medical conditions (HIV, diabetes)o Homelessness chronic unemployment

Shaping

Principle governing effective behavioral change

Proximal Goals: Behaviors clients are alreadycapable of engaging in and that are necessaryfor long term change.

Distal Goals: Behaviors that are the behaviorsthat ultimately desired, but may take some timeto accomplish.

Responses

The magnitude or severity of the sanctionshould be higher for proximal behaviors andlower for distal behaviors.

Low-level sanctions for failing to fulfill easyobligations can lead to habituation – theoffender becomes accustomed to beingpunished.

Can make behavior worse.

Responses

High magnitude sanctions for failing to meetdifficult demands that are beyond hiscapabilities can lead to hostility, depressionand a disruption of the therapeuticrelationship.

Ceiling effect: Once options have beenexhausted further efforts to improve behaviorwill be extremely challenging.

Quadrant OneHigh Risk/High Need

Drug or alcohol dependence

Severe mental illness

Deficiencies in adaptive functioning

Poor prognosis for success in standardtreatment or rehabilitation

High Risk/High Need

Negative risk factors:Early onset of delinquency or substanceabuseAntisocial personality traits

Previous failures in rehabilitationPreponderance of antisocial peers

High Risk/High Need

Status Calendar

Intensive TreatmentAmeliorate cravings and withdrawalsymptoms

Concrete skills to resist drugs and alcoholCoping strategies to deal with life’s stressors

High Risk/High Need

Compliance is proximal for basic supervisionrequirements:

Showing up for treatment or UA

Failing to appear for Court

Tampering with urine samples

Restrictive consequences: Most of these offendershave habituated to punishment and will engage insubstance abuse despite negative consequences.

Positive reinforcement can cultivate pro-socialbehaviors that can compete against substanceabuse.

Responses

Positive Reinforcement: The offender can beexpected to return to substance abuse unlesshas found a new job developed hobbies,cultivated healthy social relationships, orengaged in other pro-social activities.

Put feeling aside and offer rewards for engagingin good behaviors that portend better long-term adjustment.

Responses

Agonist Medications

Allows addicted individual to function safely andeffectively while performing daily chores androutines.

Methadone – Buprenorphine -

Quadrant TwoLow Risk/High Need

Drug/Alcohol dependence

Severe mental illness

Poor adaptive skills

Does not have negative risk factors that wouldpredict a poor response to standard treatment.

Low Risk/High Need

Noncompliance Calendar:They should focus energies on treatment. However, ifthey fail to attend treatment there should be a swiftcourt consequence.

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

Clean drug tests are distal:Early on dirty tests should be met with a more intensemodality of care.

Low Risk/High Need

Positive reinforcement: This population hasalso experienced a ceiling effect or habituationto punishment. Therefore it is important touse positive reinforcement.

Agonist Medications

This population can perform adequately inprobation-without-verdict dispositions.

Quadrant ThreeHigh Risk/Low Need

Does not have drug or alcohol dependence, severemental illness or deficient adaptive skills.

Has negative risk factors for failure in traditionalcorrectional rehabilitation programs:

Antisocial character traitsPrior failures on supervision

Deviant peer affiliations

High Risk/Low Need

Status Calendar

Pro-social Rehabilitation: Focus on altering theoffenders’ distorted perceptions, think beforethey act and consider the consequences of theiractions and build empathy for others.

Vocational preparation

Education

High Risk/Low Need

Abstinence and compliance are proximal

Low-level sanctions are merely “the cost ofdoing business”

Higher magnitude sanctions should beadministered at the outset to rapidly squelchsubstance abuse.

Higher level of response for noncompliancewith other basic requirements

High Risk/Low Need

Restrictive Consequences for failure to complywith supervision may require restrictiveconsequences to protect public safety. Theseresponses may include in-home-detention,EMP

Antagonist Medications: Block the effects ofillicit drugs while providing no intoxication oftheir own.

No treatment

Quadrant FourLow Risk/Low Need

Naïve to criminal justice system and the substanceabuse treatment system.

Do not suffer from addictions or other impairments

Do not have negative risk factions that would portendfailure in standard interventions.

Noncompliance docket

Prevention services

Abstinence is proximal

Adjusting Tracks

No assessment took is perfectly reliable andvalid

A participants subsequent performance in theprogram should serve as a guide for adjustingthe conditions of the program.

Adaptative Interventions: Pre-specified criteriafor determining when and how to adjustservices in response to participant’sperformance.

Mental Health Court

Generally appropriate for the severely andpersistently mentally ill offender.

This population generally suffers from anAxis I disorder.

These offenders are unable to maintain a stablelife style without significant assistance, andtherefore would be unable to complete therequirements of a traditional drug courtdocket.

Mental Health CourtEligibility

Who?

Axis I?

Personality disorders?

Low functioning?

Head injury?

What resources do you have?

Program Requirements

Maintain stability in order to completeprobation.

Develop access to resources in order to maintainstable life after completing the program.

Expectations may be tempered by a realizationthat this population may not be able to completethe requirements of traditional drug court.

Individualization is critical.

DWI Court

The DWI offender often scores low onrisk/need assessments, yet presents a significantpublic safety risk.

Offenders generally do not have otherinvolvement in the criminal justice system.

This population seems to do better with standalone treatment and court dockets.

Additional Dockets

Veteran’s Court

Family Dependency Treatment Court

Juvenile Drug Court

Breakout Session Group One

Traditional Drug Court: Quadrant One - HighRisk/High Need

Eligibility criteria.

Program structure.

Review responses to behaviors. (considerproximal and distal goals)

Breakout Session Group Two

Drug Court Alternative Track: Quadrant TwoLow Risk/High Need

Eligibility criteria.

Program structure.

Responses to behaviors. (consider proximaland distal goals)

Breakout session Group Three

Alternative Drug Court Track: Quadrant ThreeHigh Risk/Low Need

Eligibility criteria.

Program structure.

Responses to behaviors. (consider proximaland distal goals)

Breakout Session Group Four

Alternative Drug Court Track: Quadrant FourLow Risk/Low Need

Eligibility criteria.

Program structure.

Responses to behaviors. (consider proximaland distal goals)

Breakout Session Group Five

Additional tracks:

Identify possible additional tracks, such as mentalhealth 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 allprograms?

Breakout Session Group Six

Adaptive Interventions:

Develop a set of guidelines that will trigger anadaptive intervention. For example, missing apre-determine number of counseling sessionsmight trigger a reassignment to another docket.Consider alternate drug court tracks, and otheroptions such as mental health court, DWIcourt.