Matching Services to Client Needs in Drug Court

Treatment Research Institute, Inc. (Tri), Philadelphia PA

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): This is a competing continuation application for NIDA grant #R01-DA-13096, The Role of Judicial Status Hearings in Drug Court. The aims of this four-year study were to experimentally isolate the effects of judicial status hearings on drug court outcomes and to identify client characteristics that interact with status hearings. Results of a randomized controlled trial revealed no main effect of status hearings on counseling attendance, urinalysis results, official re-arrests and re-convictions, or self-reported substance use or criminal activity during drug court or at 6 months or 12 months post-admission. However, "high-risk" subjects who had Antisocial Personality Disorder or a prior failed history in drug abuse treatment performed more favorably when assigned to bi-weekly hearings, whereas "low-risk" subjects without these risk factors performed more favorably when assigned to as-needed hearings. With Supplemental support from NIDA and CSAT, we replicated several of these findings in two new jurisdictions in rural and urban communities. Unfortunately, we were required to stop the replication study prematurely because certain high-risk offenders were performing exceptionably poorly in the as-needed condition. As a result, the small Ns for the replication sample may not be representative of the target population and we do not have sufficient statistical power to follow up on some of the other findings or to conduct longer-term outcome analyses. It is essential to confirm these interaction effects in a fully powered study, to gain a better handle on how to explain these interaction effects, and to determine how best to exploit these effects for the benefit of drug court clients and drug court programs. We began implementing a prospective matching study to follow up on these findings. We expect to complete half of the recruitment before the current funding runs out and we are asking for three additional years of support to complete recruitment, follow participants for two years, and disseminate our findings. The Specific Aims are to evaluate the effects of matching drug court clients to the appropriate schedule of status hearings given their risk level; identify potential mediating or moderating variables that may explain the process by which status hearings exert their effects on outcomes; and identify other risk factors or matching variables that interact with judicial status hearings. We are the first research group to accomplish a randomized controlled study of status hearings in drug court and we have done so with high integrity of the experimental conditions in five different courts. We have highly trained staffs on-site at the courts; developed safe, ethical, and effective research procedures; and convened local Steering Committees comprised of the key drug court stakeholders to provide guidance to the projects. The goal of this application is to follow up on our extremely important and practical findings, to maintain this research infrastructure, and to continue conducting an unusually successful program of research with drug-involved criminal offenders.