99/189 THINGS TO CONSIDER • Least Restrictive Environment • Cost (to taxpayers) • Time • Duplication of Services • Treatment effect vs Setting effect • Non- Compliance is different than an Inability to Comply 17 MEDICATION ASSISTED TREATMENT Medication-assisted treatment (MAT) refers to the use of medications and behavioral therapy to treat severe substance use disorders Uses Opioid use disorders Alcohol use disorders Medication along with treatment Helps to normalize brain chemistry by blocking the effects of alcohol and opioids Reduces physical cravings and helps treat withdrawal symptoms 18 CACJ New Judges Orientation
3 FDA APPROVED MEDICATIONS 100/189 Naltrexone Methadone Buprenorphine Methadose, Dolophine Sublocade Belbuca, Subutex, Butrans ReVia,Vivitrol, Depade Agonist Antagonist Aka Mixed Ingredient with Naloxone: Suboxone, Zubsolv, Bunavail, Cassipa Partial agonist Medically supervised Medically supervised Prevention of relapse withdrawal, withdrawal, to opioid misuse, maintenance maintenance following medically supervised withdrawal OUD medications reduce illicit opioid use, retain people in treatment, and reduce risk of opioid overdose death better than treatment with placebo or no medication. 19 CACJ TREATMENT SERVICES • Monitoring and evaluation for program effectiveness • Technical Assistance • Comprehensive Interdisciplinary education • Partnerships with stakeholders 20 CACJ New Judges Orientation
101/189 STATEWIDE MAT COORDINATOR Serves all of Georgia’s adult accountability courts Responsible for Implementation and Expansion of MAT Identification of and connection to MAT resources Coordinates educational training presentations Provides technical assistance virtually or in person 21 EVIDENCE BASED TREATMENT FIDELITY Facilitators are trained to deliver interventions reliably according to the manual Fidelity to the treatment model is maintained through continuous supervision of the treatment providers Recidivism rates are decreased when the program is implemented as designed 22 CACJ New Judges Orientation
102/189 MODEL FIDELITY SITE VISITS 1 month prior to visit (Coordinator, Group facilitator, and Judge will be emailed) Coordinator/Group facilitator will be asked to provide a detailed schedule of evidence-based classes(calendar format per phase is helpful) Copies of licensure/certification of all treatment providers should be emailed/or faxed Copies of all evidence-based curricula certificates should be emailed/faxed A reminder email will go out to the court team two weeks prior to fidelity visit with the date(s) and time(s) of visit Treatment fidelity monitor/manager will review visit with group facilitator directly after group (15-30 minutes) 23 VIRTUAL AND ON-SITE VISITS Virtual visit will be conducted with camera and sound off as to not disrupt group On-site visit will last one or two days, depending on evidence-based treatment schedule During both Visits: evidence-based groups will be observed Feedback will be provided immediately after groups Formal Report will be generated within one month of the site visit and emailed to the coordinator, judge and group facilitator(s) 24 CACJ New Judges Orientation
103/189 COUNCIL OF ACCOUNTABILITY COURT JUDGES TREATMENT SERVICES “State Standards require that accountability courts deliver evidence-based treatment to program participants. CACJ is committed to assisting all certified and state-funded accountability courts with implementing evidence-based treatment”. www.cacj.georgia.gov 25 QUESTIONS 26 CACJ New Judges Orientation
104/189 RESOURCES Judicial Bench Book https://www.ndci.org/sites/default/files/nadcp/14146_NDCI_Benchbook_v6.pdf MHC Essential Elements https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/MHC_Essential_Elements.pdf National Drug Court Institute https://www.ndci.org/wp-content/uploads/C-O-FactSheet.pdf National Association of Drug Court Professionals https://www.nadcp.org/ Council of Accountability Court Judges https://cacj.georgia.gov/ Georgia Department of Corrections www.dcor.state.ga.us 27 CONTACT INFORMATION TARA ZELLOUS, LPC, NCC, CADCII, CPCS TREATMENT SERVICES MANAGER COUNCIL OF ACCOUNTABILITY COURT JUDGES (678) 836-3273 [email protected] 28 CACJ New Judges Orientation
105/189 Court Staffing and Court Session Structure Currie Mingledorff, Judge Superior Courts Piedmont Judicial Circuit CACJ New Judges’ Training August 15, 2023 1 My frame of reference: ������ Felony Drug Courts ������ Mental Health Courts But the principles I will discuss apply to ALL accountability courts. 2 CACJ New Judges Orientation
106/189 3 Hon. Jeffery S Bagley, Chief Judge Bell-Forsyth Judicial Circuit Former Board Member, National Association of Drug Court Professionals (All Rise) 4 CACJ New Judges Orientation
107/189 The Accountability Court Paradox ������ ... the [accountability] court judge’s challenge [is]to maintain judicial independence while, at the same time, recognizing and participating in a coordinated team approach, which is vital to the… [program’s] success. Judge Bagley 5 Understanding Judicial Independence - the challenge ������ Judges Shall Uphold the Independence, Integrity, and Impartiality of the Judiciary…. Code of Judicial Conduct, Canon 1 ������ “[J]udicial independence is in jeopardy of being compromised in a drug court because drug court judges... may be pressured to make... decisions based upon a majority vote of the drug court team members…. [T]he judge must remain steadfast in the decision-making process and not permit the team to exert unnecessary pressure and effectively invade the province of the judiciary.” Judge Bagley 6 CACJ New Judges Orientation
108/189 Understanding Judicial Independence ������ “The drug court judge ... is endowed with the power of the judiciary and the accompanying duty to keep such power separate from the other branches of government.” ������ So, “[d]ecisions regarding sanctions and incentives are made by the team, with the final decision reserved for the judge.” ������ “By adopting... policies and procedures, the judge, having consented to those policies and procedures, is able to maintain [his/her] independence because (s)he is satisfied with the rules and procedures such that when a violation occurs, and it is covered by a rule, the judge has already [generally] approved the appropriate [range of] sanction[s].....” Judge Bagley 7 The Sanction Grid: Understanding Judicial Independence ������ The team must be confident in its ability to reach a consensus and have some expectation that it will be followed by the judge in order for the program to work. The judge, on the other hand, cannot delegate judicial responsibility by permitting final decisions to be made by the team. Judge Bagley (citation omitted) ������ Suggestion - Consider adopting a grid that builds in the understanding that the Court might mitigate or aggravate (up to 50%) either way, depending on the context. 8 CACJ New Judges Orientation
109/189 9 10 CACJ New Judges Orientation
110/189 Best Practice Standards Grounded in more than 30 years of research, best practice standards are the blueprint to create the most effective treatment court programs. The Adult Drug Court Best Practice Standards, published by All Rise, and the Family Treatment Court Best Practice Standards, published through a partnership between All Rise and Children and Family Futures, provide practitioners with the standard elements needed to create desired outcomes in their treatment court. While these rigorous standards are currently only available for adult drug courts and family treatment courts, they have application for all programs. www.allrise.org 11 In order to be effective…. ❏ the accountability court judge has to be fully engaged in every aspect of the mission, purpose and function of the court; ❏ stay current; and ❏ truly lead. 12 CACJ New Judges Orientation
111/189 Precursors to successful Staffing and Court Sessions ������ Training, training, training (Especially you, Judge!) ������ Knowing who to target ������ Staying abreast of research and best practices ������ Trends in designer drugs (Tall Cop) ������ Current recommendations for incentives, sanctions and therapeutic (service) adjustments ������ Some of these are moving targets 13 Staffing - fundamentals ������ Confidential - not like the open court sessions ������ Have Confidentiality Agreements for all Team members (See The Drug Court Judicial Benchbook (2017 Update), Section 9 for helpful discussion and sample forms) – (CHECK YOUR E-MAIL GROUP) ������ Insist that ALL team members participate ������ Correlates to higher cost savings and lower recidivism ������ Ex parte communication is just as much a “no no” in accountability courts as anywhere else ������ (But see, Georgia Code of Judicial Conduct, Updated 10/25/2018 Canon 2, Rule 2.9(A)(b)(5) Judges may initiate, permit, or consider ex parte communications when authorized by law to do so, such as when issuing temporary protective orders, arrest warrants, or search warrants, or when serving on therapeutic, problem-solving, or accountability courts, including drugs courts, mental health courts, and veterans’ courts. 14 CACJ New Judges Orientation
112/189 Staffing - fundamentals ������ Because Staffing Time is limited... ������ Coordinator should communicate pre-staffing report with the whole Team ahead of time by email (but remember confidentiality) ������ Avoid conducting major policy discussions at staffing ������ quarterly brown-bag lunches ������ as policy issues come up, add them to a list of agenda items for your next policy meeting ������ Your entire Team should have copies of your policies and procedures, including sanction grid ������ Entire Team should attend. Missing team members = higher recidivism, lower cost savings 15 Staffing ������ Judge - don’t be the first to suggest a solution ������ Where appropriate, take time to teach a principle - (like, brief jail sanctions are more effective than longer ones, and why) ������ Ask the opinion of the team member who is NOT talking ������ Listen to the Team ������ Make sure they know you are hearing them ������ Remind them that ultimately your final decision comes only after you have spoken to the participant (See, The Drug Court Judicial Benchbook Section 10.2) ������ Keep it moving, within reason ������ Invite Defense Counsel, who is NOT regular Team member, to attend for that portion of staffing that involves their client (Make it as convenient as possible.) 16 CACJ New Judges Orientation
113/189 Staffing: Knowing who to target ������ Part of staffing is devoted to considering referals ������ Requires a Risk/Need Assessment ������ Make sure you have a Level of Service - Case Management Inventory (LS-CMI) (or equivalent) ahead of time ������ Apply it honestly ������ NEVER mix lower risk need offenders with higher risk/need offenders - You do not want to make someone worse! 17 Considerations for Admission ������ “Risk” means risk of committing new crimes (recidivism risk) ������ Drug offenses ������ Property offenses ������ Forgery, theft, etc…. ������ “Need” refers to treatment need and need for basic resources ������ None or little family support, ie, BRIDGES BURNED ������ No Job ������ No Drivers license ������ Lacking education, etc… 18 CACJ New Judges Orientation
114/189 Who CANNOT participate? (Objective standards) ������ Legally screened out, using objective standards by ADA: ������ Drug Traffickers ������ Dealers vs Dealers ������ Offenders with significant violence, gang members ������ Sex offenders ������ But D.A. has NO ABSOLUTE VETO (Don’t forget- Separation of Powers/Judicial Independence) ������ If person legally screens in but D.A. cannot agree to their participation, a non negotiated, (“blind”) plea is the best way to handle that. Let the chips fall... 19 Other considerations for admission ������ The home check – What does surveillance see/say? ������ Objective standards!!!!!!! ������ Has the sheriff been making undercover drug buys there? ������ The Treatment recommendation ������ Is your court supervised, outpatient program a good match for your client’s treatment needs? ������ Do they need long term in-patient treatment first/instead? ������ Other Team/staff input 20 CACJ New Judges Orientation
115/189 Sanctions, incentives and service adjustments ������ Incentives to sanctions = 4:1 ratio ������ Be creative – lots of ideas at NDCI.org ������ For sanctions, make sure you leave yourself plenty of room to incrementally increase ������ Responses to conduct should be swift and certain ������ Jail has diminishing returns ������ Best practices says 5 days max ������ Short bursts, most effective ������ Ask yourself, if you have exhausted all options before terminating anyone 21 Do you have all the information you need to respond effectively? H 32 22 CACJ New Judges Orientation
116/189 Court Sessions ������ Practice Procedural Fairness ������ listening and reflecting back ������ applying incentives, sanctions and therapeutic (service) adjustments consistently ������ explaining your rationale (for everyone!) 23 Court Sessions ������ The judge presides and is the predominant voice ������ Team members chime in where appropriate ������ The courtroom becomes a classroom ������ In 3-7 minutes the judge seeks rapport ������ listens and reflects back ������ Asks about their recovery progress ������ applies incentives, sanctions and therapeutic (service) adjustments consistently ������ explains rationale (for everyone!) ������ Ends on a positive, hopeful note 24 CACJ New Judges Orientation
117/189 Court sessions - 3 minutes seems like a long time! ***What’s on your mind today?*** ������ Get Treatment to suggest talking points ������ “What kind of thought went into your decision to change jobs? How is this different than how you made decisions in the past” ������ “I understand that in your Seeking Safety class you have talked about never giving up and keeping commitments. In what ways to you feel like you are improving in these areas? Can you share a few ways you have been able to honor commitments since you’ve been in this program?” ������ “What step are you working on in MRT? Tell me about that step. How does it apply to you?” ������ “When making big decisions, why is it important to look at the steps of problem solving and come up with as many solutions as possible?” ������ “When someone else is involved in a problem, why is it important to keep their feelings in mind when discussing the problem?” Can you share an example? ������ “Tell me about your relapse prevention plan.” 25 Court sessions - 3 minutes seems like a long time! ***What’s on your mind today?*** ������ “What have you been pondering about that you heard in a recent recovery support meeting? How are you applying that to yourself?” ������ “What do you consider to be your biggest challenge to successful long-term recovery? How are you addressing that challenge?” ������ In CBI you talked about problem-solving. Tell me about the ‘problem-solving wheel’ and share some of your thoughts about what a person should do if their first choice doesn’t work.” ������ “Give me an example of a long-term goal you have, and tell me what you have done to break that goal into bite-sized manageable steps.” ������ “What are you working on right now?” ������ “What are some signs you might notice if your medication is no longer working like it should for you? Please turn around and talk to our friends about what they should do if they discover their medication is no longer working for them?” 26 CACJ New Judges Orientation
118/189 Court sessions - 3 minutes seems like a long time! ***What’s on your mind today?*** ������ “What have you been pondering about that you heard in a recent recovery support meeting? How are you applying that to yourself?” ������ “What do you consider to be your biggest challenge to successful long-term recovery? How are you addressing that challenge?” ������ In CBI you talked about problem-solving. Tell me about the ‘problem-solving wheel’ and share some of your thoughts about what a person should do if their first choice doesn’t work.” ������ “Give me an example of a long-term goal you have, and tell me what you have done to break that goal into bite-sized manageable steps.” ������ “What are you working on right now?” ������ “What are some signs you might notice if your medication is no longer working like it should for you? Please turn around and talk to our friends about what they should do if they discover their medication is no longer working for them?” 27 Court sessions – communicate clearly ������ Motivational Interviewing - OARS ������ O – Open-ended questions ������ Avoid questions they can answer simply “yes” or “no” ������ A – Affirmation ������ Notice and praise progress (even slight progress!) ������ R – Reflective listening ������ “Give me come more details about…” ������ S – Summarizing ������ “What I hear you saying is….” 28 CACJ New Judges Orientation
119/189 Court sessions – seek thoughtful responses ������ Scaling Questions ������ “On a scale of 1-10 how important do you think it is for you to broaden your support network?” ������ “Why?” ������ “On a scale of 1-10 how confident are you that you have mastered anger management?” ������ “What skill do you plan on practicing to make it less likely you will have a problem next time someone makes you mad?” 29 Court sessions – what if…? ������ Joe participated in sober Frisbee golf, but was also late for curfew ������ Does a sanction trump an incentive? ������ Is it possible to give both to the same participant on the same day? ������ Won’t that just confuse everybody? 30 CACJ New Judges Orientation
120/189 Receiving Both an D Incentive and a Sanction? Yes! ➢ We never miss an opportunity to reinforce positive behavior – even if other things went wrong • We will carefully explain WHAT behaviors we are responding to • What do we want the participant to learn? Is our response the best way to teach it? We avoid confusion by being SPECIFIC and helping clients see how change helps THEM achieve THEIR goals! 31 Court Sessions – Effective, ������ Court reporter - ������ Have one! ������ If no court reporter - have waiver in participant contract ������ The record is your friend! ������ Sanction Hearings - ������ Do them when needed. (Not needed very often.) ������ Termination hearings - ������ are conducted separately (like probation revocation hearings) ������ To recuse or not recuse? ������ Most do not recuse; have participant waivers in contract ������ I choose to recuse; personal preference (See The Drug Court Judicial Benchbook for a great discussion about transference and countertransference, p. 204. In short, some participants are more “likeable” than others. Teams should seek training on recognizing bias in ourselves and others.) 32 CACJ New Judges Orientation
121/189 EFFECTIVE DELIVERY SCRIPTS WHAT, WHY & HOW ©Hon. Diane Bull [email protected] 33 Who do you see? 34 CACJ New Judges Orientation
122/189 Who do you see? ������ Do you see - ������ sorry drunk? ������ a moral failure who will never amount to anything? ������ a career criminal? ������ Or, do you see - ������ the grieving child who was doing fine until age 11, when his parents’ divorced ������ a young man who, as a child, saw his mother unexpectedly collapse and die while standing in the front yard waiting for the school bus? ������ a young woman who grew up with parents who were untreated addicts and/or mentally ill? ������ a man or woman who grew up with rampant domestic violence ������ an individual who, as a child, was sexually abused over many months/years 35 Who do you see? ������ ´The former high school quarterback who got hurt then got hooked on pain pills ������ ´The middle aged housewife who injured herself in a household accident and got hooked on pain pills ������ ´Former state-champion wrestler who discovered meth helped him stay within his weight class ������ ´The otherwise shy kid who found that he was no longer shy when he used alcohol ������ ´The man in his 40s, whose mother took advantage of a great business opportunity, leaving him unsupervised at age 15 ������ ´The young woman whose father was in the business of manufacturing methamphetamine and gave her a first drink of alcohol when she was 8 years old 36 CACJ New Judges Orientation
123/189 Who do you see? ������ Or, do you see them for who they can become - ������ a successful mother or father? ������ a valuable employee who excels at work ������ a successful business man or woman? ������ a future recovery counselor? ������ a future accountability court team member? ������ Remember - mental illness and/or addiction affects generations, but so does recovery! ������ Can you see it? If not, look harder! 37 Never forget: But for the grace of God… ������ Go you, or I, or ������ Anyone we love 38 CACJ New Judges Orientation
124/189 What is the Secret Ingredient? ������ LOVE. West Huddleston, Recovering Alcoholic, Former CEO, National Association of Drug Court Professionals (Now 39 For more information: Ms. Victoria Bowman – Director, Piedmont Specialty Courts 770 307-3000 ext. 4963 678 664-9854 [email protected] Currie Mingledorff 770 867-1162 (770) 868-9163 (cell) [email protected] Special Thanks: Hon. Diane Bull, Ret. https://www.facebook.com/groups/TreatmentCourt 40 CACJ New Judges Orientation
125/189 Referral, Screening and Assessment in Accountability Courts Kevin Baldwin, Ph.D. Applied Research Services, Inc. Atlanta, GA 1 The Funnel Process All Potential Participants All Referrals Participants Graduates Productive, Healthy Community Members 2 CACJ New Judges Orientation
126/189 Referrals to Accountability Courts Establish clear referral criteria that focuses on your target population and is based on: • The type of court • Availability and nature of community-based services and court resources • Risk and Needs profile (moderate to high on both) • Specific jurisdictional characteristics and issues • Maximizes access and fairness 3 Referrals to Accountability Courts • Cultivate referral sources such as: – Law enforcement and community corrections – Attorneys – Clinicians (community and hospital-based) – Other judges – Community social service providers – Family members • Provide online referral options and forms, and ensure that your referral process is as simple and transparent as it can possibly be 4 CACJ New Judges Orientation
127/189 The Purpose of Screening and Assessment • Our clients are complex, multifaceted individuals with unique histories and experiences • We work with people, not disorders • If we are to help our clients live healthier, crime- free lives, we need to take the time to accurately identify the nature of their presenting problems and the impacts they have on their lives and communities 5 Screening • Screening is a process whereby we asses the likelihood that an individual presents with one or more disorders or characteristics • The results of screening tell us where to point the shovel so we can dig deeper with specific assessments 6 CACJ New Judges Orientation
128/189 Assessment • Assessment is an ongoing process whereby we dig deep to more fully understand what specific issues, characteristics, and disorders our clients are presenting with • The results of assessment tell us what type and how much (both intensity and duration) treatment will be needed to adequately address the issues 7 A Framework for Assessment and Treatment • It helps to have a framework or model to organize our assessment and treatment efforts • In the mental health field we have a number of treatment modalities or theoretical orientations, such as Cognitive Behavioral Therapy, the Addiction Model, and the Ecological Model 8 CACJ New Judges Orientation
129/189 The RNR Model • The Risk/Needs/Responsivity (RNR) Model of offender assessment and rehabilitation • Developed by Bonta and Andrews • Preeminent model of offender rehabilitation since it was first developed in the 1980s; very well-researched • Programming needs to be targeted according to offender risk, it must address specific criminogenic needs, and it must maximize the responsivity of participants 9 The RNR Model It is important to assess: •Risk •Needs •Responsivity These form the RNR Model 10 CACJ New Judges Orientation
130/189 The Risk Principle • Match the level of a person’s risk to the level of intervention or treatment. The higher the risk, the more intensive and longer the treatment required. 11 The Needs Principle • Intervention efforts should be directed at specific criminogenic needs • Needs are dynamic issues that drive criminal behavior and are the focus of intervention, such as mental health issues and substance abuse 12 CACJ New Judges Orientation
131/189 The Responsivity Principle • Responsivity refers to the degree to which the client can effectively participate in and benefit from (that is, respond to) treatment and intervention efforts 13 The RNR Model When you measure these three factors using valid & reliable tools, you will have the baseline knowledge about your clients’ risk and needs to apply your intervention or treatment 14 CACJ New Judges Orientation
132/189 The RNR Model The more criminogenic needs you address in your courts, the greater the reduction in recidivism that you will realize; likewise, the greater the fidelity to the key components, the greater the reduction in recidivism and the greater the cost effectiveness 15 RNR Measures • Level of Service Inventory – Revised (LSI-R) • Level of Service – Case Management Inventory (LS-CMI) • Short-Term Assessment of Risk and Treatability (START) 16 CACJ New Judges Orientation
133/189 Substance Abuse Measures • Addiction Severity Index (ASI) • Texas Christian University Drug Screen V (TCUDS V) • Subtle Substance Abuse Screening Inventory – IV 17 Mental Health Measures • Brief Jail Mental Health Screen (administered in jail or at first appearance) • Symptom Checklist-90-R (SCL-90-R) • MMPI, PAI, MCMI and their relatives • Brief Symptom Inventory (BSI) • Beck Depression Inventory (BDI) • Beck Anxiety Inventory (BAI) • Trauma Symptom Inventory • PTSD Diagnostic Scale 18 CACJ New Judges Orientation
134/189 Co-occurring Disorders • A condition in which a person experiences a mental illness and a substance use disorder simultaneously • A very broad category and extent of disorders, ranging from someone with mild, situational depression due to their substance abuse all the way to a person with bipolar disorder who uses meth during acute episodes of mania. 19 Co-occurring Disorders • One study found that about 80 percent of individuals on probation and sentenced to participate in substance abuse treatment have co-occurring mental disorders (Hiller, Knight, Broome, & Simpson, 1996) • In another study, fully half of justice- involved women had co-occurring disorders (Jordan, Schlenger, Fairbank, & Caddell, 1996) 20 CACJ New Judges Orientation
135/189 Co-occurring Disorders • Other studies have found that between 72 and 87 percent of justice-involved individuals with severe and persistent mental illness (SPMI) have co-occurring substance use disorders (Abram & Teplin, 1991; Abram, Teplin, & McClelland, 2003; Chiles, Cleve, Jemelka, & Trupin, 1990; James & Glaze, 2006). 21 Co-occurring Disorders • Despite high rates of COD, relatively few justice-involved individuals report receiving adequate treatment services for these disorders in jails, prisons, or other justice settings (National GAINS Center, 2004; Peters, LeVasseur, & Chandler, 2004). • According to anecdotal reports from a number of judges, if you think you aren’t seeing these cases, you are mistaken. 22 CACJ New Judges Orientation
136/189 Trauma • According to SAMHSA, trauma can be considered a universal experience among justice-involved persons – male and female • The ACE Study – illuminated the role played by trauma in later life risky behaviors, health conditions, and general well-being • Assess for trauma, provide for trauma services and provide trauma-informed experiences in your courts and facilities 23 One Population, Many Courts • I’ve worked with practically every kind of accountability court that exists, from adult drug courts to a prostitution court • Irrespective of the type of court, participants across all these courts are very similar to one another in terms of their presenting issues • The underlying commonality is trauma, which begets mental health and substance abuse issues, lifestyle instability, criminality, etc. 24 CACJ New Judges Orientation
137/189 How do we use test results? • To specify level, type of treatment indicated (in line with the risk and needs principles) • To provide information regarding issues that should be addressed in treatment (e.g., depressive and/or anxious symptoms, suicidality) 25 How do we use test results? • To indicate the need for trauma-focused and trauma-informed interventions for both male and female participants – don’t underestimate the prevalence of trauma and the need to address it consistently and clinically • To address the complexity inherent in the treatment of co-occurring disorders 26 CACJ New Judges Orientation
138/189 How do we use test results? • To select among a range of Evidence- Based Practices (EBPs) so we can apply what research demonstrates works to a population and in a setting where we are most likely to get the intended outcomes – what works for whom, when, and under what circumstances 27 From Referral to Entry • The CACJ standard for time from referral to entry into the court is 30 days (The less time in jail awaiting court entry the better) • This is the most common issue found on peer reviews • Programs really struggle with this, and it is important to remember that this is an aspirational standard 28 CACJ New Judges Orientation
139/189 RNR Model Theory of Change 29 1. Reliably and 2. Match Degree of Accurately Identify Risk to Treatment Degree of Risk and Setting and Intensity Criminogenic Needs of Intervention 6. Use Data to 3. Apply Evidence Inform a Process of Based Practices Continuous Quality (EBPs) to Targeted Improvement (CQI) Criminogenic Needs 5. Continually Assess 4. Continually Degree to Which Monitor and Assure Program Objectives Fidelity of are Achieved Implementation Applied Research Services, Inc. – RNR Model Theory of Change – 2016 – www.ars-corp.com 30 CACJ New Judges Orientation
140/189 Maximizing Access and Fairness • Regularly examine your processes by looking at these groups: – All similar defendants in your court – All referrals – All participants – All graduates • Examine demographics and other characteristics – how dissimilar are the groups, and are there bottlenecks that prevent access or progress? 31 Resources SAMHSA’s Center for Substance Abuse Treatment (CSAT) Treatment Improvement Protocol (TIP) Series – e.g., TIP 7, Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System. This and all the other TIP volumes are excellent and free of charge. 32 CACJ New Judges Orientation
141/189 Resources The SAMHSA GAINS Center https://www.samhsa.gov/gains-center The Council of State Governments Justice Center https://csgjusticecenter.org/mental-health/ 33 Resources SAMHSA HRSA Center for Integrated Health Solutions: https://www.integration.samhsa.gov/ clinical-practice/screening-tools SAMHSA/CSAT Treatment Improvement Protocol (TIP) Series: https://www.ncbi.nlm.nih.gov/books/ NBK82999/ 34 CACJ New Judges Orientation
142/189 Kevin Baldwin, Ph.D. Applied Research Services, Inc. [email protected] 770-286-8312 www.ars-corp.com Presented at: 2023 New Accountability Court Judges Training 35 Visit our web site at www.ars-corp.com 36 CACJ New Judges Orientation
143/189 THERAPEUTIC JURISPRUDENCE How do we maximize the effect of Judicial Interaction Chief Judge Eddie Barker Joshua Nation, Clinical Director Douglas County State Court Douglas County Accountability Court Programs 1 THERAPEUTIC JURISPRUDENCE WHAT IS IT? 2 CACJ New Judges Orientation
144/189 Unlike traditional judges functioning in traditional courts, judges in problem solving courts consciously view themselves as therapeutic agents, and, therefore, one can see them as playing a therapeutic jurisprudence function in their dealings with the individuals who appear before them. Fordham Urban Law Journal, Vo. 30|Number 3, 2003, Bruce J. Winick 3 Judges develop an Therapeutic Jurisprudence and the Drug Treatment Court ongoing working movement. Revolutionizing the Criminal Justice System’s Response relationship with the to Drug Abuse and Crime in America. Participant and “this one- on-one relationship tends Hon. Peggy Fulton Hora to facilitate honesty Hon. William G. Schma through familiarity and Jon T.A. Rosenthal permits a DTC Judge to become a powerful motivator for the offender’s rehabilitation.” 4 CACJ New Judges Orientation
145/189 The judge, using the power and authority of the court, provides the addict with the initiative to stay in treatment. Without judicial leadership involving active monitoring of an offender’s recovery, a DTC would not work. “Rather than moralize about an addict’s character flaws, the Judge must assume, according to Judge Tauber, ‘the role of confessor, task master, cheerleader, and mentor.’” 5 HOW DO WE MAXIMIZE THE EFFECT OF THE JUDICIAL INTERACTION? 6 CACJ New Judges Orientation
146/189 WHAT SHOULD YOU KNOW? ROLE OF THE JUDGE IN A TREATMENT COURT “The role of the Judge is to engage people in treatment, motivate them in treatment, and be willing to reengage them when they slip and fall and fail without doing blame.” American University, BJA A Technical Assistance Guide For Drug Court Judges on Drug Court Treatment Services Kushner, Peters and Cooper (2014) 7 8 CACJ New Judges Orientation
147/189 Judge Stephen V. Manley on How to Motivate Offenders 9 What exactly does evidence based mean and why does it matter? Evidence based treatment (EBT) is treatment that has undergone rigorous research studies and has been proven to be effective in addressing specific problems within a specific population when said treatment is implemented with fidelity. Evidence based practices (EBP) is the integration of the best available research, clinical expertise, client preference, ethics, and culture to guide the delivery of treatment and services. Best Practice is the generally accepted method or technique that is widely recognized as delivering superior results. Accountability Courts are expected to implement EBT and EBP while adhering to Best Practices. 10 CACJ New Judges Orientation
148/189 What evidence based treatments are we familiar with? Moral Reconation Therapy (MRT) Thinking 4 a Change (T4C) Cognitive Behavioral Interventions for Substance Abuse (CBI-SA) MATRIX Model Seeking Safety Partners for Change Outcome Management Systems (PCOMS) Illness Management and Recovery (IMR) Relapse Prevention 11 WHY SHOULD WE KNOW IT? WORKING RELATIONSHIP BETWEEN JUDGE AND TREATMENT Everyone is working toward the same goal and a good working relationship between treatment and the Judge will strengthen the interactions of participants with both. -Participants do better when they believe all parties are working toward their benefit -Participants are more engaged in group when they know they may have to discuss the lessons with the Judge -Participants attribute more credibility to both treatment and the Judge when they are being consistent with the message of recovery -Participant outcomes are strengthened when accurate and complete notes are entered into the Case Management System by treatment and staff 12 CACJ New Judges Orientation
