Family Treatment Court Best Practice Standards: Laying the Groundwork

December 12, 20192:00-3:30 PM ET

Kirstin P. Frescoln, PhD, CPM, Senior Program AssociateBrooke O’Byrne, MBA, CADC, Senior Program Associate

Center for Children and Family Futures

2

Welcome and Housekeeping

Melissa Stein, DrPHSenior Research AssociateCriminal Justice Division

Policy Research Associates, Inc.

The views, opinions, and content expressed in this presentation and discussion do not necessarily reflect the

views, opinions, or policies of the Center for Mental Health Services (CMHS), the Center for Substance Abuse

Treatment (CSAT), the Substance Abuse and Mental Health Services Administration (SAMHSA), or the U.S. Department

of Health and Human Services (DHHS).

3

Disclaimer

4

Welcome Melissa Stein, DrPHSenior Research Associate, Policy Research Associates, Inc.

Opening Remarks Jon BergSenior Public Health Advisor, SAMHSA

Presentation Kirstin P. Frescoln, PhD, CPM Senior Program AssociateCenter for Children and Family Futures

Brooke O’Byrne, MBA, CADCSenior Program AssociateCenter for Children and Family Futures

Questions

Closing Remarks

Melissa Stein, DrPHSenior Research Associate, Policy Research Associates, Inc.

Agenda

5

Opening Remarks

Jon BergSenior Public Health Advisor

Center for Substance Abuse TreatmentSAMHSA

Introducing Today’s Presenters: Kirstin Frescoln, PhD, CPM

6

• Is a Senior Program Associate with Children and Family Futures where she supports implementation of Family Treatment Courts.

• Has more than 25 years experience developing, implementing, and evaluating community-based programs and policies to improve the health and well-being of vulnerable individuals and families, at the local, state, and federal level.

• Held previous positions as North Carolina Drug Treatment Court Manager; Senior Consultant for the National Drug Court Institute; Senior Research Associate with the University of North Carolina at Chapel Hill Center for Urban and Regional Studies; and Maternal, Infant, and Child Home Visiting Coordinator with the North Carolina Division of Public Health, Children, and Youth.

Introducing Today’s Presenters: Brooke O’Byrne, MBA, CADC

7

• Is a Senior Program Associate at Children and Family Futures, where she serves on the Change Team for two Prevention and Family Recovery Initiative sites (Mecklenburg County, NC and Jefferson County, CO).

• Has 12 years of experience in previous positions, including Director of Court Services for Nevada’s Sixth Judicial District Court and board chair of Nevada’s Rural Behavioral Health Policy Board.

• Founded her community’s first rural outpatient family-centered treatment facility.

• Is a Certified Drug and Alcohol Counselor and former director of a non-profit domestic violence organization.

Family Treatment Court Best Practice Standards

8 Standardsand Key Provisions

To obtain a copy or for more information:

Visit: www.cffutures.org

8

Download the Publication

Family Treatment Court (FTC) Best Practice Standards: Laying the Groundwork

December 12, 2019

Kirstin P. Frescoln, PhD, CPM, Senior Program AssociateBrooke O’Byrne, MBA, CADC, Senior Program Associate

Center for Children and Family Futures

10

Moving beyond guidance

FTC Best Practice Standards—Why They Matter

1. Improve practices and outcomes for children, parents, and families in family treatment courts.

2. Improve outcomes for all families involved with child welfare.

3. Direct state priorities and resources.

11

FTC Best Practice Standards Development

• Created advisory group and held kickoff eventJuly 2017• Reviewed existing literature from the FTC guidelines • Created matrix of effective strategiesAugust 2017• Developed first draft by advisory groupJanuary 2018• Reviewed matrix to further refine draft standardsNovember 2018• Peer and public review of draft standardsJanuary 2019• Review and edit process February 2019• Released September 2019

12

Family Treatment Court (FTC) Best Practice Standards

1. Organization and Structure

2. Role of the Judge

3. Ensuring Equity and Inclusion

4. Early Identification, Screening, and Assessment

5. Timely, High-Quality, and Appropriate Substance Use Disorder Treatment

6. Comprehensive Case Management, Services, and Supports for Families

7. Therapeutic Responses to Behavior

8. Monitoring and Evaluation

13

Family Treatment Court (FTC) Best Practice Standards

14

Structure of the FTC Best Practice Standards

Description – Each standard begins with a descriptive summary paragraph.Provisions – These expand on the description and are mandates stating what FTCs should do; they are designed to be as directive and measurable as possible.Rationale – Describes the reasoning and applicable research base for each provision, drawing upon both practice-based evidence and empirical studies from a wide range of related fields of study.

15

Structure of the FTC Best Practice Standards (cont’d)

Key considerations – These provide additional explanation of the provision and practical implementation advice.References – Theses are included at the end of each section.

16

Vulnerable children, parents, and family members require the intensive, collaborative efforts of child welfare,

the dependency court, treatment providers, and other community members to meet their complex

treatment and service needs.

No single agency has the skill or capacity to meet all of their needs.

1 – Organization and Structure

2Role of the

Judge

3Equity and Inclusion

4Early

Screening and

Assessment

5Timely, Quality

Treatment

6Case

Management

7Therapeutic

Behavior Response

8 – Monitoring and Evaluation

Family Treatment Court (FTC) Best Practice Standards

17

18

Standard 1

19

1. Organization and Structure: Provisions

20

1C: Multidisciplinary Team

A multidisciplinary team of professionals includes members from any agency that provides essential services for the

children, parents, and families served by the FTC.

21

1C. Multidisciplinary Team—2

• Judge• FTC coordinator• Child welfare agency/state’s

attorney• Parent’s attorney• Child’s attorney, guardian ad

litem and/or court-appointed special advocate

• Child welfare caseworker

• Substance use disorder (SUD) treatment provider

• Mental health treatment provider

• Child and adolescent services providers

• Health, educational, vocational, recovery and reunifications support, law enforcement, and probation

22

1C. Multidisciplinary Team—2

The attendance of key multidisciplinary operational team members at pre-court staffings and court review hearings helps produce positive outcomes and is part

of the core approach of drug courts.(Source: Carey, Mackin & Finigan, 2012)

23

Standard 2

24

2. Role of the Judge: Provisions

25

2C. Participation in FTC Pre-Court Staffing—1

• The judge attends the pre-court staffing along with the FTC coordinator, child welfare agency/state’s attorney, parent’s attorney, child’s attorney, guardian ad litem and/or court-appointed special advocate, child welfare social worker/caseworker, SUD treatment provider, mental health treatment provider, and children’s services providers.

26

2C. Participation in FTC Pre-Court Staffing—2

• Related health, education, and social service agencies may also participate in pre-court staffing, providing updates critical to the recovery and reunification of children, parents, and families, as well as updates on behaviors that might benefit from a response.

• The judge is aware of all applicable judicial canons, the code of ethics, and case law relating to ex parte communication and the appropriate use of information.

27

2C. Participation in FTC Pre-Court Staffing—3

Observational studies suggest that when judges do not attend pre-court staff meetings, they are less likely to be adequately informed about or

prepared for interacting with participants during review hearings.(Source: Portillo et al., 2013)

The judge encourages participants to honestly discuss their successes and challenges with parenting as well as their relationships with their children in their efforts to achieve long-term recovery, reunification, and permanency for children.

28

Standard 3

29

3. Ensuring Equity and Inclusion: Provisions

30

3. Ensuring Equity and Inclusion—1

There are opportunities to either reduce or exacerbate disproportionality at every stage of a child welfare case.

Proportional Access

Equitable Treatment

Equal Outcomes31

32

3. Ensuring Equity and Inclusion—2

An evaluation of the King County, WA Family Treatment Court (KCFTC) examined differences in outcomes between KCFTC participants and a comparison group of nonparticipants.

Families of color in the KCFTC entered treatment sooner than those in the comparison group and at a rate equivalent to that of white families in the

KCFTC. Further, children of color in the KCFTC were more likely to be returned home (i.e., to have their dependency case dismissed, be reunified, or have a trial home visit) than children of color in the comparison group

and had return rates comparable to those of white children in KCFTC. (Source: Bruns, et al., 2011)

33

Standard 4

34

4. Early Identification, Screening, and Assessment: Provisions

35

4C. Use of Valid and Reliable Screening and Assessment

Use of subjective criteria has the potential to exclude families from FTCs for reasons that have not proved valid or meaningful in the course of the court experience. Removing subjective eligibility

restrictions and applying evidence-based selection criteria significantly increase the effectiveness and cost-efficiencies of drug

courts by allowing them to serve their target population.

(Source: Bhati, Roman & Chalfin, 2008)

36

Standard 5

37

5. Timely, High Quality, & Appropriate SUD Treatment: Provisions

38

5A. Timely Access to Appropriate Treatment

Participants in an FTC that were provided immediate, intensive SUD treatment had significantly more reunifications, their children had fewer placements in longer-term foster care, and their children spent less time in non-kinship care than families not in the FTC.

(Source: Burrus, Mackin & Aborn, 2008)

(Source: Green, Rockhill & Furrer, 2007)

Mothers who entered substance use disorder treatment faster after their children were placed in substitute care

Stayed in treatment longer

Mothers who completed at least one course of treatment

Were significantly more likely to be reunified with their children

In a longitudinal study of mothers (N=1,911)

39

Time in Treatment Matters

40

Standard 6

41

6. Comprehensive Case Management, Services, and Supports: Provisions

42

6C. Recovery Supports—1

Comprehensive Screening & Assessment

Consistently High Reunification Rate

Early Access to Treatment

A Randomized Control Trial – Cook County, IL (n=3440)

(Source: Ryan, Perron, Moore, Victor & Park, 2017)

43

6C. Recovery Supports—2

A Randomized Control Trial – Cook County, IL (n=3440)

Comprehensive Screening & Assessment

Consistently High Reunification Rate

Early Access to Treatment

Recovery Coach

(Source: Ryan, Perron, Moore, Victor & Park, 2017)

44

6D. High-Quality Parenting Time

High-quality parenting and family time is important for sustaining the parent-child connection, nurturing parent-child

attachment, reducing children’s anxiety and feelings of abandonment, reunifying families, and achieving permanency.

(Sources: Smariga, 2007, Dougherty, 2004, Nesmith, 2013)

Parenting Time

(Source: Wentz, 2012)

45

46

Standard 7

47

7. Therapeutic Responses to Behavior: Provisions

48

Responding to Participant Behavior

You have a toolbox.

In the toolbox, you have:• Treatment adjustments.• Complementary services modifications.• Incentives.• Sanctions.

49

7A. Child and Family Focus—1

The FTC team’s responses support and promote improved parenting, healthy parent-child relationships, and family functioning. Responses to behavior do not have a detrimental effect on participants or their children or families and do not to interfere with dependency court hearings or requirements.

The FTC team never uses parenting or family time as an incentive or sanction. Decisions about parenting and family time are based on the children’s best interests, including safety, well-being and, permanency.

50

7A. Child and Family Focus—2

FTCs that provide parenting and children’s services have better child welfare and treatment

outcomes than those providing services targeted only to parental

SUD recovery.(Sources: Bruns et al., 2012, Rodi et al., 2015)

51

Standard 8

52

8. Monitoring and Evaluation: Provisions

53

8. Monitoring and Evaluation

Continuous quality improvement (CQI), sometimes called performance and quality improvement (PQI),

refers to an intentional process of using data to improve outcomes.

Like many complex service organizations, drug courts are highly susceptible to “drift,” meaning that the program drifts away

from fidelity to the model and outcomes for children, parents, and family members deteriorate over time.

(Source: Barbee et al., 2011)

(Sources: Van Wormer, 2010, Fay-Ramirez, 2015)

54

What’s Next

1. Sit and read them.2. Share them with stakeholders.3. Develop process for self assessment.4. Use to garner resources.5. Align with parallel initiatives.

Family Treatment Court Best Practice Standards

8 Standardsand Key Provisions

To obtain a copy or for more information:

Visit: www.cffutures.org

55

Download the Publication

Substance Abuse and Mental Health Services AdministrationSAMHSA’s mission is to reduce the impact of substance abuse

and mental illness on America’s communities.www.samhsa.gov

1-877-SAMHSA-7 (1-877-726-4727) ● 1-800-487-4889 (TDD)

GAINS Center for Behavioral Health and Justice TransformationThe GAINS Center focuses on expanding access to services for people with

mental and/or substance use disorders who come into contact with the justice system.

https://www.samhsa.gov/gains-center1-800-311-4246

Thank You

56