Examining the Effects of Juvenile Drug Treatment Courts: A Systematic Review and Meta-Analysis

• Published date: 01 January 2024
• DOI: http://doi.org/10.1177/00938548231208208
• Author: Emily E. Tanner-Smith,Frank Mojekwu,Lauren Frankel
• Date: 01 January 2024

CRIMINAL JUSTICE AND BEHAVIOR, 2024, Vol. 51, No. 1, January 2024, 148 –170.

DOI: https://doi.org/10.1177/00938548231208208

Article reuse guidelines: sagepub.com/journals-permissions

© 2023 International Association for Correctional and Forensic Psychology

148

EXAMINING THE EFFECTS OF JUVENILE DRUG

TREATMENT COURTS

A Systematic Review and Meta-Analysis

EMILY E. TANNER-SMITH

FRANK MOJEKWU

LAUREN FRANKEL

University of Oregon

We meta-analytically examined program graduation rates among juvenile drug treatment court (JDTC) participants, the

effects of JDTCs on recidivism and substance use outcomes, and the variability in these effects. We systematically searched

for controlled evaluations examining the effects of U.S.-based JDTCs relative to traditional juvenile adjudication and used

mixed-effects meta-regressions with robust variance estimates. We identified 55 eligible samples (providing data from 12,310

participants); the overall certainty of evidence was low or very low. The average graduation rate among JDTC participants

was 54.74% (95% confidence interval [CI] [0.50, 0.59]). JDTCs had modest beneficial effects on general recidivism assessed

during court supervision (odds ratio [OR] = 1.38, 95% CI [1.03, 1.84]) but these effects did not persist after program

completion. Correlational analyses suggest JDTCs may be effective when program enrollment and service provision are bet-

ter tailored to youth’s treatment needs. However, due partly to implementation failures, JDTCs may have minimal to no effects

on postprogram recidivism.

Keywords: drug courts; juvenile justice; meta-analysis; recidivism; substance use; therapeutic jurisprudence

AUTHORS’ NOTE: This work was supported by Subcontract Number 0373700101 from the American

Institutes for Research under the Prime Contract Number 2014-DC-BX-K001 from the U.S. Department of

Justice. The content is solely the responsibility of the authors and does not necessarily represent the official

views of the American Institutes for Research or the U.S. Department of Justice. Emily Tanner-Smith and Frank

Mojekwu served as collaborators in the development and revision of the Office of Juvenile Justice and

Delinquency Prevention’s Juvenile Drug Treatment Court guidelines. They have no financial interests associ-

ated with the development of these guidelines. This article does not contain any studies with human participants

or animals performed by any of the authors. For this type of study informed consent is not required.

Conceptualization: ETS; Data curation: ETS, LF; Formal analysis: ETS, FM; Funding acquisition: ETS;

Investigation: ETS, FM, LF; Methodology: ETS; Project administration: ETS, LF; Resources: ETS, FM, LF;

Supervision: ETS; Writing—original draft: ETS, FM; Writing—reviewing and editing: ETS, FM, LF.

Correspondence concerning this article should be addressed to Emily E. Tanner-Smith, Prevention Science

Institute, Department of Counseling Psychology and Human Services, University of Oregon, 5251 University

of Oregon, Eugene, OR 97403; e-mail: etanners@uoregon.edu.

1208208CJBXXX10.1177/00938548231208208Criminal Justice and BehaviorTanner-Smith et al. / Juvenile Drug Court Effects

research-article2023

Tanner-Smith et al. / JUVENILE DRUG COURT EFFECTS 149

The developmental transition from childhood to adulthood can be marked by an increase

in the frequency of risky behavior, particularly the consumption of illicit substances

(Degenhardt et al., 2016). Although developmentally normative, increased substance use

during adolescence may be associated with increased aggression, delinquency, and the cor-

responding risk of contact with the juvenile justice system (Chassin, 2008; Doran et al.,

2012; Young et al., 2012). Many justice-involved youth suffer from substance use disorders

and addiction, which are correlated with the risk of recidivism (van der Put et al., 2014).

Rehabilitative programs that treat justice-involved youth’s substance-related issues may

therefore be effective in reducing their risk of recidivism. Juvenile drug treatment courts

(JDTCs), defined here as problem-solving courts that aim to reduce recidivism by explicitly

treating youth’s substance-related problems in a therapeutic and supportive manner, offer

one such approach.

Typical elements of JDTCs include assessments of youth’s unique criminogenic risks

and needs, frequent interactions between the youth and a judge or other court staff, inten-

sive monitoring by court staff, behavior-shaping through incentives and sanctions, and

referral to community-based substance use treatment services (Belenko & Dembo, 2003).

In contrast to traditional juvenile courts, which are often guided by punitive deterrent poli-

cies, JDTCs are intended to be rehabilitative and responsive to the individual criminogenic

needs of drug-involved and justice-involved juveniles (Office of Juvenile Justice and

Delinquency Prevention [OJJDP], 2016). The goal of JDTCs is to reduce the risk of recidi-

vism by providing tailored and supportive treatment; such benefits, however, may not be

conferred to youth who fail to complete the full JDTC program.

The first drug treatment court program opened in 1989 in Miami-Dade County, Florida;

in 2020, there were an estimated 3,848 drug courts in the United States, with 618 of those

classified as JDTCs (National Drug Court Resource Center, 2021). Prior reviews suggest

that adult drug courts are effective in reducing recidivism when compared to traditional

judicial interventions (Mitchell et al., 2012; Rossman et al., 2011). Despite promising evi-

dence supporting the effectiveness of adult drug courts, the evidence based on the effective-

ness of JDTCs has been inconsistent and inconclusive (Tanner-Smith et al., 2016). This

systematic review and meta-analysis therefore seeks to synthesize the current available evi-

dence regarding the effects of JDTCs on recidivism and drug use, with specific emphasis on

understanding whether and how JDTC completion (i.e., graduation) may play a role in this

effectiveness.

JDTC MODEL

Whereas traditional criminal courts have historically used punitive approaches to deter

criminal behavior (Loughran et al., 2015), problem-solving courts use a rehabilitative ori-

entation wherein criminogenic needs are treated to reduce reoffending (Butts & Roman,

2004). Drug treatment courts are one type of problem-solving court, which aims to treat

harmful substance use behaviors that may contribute to criminal offending (van der Put et

al., 2014). JDTCs are specifically designed to use developmentally appropriate services to

address the unique treatment needs of justice-involved youth (Belenko & Dembo, 2003).

Services provided by JDTCs typically include status hearings with the court’s presiding

judge, coordination between the court and the youth’s family, random drug screenings,

community supervision, referrals to community-based substance use treatment services,