Family Drug Treatment Courts As Comprehensive Service Models: Cost Considerations

• DOI: http://doi.org/10.1111/jfcj.12060
• Published date: 01 September 2016
• Date: 01 September 2016

Family Drug Treatment Courts As

Comprehensive Service Models: Cost

Considerations

By Jody Brook, Becci A. Akin, Margaret H. Lloyd,

Michelle Johnson-Motoyama, and Yueqi Yan

ABSTRACT

Literature on family drug treatment courts (FDTCs) suggests that parental par-

ticipation in these courts is associated with improved substance abuse treatment and

child welfare system outcomes. Despite these beneficial outcomes, FDTCs serve only

7-10% of eligible child welfare involved families. As part of a FDTC evaluation, this

FDTC site sought to provide stakeholders with information about costs and benefits.

Considering the program costs alongside the cost avoidance from reduced time in

Dr. Jody Brook is an Assistant Professor at the University of Kansas, School of Social Welfare. She

has served as a National Research/Doctoral Fellow for the Administration for Children and Families

(USDHHS-Children’s Bureau) in the area of substance abuse in child welfare, as well as serving as Principal

or Co-Principal Investigator for 5 externally funded programs, all in the area of community responsiveness

to substance abuse and child welfare. Currently, this work involves serving as an evaluator for 7 family drug

court implementations in 2 States, and overseeing the implementation of statewide universal screening for

substance use disorders among child welfare involved families. Her interests include provision of targeted

evidence based parenting programs within the child welfare setting, and utilization of mixed methods

research.

Dr. Becci A. Akin is an Assistant Professor at the University of Kansas, School of Social Welfare.

Dr. Akin serves as the Principal or Co-Principal Investigator for 6 externally funded research projects, all in

the area of child welfare, children’s mental health, and implementation research and program evaluation.

Margaret H. Lloyd, M.S. is a doctoral candidate at the University Of Kansas School Of Social Wel-

fare researching the intersection of substance abuse, child well-being and the legal system.

Dr. Michelle Johnson-Motoyama is an Associate Professor at the University of Kansas School of

Social Welfare. Professor Motoyama’s scholarship focuses on preventing child maltreatment and addressing

social disparities in child welfare and child health with an emphasis on Latino populations. She is the Princi-

pal Investigator of a 5 site family drug court evaluation. Her research studies have been supported by the

National Institutes of Health, the Substance Abuse and Mental Health Services Administration in the U.S.

Department of Health and Human Services, and the Lois and Samuel Silberman Fund in the New York

Community Trust.

Yueqi Yan, M.S. is a doctoral candidate at the University of Kansas, School of Social Welfare. Yue-

qi’s research focuses on how family and child well-being is impacted by parental substance abuse and other

behaviors known to increase risk for poor outcomes. His area of interest expands to children’s mental health,

evidence-based practice, heterogeneity of treatment effects, and advanced quantitative research methods.

Juvenile and Family Court Journal 67, No. 3

©2016 National Council of Juvenile and Family Court Judges

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foster care, this analysis determined that FDTC participation resulted in a net sav-

ings per child of $9,710. The cost component of the evaluation proved valuable,

challenging, and informative.

Key words: Family drug court, substance abuse, parenting education, cost analysis, foster care.

The first family drug treatment court (FDTC) was initiated in Reno, NV in 1994

for the purposes of improving outcomes for substance-abuse affected families in the child

welfare system (CWS) (McGee, 1997), as a response to increasing numbers of families

with parental substance abuse facing child maltreatment charges, and worsening case

outcomes for these families. Research on child maltreatment conducted during this time-

frame confirms this observation. An early work by Chaffin, Kelleher, & Hollenberg

(1996) found that parental substance use disorders (SUD) were associated with increased

child maltreatment occurrence, and confirmed earlier work by Walker, Zangillo, &

Smith (1991) that showed that parental substance abuse was associated with longer stays

in foster care and decreased likelihood of reunification. A central premise of FDTC pro-

gramming was that the parents’ untreated SUD represented a key barrier to successful

reunification for these families and, if the FDTC could be used to ensure adequate access,

intensity and supervision of substance abuse treatment, the disorder would abate thus

making reunification possible (McGee, 1997). Early anecdotal experiences supported the

use of FDTCs as a viable alternative to traditional court dockets, and similar FDTCs

arose across the U.S. (McGee, 1997).

One significant factor influencing FDTC dissemination was the passage of the

Adoption and Safe Families Act of 1997 (ASFA), which reduced the amount of time

available to foster care involved families to reunify before a mandatory permanency hear-

ing from 18 months to 12 months. ASFA further stipulated that termination proceed-

ings must initiate if a child spends 15 of 22 months in out of home care. This change

affected all CWS-involved families, but exerted particular pressure on families with par-

ental SUD because of the intractable nature of substance use disorders and the amount of

time typically required for treatment access and necessary prolonged service duration and

intensity. Given these time constraints, FDTCs offered a desirable alternative to tradi-

tional child welfare practice given their explicit focus on timely access to substance abuse

treatment and other services. Since that time, the number of courts has risen dramatically

and there are currently over 350 FDTCs in the U.S.

Concurrent with the growing number of FDTCs, the body of literature on these

courts has expanded. Author (2015) catalogued studies on FDTCs (both peer-reviewed and

non-peer reviewed professional literature) and identified 18 publications between 2004 (the

year of the first peer-reviewed FDTC study) and 2014 that compared FDTCs to non-

FDTCs on key child welfare outcomes. Nine of these studies were published in the peer-

reviewed literature. Although all nine used quasi-experimental designs (thus were limited

in rigor), the three strongest studies used rigorous propensity score matching techniques to

establish a comparison group from state child welfare databases for families with similar

demographic characteristics as treatment group participants (Worcel, Furrer, Green, Burrus

& Finigan, 2008; Bruns, Pullmann, Weathers, Wirschem & Murphy, 2012; Chuang,

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