Academic journal article Fordham Urban Law Journal

What Works and What Does Not

Academic journal article Fordham Urban Law Journal

What Works and What Does Not

Article excerpt




Michael Rempel Center for Court Innovation

Adele V. Harrell The Urban Institute

Jeff Fagan Columbia University School of Law

Barbara Babb University of Baltimore School of Law

Michael Rempel Center for Court Innovation

I want to talk about treatment modality and participant progress in recovery. Most of my examples are going to be regarding drug courts, with just one other kind of court, the domestic violence court. Of cases handled in the Bronx Misdemeanor Domestic Violent Court, seventy-five percent are mandated to a batterer intervention program.

There are a number of other types of programs--substance abuse treatment, alcohol treatment, combined programs--that are available. For instance, one type of combined program, batterer intervention and alcohol treatment, is a function of the existence of the domestic violence court in the Bronx. Recently that program was determined to be poorly run, so that's no longer used anymore. So variables that may not directly relate to treatment, but relate more to the relationships between the court and available treatment providers may affect the modality used.

There are actually four New York City drug courts. This just gives the distribution of first treatment modality for those four courts. Immediately you see that Brooklyn and Manhattan are fairly similar. Both start out by sending about half of their participants to a long-term residential program.

Queens sends far fewer to a residential program, and when you look at other data about Queens, you see that they have a primarily young population, a population whose primary drug tends to be marijuana. So the clinical need is less, so they send fewer people to a residential program.

But then you get to the Bronx. Only four percent go to residential programs, eighty-five percent go to intensive outpatient. Well, that is not a function of clinical need. That is a function of the particular relationship between the court and treatment providers in the Bronx. In the Bronx, instead of referring out to a large number of treatment providers, they have a core of about ten to fifteen providers, all of which run intensive outpatient programs, some of which run other modalities.

But the dominant modality of treatment providers in the Bronx is intensive outpatient. Bronx courts tend to work very closely with these providers, so that the structural relationship between the court and those providers leads to an especially high degree of outpatient use.

I will just preview the results. If you were to look at retention rates across these courts, you could not necessarily conclude that one court is doing better or worse than the other based on modality they are using. But you would conclude that there are different types of relationships going on that are affecting the kinds of modalities being used.

Just to give a little bit of a overview of the other theme of the day that I want to talk to you about, I want to switch to the page that is titled "Graduate Compliance in the Brooklyn Treatment Court."

This is the other kind of necessity under treatment, that you have your modality, relationships between court and providers, and then in turn you have the participant response to that and their progress, not their outcomes but their progress, during the treatment and recovery process.

In this chart you see just the basic distribution of results for successful participants at the Brooklyn Treatment Court, and despite being; successful--everyone represented in this chart is a graduate--only twenty-eight percent had zero positive drug tests during their participation; only thirty-eight percent had no unexcused treatment absences; and only fifteen percent avoided going out on a warrant.

Immediately you see that the recovery process tends to involve extensive relapses. …

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