Academic journal article Journal of Cognitive Psychotherapy

A Proposed Prevention Intervention for Nondrug-Dependent Drug Court Clients

Academic journal article Journal of Cognitive Psychotherapy

A Proposed Prevention Intervention for Nondrug-Dependent Drug Court Clients

Article excerpt

A substantial body of research supports the effectiveness of drug courts in terms of reducing drug use and criminal recidivism among drug-involved offenders. However, it is unclear whether drug courts are appropriate for all clients, most notably the sizeable portion of clients who do not have a diagnosable or clinically significant substance use disorder. For these clients, drug court treatment may be ineffective or even contraindicated. Instead, best practice standards suggest that these clients would benefit from a prevention intervention designed to interrupt the acquisition of addictive behaviors. Unfortunately, such interventions have not been tested with adult offenders in drug courts. In this article, we describe a platform of cognitive and behavioral techniques that can potentially be used with nondrug-dependent drug court clients.

Keywords: drug courts; prevention; drug abuse; criminal justice

Over the past 25 years, the criminal justice system has been flooded with increasingly larger numbers of drug-involved criminal offenders (Mumola & Karberg, 2006). Given the limited success of standard intervention approaches used with this population, such as imprisonment and mandated substance abuse treatment, the demonstrated success of drug courts has given the criminal justice system an empirically supported intervention that has since been widely implemented. In short, a large and growing body of empirical research suggests that drug courts are outperforming all other strategies that have been used with drug-involved offenders in terms of reducing criminal recidivism and relapse to drug use (e.g., Government Accountability Office, 2005; Marlowe, DeMatteo, & Festinger, 2003).

As drug courts continue to proliferate across the United States, researchers have begun asking more nuanced and sophisticated questions about the appropriateness of the one-size-fitsall treatment approach used in most drug court programs. Of note, there is reason to question whether standard drug court treatment is appropriate for drug court clients who do not have a diagnosable or clinically significant substance use disorder (Kleiman et al., 2003; see DeMatteo, Marlowe, & Festinger, 2006). The drug court model assumes that all clients are addicted to drugs, and the intensive treatment approach is designed for drug-dependent clients who are exhibiting the clinical symptoms of addiction. Needless to say, this approach may not be clinically appropriate for nondrug-dependent clients. Compounding the problem is the absence of an appropriately tailored intervention for drug court clients with less severe drug problems.

The purpose of this article is to describe a prevention intervention designed for drug court clients who do not have a diagnosable or clinically significant drug use problem. After examining the nexus between drug use and crime, this article discusses the two competing treatment approaches that have historically been used with drug-involved criminal offenders. As will be discussed, both approaches have met with limited success. Next, this article will describe drug courts and summarize the large body of research supporting the effectiveness of drug courts. Finally, after establishing the existence of nondrug-dependent drug court clients, this article will propose a platform of cognitive and behavioral techniques that appear to be appropriately tailored to the clinical needs of these drug court clients.

SCOPE OF THE PROBLEM AND HISTORICAL RESPONSES

The number of drug-involved offenders in the criminal justice system has risen sharply in the past 25 years. The "War on Drugs," which began in the 1970s and continued in the 1980s, led to a large expansion in the United States inmate population. Correctional admissions more than tripled (Harrison & Karberg, 2003), with drug violations accounting for roughly 60% of the increase in the federal inmate population and over 30% of the increase in state inmates (Harrison & Beck, 2002). …

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