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Friday, May 20, 2011

Drug Courts and Child Protection

The drug court experience has been used in the USA for several years with largely promising outcomes. An interesting pilot project has been underway in the United Kingdom. A major goal has been to see whether or not it will be possible for children to be kept within the family. If moved out of the family, can the child be returned sooner?

Just published, The Family Drug & Alcohol Court (FDAC) Evaluation Project Final Report has some good news that should encourage the role that courts can play in altering outcomes in families where parental addiction is a factor. The drug court experience has some significant differences that can be a very powerful reason why such interventions have a higher prognosis for success. As the authors note:

There are a number of key differences between FDAC and ordinary care proceedings.
In ordinary care proceedings:
 There are no dedicated judges or magistrates and little judicial continuity.
 There is no specialist team attached to the court.
 Assessments may be ordered from a range of different experts and can take
months to be carried out and reported on.
 There are no hearings without lawyers.
 Guardians are not appointed to cases immediately.
 There is little co-ordination of services for parents.


While the cases that were being dealt with were often complicated and the history challenging, this approach brought intervention sooner. Perhaps vital, the level of support was also greater, more coordinated and more intense due to this coordinated response. This led to a plan that was structured towards the specific needs of the client. Sustained sobriety looks to be more promising with the parents who went through the program.

One area of disappointment is that the research could not help to identify who was more or less likely to be successful. "Although the lack of clear predictors may be because of the small samples in this study, the same overall result was found in the large-scale research into Family Drug Treatment Courts in the USA." Thus, this factor seems to be one that eludes researchers making the clinical targeting of this type of intervention difficult to plan - we may not yet have the kind of data that will help identify which families will benefit the most. This is unfortunate as increasing budgetary pressures in child protection programs in many countries mean that well targeted programming is increasingly needed.

This is not a cheaper process although children were in care for less time which may be where the most cost savings can be found - again - important in our budget conscious world.

The overall conclusions:

"The evidence from this evaluation suggests that FDAC is a promising approach. More FDAC
than comparison parents had controlled their substance misuse by the end of proceedings
and had been reunited with their children. FDAC parents were engaged in more substance
misuse services over a longer period of time than comparison parents. There is evidence of
financial savings in FDAC cases in relation to court hearings, out-of-home placements, and
the reduction in the number of contested proceedings.

FDAC is operating as a distinctive model of a problem-solving court. All those involved in
FDAC thought that this was a better approach than ordinary care proceedings. Nearly all
parents would recommend FDAC to other parents in their situation. The professionals and
parent mentors were clear that FDAC should be rolled out." (p. 12 of the Executive Summary)

However, like so many researchers, the authors point out the challenge of getting and sustaining sobriety. Concurrent planning is needed where that cannot be achieved and, as seen in other research, more parents will fail to achieve long term sobriety versus those that will.

This option shows promise as one way in which these cases can be managed effectively. It is not nirvana. It is one option that will work in some places some of the time. Yet, where it can work and the services to support it exist, this is a worthwhile idea.

Reference:

Harwin J, Ryan M and Tunnard J, with Pokhrel S, Alrouh B, Matias C and MomenianSchneider S (May 2011) The Family Drug and Alcohol Court (FDAC) Evaluation Project
Final Report. Brunel University.

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