Women in Treatment Courts

Size: px

Start display at page:

Download "Women in Treatment Courts"

Frank Golden
6 years ago
Views:

1 Justice Programs Office National Drug Court Resource Center Women in Treatment Courts Wednesday, February 22, :00pm-2:30pm EST Panelists: Hon. William Schma Valerie Moore

2 2 Agenda Terms Gender in Drug Courts Complex Women-Specific Issues First Women s Treatment Court Importance and Need The Right Judge Screening Instruments Incentives and Sanctions Treatment Programming Suggested Evidence-Based Curricula Fidelity to Models and Oversight Access to Services Aftercare/Continuing Care Strategies Trauma-Informed Treatment Court Tips

3 3 Terms Gender-Responsive Treatment o Creating an environment through site selection, staff selection, program development, content, and material that reflects an understanding of the realities of the lives of women and that addresses and responds to their strengths and challenges Gender-Specific Program o These programs often employ and treat only women but they do not necessarily provide gender-responsive treatment Bloom, B., Owen, B., & Covington, S. (2004). Women offenders and gendered effects of public policy. Review of Policy Research, 21, Greenfield, S. F., & Grella, C. (2009). What is women-focused treatment for substance abuse? Psychiatric Services, 60,

4 4 Terms Gender-responsive principles: o Gender o Environment o Relationships o Services o Socioeconomic Status o Community Covington, S. (2008). Women and addiction: a trauma-informed approach. Journal of Psychoactive Drugs, SARC Supplement 5,

5 5 Gender in Drug Courts o Women made up about 32% of participants in drug courts in 2014 o Women graduated from some drug courts at rates substantially below those of male drug court participants. o Best practice standards require drug courts to monitor access and outcomes for female participants and deliver evidence-based gender-specific services. NDCI. June Painting the Current Picture: A National Report on Drug Courts and Other Problem-Solving Courts in the US.

6 6 Complex Women-Specific Issues Many studies have shown Women offenders are significantly more likely than men to have coexisting psychiatric disorders, parental stress, housing issues, and extensive histories of sexual and physical abuse. Men and women have different pathways to crime and addiction, continue to use drugs for different reasons, enter and remain in treatment for different reasons, and have a greater unmet need for treatment and therapy. Very few services available specifically for women D Angelo, L., Wolf, R. V. (2002). Women and Addiction: Challenges for Drug Court Practitioners. The Justice System Journal, Vol. 23, No. 3, Messina, N., Calhoun, S., & Ward, U. (2012). Gender-responsive drug court treatment: a randomized controlled trial. Criminal Justice and Behavior, 39,

7 7 Complex Women-Specific Issues Common Themes in the Lives of Addicted Women: o Treatment issues: Lack of services for women Not understanding treatment for women Long waiting lists Lack of childcare services Shame and stigma o Relationship issues: Fear of losing children Fear of losing partner o Systemic issues: Lack of financial resources Lack of clean/sober housing Poorly coordinated services Covington, S. (2008). Women and addiction: a trauma-informed approach. Journal of Psychoactive Drugs, SARC Supplement 5,

8 8 Complex Women-Specific Issues Criminal Behavior: o Nonviolent crimes o Common crimes tend to be shoplifting, prostitution, paper crimes o Drug use, possession, or small amounts of distribution D Angelo, L., Wolf, R. V. (2002). Women and Addiction: Challenges for Drug Court Practitioners. The Justice System Journal, Vol. 23, No. 3,

9 9 Complex Women-Specific Issues Mental Health Issues: o Trauma o Higher prevalence among women Substance Use: o When women enter treatment, they typically present with a more severe clinical profile (e.g., more medical, behavioral, psychological and social problems) than men, despite having used less and for a shorter period of time. o Women are more susceptible to craving and relapse than men are D Angelo, L., Wolf, R. V. (2002). Women and Addiction: Challenges for Drug Court Practitioners. The Justice System Journal, Vol. 23, No. 3, Greenfield, S.F., Back, S.E., Lawson, K., & Brady, K.T. (2010). Substance Abuse in Women. Psychiatric Clinics of North America, Vol. 33(2), NIDA (2016). Substance Use in Women. Retrieved February 16, 2017, from

10 10 Complex Women-Specific Issues Family: o Economic dependence on an unhealthy partner/relationship o Instability at home o Single parent o Women in treatment can be separated from children (due to foster care or case in CPS) Gender Socialization: o Lack of self-esteem, self-respect, confidence Social Issues: o More likely to be unemployed D Angelo, L., Wolf, R. V. (2002). Women and Addiction: Challenges for Drug Court Practitioners. The Justice System Journal, Vol. 23, No. 3,

11 11 Kalamazoo County Women s Treatment Court 1 st Women s Drug Court in the US Developed by Judge Schma

12 12 Importance and Need Gender-Responsive Drug Court Treatment: 1. Participants in the gender-responsive group had better intreatment performance, more positive perceptions related to their treatment experience and reductions in PTSD symptomology 2. The consistent literature outlining the extensive trauma histories of women as compared to men and the undeniable link between childhood trauma and adult addictive and criminal behaviors suggest that these issues need to be addressed safely and systematically for women to best meet their treatment needs. US Department of Health and Human Services. (2016). Messina, N., Calhoun, S., & Ward, U. (2012). Gender-responsive drug court treatment: a randomized controlled trial. Criminal Justice and Behavior, 39,

13 13 Gender of the Judge o Certain topics must be treated with more delicacy Personality o Personal, but professional o Boundaries o Know the children s names Leadership Judicial Training The Right Judge

14 14 Screening Instruments Alcohol and Drug o Addictions Severity Index (ASI) o AUDIT (alcohol, drugs, adults, clinician administered) Criminal History o LSI-R, COMPAS, State-Specific Trauma o The Life Event Checklist (LEC): 17-item, self-report measure o Trauma History Screen (THS): 14-item, self-report measure SAMHSA-HRSA Center for Integrated Health Solutions. Screening Tools. Retrieved from

15 15 Screening Instruments PTSD o Clinician Administered PTSD Scale (CAPS-5): 30-item structured interview o Posttraumatic Diagnostic Scale (PDS): 49-item, self-report measure Mental Health o Mood Disorder Questionnaire (MDQ): 15-item, self-report questionnaire to identify bipolar disorder o Patient Health Questionnaire (PHQ-9): 9-item instrument for screening, diagnosing, and measuring severity of depression SAMHSA-HRSA Center for Integrated Health Solutions. Screening Tools. Retrieved from

16 16 Incentives and Sanctions Incentives o Visitation with child in foster care o Anything that helps build self-esteem Talking in the court room about how well a participant is doing Allowing participants to show pictures of their kids Bringing their kids to the court room Sanctions o Should not be punitive o Should relate to course of treatment o Utilize therapeutic adjustments

17 17 Treatment Programming Must meet standards of care for treatment courts and ASAM criteria Genderresponsive clinicians

18 18 Suggested Evidence-Based Curricula Seeking Safety, Lisa Najavits Helping Women Recover, Stephanie Covington Beyond Trauma, Stephanie Covington Dialectical Behavioral Therapy (DBT), Marsha M. Lenihan Eye Movement-Desensitization and Reprocessing (EMDR), Francine Shapiro

19 19 Fidelity to Models and Oversight Delivered by female clinicians with background in trauma-informed care to female participants Imperative that experts monitor group processes Ensure both curricula and approach to delivery meets standards

20 20 Access to Services Provide onsite child care Ensure initial and ongoing healthcare appointments Safe housing Pre-employment training Job placement assistance Psychiatric mental health and medication management Parenting courses o Adult drug courts that provided parenting classes had 65% greater reductions in criminal recidivism and 52% greater cost savings than those courts that did not provide parenting classes Carey, S.M., J.R., & Finigan, M.W. (2012). What Works? The 10 Key Components of Drug Court: Research-based best practices. Drug Court Review.

21 21 Aftercare/Continuing Care Ensure women can come back to treatment/court when needed Ensure access to safe housing for women o Halfway house o Oxford Housing o Transitional housing Identify potential women-only housing opportunities in community Develop relapse prevention plan Ensure continued access to health care and medications

22 22 Strategies for Developing a Gender- Responsive Program Relationships are key to a woman s recovery o Relationship with family dependency courts o Child Protective Services Include case worker on mother s status Reunion with children is not an initial motivator, but is important later in the recovery process o Assign trained peer mentor or peer support early on in program Trauma training for drug court team o Develop trauma-informed program o Language o Approach National Association of Drug Court Professionals. (2013). Adult Drug Court Best Practice Standards, Vol. 1.

23 23 Strategies (cont d). Respond quickly at time of arrest o Opportunity at crisis point o Intake Screening Treatment o Up-front identification of: Substance Use Mental Illness Trauma Criminogenic Needs Build in programmatic flexibility o Meet changing dynamics and needs of participants

24 24 Strategies (cont d). Unified written case plan or status report o Include data and narrative from all direct services persons Counties without resources for separate court o Consider separate court docket D Angelo, L., Wolf, R. V. (2002). Women and Addiction: Challenges for Drug Court Practitioners. The Justice System Journal, Vol. 23, No. 3,

25 25 Trauma-Informed Treatment Court Tips Judge Coordinator/ Case Manager Demonstrate a commitment to providing trauma-informed care Consider the language used in the courtroom and by the team Conduct trauma screen Compile list of trauma resources and programs for participants Plan trainings on trauma Reexamine policies and procedures

26 26 Trauma-Informed Treatment Court Tips Treatment Provider Defense Counsel Prosecutor Conduct a validated trauma assessment Provide or refer the individual to appropriate trauma-informed treatment services Receive training on trauma; learn grounding techniques to help your client feel safe Communicate with your client in a respectful manner Receive training on trauma Be transparent in interactions with participants

27 27 References Bloom, B., Owen, B., & Covington, S. (2004). Women offenders and gendered effects of public policy. Review of Policy Research, 21, Carey, S.M., J.R., & Finigan, M.W. (2012). What Works? The 10 Key Components of Drug Court: Research-based best practices. Drug Court Review. Covington, S. (2008). Women and addiction: a trauma-informed approach. Journal of Psychoactive Drugs, SARC Supplement 5, D Angelo, L., Wolf, R. V. (2002). Women and Addiction: Challenges for Drug Court Practitioners. The Justice System Journal, Vol. 23, No. 3, Retrieved from Fallot, Ph.D., Roger D, Harris, Ph.D., Maxine. (July 2009). Creating Cultures of Trauma Informed Care (CCTIC): A Self-Assessment and Planning Protocol. Community Connections. Version Greenfield, S.F., Back, S.E., Lawson, K., & Brady, K.T. (2010). Substance Abuse in Women. Psychiatric Clinics of North America, Vol. 33(2), Greenfield, S. F., & Grella, C. (2009). What is women-focused treatment for substance abuse? Psychiatric Services, 60, Messina, N., Calhoun, S., & Ward, U. (2012). Gender-responsive drug court treatment: a randomized controlled trial. Criminal Justice and Behavior, 39, National Association of Drug Court Professionals. (2013). Adult Drug Court Best Practice Standards, Vol. 1. Retrieved: National Center on Domestic Violence, Trauma and Mental Health. (2005) Responding to Domestic Violence: Tools for Mental Health Providers. Residential Domestic Violence: Sample Forms for Mental Health.Creating Accessible, Culturally Relevant Domestic Violence and Trauma Informed Agencies. A Self-Reflection Tool. Retrieved from NIDA (2016). Substance Use in Women. Retrieved February 16, 2017, from SAMHSA-HRSA Center for Integrated Health Solutions. Screening Tools. Retrieved from Substance Abuse and Mental Health Services Administration, SAMHSA s National Center on Trauma-Informed Care and SAMSHA s National GAINS Center for Behavioral Health and Justice: Essential Components of Trauma-Informed Judicial Practice. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.

28 28 Resources The National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online database of mental health and substance abuse interventions. Sep 18, 2014 Evidence Based Programs / NREPP SAMHSA NADCP Adult Drug Court Best Practice Standards: pdf. US Department of Health and Human Services, Office on Women s Health: National Drug Court Resource Center, List of Incentives and Sanctions:

29 Thank you! Questions? Contact Information: National Drug Court Resource Center ndcrc@american.edu http://ndcrc.

29 29 Thank you! Questions? Contact Information: National Drug Court Resource Center Justice Programs Office facebook.com/aujpo

Screening & Assessment for Trauma in Drug Courts

Screening & Assessment for Trauma in Drug Courts Chanson Noether & Lisa Callahan NADCP Annual Meeting July 15 th, 2013 What is Trauma? Individual trauma results from an event, series of events, or set