Fidelity to the 10 Key Components

Fidelity to the 10 Key Components

In fiscally challenging times, there is always the pressure to do more
with less. This raises the critical question of whether certain
components of the drug court model can be dropped or the dosage
decreased without eroding the effects. The “key components” of drug
courts are hypothesized to include a multidisciplinary team approach, an
ongoing schedule of judicial status hearings, weekly drug testing,
contingent sanctions and incentives, and a standardized regimen of
substance abuse treatment (NADCP, 1997). Each of these hypothesized key
components has been studied by researchers or evaluators to determine
whether it is, in fact, necessary for effective results. The results
have confirmed that fidelity to the full drug court model is necessary
for optimum outcomes — assuming that the programs are treating their
correct target population of high-risk, addicted drug offenders.

Multidisciplinary Team Approach
The most effective drug courts require regular attendance by the judge,
defense counsel, prosecutor, treatment providers and law enforcement
officers at staff meetings and status hearings (Carey et al., 2008).
When any one of these professional disciplines was regularly absent from
team discussions, the programs tended to have outcomes that were, on
average, approximately 50 percent less favorable (Carey et al., in
press). In other words, if any one professional discipline walks away
from the table, there is reason to anticipate the effectiveness of a
drug court could be cut by as much as one half.

Judicial Status Hearings
Research clearly demonstrates that judicial status hearings are an
indispensible element of drug courts (Carey et al., 2008; Festinger et
al., 2002; Marlowe et al., 2004a, 2004b, 2006, 2007). The optimal
schedule appears to be no less frequently than bi-weekly hearings for at
least the first phase (first few months) of the program. Subsequently,
the frequency of status hearings can be ratcheted downward; however, it
appears that status hearings should be held at least once per month
until participants have achieved a stable period of sobriety and have
completed the intensive phases of their treatment regimen.

Drug Testing
The most effective drug courts perform urine drug testing at least
twice per week during the first several months of the program (Carey et
al., 2008). Because the metabolites of most common drugs of abuse remain
detectable in human bodily fluids for only about one to four days,
testing less frequently can leave an unacceptable time gap during which
participants can use drugs and evade detection. In addition, drug
testing is most effective when it is performed on a random basis. If
participants know in advance when they will be drug tested, they may
adjust their usage accordingly or take other countermeasures in an
effort to beat the tests.

Graduated Sanctions & Rewards
The pervasive perception among both staff members and participants in
drug courts is that sanctions and incentives are strong motivators of
positive behavioral change (Lindquist et al., 2006; Goldkamp et al.,
2002; Harrell & Roman, 2001; Farole & Cissner, 2007). Two
randomized, controlled experiments have confirmed that the imposition of
gradually escalating sanctions for infractions, including brief
intervals of jail detention, significantly improves outcomes among drug
offenders (Harrell et al., 1999; Hawken & Kleiman, 2009). Comparably
less research has addressed the use of positive rewards in drug courts,
but preliminary evidence suggests that tangible incentives may improve
outcomes especially for the more incorrigible, higher-risk participants
(Marlowe et al., 2008).

Substance Abuse Treatment
Longer tenure in substance abuse treatment predicts better outcomes
(Simpson et al., 1997) and drug courts are proven to retain offenders in
treatment considerably longer than most other correctional programs
(Belenko, 1998; Lindquist et al., 2009; Marlowe et al., 2003). The
quality of treatment is also a critically important consideration.
Significantly better outcomes have been achieved when drug courts
adopted standardized, evidence-based treatments, including Moral
Reconation Therapy (MRT; Heck, 2008; Kirchner & Goodman, 2007), the
MATRIX Model (Marinelli-Casey et al., 2008) and Multi-Systemic Therapy
(MST; Henggeler et al., 2006); as well as culturally proficient services
(Vito & Tewksbury, 1998). What all of these evidence-based
treatments share in common is that they are highly structured, are
clearly specified in a manual or workbook, apply behavioral or
cognitive-behavioral interventions, and take participants’ communities
of origin into account.