Helping Courts Guide Young Lives Back on Track

This month, communities across the country are marking National Recovery Month, celebrating people of all ages in recovery from drug and/or alcohol addiction. Listening to their stories reminds us all that recovery and treatment are not the same for everyone. Recovery can be particularly challenging for youth, whose brains and bodies are still developing physically, mentally, and emotionally. Their assets and needs must be uniquely addressed.

Juvenile justice systems can serve as a major source to refer entering adolescents who need services. Today more than 400 Juvenile Drug Treatment Courts (JDTC) are making it possible for youth to access treatment and making referrals to family, social, and educational support services so youth can recover from substance use disorders, decrease possible lifelong impacts on their brain growth and cognitive development, and reduce their risk for re-offending.

To strengthen the capacities of these courts to organize and manage their programs to more effectively address the challenges presented by adolescents with substance use and mental health disorders, the U.S. Department of Justice’s Office of Juvenile Justice and Drug Prevention (OJJDP) released new research-informed guidelines last December.

Working closely with OJJDP, AIR experts conducted research including a meta-analysis of studies comparing JDTCs with traditional youth courts; systematic reviews of practices (for juvenile drug treatment courts and youth-serving systems more broadly) with demonstrated impact on youth outcomes; a systematic scan of policies and practices for 25 JDTCs in 20 states; and in-person and online feedback from stakeholders in a strategically selected sample of JDTCs to develop the new guidelines. (For details on our partners and the rigor of the research, see Behind the Guidelines, below.)

Our team identified a series of research-informed practices shown to reduce the likelihood of further delinquency and involvement with substance use. The guidelines pinpoint practices that may lead to recovery, including:

  • The importance of carefully screening youth and redirecting those who do not have substance-use disorders to other programs.
  • The critical role that families play in supporting their children throughout the process. Youth with substance-use disorders are more likely to succeed in treatment and participate in juvenile drug treatment court programs when their families are engaged in the treatment (including treating the parents for substance and mental disorders) and when parents work with the court in behavioral management of the youth at home and in the community.
  • The value of assigning incentives and sanctions to shape adolescent behaviors. Youth are more likely to develop the decision-making and problem-solving skills that will sustain recovery when the court makes effective use of both incentives and sanctions. For example, a court might work with a young person to identify meaningful incentives (i.e., gift cards, verbal praise, extended curfews) to motivate compliance with the expectations of the program, and at the same time, define sanctions (such as consequences for missing therapy and failing a drug test) that delay progress toward program completion and cause youth to lose ground.
  • The need to focus on pro-social outcomes as well. It is critical to focus not only on treatment and compliance within the courts, but also to support and encourage these young people to engage with their schools, their work, and with positive social and leisure activities (i.e., sports clubs, youth groups, and social clubs).

Among the guidelines’ recommendations:

  • Juvenile drug treatment courts must plan for and provide their youth with access to a broad continuum of evidence-based treatment options including adolescent-specific, home-based outpatient, and intensive outpatient treatment; individual, group, and family treatment; and inpatient and residential treatment.
  • A clearly defined referral process should be in place to make it as easy as possible to effectively coordinate among families, the court, and the community’s treatment and social service providers.
  • Courts must identify and recommend treatment providers that use evidenced-based treatment approaches and models. These substance treatment programs should offer family therapy, motivational enhancement therapy, or cognitive behavioral therapy that follows standardized treatment protocols.
  • Courts should not refer youth to standard community services, stand-alone self-help treatment, or generic counseling programs that do not incorporate family therapy, motivational therapy, or cognitive behavioral therapy components.

The new guidelines have filled a void in the Juvenile Drug Treatment Court field. Previously, there was no comprehensive set of research-informed guidelines for the structure and work of these courts.

As Justin Riley Luke, CEO of Denver-based, Young People in Recovery, told me, “These guidelines are crucial because youth in or seeking recovery…deserve customized care, [and those] responsible for providing these life-saving resources need to be held to appropriate quality-of-care standards.” 

Now new research is underway to learn how the guidelines are working and their impact on improving the effectiveness of juvenile drug treatment court programs.

Roger Jarjoura is a principal researcher at AIR. He spent 19 years as a faculty member in the Indiana University School of Public and Environmental Affairs, where he designed and evaluated interventions that featured restorative justice and mentoring for juvenile and adult offenders in reentry from incarceration.

AIR Principal Communication Specialist Lori Agin contributed to this report. Her work focuses on health issues.

Behind the Guidelines

The new Juvenile Drug Court Treatment Guidelines are the result of an 18-month extensive research initiative led by AIR, funded and guided by the Department of Justice’s Office of Juvenile Justice and Drug Prevention, with significant contributions from research partners at the Court-Centered Change Consultant Network, George Mason University, Vanderbilt University, and WestEd. Additional review and counsel came from a panel of 35 federal partners and experts from the juvenile drug court field. The panel included judges, prosecutors, defenders, treatment providers, parents, and young adults—the typical members of Juvenile Drug Treatment Court teams—plus researchers. The panel provided input for developing guidelines, feedback on each draft, and advice on the communication and dissemination plans for the finished guidelines.

Here is how the research was conducted: 

1. We established an evidence-based protocol to translate research about juvenile drug courts and related interventions into actionable, understandable, and measurable guidelines.

Four systematic research reviews focused on the effectiveness and implementation of juvenile drug courts’ adolescent substance use treatment programs and the implementation of adolescent-focused, evidence-based programs in juvenile justice, education, health, and child welfare. 

Because each review had a different focus, the methods used to synthesize the results were different (e.g. qualitative vs. quantitative results) but generally followed the methodological expectations for the conduct of systematic reviews outlined by The Campbell Collaboration. Full reports for each review including details of the findings and methodologies are available on the OJJDP website.  

Guideline statements were developed around the findings with the highest credibility ratings. Researcher confidence relative to each finding was judged on a four-point scale that reflected the amount of evidence, the analysis of the evidence, and the findings’ connection to evidence. For each systematic review, research teams used a three-step process to determine the credibility of findings within the context of the qualitative and quantitative evidence presented in each study included in the systematic reviews.

2. To understand specific outcomes from juvenile drug treatment courts, the research team identified 46 randomized and well-controlled quasi-experimental evaluation studies that reported on the effects of Juvenile Drug Treatment Courts compared to traditional juvenile court processing and used research synthesis techniques to examine implementation characteristics and outcomes related to recidivism and drug use outcomes across these studies.

We identified common implementation themes associated with more positive juvenile drug treatment court outcomes such as reducing the likelihood of further delinquency and involvement with substance abuse.

3. A systematic scan of policies and practices collected data from 25 juvenile drug treatment courts in 20 states. To be included in the scan, a juvenile drug treatment court had to have been created in 2004 or later (excluding court programs that predated the 16 Strategies in Practice) and have been operational for at least two years. Data included information on their current operations and structures, challenges to implementation, and perceived or measurable successes.

4. A series of listening sessions, conducted on site and through webinar interviews, identified issues in screening, eligibility, assessment, treatment, family collaboration, and outcome monitoring. Results from these listening sessions provided more input for the draft guidelines.

For more information on the guidelines’ goals, objectives, and activities—as well as names of the research team, experts, and partners—see Frequently Asked Questions.