Evidence Rating: Promising | More than one study
Date:
This program incorporates contingency management protocols and multisystemic therapy into traditional juvenile drug court services to provide juveniles and families with additional engagement opportunities and support to reduce recidivism and substance abuse. The program is rated Promising. The program statistically significantly reduced alcohol and poly drug use, positive drug urine screens, status offenses, and property offenses. The program had mixed effects on marijuana use and offenses.
A Promising rating implies that implementing the program may result in the intended outcome(s).
This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.
Program Goals
Juvenile drug courts are problem-solving courts for cases involving substance-abusing juveniles in need of specialized treatment services. The emphasis is on providing treatment to eligible, drug-involved juveniles with the goal of reducing recidivism and substance abuse. The addition of the contingency management protocol and multisystemic therapy provides juveniles and families with additional engagement opportunities and support to improve the juvenile’s behavior.
Program Components/Services Provided
Juvenile drug courts are administered by a team of professionals, including court personnel (such as judges) and other treatment and social service providers. Juvenile drug court programs involve drug testing, ongoing case management, and weekly status hearings. In addition, treatment providers work closely with juveniles and their families to target substance use and related problem behaviors.
Contingency management is a threefold process consisting of 1) addressing the target behavior or behaviors, 2) providing tangible reinforcers when those behaviors are exhibited, and 3) removing incentives when those behaviors are not shown (Petry 2000).
Integrating the contingency management protocol with juvenile drug court services includes several components. The first component is the use of validated instruments and clinical interviews to determine the extent of the juvenile’s substance use. The scale ranges from experimental use to abuse/dependency. If the juvenile’s substance use is measured toward the latter end of the scale, he or she is introduced to the contingency management protocol and referred to treatment services.
At that time, a therapist employed by a community-based service provider collaborates with the juvenile and parents/guardians to analyze the juvenile’s substance use behaviors. Referrals are made to self-management and drug refusal skills training, then the juvenile and parents/guardians create a contingency contract to outline rewards for negative substance screens and consequences for positive ones.
Contingency contracts include a list of reasonable rewards for abstaining from substance use. These include incentives such as Internet access, a later curfew, or gift cards to stores or restaurants. A voucher system with levels and points is assigned to the list of incentives to encourage juveniles to abstain from substance use. Points are earned or lost based on drug screens and can be redeemed for rewards at any time.
At program completion, the therapist works with the juvenile and parents/guardians to create an aftercare plan.
Multisystemic therapy enlists the support of family members in the treatment process. The juvenile drug courts incorporate key therapeutic elements and skills building of multisystemic therapy into their creation and implementation of treatment programs. Key strategies include juvenile and family collaboration in the development of treatment goals, conceptualizing interventions to meet those goals, maintaining a nonblaming stance, and incorporating skills such as empathy, reflective listening, and flexibility. The overall goal of multisystemic therapy is to keep juveniles who exhibit serious problems—such as criminal behavior—at home, in school, and out of trouble. Juveniles are treated in the environments where their problem behaviors exist (i.e., home, school) rather than in an unfamiliar environment (i.e., custody) to enable change.
Study 1
Child Behavior Checklist
There were no statistically significant differences between treatment conditions reported for symptoms on the Child Behavior Checklist at 12 months after treatment.
Days in Out-of-Home Placement
There were no statistically significant differences between treatment conditions on the average number of days in out-of-home placement throughout the study period.
Crimes Against Persons
Juveniles in the DC/MST/CM condition reported fewer crimes against persons at 12 months following treatment, compared with juveniles in the FC condition. This difference was statistically significant.
General Theft
There were no statistically significant differences reported between treatment conditions on general theft at 12 months following treatment.
Status Offense
Juveniles in the DC/MST/CM condition reported fewer status offenses at 12 months following treatment, compared with juveniles in the FC condition. This difference was statistically significant.
Poly Drug Use
Juveniles in the DC/MST/CM condition reported less polydrug use at 12 months following treatment, compared with juveniles in the FC condition. This difference was statistically significant.
Drug Urine Screening
Between the 4- and 12-month posttreatment surveys, juveniles in the DC/MST/CM condition had lower percentages of positive screens, compared with juveniles in the FC condition. This difference was statistically significant.
Alcohol Use
Henggeler and colleagues (2006) found that juveniles in the drug court with multisystemic therapy enhanced with contingency management (DC/MST/CM) condition reported less alcohol use at 12 months following treatment, compared with juveniles in the usual family court with community services (FC) condition. This difference was statistically significant.
Marijuana Use
Juveniles in the DC/MST/CM condition reported less marijuana use at 12 months after treatment, compared with juveniles in the FC condition. This difference was statistically significant.
Study 2
SRD Person Offenses
During months 7–9 following baseline, juveniles in the CM–FAM group reported a decrease in the rate of person offenses (73 percent), whereas juveniles in the treatment-as-usual group reported an increase (95 percent) in the rate of person offenses. This difference was statistically significant.
Self-Report Delinquency Scale (SRD) General Delinquency
During months 7–9 after baseline, there were no statistically significant differences between groups on self-reported general delinquency.
SRD Property Offenses
During months 7–9 following baseline, juveniles in the CM–FAM group reported a larger decrease in the rate of property crimes, compared with the treatment-as-usual group (88 percent, compared with 66 percent). This difference was statistically significant.
Urine Drug Screens: Marijuana
Henggeler and colleagues (2012) found that during months 7-9 post baseline, the odds of a positive marijuana per drug screen for treatment-as-usual youths increased 94 percent, compared with a decrease of 18 percent for contingency management-family engagement (CM-FAM) youths. This difference was statistically significant.
Timeline Follow-Back: Marijuana
During months 7-9 after baseline, there were no statistically significant differences between groups on self-reported use of marijuana.
Study 1
Henggeler and colleagues (2006) conducted a randomized experimental design with intent-to-treat analysis to evaluate the impact on substance use, criminal behavior, incarceration, and symptomology of various interventions integrated into three juvenile drug courts (JDCs) in Charleston County, S.C.
The study population was recruited from the South Carolina Department of Juvenile Justice. The final sample consisted of 161 substance-abusing and -dependent juveniles (according to the DSM–IV, Fourth Edition), ages 12 through 17. Youths were excluded if they were already formally involved in substance abuse treatment or if a family member had already received Multisystemic Therapy (MST) treatment.
Selected persons were randomly assigned to one of four treatment conditions: 1) family court with community services (FC), 2) drug court with community services (DC), 3) drug court with MST (DC/MST), and 4) drug court with MST enhanced with contingency management (DC/MST/CM). No nontreatment comparison group was included in the study. Assessments were conducted at three points in time: pretreatment, 4 months following treatment, and 12 months following treatment.
Sample youths were on average 15.2 years old and predominantly male (83 percent) and African American (67 percent). Another 31 percent were white, and 2 percent identified as biracial. Youths averaged 3.6 arrests before entering the study. There were no significant differences between groups at pretreatment.
Substance abuse was measured through self-reports and biological indices (drug urine screens from the three drug courts). Because of low positive screens for cocaine and amphetamines, analysis focused solely on cannabis use. Criminal behavior was assessed through self-reports and arrest records. Mental health symptoms were assessed through youth and caregiver reports. Data was analyzed looking at the effects at 12 months following recruitment.
Study 2
Henggeler and colleagues (2012) conducted a randomized experimental design with intent-to-treat analysis to evaluate the impact of JDCs with the contingency management–family engagement intervention (CM–FAM) on substance abuse and criminal behavior.
Six JDCs were used in the study. Three were randomly selected to receive training and support to implement CM–FAM for 18 months, and the other three were randomly selected to deliver their treatment as usual. Juveniles in JDCs were referred from juvenile justice authorities, family court, or county departments of mental health and social services. For participation, juveniles had to be between 12 and 17 years old, be on formal or informal probationary status, and speak English fluently.
Juveniles in the study did not differ in their demographic or diagnostic characteristics. Participants were, on average, 15.4 years old, mainly male (83 percent), and mostly white (57 percent). Another 40 percent were African American, 3 percent identifying as biracial. Final analyses included data from 104 juveniles, with 63 juveniles in the CM–FAM condition and 41 juveniles in the treatment-as-usual condition.
Juvenile outcomes were measured using self-reported substance use and delinquent behavior at baseline, and at 3, 6, and 9 months after recruitment. Urine drug screens were collected at random times weekly. Self-reported substance use was evaluated using a timeline follow-back methodology for the previous 90 days at the time of survey. Analyses were performed using mixed-effects regression models.
These sources were used in the development of the program profile:
Study 1
Henggeler, Scott W., Colleen A. Halliday–Boykins, Philippe B. Cunningham, Jeff Randall, Steve B. Shapiro, and Jason E. Chapman. 2006. “Juvenile Drug Court: Enhancing Outcomes by Integrating Evidence-Based Treatments.” Journal of Counseling and Clinical Psychology 71(1):42–54.
Study 2
Henggeler, Scott W., Michael R. McCart, Philippe B. Cunningham, and Jason E. Chapman. 2012. “Enhancing the Effectiveness of Juvenile Drug Courts by Integrating Evidence-Based Practices.” Journal of Consulting and Clinical Psychology 80(2):264–75.
These sources were used in the development of the program profile:
Henggeler, Scott W., Jason E. Chapman, Melisa D. Rowland, Colleen A. Halliday–Boykins, Jeff Randall, Jennifer Shackelford, and Sonja K. Schoenwold. 2008. “Statewide Adoption and Initial Implementation of Contingency Management for Substance Abusing Adolescents.” Journal of Counseling and Clinical Psychology 76(4):556–67.
Petry, Nancy M. 2000. “A Comprehensive Guide to the Application of Contingency Management Procedure in Clinical Settings.” Drug and Alcohol Dependence 58(1–2):9–25.
Sheidow, Ashli J., Jayani Jayawardhana, W. David Bradford, Scott W. Henggeler, and Steven B. Shapiro. 2012. "Money Matters: Cost-Effectiveness of Juvenile Drug Court With and Without Evidence-Based Treatments." Journal of Child and Adolescent Substance Abuse 21:69–90.
Following are CrimeSolutions-rated programs that are related to this practice:
Juvenile drug courts are dockets within juvenile courts for cases involving substance abusing youth in need of specialized treatment services. The focus is on providing treatment to eligible, drug-involved juveniles with the goal of reducing recidivism and substance abuse. The practice is rated Promising in reducing recidivism rates, and No Effects for reducing drug-related offenses or drug use.
Evidence Ratings for Outcomes
Crime & Delinquency - Multiple crime/offense types | |
Crime & Delinquency - Drug and alcohol offenses | |
Drugs & Substance Abuse - Multiple substances |
Age: 12 - 17
Gender: Male, Female
Race/Ethnicity: White, Black, Other
Geography: Suburban Rural
Setting (Delivery): Other Community Setting, Courts
Program Type: Alcohol and Drug Therapy/Treatment, Alcohol and Drug Prevention, Drug Court, Family Therapy, Individual Therapy, Probation/Parole Services, Wraparound/Case Management
Targeted Population: Alcohol and Other Drug (AOD) Offenders
Current Program Status: Active