Program Profile: Tulsa (OK) Family Drug Court

This is a treatment court dedicated to cases of child abuse and neglect, in which parental substance abuse is one of the primary reasons for child welfare involvement. The program provides parenting training in conjunction with substance abuse treatment to increase the likelihood of reunification. The program is rated Effective. Families who received services through the Family Drug Court were statistically significantly more likely to reunify than comparison families.

An Effective rating implies that implementing the program is likely to result in the intended outcome(s).

Program Goals

The Family Drug Court (FDC) in Tulsa, Oklahoma, is a dependency treatment court dedicated to cases of child abuse and neglect in which parental substance abuse was one of the primary reasons for child welfare system involvement. The goals of the program are to help parents recover from substance abuse, improve parenting and family functioning, and ultimately reunite parents and children.

Targeted Population/Eligibility

Eligible families are invited to participate in the program if parental substance abuse was one of the primary reasons for involvement with the child welfare system. Entry into FDC is voluntary; however, once involved, a family cannot voluntarily exit the FDC. Parents can only exit the program by either failing to complete or successfully graduating from the program.

Program Components

Adult participants are mandated to outpatient substance abuse treatment at a minimum, with additional services provided depending on the needs of parents (including being wait-listed for inpatient substance abuse treatment). The program also involves FDC team meetings prior to court hearings (to discuss admissions and progress of program participants); the use of phases, rewards, and progressive sanctions; frequent and random urinalysis; and cross-disciplinary collaboration and training.

While receiving treatment, participants are also required to engage in two parenting/family dynamics programs, Strengthening Families Program (SFP) and Celebrating Families! (CF). The programs are implemented in a paired sequence (beginning with SFP and then CF) during which FDC participants are also required to receive substance abuse treatment. SFP is designed to work with individuals in earlier phases of substance abuse recovery and focuses heavily on skill-based training, whereas CF targets clinical behaviors related to family dynamics associated with substance abuse for those who are further along in recovery. Within 3 months of initiating FDC participation, parents begin the next available group of SFP, followed by CF. If participants miss more than two sessions of either program, they are removed from the group. 

Program Theory

FDCs are modeled on adult drug courts and rooted in therapeutic diversion. These courts emphasize substance abuse treatment and sustaining parental rights and reunification with their children. FDCs make use of the “10 key components” that adult drug courts use to develop and maintain services.  FDCs build upon that framework while addressing issues that are unique to child welfare courts such as avoiding long-term placement in foster care for the children and giving the parents the opportunity to demonstrate to the court that they can become responsible caregivers (Brook et al. 2015; DSG 2016). 

Study

Brook and colleagues (2015) conducted a quasi-experimental design in which families assigned to Family Drug Court in Tulsa, Oklahoma, were matched (via propensity scores) with a comparison group of families in the adoption and foster care system.

A total of 226 treatment cases were available for study during the evaluation period.  The full pool of potential comparison cases in Oklahoma’s Adoption and Foster Care Analysis and Reporting System (AFCARS) was reduced through the application of four criteria: 1) dates of children’s removal from their homes or their discharge from foster care; 2) reasons for alleged maltreatment must be due to parental alcohol or drug abuse; 3) age of the child at time of removal (must be under 17); and 4) only non-emancipated children. The remaining cases in the comparison pool were subjected to propensity score matching to the treatment cases on 14 child indicators. This resulted in a potential comparison pool of 3,827 cases. The final comparison group was composed of 418 treatment cases (204 FDC cases were matched with two comparison cases; an additional 10 were matched with only one comparison case, and 12 cases could not be matched and were excluded from further analysis).

After generating the comparison sample, life tables and Cox regression were used to assess whether FDC participants were more likely to reunify with their families of origin and the likelihood of reunification for the FDC group over time compared with the comparison group, after controlling for those covariates. The matched samples were found to have no significant between-group differences at baseline, except for removal time.

The treatment group sample was 49.5 percent female. The racial/ethnic diversity of the children in the treatment sample was 43.5 percent white, 10.3 percent American Indian, 5.6 percent African American, and 40.7 percent other races.  Of the total treatment sample, 12.6 percent of the children were Hispanic. The comparison sample was similar, with mostly female children (44.5 percent). Of the comparison sample, 40.2 percent were white, 8.6 percent were African American, 7.4 percent were American Indian, and 43.8 percent were from other races.  A total of 11.5 percent of the children in the comparison sample were Hispanic. The mean age of the child at removal was the same for the treatment and comparison cases (3.4 years old).

The primary outcome of interest was family reunification, which was measured though official records. Case outcomes were tracked from January 2011 through September 2013. A Cox regression was conducted to examine the likelihood of reunification over time for the FDC group, compared with the matched comparison group.  The variables known to be predictive of reunification were used as control variables in the analysis. 

The study authors conducted an additional cost-benefit analysis of the Tulsa Family Drug Treatment Court (FDTC). The following three measures were used: 1) cost avoidance (e.g., days saved, out-of-home-care costs); 2) program operational costs; and 3) net cost savings, calculated from the first two measures. There were 277 children and 171 parents in the sample. The study authors found that the total cost avoidance was approximately $18,625 per child served. Costs for the two parenting programs totaled $175,000 per year. The Tulsa FDTC court costs (including personnel and drug testing) totaled $792,635 per year. To calculate net cost savings, the total costs of the program were divided by the number of children served annually, with a cost to serve per child of $8,906. The difference between cost avoidance per child and the cost to serve per child was $9,719; thus, the FDTC resulted in a net cost savings per child of more than $9,700 (Brook et al. 2016).

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Brook, Jody, Becci A. Akin, Margaret H. Lloyd, Michelle Johnson-Motoyama, and Yueqi Yan. 2016. “Family Drug Treatment Courts as Comprehensive Service Models: Cost Considerations.” Juvenile and Family Court Journal 67(3):23-43.

Development Services Group, Inc. 2016. “Family Drug Courts.” Literature review. Washington, D.C.: Office of Juvenile Justice and Delinquency Prevention.

https://www.ojjdp.gov/mpg/litreviews/Family_Drug_Courts.pdf

Oklahoma Department of Mental Health and Substance Abuse Services. 2015. Family Drug Courts.

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