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JUVENILE DRUG TREATMENT COURT (JDTC) EVIDENCE-BASED PRACTICES: WHAT ARE THEY AND WHY ARE THEY IMPORTANT?
group of young people and two adults studying
FEATURED GUESTS DR. JULIE BALDWIN, ASSOCIATE DIRECTOR, AND MATT COLLINSON, RESEARCH SPECIALIST, JUSTICE PROGRAMS OFFICE, AMERICAN UNIVERSITY (DC)
Several Juvenile Drug Treatment Court (JDTC) Guidelines (e.g., Guideline 6.1 and 6.4), stress the need to follow evidence-based practices, such as a treatment modality, incentive structure, and family engagement strategy. But what do we mean when we say that a practice is evidence-based? Why do JDTCs need to use evidence-based interventions with their participants?

In the research world, when referring to an intervention or process, the term evidence based means empirically tested and found to improve the chances of achieving a desired outcome in comparison to doing nothing or using some other process. When court practitioners adopt a new practice, they often want to see if it is more effective than their previous practice - often referred to as “practice (process or treatment) as usual.” The Office of Justice Programs considers a practice to be evidence-based when causal evidence of its effectiveness has been found, typically through high-quality outcome or impact evaluations.
...while innovation is important and necessary in certain cases, there are often appropriate interventions available that have been deemed evidence-based, and we should seek these out before re-inventing the wheel or deviating from evidence-based practices that can result in decreased effectiveness and unachieved goals.
For example, OJJDP’s Model Programs Guide utilizes the evidence ratings of “effective,” “promising,” and “no effect” in conjunction with the quantity indicators of “one study” or “more than one study.” “Effective”  indicates that there is strong evidence that a practice achieves intended outcomes when implemented with fidelity because one or more high-quality, rigorous studies (e.g., randomized controlled trials) have shown the practice to increase the likelihood of achieving target outcomes. “No Effect” refers to practices where studies have produced strong evidence that they did not achieve intended outcomes when implemented with fidelity. Finally, “Promising Practices”  are those that have some evidence indicating they achieve intended outcomes, and further research is recommended.
Why does any of this matter for JDTCs? JDTC staff strive to improve the lives of youth participants in their programs, and they desire and intend to use interventions that help the young people in their care. Unfortunately, not all treatments and practices available are evidence-based. However, many have been evaluated. Accordingly, to best meet the needs of the young people they serve, JDTCs should make a concerted effort to provide them with evidence-based care. Additionally, while innovation is important and necessary in certain cases, there are often appropriate interventions available that have been deemed evidence-based, and we should seek these out before re-inventing the wheel or deviating from evidence-based practices that can result in decreased effectiveness and unachieved goals.

To ensure your treatment providers are providing evidence-based interventions in line with the Guidelines, you as JDTC team members are encouraged to talk with your JDTC treatment providers about the services they provide. Remember, there are best, effective, promising, and emerging practices available and continually being developed for your JDTC to improve the lives of our youth significantly. To follow the Guidelines most closely, it is crucial to use evidence-based interventions in your courts.

RESOURCES
  • Visit the SAMHSA's National Registry of Evidence-Based Programs and Practices (NREPP). 
  • For additional information on evidence-based family treatments, visit the National Institute on Drug Abuse (NIDA) website here
  • Does your team need training and technical assistance (TTA) to put the JDTC Guidelines into practice? Request TTA here
  • Want access to more resources? Click here for team training webinars, resources and tools, and other publications relevant to screening and assessment tools that you can share with your team!
WELCOMING EVIDENCE-BASED TREATMENTS (EBTS) AND BUILDING ACCOUNTABILITY FOR THE JUVENILE DRUG TREATMENT COURT TEAM, YOUTH, AND FAMILY
Many Juvenile Drug Treatment Courts (JDTCs) have accountability as part of their mission statement. Holding youths accountable for desired behavior is one part of accountability. However, accountability is not just for the youth. The team should hold itself accountable for providing JDTC participants with a continuum of services and treatment interventions, delivered by trained and certified treatment professionals who have proven to be effective in promoting change. 

JDTC teams have every reason to welcome evidence-based treatments (EBTs) and to include them in their programs. Using evidence-based treatments takes the guesswork out of what treatment to offer and what to expect from treatment interventions. Using EBTs ensures that what you provide to youths as treatment will give youths and family members the tools they need for success in your JDTC and beyond. The tools include an understanding of substance using behavior and triggers, as well as strategies for replacing substance use-related unhealthy, developmentally disruptive and anti-social behavior with healthy, life-affirming and developmentally desirable behavior and activities. 

Short-Term Actions

1) Create a shared knowledge base for all team members about the continuum of EBTs that exist for adolescents and that would be appropriate to provide to your JDTC participants. State- and county-level departments of behavioral health or health and human services have experts on staff that are knowledgeable about different types of EBTs, the populations they are appropriate for, and criteria for their use. Contact the relevant behavioral health department to ask for a speaker to meet with your team and interested stakeholders for a Q&A 101 session on EBTs for adolescents with substance use disorders.

Click below to link to additional resources to use to prepare for the Q&A session:

Screening, Brief Interventions, and Referral to Treatment (SBIRT):

2) Schedule a team meeting to set goals and create an action plan for securing and sustaining EBT interventions and services to meet the needs of JDTC participants. Click here for an action planning template.
Long-Term Actions

1) Map your community’s treatment resources. Work with county- or state-level government behavioral health experts and/or use SAMHSA internet resources such as the Behavioral Health Treatments and Services and the Behavioral Health Treatment Services Locator, to find evidence-based treatment resources in your community. Invite providers to complete a survey on their services. Ask them to make a presentation to your team about their services. Hold an open house so that your team may visit the program, meet staff, and see the program setting.

Click below to link to additional resources on community treatment mapping tools


2) Develop contracts with providers for services that meet your team’s EBT goals. Hold a team brainstorming session on service features to be included in contracts to achieve the team’s EBT services goals. Ask relevant state or county department of behavioral health or health and human services staff to facilitate the brainstorming session. 
PUBLICATIONS
Publication of juvenile drug treatment court guidelines publication in various blue color blocks
The Juvenile Drug Treatment Court Guidelines (Guidelines) are based on current research. The Guidelines provide juvenile courts with an evidence-based, treatment-oriented approach that emphasizes family engagement. Also addressed are the co-occurring mental health disorders that many youth with substance use disorders experience. The Guidelines are organized into key objectives with corresponding guideline statements. References to the rigorous supporting research as well as considerations for implementation are provided.

Click here to download this publication. 
The Guide to the Guidelines Series: Practical Tips for Juvenile Drug Treatment Courts to Implement will provide JDTC professionals and teams with advice and tips on the Guidelines. Each of the Guidelines works toward achieving reduced substance use, healthy adolescent development, and reduced delinquency with youth through the use of short- and long-term actions to implement practices with the goals of increasing JDTC effectiveness and positively influencing youth. 

Click here to download this publication. 
NEWS & RESOURCES
The Addiction Policy Forum has published a fact and figures sheet breaking down national data on substance use and its impact throughout the years. View the fact and figures sheet here.   
A 2015 Youth Risk Behavior Surveillance System national survey gathered by the Centers for Disease Control and Prevention (www.CDC.gov) was analyzed by Oregon State University (OSU) and published in the Drug and Alcohol Dependence journal. OSU found that lesbian, gay, bisexual, or transgender (LGBT) youth were at higher risk of participating in polysubstance use, such as alcohol, marijuana, and nicotine, than heterosexual youth. To read OSU's analysis, click here.  
(Manchester, NH) The John H. Sununu Youth Services Center will be adding a drug treatment facility to deliver services to youth ages 12 to 18 with substance use disorders. Read more about the progress of their new facility as construction comes to an end. 
(Columbia, OH) Noah, an 18 year old, is speaking about the positive outcomes and opportunties of his alternative sentencing and participation in drug court. Como Youth Works, a local non-profit, has helped young adults with substance use and to find ways to equip youth with skills that will help them when they finish the drug court program. Learn more about this young man's story and how Columbia is encouraging additional expansion of drug court programs. 
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