Evaluating the Impact of Adding the
Reclaiming Futures Approach to Juvenile
Treatment Drug Courts
Michael L. Dennis, Ph.D., Kate Moritz, M.A., Rachel Meckley, Nora Jones,
M.S., Chestnut Health Systems, Normal, IL
Susan Richardson, Cora Crary, Laura Nissen, Ph.D., Reclaiming Futures
National Program Office, Portland State, University, Portland, OR
Mac Prichard, M.P.A., Liz Wu, Prichard Communications, Portland, OR
May 8, 2012
Report to Kristin Schubert, Robert Woods Johnson
Foundation, Reclaiming Futures; Robert Vincent,
Substance Abuse and Mental Health Services
Administration; and Gwendolyn Williams, Office of
Juvenile Justice and Delinquency Prevention,1 Office
of Justice Programs
Click Acknowledgement
to edit Master title style
2
 Analysis for this presentation was supported by the Center for Substance
Abuse Treatment (CSAT), Substance Abuse and Mental Health Services
Administration (SAMHSA) contract 270-07-0191 using data provided by 27
Juvenile Treatment Drug Court (JTDC) grantees funded by SAMHSA , Office
of Juvenile Justice and Delinquency Prevention (OJJDP), and/or Reclaiming
Futures (TI17433, TI17434, TI17446, TI17475, TI17484, TI17476, TI17486,
TI17490, TI17517, TI17523, TI17535; 655371, 655372, 655373, (TI22838,
TI22856, TI22874, TI22907, TI23025, TI23037, TI20921, TI20925, TI20920,
TI20924, TI20938, TI20941)
 The authors thank these grantees and their participants for agreeing to
share their data to support this secondary analysis as well as the following
people for assistance in preparing and/or feedback on the presentation:
Jimmy Carlton, Michael French, Mark Fulop, Lori Howell, Pamela Ihnes,
Rachel Kohlbecker, Kathryn McCollister, Daniel Merrigan, Scott Olsen.
 The opinions about this data are those of the authors and do not reflect
official positions of the government or individual grantees. Please direct
correspondence to Michael L. Dennis, Chestnut Health Systems, 448 Wylie
Drive, Normal, IL 61701, mdennis@chestnut.org 309-451-7801.
 This presentation is available at www.gaincc.org/presentations
Click to edit
Purpose
Master title style
3
1. Illustrate why it is so important to intervene
with juvenile drug users
2. Review what we know about juvenile treatment
drug courts (JTDC) so far
3. Compare JTDC to a newer Reclaiming Futures
version of JTDC in terms of their impact on
substance use, recovery, emotional problems,
illegal activity and costs to society
Click to edit Master title style
4
Background
Adolescence
is the
AgeMaster
of Onset
Click
to edit
title style
5
100
90
80
70
60
Over 90% of
use and
problems
start
between the
ages of 12-20
People with drug
dependence die an
average of 22.5 years
sooner than those without
a diagnosis
It takes decades before
most recover or die
Severity Category
Other drug or
heavy alcohol use
in the past year
50
40
Alcohol or Drug Use
(AOD) Abuse or
Dependence in the
past year
20
10
0
65+
50-64
35-49
30-34
21-29
18-20
16-17
14-15
12-13
Percentage
30
Age
Source: 2002 NSDUH and Dennis & Scott, 2007, Neumark et al., 2000
Adolescence
Use
to Range
of Problems
Click
toRelated
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title style
6
Source: Dennis & McGeary, 1999; OAS, 1995
6
Other Life Course
to Focus
on Adolescents
Click toReasons
edit Master
title style
7
 People who start using under age 15 use 60% more years
than those who start over age 18
 Entering treatment within the first 9 years of initial use leads
to 57% fewer years of substance use than those who do not
start treatment until after 20 years of use
 Relapse is common and it takes an average of 3 to 4
treatment admissions over 8 to 9 years before half reach
recovery
 Of all people with abuse or dependence 2/3rds do eventually
reach a state of recovery
 Monitoring and early re-intervention with adults has been
shown to cut the time from relapse to readmission by 65%,
increasing abstinence and improving long term outcomes
Source: Dennis et al., 2005, 2007; Scott & Dennis 2009
What
Treatment?
Click to
edit Is
Master
title style
8
 Motivational interviewing and other protocols to help them
understand how their problems are related to their substance
use and that they are solvable
 Detoxification and medication to reduce pain/risk of
withdrawal and relapse, including tobacco cessation
 Evaluation of antecedents and consequences of use
 Group, individual or family outpatient including relapse
prevention planning
 More systemic family approaches
 Proactive urine monitoring
 Motivational incentives / contingency management
 Residential, intensive outpatient (IOP) and other types of
structured environments to reduce short term risk of relapse
 Access to communities of recovery for long term support,
including 12-step, recovery coaches, recovery schools,
recovery housing, workplace programs
 Continuing care, phases for multiple admission
The
Treatment
Gapstyle
Click to
edit
Master title
9
Over 88% of adolescent and
young adult treatment and
over 50% of adult treatment is
publicly funded
Few Get Treatment:
1 in 20 adolescents,
1 in 18 young adults,
1 in 11 adults
25%
Much of the private
funding is limited to 30
days or less and
authorized day by day or
week by week
20.1%
20%
15%
10%
7.4%
7.0%
5%
1.1%
0.4%
0.6%
0%
12 to 17
18 to 25
Abuse or Dependence in past year
26 or older
Treatment in past year
Source: Substance Abuse and Mental Health Services Administration, Office of Applied Studies (2012). National Survey on Drug Use and Health, 2009. [Computer
file] ICPSR29621-v2. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2012-02-10. doi:10.3886/ICPSR29621.v2. Retrieved
from http://www.icpsr.umich.edu/icpsrweb/SAMHDA/studies/29621/detail .
Other Problems
Click toWith
edit Master
the U.S.title
Treatment
style System
10






Less than 75% stay the 90 days recommended by NIDA
(half less than 50 days)
Less than half are positively discharged
Less than 10% leaving higher levels of care are transferred
to outpatient continuing care
The majority of programs do NOT use standardized
assessment, evidenced-based treatment, track the clinical
fidelity of the treatment they provide, or monitor their
own performance in terms of client outcomes
Average staff education is an Associate Degree
Staff stay on the job an average of 2 years
Source: Institute of Medicine (2006). Improving the Quality of Health Care for Mental and
Substance-Use Conditions . National Academy Press. Retrieved from
http://www.nap.edu/catalog.php?record_id=11470
The Cost of
Treatment
Episode
vs.style
Consequences
Click
to edit Master
title
Screening & Brief Inter.(1-2 days)
Outpatient (18 weeks)
In-prison Therap. Com. (28 weeks)
Intensive Outpatient (12 weeks)
Adolescent Outpatient (12 weeks)
Treatment Drug Court (46 weeks)
Methadone Maintenance (87 weeks)
Residential (13 weeks)
Therapeutic Community (33 weeks)
$70,000
$60,000
$50,000
$40,000
$30,000
$20,000
$0
SBIRT models popular due to
ease of implementation and
low cost
$10,000
11
$407
• $750 per night in Medical Detox
$1,132
• $1,115 per night in hospital
$1,249
• $13,000 per week in intensive
$1,384
care for premature baby
$1,517
• $27,000 per robbery
• $67,000 per assault
$2,486
$4,277
$10,228
$14,818
$22,000 / year
to incarcerate
an adult
$30,000/
child-year in
foster care
$70,000/year to
keep a child in
detention
Source: French et al., 2008; Chandler et al., 2009; Capriccioso, 2004 in 2009 dollars
Return
on Investment
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to edit
Master title(ROI)
style
12
• Substance abuse treatment has been shown to have
a ROI within the year of between $1.28 to $7.26 per
dollar invested
• GAO’s recent review of 11 drug court studies found
that the net benefit ranged from positive $47,852 to
negative $7,108 per participant.
• Best estimates are that Treatment Drug Courts have
an average ROI of $2.14 to $3.69 per dollar invested
This also means that for every dollar treatment is cut,
it costs society more money than was saved within
the same year
Source: Bhati et al., (2008); Ettner et al., (2006), GAO (2012), Lee et al (2012)
Click
to edit
Master
title
style
Juvenile
Justice
System
and
Substance
Use
13
 About half of the youth in the juvenile justice system
have drug related problems (Office of Juvenile
Justice and Delinquency Prevention (OJJDP), 2001;
Teplin et al., 2002).
 Juvenile justice systems are the leading source of
referral among adolescents entering treatment for
substance use problems (Dennis et al., 2003; Dennis,
White & Ives, 2009).
 By late 2004, there were 357 juvenile treatment
drug courts (JTDC) and the number of courts has
continued to grow at a rate of 30-50% per year.
Source: Dennis, White & Ives, 2009
Recommended
Components
JTDC
Click to edit Master
title style
14
1. Formal screening process for early identification and referral
for substance use and other disorders/needs
2. Multidimensional standardized assessment to guide clinical
decision-making related to diagnosis, treatment planning,
placement and outcome monitoring
3. Interdisciplinary-treatment drug court team
4. Comprehensive non-adversarial team-developed treatment
plan, including youth and family
5. Continuum of substance-abuse treatment and other
rehabilitative services to address the youths needs
6. Use of evidence-based treatment practices
Recommended
Components
Click to edit
Master titleJTDC
style(cont.)
15
6.
Monitoring progress through urine screens and weekly
interdisciplinary-treatment drug court team staffings
7.
Feedback to the judge followed by graduated performancebased rewards and sanctions
8.
Reducing judicial involvement from weekly to monthly with
evidence of favorable behavior change over a year or longer
9.
Advanced agreement between parties on how on
assessment information will be used to avoid selfincrimination
10. Use of information technology to connect parties and
proactively monitor implementation at the client and
program level
Source: National Association of Drug Court Professionals, 1997; Henggeler et al., 2006; Ives et al., 2010.
Level of Click
Evidenced
to editisMaster
Available
titleon
style
Drug Courts
16
Beyond a
Reasonable
Doubt
Clear and
Convincing
Evidence
Preponderance
of the Evidence
Probable
Cause
Reasonable
Suspicion
STRONGER
Law
Science
Meta Analyses of Experiments/ Quasi
Experiments (Summary v Predictive, Specificity,
Replicated, Consistency)
Dismantling/ Matching study (What worked for
whom)
Experimental Studies (Multi-site, Independent,
Replicated, Fidelity, Consistency)
Quasi-Experiments (Quality of Matching, Multisite, Independent, Replicated, Consistency)
Pre-Post (multiple waves), Expert Consensus
Correlation and Observational studies
Case Studies, Focus Groups
Pre-data Theories, Logic Models
Anecdotes, Analogies
Source: Marlowe 2008, Ives et al 2010
Level of Click
Evidenced
to editisMaster
Available
titleon
style
Drug Courts
17
Beyond a
Reasonable
Doubt
Clear and
Convincing
Evidence
Preponderance
of the Evidence
Probable
Cause
Reasonable
Suspicion
STRONGER
Law
Science
Adult Analyses
Drug Treatment
Courts: 5 Quasi
meta analyses
Meta
of Experiments/
ofExperiments
76 studies found
crimevreduced
7-26%
with
(Summary
Predictive,
Specificity,
$1.74
to $6.32
return on investment
Replicated,
Consistency)
Dismantling/
Matching
(What
worked for
DWI Treatment
Courts:study
one quasi
experiment
and
five observational studies positive findings
whom)
Experimental Studies (Multi-site, Independent,
Family
Drug Treatment
Courts: one multisite
Replicated,
Fidelity, Consistency)
quasi experiment with positive findings for
Quasi-Experiments
parent and child (Quality of Matching, Multisite, Independent, Replicated, Consistency)
Pre-Post
waves),Courts
Expert–Consensus
Juvenile (multiple
Drug Treatment
one 2006
Correlation
studies quasiexperiment,and
oneObservational
2010 large multisite
Case
Studies, &Focus
Groups
experiment,
several
small studies with similar
or betterTheories,
effects than
regular
adolescent
Pre-data
Logic
Models
outpatient Analogies
treatment
Anecdotes,
Source: Marlowe 2008, Ives et al 2010
JuvenileClick
Treatment
Court
to edit Drug
Master
titleEffectiveness
style
18
 Low levels of successful program completion among
youths in drug courts was noticeable in several early
studies (Applegate & Santana, 2000; Miller, Scocas
& O’Connell, 1998; Rodriguez & Webb, 2004)
 JTDC was found to be more effective than
traditional family court with community service in
reducing adolescent substance abuse (particularly
when using evidence-based treatment) and criminal
involvement during treatment (Henggeler et al.,
2006)
 JTDC youth did as well or better than matched youth
treated in community based treatment (Sloan,
Smykla & Rush, 2004; Ives et al., 2010)
 But still much room for improvement
Click to edit Master title style
19
Methods
Juvenile Treatment
Court (JTDC)
Click to Drug
edit Master
title Grants
style (n=1,934)
20
 Juvenile Treatment Drug Court (DC)
– Original cohort of 11 CSAT grantee sites using the GAIN in
Laredo, TX; San Antonio, TX; Belmont, CA; Tarzana, CA;
Pontiac, MI; San Jose, CA; Austin, TX; Peabody, MA;
Providence, RI; Detroit, MI; and Philadelphia, PA
– Intake data collected from these sites on N=1,771
adolescents between January 2006 through March 2009
with 1+ follow-up at 3, 6, and 12-months post intake
 Juvenile Treatment Drug Court (JTDC)
– Cohort of 6 CSAT grantee sites using the GAIN in San
Antonio, TX; Seattle, WA; San Rafael, CA; Buffalo, NY; Box
Elder, MT; and Viera, FL
– Intake data collected from these sites on N=163 Adolescents
between January and November 2011 with 1+ follow-up at 3,
6, and 12-months post intake
Reclaiming
Futures
JTDC
(RF-JTDC)
Click
to edit
Master
titleGrants
style (n=811)
21
 Reclaiming Futures – Office of Juvenile Justice and
Delinquency Prevention (RF-OJJDP)
– Cohort of 3 grantee sites using the GAIN in Greene County,
MO; Hocking County, OH; and Nassau County, NY
– Intake data collected from these sites on N=457
adolescents between January 2008 through December
2011 with 1+ follow-up at 3, 6, and 12-months post intake
 Reclaiming Futures – Juvenile Drug Court (RF-JDC)
– Cohort of 6 grantee sites using the GAIN in Hardin County,
OH; Snohomish County, WA; Travis County, TX; Ventura
County, CA; Cherokee Nation, OK; and Denver, CO
– Intake data collected from these sites on N=354
adolescents between January 2010 through December
2011 with 1+ follow-up at 3, 6, and 12-months post intake
ClickGAIN
to edit
Master
title style
Initial
(GAIN-I)
22
 Administration Time: Core version 60-90 minutes; full version 110140 minutes (depending on severity)
 Training Requirements: 3.5 days (train the trainer) plus recommend
formal certification program (Administration certification within 3
months of training; Local Trainer certification within 6 months of
training); advanced clinical interpretation recommended for clinical
supervisors and lead clinicians
 Mode: Generally staff-administered on computer (can be done on
paper or self-administered with proctor)
 Purpose: Designed to provide a standardized biopsychosocial for
people presenting to a substance abuse treatment using DSM-IV for
diagnosis and ASAM for placement and needing to meet common
requirements (CARF, COA, JCAHO, insurance, CDS/TEDS, Medicaid,
CSAT, NIDA) for assessment, diagnosis, placement, treatment
planning, accreditation, performance/outcome monitoring, economic
analysis, program planning, and supporting referral/communications
with other systems
GAIN
ClickInitial
to edit(GAIN-I)
Master(continued)
title style
23
 Scales: The GAIN-I has 9 sections (access to care, substance use,
physical health, risk and protective behaviors, mental health,
recovery environment, legal, vocational, and staff ratings) that
include 103 long (alpha over .9) and short (alpha over .7) scales,
summative indices, and over 3,000 created variables to support
clinical decision-making and evaluation. It is also modularized to
support customization.
 Response Set: Breadth (past-year symptom counts for behavior and
lifetime for utilization), recency (48 hours, 3-7 days, 1-4 weeks, 2-3
months, 4-12 months, 1+ years, never), and prevalence (past 90
days); patient and staff ratings
 Interpretation:
– Items can be used individually or to create specific diagnostic or
treatment planning statements
– Items can be summed into scales or indices for each behavior
problem or type of service utilization
– All scales, indices, and selected individual items have
interpretative cut points to facilitate clinical interpretation and
decision making
Society
Click toCost
editto
Master
title style
24
 Costs of Service Utilization (conservative)
– The frequency of using tangible services (e.g., health care
utilization, days in detention, probation, parole, days of
missed school) in the 12 months before and after intake
valued by economists (French et al., 2003; Salomé et al.,
2003), adjusted for inflation to 2010 dollars and summed
 Costs of Crime (tangible & intangible)
– The frequency of committing crimes (e.g., property crime,
interpersonal crime, drug/other crime) in the 12 months
before and after intake valued on tangible and intangible
costs by economists (McCollister et al., 2010), adjusted for
inflation to 2010 dollars and summed
Service Click
Utilization
Costs
(conservative)
to editUnit
Master
title
style
25
Description
Inpatient hospital day
Emergency room visit
Outpatient clinic/doctor’s office visit
Nights spent in hospital
Times gone to emergency room
Times seen MD in office or clinic
Days bothered by any health problems
Days bothered by psychological problems
How many days in detox
Nights in residential for AOD use
Days in Intensive outpatient program for AOD use
Times did you go to regular outpatient program
Days missed school or training for any reason
How many times arrested
Days on probation
Days on parole
Days in jail/prison/detention
Days detention/jail
Unit
Days
Visits
Visits
Nights
Times
Times
Days
Days
Days
Nights
Days
Times
Days
Times
Days
Days
Days
Days
Cost in 2010$
$1,432.81
$ 269.87
$ 76.83
$1,432.81
$ 269.87
$ 76.83
$ 25.63
$
9.90
$ 259.00
$ 151.66
$ 104.19
$ 280.70
$ 18.38
$2,125.81
$ 5.76
$ 18.59
$ 81.06
$ 113.60
CostClick
of Crime
& intangible)
to edit(tangible
Master title
style
26
Offense
Murder
Rape/sexual assault
Aggravated assault
Robbery
Motor vehicle theft
Arson
Household burglary
Larceny/theft
Stolen property
Vandalism
Forgery and counterfeiting
Embezzlement
Fraud
Tangible\a
$1,294,788
$41,775
$19,787
$21,672
$10,669
$16,638
$ 6,249
$ 3,568
$ 8,076
$ 4,922
$ 5,332
$ 5,550
$ 5,096
Intangible\b Total Cost 2010$
$8,550,058
$9,844,845
$202,197
$243,972
$96,239
$116,026
$22,864
$44,536
$ 265
$10,934
$ 5,199
$21,837
$ 325
$ 6,574
$ 10
$ 3,578
$
$ 8,076
$
$ 4,922
$
$ 5,332
$
$ 5,550
$
$ 5,096
\a Including the cost to the victim, justice system, and criminal career
\b Including the cost of pain & suffering, prorated risk of homicide
Click to edit Master title style
27
Results: Baseline Needs
Count of Major
ClickClinical
to edit Master
Problems
title
atstyle
Intake: RF JTDC
28
*Based on count of self reporting criteria to suggest alcohol, cannabis, or other drug
disorder, depression, anxiety, trauma, suicide, ADHD, CD, victimization, violence/
illegal activity
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Number of
Click
Clinical
to edit
Problems:
Master title
JTDC
style
vs. RF-JTDC
29
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
General
RF-JTDC
Click Victimization
to edit MasterScale:
title style
30
*Mean of 15 items
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Major Clinical
by Victimization:
ClickProblems*
to edit Master
title style RF-JTDC
31
*Based on count of self reporting criteria to suggest alcohol, cannabis, or other drug disorder,
depression, anxiety, trauma, suicide, ADHD, CD, victimization, violence/ illegal activity
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
SeverityClick
of Victimization:
to edit Master JTDC
title style
vs. RF-JTDC
32
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Click Age
to edit
of Onset:
MasterJTDC
title style
33
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
ClickAge
to edit
of Onset:
Master
RF-JTDC
title style
34
RF JTDC Early Onset
and Higher Prevalence
of Mental Health and
Victimization
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Click to edit Master title style
35
Results: Services
Services
Received
Click to
edit Master
title style
36
*Days of Substance Abuse (SA), Mental Health (MH), Physical Health (PH) treatment and Juvenile Justice System Involvement
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Increase Click
in Average
to editCost
Master
of Service
title style
Utilization
37
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Treatment
Click to
Initiation*:
edit Master
JTDC
titlevs.
style
RF-JTDC
38
*Initial GAIN interview was administered within 14 days before to seven days after admission to Treatment
\c Other JTDC has significantly higher rate than RF-JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Engagement*:
Click to edit Master
JTDC vs.
titleRF-JTDC
style
39
*In initial Treatment 30+ days and reported 3+ days of Treatment
\d RF-JTDC has significantly higher rate than Other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Continuing
Click to edit
Care*:
Master
JTDCtitle
vs. style
RF-JTDC
40
*Received Treatment 90-180 days post intake
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Level
ClickoftoCare*:
edit Master
JTDC vs.
titleRF-JTDC
style
41
*OP: Outpatient, IOP: Intensive Outpatient; STR: Short Term Residential; M-LTR: Medium to Long Term Residential;
CC-OP Continuing Care Outpatient.. Distribution of clients by Level of Care is significantly different between JTDC and
RF-JTDC.
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
TypeClick
of Treatment*:
to edit Master
JTDC
title
vs.style
RF-JTDC
42
*A-CRA: Adolescent Community Reinforcement Approach; ACC: Assertive Continuing Care; MET/CBT: Motivational
Enhancement Therapy/ Cognitive Behavior Therapy; EBTx: Other evidenced based treatment approaches with outcome
data.. Distribution of clients by Type of Treatment is significantly different between JTDC and RF-JTDC.
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Length
Click of
to Stay*:
edit Master
JTDC title
vs. RF-JTDC
style
43
*Distribution of clients by Length of Stay is significantly different between JTDC and RF-JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Any Self
ClickHelp
to edit
Activity:
Master
JTDC
titlevs.
style
RF-JTDC
44
\c Other JTDC has significantly higher rate than RF-JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Click to edit Master title style
45
Results: Outcomes
Change
Click toinedit
Days
Master
of Abstinence*
title style
46
* Days of abstinence from alcohol and other drugs while living in the community; If coming from detention at intake, based on the
90 days before detention.
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Change
Click in
to Being
edit Master
in Early
title
Recovery*
style
47
* No past month use, abuse or dependence symptoms while living in the community
\a p<.05 that post minus pre change is statistically significant
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Change
ClickintoEmotional
edit Master
Problems
title style
Scale*
48
*Proportional average of recency and days of emotional problems (bothered, kept from responsibilities, disturbed by memories,
paying attention, self-control) in past 90
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Change
Click to
inedit
DaysMaster
of Victimization*
title style
49
*Number of days victimized (physically, sexually, or emotionally ) in past 90
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Change
Click to
inedit
Illegal
Master
Activities
title style
Scale*
50
*Recency and days (during the past 90) of illegal activity and supporting oneself financially with illegal activity
\a p<.05 that post minus pre change is statistically significant
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Change inClick
Average
to edit
Number
Masterof
title
Crimes
style Reported
51
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
Change in Average
of Crimes
Click toNumber
edit Master
titleReported
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*Sum of all crimes reported by type
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
Source: CSAT 2010 SA Data Set subset to 1+ Follow ups
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*Based on the frequency of crime times the average cost to society of that crime estimated by McCollister et al (2010) in
2010 dollars; distribution capped at 99th percentile to minimize the impact of outliers...
\a p<.05 that post minus pre change is statistically significant
\b p<.05 that change for Reclaiming Futures JTDC is better than the average for other JTDC
CSAT 2010 SA Data Set subset to 1+ Follow ups
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Discussion
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Limitations
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 This analysis is based on self-reported data
 The conditions were defined by grant mechanism, it would be
better to classify one JTDC site using the RF model (King County)
with RF JTDC and drop youth served by other (non JTDC) diversion
program tracks from both sets of grants
 There were some baseline differences between JTDC and RF-JTDC
that have only been controlled for by looking at change (vs. more
elaborate matching) and is observational
 There was data missing due to attrition (26% to 37%), so outcomes
had to be estimated based on the average of the observed waves
 No formal cost analyses of JTDC or Reclaiming Futures JTDC were
done so cost estimates here are likely to be lower bound estimates
 While adjusted for inflation, the costs of service utilization are
somewhat dated and should ideally be updated
 The cost of crime was based on estimates developed for adults
(McCollister et al., 2010) that have been applied here to youth
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 The Reclaiming Futures JTDC reached more clinically
severe youth, provided them with more services and
did as well or better as the average JTDC
 The Reclaiming Futures did better than the average
JTDC model in terms of
–
–
–
–
increasing the alcohol and drug abstinence (26% vs. 42%)
reducing emotional problems (-16% vs. -24%)
reducing days of victimization (+37% vs. -97%)
reducing the number of crimes overall (-50% vs. -66%),
property crimes (-53% vs. -62%), violent crimes (-33% vs. 67%) and substance related (i.e., DUI, drug, gambling,
prostitution, probation violation) crimes (- 54% vs. -72%)
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 Reclaiming Futures JTDC costs more than average
JTDC in terms of the change in services provided
(+$1,673 vs. +$4,022)
 However, Reclaiming Futures JTDC was also
associated with greater saving than average JTDC in
terms of reductions in the tangible and intangible
costs of crime
– in raw dollars (-$86,202 vs. -$192,552 per youth)
– and as a percent of baseline costs (-41% vs. -76%)
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 Doing several double checks and sensitivity
analyses, and running by site to verify and better
understand the findings.
 Will work to publish these findings and to do more
comprehensive analyses in terms of case mix
adjustment and costs
 OJJDP is expected to solicit and fund another round
of Reclaiming Futures JTDC
 University of Arizona has just been funded to
conduct a more formal evaluation of the RF-JTDC
model and how it compares to other JTDC
Resources
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 Cost-Effective evidence-based practices A-CRA & MET/CBT tracks
here, more at www.chestnut.org/li/apss or
http://www.nrepp.samhsa.gov/
 Most withdrawal symptoms appeared more appropriate for
ambulatory/outpatient detoxification, see
http://www.aafp.org/afp/2005/0201/p495.html
 Trauma informed therapy and sucide prevention at
http://www.nctsn.org/nccts and http://www.sprc.org/
 Externalizing disorders medication & practices
http://systemsofcare.samhsa.gov/ResourceGuide/ebp.html
 Tobacco cessation protocols for youth
http://www.cdc.gov/tobacco/quit_smoking/cessation/youth_tobacc
o_cessation/index.htm
 HIV prevention with more focus on sexual risk and interpersonal
victimization at http://www.who.int/gender/violence/en/ or
http://www.effectiveinterventions.org/en/home.aspx
 For individual level strengths see
http://www.chestnut.org/li/apss/CSAT/protocols/index.html
 For improving customer services http://www.niatx.net
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References
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