Drug Courts May Invite a New - and Surprising - Type of Therapeutic Alliance
The National Association of Drug Court Professionals commissioned an observational study of the interaction of drug court judges with offenders and jurors.
Drug courts were first established in Miami, Fla., in 1989 as a way to divert nonviolent, drug-abusing offenders to court-supervised drug treatment.
The principal investigator observed 15 courtrooms on site or by film and interviewed 23 judges in person or by telephone to inquire about:
- Their impressions of their relationship with drug court participants
- The models and framework that guide their practice
- Their understanding of addiction.
Preliminary observations based on the study's small, nonrepresentative sample revealed:
- Although there are a wide variety of courtroom environments and styles of proceedings, judges share similar views as to their roles.
- Interviews with the judges suggested that drug court processes were often dictated more by workload than by judges' conceptions of how a drug court should be run.
- Judges also indicated that they valued the relationship between themselves and the defendant.
An article on the study was published in the first edition of the National Drug Court Institute Review, a professional journal for drug court personnel.
The Robert Wood Johnson Foundation (RWJF) provided a grant of $54,520 from March 1997 to February 1998 to support this project.
More than 1 million people each year are arrested for drug crimes, according to Drug Strategies, a Washington-based policy advocacy organization.
Drug offenses are the primary cause of overload in all parts of the criminal justice system. An untreated drug problem creates a cycle of crime; drug abusers are more likely than others to become repeat offenders. Research also has indicated that treatment is the most cost-effective way to combat drug abuse and drug-related crime.
A 1994 RAND Corporation study found that $34 million invested in treatment would reduce cocaine use as much as an expenditure of $246 million for law enforcement or $366 million for interdiction. Yet, rising incarceration costs and get-tough crime policies have made drug treatment scarce in prisons; less than 10 percent of prisoners needing intensive treatment receive such treatment.
In 1989, Janet Reno, then state's attorney of Dade County, Fla., initiated development of the first drug court to serve as an alternative to the traditional court system. The goal of drug courts is to reduce incarceration costs, drug abuse, and recidivism by diverting nonviolent offenders to treatment and other social and vocational services.
Judges go beyond simply referring substance abusers to treatment: They supervise the treatment and hold offenders accountable for their behavior. And judges can refer patients to more intensive treatment or impose sanctions including jail time based on an offender's performance. By 1993 Miami's drug court had reduced both rearrest rates and incarceration costs, according to Drug Strategies. At the time of this project, there were drug courts operating in more than 100 cities nationwide.
Despite their promise, cities often grapple with the implementation of drug courts. The cultures and principal objective of the drug treatment and criminal justice systems are quite different. Major implementation issues can include:
- disagreement over who is in charge of the offender,
- the treatment staff's adverse reaction to judicial sanction, and
- potential withholding of clinical information from the court.
The project funded by RWJF was designed to study the barriers to optimal functioning of drug courts that emerge from the conflict between the cultures of the treatment and criminal justice systems. The principal investigator, an independent psychiatrist and former RWJF Health Policy Fellow, conducted the work under the auspices of the National Association of Drug Court Professionals, which represents judges and other drug court personnel.
Early in the course of the grant, the principal investigator concluded that most of the operating drug courts had resolved the initial barriers by working out conflicts over time, by contracting with more compatible treatment centers, or by obtaining guidance from more established mentor courts and other resources.
Therefore, the principal investigator shifted the focus of the project so it became an observational study of the interaction of drug court judges with offenders and jurors. The goals of this study were to:
- identify variables in the courtroom that affect the interaction between judges and defendants, the latter called participants in this report,
- document variability within a sample of drug court programs, and
- generate questions for future study.
The principal investigator observed 15 courtrooms on site or by film and interviewed 23 judges in person or by telephone to inquire about their impressions of their relationship with drug court participants, about the models and framework that guide their practice, and about their understanding of addiction.
In consultation with judges, the principal investigator developed a checklist of 17 variables that might affect the interaction between judges and participants, including ambient noise in the courtroom, seating arrangements, eye and body contact, and scheduling and frequency of sessions. She completed this checklist while observing 500 judge-participant interactions.
As a result of her interviews and observations, the investigator concluded that there is considerable variation in drug court environments and processes. Judges agree about the importance of their unconventional courtroom role, the symbolism of the robe, and their authority to impose sanctions. Other observations from the investigator's report include the following:
- Court workloads rather than judges' conceptions of how a drug court should be run dictate proceedings.
- Judges value highly the relationship between themselves and participants.
- Several judges viewed themselves as leaders of a team of justice and treatment professionals.
- Several judges perceived themselves as organizing a community of recovering people.
- Just as a therapeutic alliance can develop between psychotherapist and patient that promotes recovery, a similar alliance may develop between judges and participants.
Future studies may seek to model this alliance and document its effect on treatment outcome.
The principal investigator proposed that future studies should address what makes a good drug court judge, how the judge-participant relationship affects outcome, and how the courtroom environment can affect that relationship.
The principal investigator's observation of drug courts was limited to courts primarily in the northeastern United States and south Florida. These were selected on the basis of convenience or reputation. The sample is not necessarily representative of drug courts nationwide, the principal investigator acknowledged.
An article based on conclusions from the observational study was published in the inaugural issue of the National Drug Court Institute Review. (An RWJF grant, ID# 034781, supported publication of the journal.) The National Association of Drug Court Professionals has also distributed the article during the institute's judge-training sessions. The principal investigator has also written opinion/editorial articles on drug courts that have appeared in the Wall Street Journal and other publications.
AFTER THE GRANT
No further activities are currently anticipated. A 1997 US General Accounting Office report concluded that there were insufficient data to determine whether drug courts reduce recidivism and relapse. A 1998 review by the Columbia University National Center on Addiction and Substance Abuse (CASA) concluded that drug courts substantially reduce drug use and criminal behavior among offenders who participate.
GRANT DETAILS & CONTACT INFORMATION
Study of Barriers That Hinder Collaboration between Drug Courts and the Substance Abuse Treatment System
National Association of Drug Court Professionals (Alexandria, VA)
Dates: March 1997 to February 1998
Sally L. Satel, M.D.
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Satel SL. "Observational Study of Courtroom Dynamics in Selected Drug Courts." National Drug Court Institute Review, 1(1): 4372, Summer 1998.
Satel SL. "Do Drug Courts Really Work?" in the City Journal, Summer 1998.
Satel SL. "Can This Stick Win the Drug War?" in the New York Post, July 20, 1998.
Satel SL. "For Addicts, Force Is the Best Medicine," in the Wall Street Journal, January 6, 1998.
Report prepared by: Janet Heroux
Reviewed by: Richard Camer
Reviewed by: Marian Bass
Program Officer: Michael Beachler
Program Officer: M. Katherine Kraft