Matching to Sufficient Treatment: Some Characteristics of Undertreated (Mismatched) Clients

Validating Drug Court Collaboration Instrument: Differences in Model Adherence Between Adult and Juvenile Drug Courts

Drug courts aim to significantly address drug abuse and drug-related criminality. However, the effectiveness of drug courts varies from court to court. The variation of success demands insights regarding what is going on inside the "black box" of drug court practices. Therefore, it is necessary to evaluate to what extent drug courts are operated in adherence with guiding principles and strategies. Using a national sample and validated measures, the current article examines the "black boxes" of adult and juvenile drug courts across the country. We found that, in general, adult drug courts face less model adherence challenges in comparison with juvenile courts, which may, in part, explain why adult drug courts perform better than juvenile drug courts overall.

Collaboration: A Mechanism of Drug Court Model Adherence

Drug courts solve problems, namely, reducing drug use and recidivism. The current research attempts to answer the question of how to ensure program fidelity and therefore optimize the efficacy of drug courts. Justice professionals and scholars have recognized that there are multiple internal and external threats that could undermine the drug court operation. At this point, the mechanism(s) by which threaten factors affect drug court program fidelity has been neither theoretically modeled nor empirically tested. In the present study, using a national sample and the Structural Regression Analysis (SRA), we found collaboration and judicial decision making are the most important factors for maintaining drug court program fidelity. This is because collaboration and judicial decision making can mediate the threats and challenges from many quarters, including the lack of information sharing and evaluation, treatment, operational support, and community and political support.

Factors Predicting Patient's Allocation to Short- and Long-Term Therapeutic Community Treatments in the Italian VOECT Cohort Study

The Evaluation of Therapeutic Community Treatments and Outcomes (VOECT) study was conducted in 131 Italian Therapeutic Communities (TCs) in 2008/2009. All of the patients entering residential treatment for drug or alcohol dependence were invited to participate. Data regarding patient socio-demographic characteristics, drug and alcohol consumption, health and psychopathological status, prior treatments and outcomes, and their motivation score were collected upon enrolment onto the study. The aim of this work was to identify the factors associated with allocation to short- versus long-term programmes in drug or alcohol dependent patients entering TCs in Italy. Of the 2470 patients included in the analysis, 30.8% were allocated to short-term treatment and 69.2% to long-term treatment. Several factors were significantly associated with the allocation to short- and long-term treatments: unstable living conditions; entering the TC when not detoxified; a high Symptom Checklist-90 somatization score; prior cessation episodes; previous in-patient detoxification treatments; psychosocial treatments; entering the TC by oneself; and a low motivation score.

Predictors of cessation treatment outcome and treatment moderators among smoking parents receiving quitline counselling or self-help material

OBJECTIVE

Several cessation treatments effectively enhance cessation, but it is not always clear which treatment may be most suitable for a particular client. We examined predictors of treatment outcome and treatment moderators among smoking parents in the Netherlands.

METHOD

We conducted secondary analyses of a randomized controlled trial in which smoking parents received either quitline counselling (n=256) or a self-help brochure (n=256). Data collection was completed in October 2012. Endpoints were 7-day point prevalence abstinence and 6-month prolonged abstinence at 12-month follow-up. Potential predictors and moderators included socio-demographic characteristics, smoking-related variables, and child-related variables.

RESULTS

Male gender, higher employment status, lower daily cigarette consumption, higher levels of confidence in quitting, presence of a child with a chronic respiratory illness, and wanting to quit for the health of one's child predicted abstinence at 12months. Significant treatment moderators were intention to quit and educational level. Quitline counselling was effective regardless of intention to quit and educational level, but self-help material was less effective among less motivated and lower educated parents.

CONCLUSION

Certain subgroups of smokers, such as parents who are concerned about the health of their child, are particularly receptive to cessation support. Individual characteristics should be considered in treatment selections.