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Family Treatment Court: The Judge as a Therapeutic Intervention

Gail A. Barber Gail A. Barber, Director, Iowa Children’s Justice, State Court Administration, Judicial Branch of Iowa

Summary: The author shares how six family treatment courts were established in Iowa under a federal grant and how an independent evaluation determined that children spent less time in out-of-home care, parents were more successful in substance abuse treatment, and over 4 million dollars in foster care costs and the cost of services was saved.


Family treatment court (FDTC) is a proven model of family intervention and specialty court process that is growing in acceptance. This practice demonstrates great promise in serving families where parental substance abuse is central to involvement in the child welfare system. In Iowa, it took just one innovative judge starting a family treatment court 10 years ago and keeping track of the results to garner the interest of the court and our child welfare partners. That one court, operating in a new way, has now developed into an expanding practice in Iowa.

Judicial leadership and willingness to operate differently are the keys to building collaboration with partners, establishing a treatment team and creating a recovery environment in the courtroom, all essential elements of an effective family treatment court. In 2007, with assistance from the National Center on Substance Abuse and Child Welfare (NCSACW), Iowa Children’s Justice (Iowa’s version of court improvement project) built a collaborative partnership team to learn more about family treatment court and determine if it might be one approach to use in Iowa to better serve our families with substance use problems. In addition to judicial officers and ICJ staff, key state partners included the Iowa Department of Human Services, Iowa Department of Public Health, and the Office of Drug Control Policy.

After determining that the specialty court approach showed promise, a joint grant was written, with ICJ as the lead. Through this successful federal grant, six family treatment courts were started. Among the most important elements included in the grant were:

  • Development of a multi-disciplinary collaborative team
  • Cross and joint training
  • Frequent court hearings
  • Joint case planning
  • Early access to substance use disorder assessment and treatment
  • An independent evaluation.

The independent evaluation demonstrated some important results. For example, children experienced shorter stays in out-of-home care, and parents remained in substance abuse treatment and aftercare four times as long as the comparison group. In a cost avoidance study that was also done, it was determined that family treatment court avoided over 4 million dollars in foster care and additional services experienced by comparison families.

With substance use and abuse affecting approximately 70% of families involved in the child welfare system, these results convinced the court that this specialty court approach was important to continue to offer to families involved in the child welfare system.

While improved outcomes and cost avoidance were measured, systemic change was an unplanned result. Professionals working together in family treatment court improved their working relationship on other child welfare cases. Judges talked about a change in how they viewed their other cases. In advocating for other judges to look at the specialty court concept, one FTC judge said: “This will change your perspective, it will change the way you do your work. But I wish I had worked this way my entire career.” Parents commented that their view of the state agency had changed, viewing social workers as working with them not against them.

As part of this grant, we made a commitment to the supreme court to develop a set of standards that would apply to all courts that wanted to implement family treatment courts. Standards have now been developed and presented to the supreme court for adoption. The standards were based on “ten critical elements of system linkage,” as identified by the NCSACW, along with lessons learned in the five year grant period, and most recognized best practice. The standards establish the essential elements for all FTCs, but recognize the need for local differences, including frequency of hearings, make-up of the community support committee, and informal and formal supports available locally. Since the development of the standards, any Iowa juvenile court that wishes to learn more about family treatment makes contact with Iowa Children’s Justice (ICJ) staff. We provide the draft standards of practice, participant manuals developed by other judges, the Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR) manual, along with ICJ commitment to assist them by providing training and technical assistance.

In addition to the six existing FTC courts, there are six emerging courts working to meet the standards and serving families affected by substance use. ICJ staff provide consultation in treatment team creation, community support committee development, resource materials, and assessment of progress toward meeting the family treatment team standards. As these courts progress, ICJ staff continue to monitor adherence to treatment court standards, and gather evaluation data.

While family treatment courts are an effective way to serve families, not all counties will have the case load and resources adequate to develop such courts. We are presently developing a plan to assist all courts in understanding the role of substance abuse in child welfare cases, and how taking some lessons learned from family treatment court could improve the outcomes for children and families in any local juvenile court.

Key elements that can be incorporated into any community or court are:

  • Building collaborative partnerships
  • Seeking training opportunities for cross-system knowledge
  • Early identification, assessment and referral to substance abuse treatment, and services for children
  • Shared accountability
  • Evaluation of the results and plan for improvement

Author’s biography:

Gail Barber has served as the director of Iowa Children’s Justice since 1999. She received her MSW from the University of Iowa, and has spent her entire social work career serving children and families involved in the child welfare system.

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