Dependency Drug Court Demonstrates Success with Evidence-Based Holistic Interventions

Jeri Beth Cohen Jeri Beth Cohen, Judge, Miami-Dade County Dependency Drug Court, FL

Summary: The author shares a program unique to Miami, the Engaging Moms casework model, which has increased the likelihood of positive child welfare outcomes when compared to standard drug court case management.


Since its inception in 1999, the Miami–Dade Dependency Drug Court (DDC) has provided evidence-based integrated and holistic interventions for both parents and children. These services incorporate trauma-based interventions such as the Seeking Safety intervention and domestic violence counseling; intensive mental health treatment; substance abuse counseling with a strong emphasis on peer support through Narcotics and Alcoholics Anonymous; evidence-based parenting using the Nurturing and Strengthening Families protocol; early assessments and screenings for both parents and children; parent-child psychotherapy (dyadic therapy); housing and job assistance; and monetary assistance for medical and dental care.

The dependency drug court is a 12 to 15 month program organized into four phases. Progression through the phases is related to the parents’ progress through substance abuse treatment, compliance with court orders and improvements in parenting. An assessment of the parent (using the Addiction Severity Index and other structured instruments), is conducted immediately upon acceptance into DDC, and placement in appropriate substance abuse and mental health treatment is commenced, in many instances, even before the arraignment of the case. Whenever possible, children are kept with their parents in maternal or family addiction programs. These programs all offer trauma-informed therapy and the Seeking Safety intervention. The largest of our family addiction programs offers a child care facility that, with assistance from the court, has obtained the highest state accreditation. When parents and children are separated, visitations may occur up to three times per week in order to maintain parent-child bonding. All custodians, whether relative caretakers or foster parents, are strongly encouraged to co-parent with the biological parents in order to guide them through the dependency drug court process and serve as parenting mentors. This approach facilitates quicker permanency decisions and greater stability for children by developing an “extended family” approach to the child welfare system.

Unique to Miami is the Engaging Moms casework model (EMP), based on the theory and method of multidimensional family therapy. The seminal research on EMP was undertaken by Dr. Gail Dakof, professor of psychology, at the University of Miami, and the Miami DDC.[1] Each parent in DDC is assigned an EMP counselor who has contact with the parent on a weekly basis either by phone or in person. Counselors are available more frequently on an as-needed basis. Each specialist is matched with a dedicated trained child welfare worker. The attorneys, specialists, child welfare caseworkers and treatment providers work as a team and staff the cases weekly.

EMP counselors focus on six core areas of change: (1) parent’s motivation to succeed and change lifestyle; (2) emotional attachments between the parent and child; (3) relationships between the parent and family of origin; (4) parenting skills; (5) the parent’s romantic relationships; and (6) coping and problem-solving skills. Parents achieve change by participating in a series of integrated individual and family sessions with their counselors (e.g., individual sessions with parent, extended family and significant other).

EMP is organized into three stages:

  • Stage 1: Alliance and Motivation
  • Stage 2: Behavioral Change
  • Stage 3: Launch to an Independent Life.

In stage 1, the counselor focuses on two goals: (1) building a strong therapeutic alliance with the parent and extended family, and (2) enhancing parent and family motivation to participate in drug court and change behavior; stage 2 focuses on behavioral change in both the parent and extended family/spouse focusing especially on drug use, parenting and romantic relationships. In the final phase, the EMP counselor assists the parent in preparing for an independent life by developing a practical and workable routine for everyday life, including managing relapse.

EMP has shown considerable promise, specifically by increasing the likelihood of positive child welfare outcomes when compared to standard drug court case management. EMP has been shown to reduce the number of parental rights terminations and placements in foster care. Moreover, parents benefit from EMP by showing a reduction in drug and alcohol use, mental health symptomology and an improvement in parenting practices.

Most importantly, DDC focuses on interventions for children, including frequent developmental screenings for children 0–3, using the “Ages and Stages Questionnaire,” and interactive parenting programs including Nurturing and Strengthening Families and parent-child psychotherapy (dyadic therapy). Both interventions have shown great success in changing parenting attitudes and practices.[2]


References:

[1] Dakof, G. A., Cohen, J. B., & Duarte, E. (2009). Increasing family reunification for substance-abusing mothers and their children: Comparing two drug court interventions in Miami. Juvenile and Family Court Journal, 60, 11–23.
Dakof, G. A., Cohen, J. B., Henderson, C., Duarte, E., Boustani, M., Blackburn, A., Dependency Drug Court 267 et al. (2010). A randomized pilot study of the engaging moms program for family drug court. Journal of Substance Abuse Treatment, 38, 263–274.

[2] Dice, Claussen, Katz & Cohen (2004). Parenting in Dependency Drug Court. Juvenile and Family Court Journal, vol. 55, 1-10.
Lederman, C., & Osofsky, J. D. (2008). A judicial–mental health partnership to heal young children in juvenile court. Infant Mental Health Journal, 29, 36–47.
 

 

National CASA Association Reprint Policy

If an article published in The Judges' Page is reproduced, credit shall be given to the author(s) of the article, the National CASA Association and the National Council of Juvenile and Family Court Judges
 

National CASA Association | 800.628.3233 | 100 West Harrison, North Tower, Suite 500, Seattle, WA 98119 | staff@casaforchildren.org

National CASA (Court Appointed Special Advocates) ©2015. The National CASA logo, CASA ®, "A Powerful Voice in a Child’s Life," "Stand Up for an Abused Child," "Speak Up for a Child," "Light of Hope" and "Give the Light of Hope to a Child" are all registered trademarks of National CASA.