Final Report of the Cross-Site Evaluation of the Juvenile Drug Treatment Court (JDTC) Guidelines:

JDTC vs. TJC to rigorously test the direct effect of JDTC’s impact relative to TJC. In 8 sites, youth who

ii on youth with high need for substance use treatment and high risk of recidivism.The later was a more restricted subset than recommended in original guidelines.
Varia�on in Effects by Site.The size of the JDTC vs. TJC effects varied by site.The TJC in one site did beter than JDTC.It is notable that this was the site with the smallest difference in Guideline implementa�on between JDTC and TJC.This finding provided further evidence of the value of the Guidelines in promo�ng effec�ve program prac�ces.

Efficient Evalua�on of Need and Risk.
A 10-item youth screener from the Global Appraisal of Individual Needs (GAIN) was used in this evalua�on to triage low, moderate, and high need for substance use treatment and risk of recidivism.The findings of this simple tool were overridden by local courts/staff in less than 5% of the cases.The measure of need accurately predicted reten�on along a juvenile jus�ce to substance use treatment services cascade (i.e., need, referral, ini�a�on, engagement, con�nuity of care).This result validated that the tool predicts which youth are likely to show up to, be admited to, and stay in treatment.Combining need and risk was a very reliable predictor of rearrest in the next 6 to 12 months.It was then used as a control to show that the effects of JDTC (vs TJC) on recidivism were being driven by the subset of youth with high need and high risk.
Correlates of Original Placement Rule.Referring youth with moderate/high need and risk to JDTC also resulted in that group of youth having higher rates (than youth in TJC) of co-occurring problems (mental health, trauma, vic�miza�on) and family environmental risk.Further restric�ng the target popula�on to only those with high need and risk would have led to even higher rates -par�cularly for trauma and vic�miza�on.
Recommenda�ons for Guidelines.It was recommended that the JDTC Guidelines, and related training and technical assistance: a) use evidence-based screening on need/risk to assist with placement; b) focus on those with high need/risk; c) measure/monitor youth movement along the behavioral health services cascade to track general performance and to catch health disparity / opera�onal issues to ensure youth who need services receive them; d) to improve communica�on and the quality of data sharing between juvenile jus�ce and behavioral health agencies; e) add more informa�on to improve the use of urine tes�ng (par�cularly for cannabis) and minimize use of deten�on through implementa�on of alterna�ve approaches to behavior change; f) collaborate across sites to create a common data set as most courts have small numbers of youth; and g) clarify several terms/prac�ces with which some JDTC struggled (e.g., screening vs. assessment, case management).The evalua�on report was one of several sources used to revise the guidelines and training and technical assistance protocols.

Strengths and Limitations.
The evaluation had several strengths including building on recent summaries of evidence, collaboration across multiple sites and stakeholders, mixed methods, standardized measures, larger sample sizes, and higher follow-up rates than most earlier studies.However, it is also important to acknowledge several limitations.The preliminary design assumptions that each site could recruit and assign 150 youth to each of two courts within 2 years proved unrealistic for individual sites.Similarly, the assumption that the TJC was using discrete staff/resources and not using many of the same strategies recommended in the guidelines was incorrect to varying degrees in all sites.Variation in how JDTC implemented the guidelines and the training/technical assistance their received also presented challenges for the evaluation that might have been better addressed by a more long-term commitment to common data and workforce development with monitoring over time as used in much of health care.Complicating matters further, the 2020 COVID pandemic hit during the middle of the study, causing changes in many procedures, lower case flow, and lower follow-up survey completion rates.Technically there were also issues with the non-normal distribution of several outcomes, and violations of the assumption of the needs-based assignment model that JDTC would only produce a shift in the regression line.In practice, JDTC changed both the regression line and the slope.While this result limited the number of sites/youth and power of many analyses, the multiple sources of data still provide a consistent emerging picture.
This resource was prepared by the author(s) using Federal funds provided by the U.S. Department of Justice.Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice.