Family treatment drug courts
Family treatment drug courts (FTDCs), also called family treatment courts (FTCs), family dependency treatment courts (FDTCs), or family drug courts (FDCs), work with parents involved in the child welfare system who may lose custody of their children due to parental substance use and related functional impairments in parenting1. FTDCs are specialized civil courts within the justice system that provide programs and services for families and children, including intensive judicial monitoring, substance use treatment, frequent drug testing, comprehensive wrap-around services, and rewards and sanctions linked to program compliance2, 3. Eligible families are referred to FTDCs by a parent’s attorney, a social worker, a FTDC administrator, or a family court judge; program participation is voluntary3, 4. Program eligibility and criteria in FTDCs vary by local jurisdictions2. FTDCs seek to address both child safety issues and parental substance use treatment5.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased family reunification
Increased substance use disorder treatment
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Improved family functioning
Reduced child maltreatment
What does the research say about effectiveness?
There is strong evidence that family treatment drug courts (FTDCs) increase the likelihood that children will safely reunite with their parent(s)5, 6, 7, 8, 9, 10. Parents who participate in FTDCs are more likely to enter and complete substance use treatment than parents who receive usual care9, 10, 11, 12.
Parents who participate in FTDCs receive more treatment than parents who don’t participate in FTDCS3, 11, 12, 13. FTDCs can reduce the time children spend in foster care5, 9, 10 and may also improve family functioning14, 15. Effects on recurrence of child abuse and neglect and children’s re-entry to foster care are unclear6, 7, 14. Parents who complete FTDC programs are more likely to reunite with their children than participating parents who do not complete the program or who do not participate4. Participating parents who are employed and receive treatment longer are more likely to reunite with children than other participants; participants’ traumatic symptoms appear to be negatively associated with family reunification16. Enhancing FTDCs with intensive, individualized multi-dimensional family therapy and strategies to increase family engagement and retention, such as peer mentoring and support groups, may further increase the likelihood of reunification1, 15, 17, 18, 19.
Effects of FTDCs on a child’s permanent placement are mixed20. In some circumstances, children whose parents are participating in FTDCs are not placed in their permanent homes as quickly as children whose parents are in usual care, perhaps because FTDCs allow parents more time to achieve sobriety than the traditional justice system11, 13. In other circumstances, children whose parents are participating in FTDCs move more quickly toward permanency than children whose parents are not3, 8, 12, 21.
Parents in FTDCs are more compliant with court orders and more likely to believe the court process is fair compared to those in traditional dependency courts22. Cost-benefit analyses estimate that a FTDC can yield cost savings by reducing foster care use, substance-affected child births, Medicaid and other health service costs, and increasing family reunification23: a Baltimore-based study estimated $5,500 of savings per family and another study found a net savings of $9,710 per child24, 25.
For successful FTDC programs, researchers recommend providing comprehensive and tailored services to meet parents’ needs, informing communities of FTDCs, integrating effective therapy or parenting programs (e.g., Cognitive Behavioral Therapy, Strengthening Families Program), offering recovery supports, encouraging family engagement, and adopting trauma-informed care in FTDCs1, 26, 27, 28, 29, 30.
How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.
It is unclear what impact family treatment drug courts (FTDCs) have on disparities in family and child well-being or family reunification by parental race and ethnicity, and substance use. A Midwest metropolitan area-based study suggests family reunification rates do not vary by the race or ethnicity of participating families7; another study suggests lower likelihood of reunification for parents using prescription opioid and heroin29. For successful program outcomes, researchers recommend improving participants’ program engagement with service providers and courts, especially for participants with minoritized races and ethnicities33. Implementing informed assessments, staff training, and culturally responsive treatment procedures are recommended for inclusive practices in FTDCs for participants of color29. Reforming FDTCs with the incorporation of trauma-informed care principles can increase transparency, safety, and support with strengths-based resources30.
What is the relevant historical background?
American policing, behavior criminalization, and justifying incarceration has stemmed from racist practices since the 1700s34. In 1965, Congress’s Law Enforcement Assistance Act marked the beginning of federal government involvement in criminal justice and law enforcement and the Johnson Administration declared a “war on crime” a year later, with increasingly harsh and punitive sentencing laws alongside aggressive policing35. The U.S. justice system was designed to deter crime through aversive control and social isolation, not to support socially significant behavior change and reinforce prosocial behavior34. Additionally, as it relates to drug use, the U.S. policing and justice system have worked disproportionately against people of color: Black people are more likely to be arrested for drug law violations than white people, although their rates of illicit drug use are similar36. Significant disparities in enforcement of marijuana laws have imposed arrests, prosecutions, and convictions on individuals and communities, separated families, and deprived individuals of child custody, immigration status, voting rights, eligibility for public housing, financial aid for education, and access to employment37, 38.
As alternatives to traditional family courts, family treatment drug courts (FTDCs) were developed in the mid-1990s, modeled after adult drug courts2, 39. Since the first FTDC opened in Reno, Nevada, FTDCs have grown quickly in the U.S. due to increasing parental substance use in child abuse and neglect cases2. FTDCs take a collaborative, family-centered approach based on two important concepts: therapeutic jurisprudence (i.e., therapeutically applying the law to promote family well-being) and procedural justice (i.e., fair processes in the justice system)1.
Equity Considerations
- Who is participating in FTDCs in your community? What barriers exist to participating?
- How can FTDC service providers increase awareness of their services? How can FTDC service providers engage participants of color more and help them complete the FTDC program?
- Is there trauma-informed training available for service providers and FTDC staff in your community? Does the training help recognize stereotypes and biases?
Implementation Examples
As of 2019, there are about 500 family treatment drug courts operating in the United States31. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers grants to state, local, and territorial governments and tribal organizations for implementing substance use disorder treatment and recovery support in existing adult and family treatment drug courts32.
Implementation Resources
‡ Resources with a focus on equity.
OJJDP-FDC guidelines - Children and Families Futures. (2015). Guidance to States: Recommendations for developing family drug court (FDC) guidelines. Office of Juvenile Justice and Delinquency Prevention (OJJDP), Office of Justice Programs.
Footnotes
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1 Ramey 2022 - Ramey, J. S. & Volk, F. (2022). Lessons learned from a coalition-driven implementation of a Family Treatment Court in a rural mid-Atlantic region county. Journal of Rural and Community Development, 17(4), 73-85.
2 OJJDP MPG-FDC - Office of Juvenile Justice and Delinquency Prevention (OJJDP). (2016). Model Programs Guide (MPG) literature review: Family Drug Courts (FDC).
3 Green 2007 - Green, B. L., Furrer, C., Worcel, S., Burrus, S., & Finigan, M. W. (2007). How effective are family treatment drug courts? Outcomes from a four-site national study. Child Maltreatment, 12(1), 43-59.
4 Gifford 2014 - Gifford, E. J., Eldred, L. M., Vernerey, A., & Sloan, F. A. (2014). How does family drug treatment court participation affect child welfare outcomes? Child Abuse & Neglect, 38(10), 1659-1670.
5 Lloyd 2015 - Lloyd, M. H. (2015). Family drug courts: Conceptual frameworks, empirical evidence, and implications for social work. Families in Society: The Journal of Contemporary Social Services, 96(1), 49-57.
6 Zhang 2019b - Zhang, S., Huang, H., Wu, Q., Li, Y., & Liu, M. (2019). The impacts of family treatment drug court on child welfare core outcomes: A meta-analysis. Child Abuse & Neglect, 88, 1-14.
7 Mersky 2023 - Mersky, J. P., Lee, C. P., Liu, X., & Janczewski, C. E. (2023). Impact of a family treatment court on child permanency and safety. Child Abuse & Neglect, 146, 106512.
8 Sieger 2021 - Sieger, M. H. L., Becker, J., & Brook, J. (2021). Family treatment court participation and permanency in a rural setting: Outcomes from a rigorous quasi-experiment. Child & Family Social Work, 26(4), 540-549.
9 Marlowe 2012 - Marlowe, D. B. & Carey, S. M. (2012). Research update on Family Drug Courts. Need to Know. Alexandria, VA: National Association of Drug Court Professionals (NADCP).
10 van Wormer 2016 - van Wormer, J. & Hsieh, M. L. (2016). Healing families: Outcomes from a family treatment drug court. Juvenile & Family Court Journal, 67(2), 49-65.
11 Worcel 2008 - Worcel, S. D., Furrer, C. J., Green, B. L., Burrus, S. W. M., & Finigan, M. W. (2018). Effects of family treatment drug courts on substance abuse and child welfare outcomes. Child Abuse Review, 17(6), 427-43.
12 Bruns 2012 - Bruns, E. J., Pullman, M. D., Weathers, E. S., Wirschem, M. L., & Murphy, J. K. (2012). Effects of a multidisciplinary family treatment drug court on child and family outcomes: Results of a quasi-experimental study. Child Maltreatment, 17(3), 218-30.
13 Chuang 2012 - Chuang, E., Moore, K., Barrett, B., & Young, M. S. (2012). Effect of an integrated family dependency treatment court on child welfare reunification, time to permanency and re-entry rates. Children and Youth Services Review, 34(9), 1896-1902.
14 Rodi 2015 - Rodi, M. S., Killian, C. M., Breitenbucher, P., et al. (2015). New approaches for working with children and families involved in family treatment drug courts: Findings from the Children Affected by Methamphetamine Program. Child Welfare, 94(4), 205-232.
15 Cosden 2015 - Cosden, M. & Koch, L. M. (2015). Changes in adult, child, and family functioning among participants in a family treatment drug court. Child Welfare, 94(5), 89-106.
16 Sieger 2022 - Sieger, M. H. L., Becker, J., Nano, X., & Brook, J. P. (2022). Predicting substance use treatment completion & reunification among family treatment court-involved parent–child dyads. Journal of Public Child Welfare, 16(2), 272–294.
17 Drabble 2016 - Drabble, L. A., Haun, L. L., Kushins, H., & Cohen, E. (2016). Measuring client satisfaction and engagement: The role of a mentor parent program in family drug treatment court. Juvenile & Family Court Journal, 67(1), 19-32.
18 Child 2015 - Child, H. & McIntyre, D. (2015). Examining the relationships between family drug court program compliance and child welfare outcomes. Child Welfare, 94(5), 67-87.
19 Oliveros 2011 - Oliveros, A. & Kaufman, J. (2011). Addressing substance abuse treatment needs of parents involved with the child welfare system. Child Welfare, 90(1), 25–41.
20 Campbell-Eggins 2024 - Eggins, E., Wilson, D. B., Betts, J., Roetman, S., Chandler-Mather, N., Theroux, B., & Dawe, S. (2024). Psychosocial, pharmacological, and legal interventions for improving the psychosocial outcomes of children with substance misusing parents: A systematic review. Campbell Systematic Reviews, 20, e1413.
21 Moore 2020 - Moore, K., Sharp, A., Alitz, P., Yampolskaya, S., Kleinman, M., Carlson, M., & Argerious, A. (2020). Reconsidering success for an integrated family dependency treatment court. Children and Youth Services Review, 114, 105037.
22 Fessinger 2019 - Fessinger, M., Hazen, K., Bahm, J., Cole-Mossman, J., Heideman, R., & Brank, E. (2020). Mandatory, fast, and fair: Case outcomes and procedural justice in a family drug court. Journal of Experimental Criminology, 16, 49-77.
23 Logsdon 2021 - Logsdon, A. R., Antle, B. F., & Kamer, C. (2021). Family Treatment Drug Court cost analysis: An in-depth look at the cost and savings of a Southeastern Family Treatment Drug Court. Child Welfare, 99(5), 51-74.
24 Burrus 2011 - Burrus, S. W. M., Mackin, J. R., & Finigan, M. W. (2011). Show me the money: Child welfare cost savings of a family drug court. Juvenile and Family Court Journal, 62(3), 1-14.
25 Brook 2016 - Brook, J., Akin, B. A., Lloyd, M. H., Johnson-Motoyama, M., & Yan, Y. (2016). Family drug treatment courts as comprehensive service models: Cost considerations. Juvenile and Family Court Journal, 67(3), 23-43.
26 Murphy 2017 - Murphy, A. L., Harper, W., Griffiths, A., & Joffrion, C. (2017). Family reunification: A systematic review of interventions designed to address co-occurring issues of child maltreatment and substance use. Journal of Public Child Welfare, 11(4–5), 413-432.
27 Rodi 2022 - Rodi, M. S., Dahlgren, J. A., Smith, L., & Kissick, K. (2022). Characteristics of Family Treatment Courts, the families they serve, and their capacity to meet the demands of their communities. Child Welfare, 100(3), 103-130.
28 Barnett 2023 - Barnett, K. B., Amason, J., Wagner, D. & Ray, H. E. (2023). Characteristics of substance-addicted mothers that predict graduation from the family treatment court. Journal of Nursing Scholarship, 55, 637-645.
29 Kleinman 2024 - Kleinman, M. E., Smith, C., IV, Yampolskaya, S., Sharp, A., Carlson, M., & Moore, K. (2024). Typologies of Family Dependency Treatment Court participants: Parental characteristics and differential child placement outcomes. Substance Use & Misuse, 59(7), 1072-1082.
30 Tach 2022 - Tach, L., Morrissey, M. B., Day, E., Vescia, F., & Mihalec-Adkins, B. (2022). Experiences of trauma-informed care in a Family Drug Treatment Court. Social Service Review, 96(3), 465-506.
31 OJJDP-FTC - Office of Juvenile Justice and Delinquency Prevention (OJJDP). (2021, May 25). Family Treatment Court program (FTC).
32 SAMHSA-TDC - The Substance Abuse and Mental Health Services Administration (SAMHSA). (2024, March 13). Grants to expand substance use disorder treatment capacity in adult and family treatment drug courts (TDC).
33 Logsdon 2021a - Logsdon, A.R., Antle, B.F., Katz, R.S., Barbee, A.P., Kamer, C. and Spriggs, A. (2021). The impact of engagement on child welfare families involved with Family Treatment Drug Courts. Juvenile and Family Court Journal, 72(4), 43-56.
34 Leland 2022 - Leland, W., & Stockwell, A. (2022). Anti-oppressive restorative justice: Behavior analysis in alternatives to policing. Behavior Analysis in Practice, 15(4), 1232–1236.
35 NASEM 2014 - National Academies of Sciences, Engineering, and Medicine (NASEM), National Research Council. (2014). The growth of incarceration in the United States: Exploring causes and consequences. The National Academies Press.
36 SP-Ghandmoosh 2023 - Ghandmoosh, N. & Barry, C. (2023, November 2). One in five: Disparities in crime and policing. The Sentencing Project (SP).
37 Crawford 2021 - Crawford NN. We’d go well together: A critical race analysis of marijuana legalization and expungement in the United States. Public Integrity. 2021;23(5):459-483.
38 Schlussel 2017 - Schlussel D. The mellow pot-smoker: White individualism in marijuana legalization campaigns. California Law Review. 2017;105(3):885-928.
39 NDCI 2004 - National Drug Court Institute (NDCI) and Center for Substance Abuse Treatment. (2004). Family dependency treatment courts: Addressing child abuse and neglect cases using the drug court model. Washington, D.C.: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Assistance.
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