Registration for a Systematic Review: Family treatment drug courts for improving parental legal and psychosocial outcomes

Abstract

A substantial portion of parents involved in child welfare systems have co-occurring substance abuse issues (Laslett et al., 2012; Miller et al., 2013; Williams et al., 2011; Young et al., 2007). In addition, child welfare cases characterised by parental substance abuse tend to result in more detrimental outcomes for families than cases without parental substance abuse issues (Brook & McDonald, 2009; Connell et al., 2007; Smith et al., 2007). In the United States, the high rate of parental substance abuse amongst child welfare cases transitioned to judicial settings (Miller, 2004) led to adaptation of the adult drug court model into a Family Treatment Drug Court to deal with child welfare cases characterised by parental substance abuse. Family Treatment Drug Courts (FTDCs) have increased in popularity over the last 15 years (Fay-Ramirez, 2015). This trend is, in part, driven by increasing recognition that individuals that come through the criminal, juvenile and civil (family) court system often have co-occurring issues such as mental health or addiction issues that need to be addressed in order to motivate behaviour change in the interest of children, or the parent themselves (Fay-Ramirez, 2015; Tiger, 2012). For child welfare cases, parental substance abuse is seen as the problem that hinders the establishment of a stable family environment that would enable the child’s return to parents’ care. Thus, the primary goal of FTDCs is to treat the parental legal and psychosocial issues in child welfare cases, with a key aim being to reunify families, achieve permanent placements for children in a timely manner, and address substance abuse issues among parents. FTDCs typically involve in- or out-patient treatment of drug and alcohol addiction, monitoring and supervision whist in the FTDC program, incentives and sanctions for sobriety and other prosocial family behaviour, mental health counselling, and parenting assistance (Fay-Ramirez, 2015). Although FTDCs are becoming more popular around the world (Bruns et al., 2012; Fay-Ramirez, 2015), the evidence for FTDC effectiveness is mixed and it is currently unclear what benefits and consequences these courts hold for parents. Some research suggests that the FTDC model promotes better long-term outcomes for parents and families over their traditional courtroom counterparts (Downey & Roman, 2010; Picard-Fritsche et al., 2011). However, other research is less equivocal (e.g., Miethe et al., 2000). For example, some reports suggest that the use of the drug treatment model may be more stigmatising than the regular court system and thus not effective for long-term family reintegration (Miethe et al, 2000). In addition, scholars have raised concern over whether studies showing positive outcomes have been driven by the FTDC therapeutic model of justice, or the extent of surveillance used by the FDTCs to monitor parents and families (Tiger, 2012; Marlow, DeMatteo, & Festinger, 2003). Moreover, existing reviews of FTDCs lack methodological rigour, fail to integrate the full range of parental legal and psychosocial outcomes, or tend to focus on child outcomes (see ‘Existing Reviews’ section below). Although a focus on child outcomes is warranted, the full impact of FTDCs on vulnerable families with both child welfare and parental substance abuse issues remains unclear without a comprehensive understanding of the effect of FTDCs on parental legal and psychosocial outcomes. Therefore, a methodologically rigorous review and synthesis of the growing number of FTDC impact evaluations is required to thoroughly understand whether FTDCs are effective for improving parental legal and psychosocial outcomes.