Anne Nordberg

Predicting Termination from Drug Court and Comparing Recidivism Patterns: Treating Substance Use Disorders in Criminal Justice Settings

Drug courts have been used in the criminal justice system to treat substance use disorders since 1989. This study evaluates a drug court in Indiana, focusing specifically on the most predictive variables for being terminated from the program and comparing recidivism patterns of drug court and probation participants. Participants were most likely to be terminated from drug court if they did not have a high school diploma or equivalent at admission, were not employed or a student at admission, identified cocaine as a drug of choice, had more positive drug tests, had a violation within the first 30 days of the program, and had a criminal history. Additional findings suggest that drug court is more effective than probation at reducing criminal recidivism rates for offenders with substance use disorders. Implications for drug court practice and future research are discussed.

A Qualitative Study Assessing the Effectiveness of the Key Components of a Drug Court

Drug courts are guided by 10 key components that help ensure fidelity to the treatment model and guide practitioners in effectively treating substance use disorders in criminal justice settings. This qualitative study assessed the effectiveness of certain key components, such as the quality of substance abuse treatment and the importance of frequent contact with the judge, by interviewing drug court participants (N = 41). Participants felt that the substance abuse counseling they received could have been improved by offering more individual counseling and by developing a trustworthy therapeutic relationship among the drug court team, participants, and substance abuse counselors. Having frequent contact with the judge and the random drug testing system were viewed as effective interventions in assisting participants with being successful in the program, with the ultimate goal of graduating drug court. Implications for drug court practice and future research are discussed.

Improving graduation rates in drug court: A qualitative study of participants’ lived experiences:

For nearly three decades, drug courts have provided a rehabilitative approach within the criminal justice system for individuals who have a substance use disorder. The goal of drug courts is to reduce criminal recidivism, and research has consistently suggested that participants that graduate drug court are less likely to recidivate than those who are terminated from the program. This qualitative study adds to the literature by asking drug court participants (N = 42) their views on the most helpful aspects of the program that support them in graduating and how the program could be more helpful to support them in graduating. Two themes emerged from the data: (1) participants felt that interventions that are common to drug courts, such as drug testing and having frequent contact with the judge, were most helpful in supporting them in graduating the program; (2) participants felt that the agencies that offered treatment for their substance use disorders used punitive tactics and judgmental approaches that compromised the quality of treatment they received, and they felt that this was a barrier to them graduating the program. The findings are discussed in reference to drug court practice.

Environmental influences on services for and mental health of incarcerated populations: A review

There has been growing concern about the quality of health services, including mental health services, within the world’s and prisons. The purpose of the current qualitative interpretive meta-synthesis (QIMS) is to examine the prison environment and how it influences the mental health services delivered to prisoners. It is the hope of these authors that with this QIMS, knowledge improvements and modifications to current policies and practices can begin to take shape. A total of five studies published between 2003 and 2013 were utilized for this QIMS. Participants in all five studies included males and females incarcerated in England, Wales, and the United States. Three overarching themes were identified after analysis: difficulties with accessing services, difficulties with primary staff, and isolation. In each overarching theme, sub-themes are reviewed in detail. These three broad categories are discussed in relation to the person-in-environment system, demonstrating its application in an incarcerated setting.

Adolescent Pregnancy in Canada: Multicultural Considerations, Regional Differences, and the Legacy of Liberalization

This chapter explores adolescent pregnancy among Canadians. Canada enjoys a relatively low teenage pregnancy rate compared with other Western nations, but aggregate statistics mask regional variations. As a vast nation with two European colonial settler populations and diverse Aboriginal peoples, Canada has historically been a diverse country. Canada’s multicultural policy has further diversified the population, making large urban centers such as Toronto, Montreal, and Vancouver among the most diverse cities in the world. Federally funded health care is managed at the provincial level making each province’s priorities and delivery different. While a human sexual rights perspective broadly frames reproductive health and national guidelines for sexual health education, local programs are not bound to them. Women generally enjoy high levels of access to health care, abortion, and reproductive health information, but there is variation in access, attitudes, and behaviors. The ethno-cultural diversity of Canada’s population, its regional differences, languages, and religions challenge aggregate analyses and social service implementation. These concerns are reflected in the body of research about adolescent pregnancy in Canada. In this chapter, we describe variation in, and attitudes toward, adolescent pregnancy and sexual behavior are described with emphasis on adolescents and young women. These issues remain strongly influenced by Canada’s extensive geographical realities as well as political, social, and economic values that reflect dedication to upholding multicultural differences, social justice, and freedom. Widely sanctioned reproductive choice and sexual education programs exemplify how Canadian values translate into rational and health promoting policies rather than punitive and restrictive agendas which lead to less effective health and mental health care for women and their newborns. We discuss these issues in this chapter but first we begin by providing a brief description of Canada’s history and its population.

Suicidality and Other Health Risk Behaviors among Female Youth in Juvenile Detention

ABSTRACT This study investigates suicidality and health-risk behaviors among female juvenile detainees and identifies the extent to which suicidal behaviors are correlated with other risky activities. This study also explores 12 health risk behaviors, their prevalence, and relative associations to suicidal behaviors within the sample-population. Researchers collected data from 104 female adolescents, ages 12 to 20, residing in a long-term, detention center in the southeastern region of the United States. Descriptive statistics and regression analysis were utilized. Suicidal ideations (40%) and suicide attempts (34%) were highly prevalent among female juvenile detainees. Results also suggest that the persistence of suicidal ideations was significantly influenced by exposure to various forms of interpersonal violence. Despite increased exposure to psychosocial factors strongly correlated to suicidal and high risk behaviors, little attention has been given to this particular population. Research recommendations are also discussed.

Participants’ views on the strengths and limitations of drug court: Recommendations to enhance assessment and treatment of mental illnesses

ABSTRACT Since 1989, drug courts have provided an alternative to incarceration for arrestees who have a substance use disorder. Previous research has suggested that participants who graduate from the program are less likely to recidivate than those who are terminated from the program. The majority of research on drug courts is quantitative; therefore, the benefits of qualitative methods are not fully seen in the literature. This qualitative study developed an in-depth understanding of participants’ (n = 42) views on the strengths and limitations of a Midwestern drug court. Two themes emerged from the data. First, participants felt that the drug court promoted camaraderie, which enhanced their motivation for change and supported them in graduating from the program. Second, participants felt that the drug court did not adequately treat their mental illnesses, which for some resulted in relapse and was perceived as a barrier to graduating from the program. Recommendations for drug court practice are discussed.

A community of singers: employing exploratory cluster analysis to reveal profiles of psychosocial characteristics among members of a street choir for homeless and formerly homeless individuals

ABSTRACT This exploratory study employed cluster analysis to identify profiles of resilience, social support, stress, and mental health among members of a homeless and formerly homeless street choir; we examined the association between choir attendance and cluster membership, and the interaction of cluster membership and race. Respondents (N = 111, 66% African American, 84% homeless) had participated in the choir for an average of 12 months (SD = 12.02). We stratified the analysis according to homelessness status. Among those housed, k-means cluster analysis revealed two profiles: (1) relatively resourced but lower resilience, and (2) high resilience. Three profiles emerged among the homeless: (1) psychologically vulnerable, high stress and mental health concerns; (2) relatively resourced, showing average levels of mental health concerns and social support, minimally elevated stress, and higher resilience; and (3) low resilience. Examining the interaction, non-African American, housed participants in the high resilience cluster reported the most frequent choir attendance (M = 4.00, SD = 0.00); among the homeless, non-African Americans in the psychologically vulnerable cluster reported the most frequent attendance (M = 3.88, SD = 1.25). Results support the need for programs that address higher order needs concurrently with housing; they also highlight the ongoing need to provide particular outreach to minority populations.

A Phenomenological and Grounded Theory Study of Women’s Experiences in Drug Court: Informing Practice Through a Gendered Lens

Drug courts have been a growing part of the criminal justice system since 1989. This qualitative study adds to the existing literature by developing an in-depth understanding of drug court from a woman’s (N = 25) perspective. Phenomenology and grounded theory guided the data collection and analysis, resulting in three themes. First, the women found the drug court team to be compassionate and empathetic, which they reported supported them in being successful in the program. Second, the majority of women reported histories of trauma and felt that the drug court could be improved by offering them more resources to treat their trauma. Third, the majority of women reported being single mothers and they shared examples of how being a single parent was a challenge to being successful in the drug court. Implications for drug court practice are discussed.

A qualitative investigation into military veterans’ experiences in a problem-solving court: Factors that impact graduation rates

ABSTRACT Veterans treatment courts (VTCs) are designed to offer a rehabilitative approach to criminal justice, focusing on treatment for mental health and substance use disorders. This qualitative study develops an in-depth understanding of a Midwestern VTC by asking participants (n = 15) their views on the most helpful aspects of the program and how the program could be more helpful. Three themes emerged from the data. 1) Military veterans felt that they were treated in a compassionate and caring manner, while also being held accountable for their behaviors. 2) Military veterans felt that they were not labeled by their mental health diagnoses, but that their identities as people and military veterans were more fully recognized. 3) Military veterans were dissatisfied with some of the services they received from the local VA. These findings are discussed in the context of problem-solving courts and military veterans’ experiences of services.