Adult Treatment Court Best Practice Standards

I. Target Population
Treatment courts are most effective and cost-efficient when they serve high-risk and high-need persons who require an intensive combination of treatment and supervision. This finding has been reported in all treatment court models examined to date. The definition of high need has, therefore, been broadened to apply to all adult treatment courts and includes not only a compulsive substance use disorder but also a serious and persistent mental health or trauma disorder and other significant treatment or social service needs, such as traumatic brain injury, insecure housing, or compulsive gambling.

Treatment courts are also discouraged from imposing unwarranted admissions requirements that do not improve outcomes or protect public safety and disproportionately exclude members of some sociodemographic or sociocultural groups.

II. Equity and Inclusion
Ensuring equitable access, services, and out­comes for all sociodemographic and sociocul­tural groups is a critical obligation of treatment courts. Research conducted in the past decade provides substantial guidance for treatment courts to monitor and rectify unwarranted cul­tural disparities. Examples of effective practices include removing invalid eligibility restrictions that needlessly exclude some cultural groups, engaging in proactive and culturally congruent outreach efforts, delivering culturally proficient treatments and complementary services, and avoiding monetary or other resource require­ments that do not improve outcomes or protect public safety.

III. Roles and Responsibilities of the Judge
Research underscores the critical impact of the judge in all treatment court models and for all sociodemographic groups examined thus far. Although biweekly court status hearings (every 2 weeks) produce superior outcomes in the first phase of adult drug courts, new evidence sug­gests that weekly hearings may be required in the first phase for participants needing greater structure and consistency, such as persons with a co-occurring mental health and substance use disorder or those lacking stable social supports. Studies of procedural fairness also offer up­dated guidance to help treatment court judges enhance participants’ motivation for change, provide needed support and encouragement, avoid shaming, stigmatizing, or retraumatizing participants, and enhance sociocultural equity.

IV. Incentives, Sanctions, and Service Adjustments
Delivering fair, effective, and safe responses for participant performance is critical for success­ful outcomes in treatment courts and one of the most difficult challenges for staff. Careful guidance is provided to help staff classify the difficulty level of participants’ goals, and to deliver incentives or sanctions to enhance their attainment of achievable (proximal) goals and service adjustments to help them develop the skills and resources needed to achieve difficult (distal) goals. Cautious advice is provided to help treatment courts avoid serious negative side ef­fects from the misapplication of high-magnitude sanctions, especially jail detention, and prac­tical suggestions are offered to help programs deliver a creative range of low-cost incentives to maximize success. Finally, an example of an evidence-based phase structure with appropri­ate phase advancement criteria is provided to help treatment courts avoid placing premature demands on participants and address their goals in a manageable and effective sequence.

V. Substance Use, Mental Health, and Trauma Treatment and Recovery Management
Treatment courts serve high-need persons with serious and persistent substance use, mental health, and/or trauma disorders. Achieving suc­cessful outcomes for these individuals requires treatment courts to deliver services that are desirable and acceptable to participants and ad­equate to meet their validly assessed treatment needs. This includes:

• Collaborative, person-centered treatment
• Psychiatric medication and medication for addiction treatment (MAT)

Recovery management interventions should be core components of the treatment court regimen and delivered when participants are motivated for and prepared to benefit from the services.

VI. Complementary Services and Recovery Capital
Complementary services are strengths-based and help participants to develop the person­al, familial, social, cultural, financial, and other recovery capital needed to help them sustain indefinite recovery and enhance their overall quality of life.

Treatment courts should routinely assess participants’ recovery capital and deliver desired complementary services to enhance their long-term adaptive functioning and life satisfaction. Importantly, complementary services also include health-risk prevention measures that are proven to reduce overdose and death rates, transmission of com­municable infections, and other serious health risks.

Treatment courts should not interfere with participant access to statutorily authorized and evidence-based health-risk prevention mea­sures, which may include safer-sex education and training on and distribution of condoms and other safer-sex products, naloxone overdose-re­versal kits, fentanyl and xylazine test strips, and unused syringes.

VII: Drug Testing
Standard VII will include new and updated research, address frequently asked questions from the field, and provide updated content related to trauma-responsive drug testing and illicit substances.

VIII: Multidisciplinary Team
Standard VIII will include new and updated research, updates from the recently published Critical Issues for Defense Attorneys monograph, and the addition of the role of peer recovery support specialists based on the recently published Incorporating Peer Recovery Support into Treatment Courts: Practice Guidelines for Treatment Court Professionals. In addition, the commentary will be expanded to address frequently asked questions from the field on each discipline.

IX: Participant Performance Monitoring
Standard IX will have a revised title in the second edition and provide new content related to evidence-based practices in community supervision, case management, and clinical case management. The topics of caseload and census will remain in this standard as provisions. This standard will also include new and updated research and address frequently asked questions from the field.

X: Program Monitoring and Evaluation
Standard X will include new and updated research and address frequently asked questions from the field.

In 2013 and 2015, All Rise, then NADCP, released the first edition of the Adult Drug Court Best Practice Standards in two volumes. The combined landmark document was the product of more than six years of exhaustive work by diverse experts who reviewed scientific research on best practices in treatment courts, other correctional rehabilitation programs, and substance use, mental health, and trauma treatment, and distilled that vast literature into measurable and achievable best practice recommendations.

Within two years of publication, 80% of U.S. states and territories responding to a national survey reported that they had adopted the standards for purposes of credentialing, funding, and/or training new and existing drug courts in their jurisdiction.

Several updates were made in 2018, but it became clear that the standards would need more significant revision to remain at the forefront of evidence-based best practices.

In December, 2020, All Rise convened a panel of researchers and subject matter experts—facilitated by All Rise Director of Standards Meghan Wheeler—to review each standard for necessary updates. In the following two years, the core group of contributors to this second edition; Doug Marlowe, Meghan Wheeler, John Gallagher, Carol Venditto, Terrence Walton, and Aaron Arnold, have gone above and beyond to make this publication a reality.

Dr. Douglas Marlowe, All Rise Senior Scientific Consultant, who authored the original standards, has dedicated countless hours to meticulously reviewing, critiquing, revising, and authoring new content for this second edition. His unwavering passion and diligence went into each word to ensure that the standards reflect the latest research in our field.