From Referral to Treatment: Implementation Processes in Juvenile Drug Treatment Court Programs
| Published date | 01 December 2023 |
| DOI | http://doi.org/10.1177/14732254221122625 |
| Author | Alison Greene,Josephine D. Korchmaros,Raanan G. Kagan,Erika M. Ostlie,Monica Davis |
| Date | 01 December 2023 |
| Subject Matter | Original Articles |
https://doi.org/10.1177/14732254221122625
Youth Justice
2023, Vol. 23(3) 286 –310
© The Author(s) 2022
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DOI: 10.1177/14732254221122625
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From Referral to Treatment:
Implementation Processes in
Juvenile Drug Treatment Court
Programs
Alison Greene , Josephine D. Korchmaros,
Raanan G. Kagan, Erika M. Ostlie and Monica Davis
Abstract
Juvenile Drug Treatment Courts (JDTCs) provide a critical opportunity to identify and treat youth with
substance use disorders (SUD). Structuring JTDCs to minimize process complexity and time to treatment is
important. Results across eight JDTCs indicate the number of steps between referral and enrollment varied
from 2 to 7, and the potential wait time varied from 1 to 58 days. The number of steps between referral
and SUD treatment varied from 3 to 8, and the potential wait time varied from 2 to 118 days. Information
regarding JTDC process can inform the field about JTDC practice, including barriers to treatment as well as
areas for improvement.
Keywords
implementation, juvenile justice, substance use disorder, treatment, youth
Juvenile Drug Treatment Courts
In the United States, Juvenile Drug Treatment Courts (JDTCs) provide a critical opportu-
nity to identify and treat youth with substance use disorders (SUD). Despite a steady
decline in the juvenile arrest rate for drug violations over the past 20 years in the United
States (Office of Juvenile Justice and Delinquency Prevention (OJJDP), 2020), the number
of drug offense cases remains very high. In 2018, 14 percent of delinquency cases (over
100,000) handled by courts with juvenile jurisdiction were for drug offenses (Hockenberry
and Puzzanchera, 2020). In addition, a national study conducted in the United States with
nearly 10,000 youth across 18 states found that a third of justice-involved youth met
Corresponding author:
Alison Greene, School of Public Health, Indiana University Bloomington, 1025 East 7th Street, Bloomington, IN 47405-
7109, USA.
Email: greeneiu@iu.edu
1122625YJJ0010.1177/14732254221122625Youth JusticeGreene et al.
research-article2022
Original Article
Greene et al. 287
criteria for SUD (Wasserman et al., 2010). The juvenile justice system is the largest referral
source to SUD treatment in the United States, accounting for 43 percent of adolescent treat-
ment admissions (Substance Abuse and Mental Health Services Administration (SAMHSA)
Center for Behavioral Health Statistics and Quality, 2017).
Juvenile Drug Courts were established in the mid-1990s and aim to divert youth with
substance use issues, as identified through screening and assessment as a process of jus-
tice system involvement, from incarceration to alternative responses that could include
treatment, court supervision, drug testing, and family and community linkages. Although
many Juvenile Drug Courts initially had the component of treatment, not of all them did;
however, currently they all include treatment and are now JDTCs. As dockets within juve-
nile courts specifically designed for youth with SUDs, JDTCs enable access to treatment
and needed services that youth may otherwise not receive. For many justice-involved
youth, JDTCs are the main identifier of their SUD and their main pathway to treatment.
Therefore, it is important to examine the pathway and related barriers within the
process.
Best Practices
Historically, there has been an emphasis on best practices and integration of research-
informed, or evidence-based, approaches in JDTCs (Belenko and Logan, 2003; Chassin,
2008; Henggeler et al., 2012). A critical component is to support timely access and suc-
cessful linkage to SUD treatment services once need is determined (Garnick et al., 2006;
Scott et al., 2018). A standard for timely referral to treatment is 14 days from the time of
determined need (Belenko et al., 2017; Garnick et al., 2009; Knight et al., 2016). Reducing
barriers that impede linkage to treatment is also critical (Priester et al., 2016; Rapp et al.,
2006). This includes considering structural barriers related to treatment provision, service
location, and service availability (Priester et al., 2016), lack of transportation and limited
access to support services (Godley et al., 2000), and addressing long wait times, which
have been found to be deterrents to treatment (Grella et al., 2004). Screening and assess-
ment to identify need, treatment planning, and an active treatment assignment or ‘hand-
off’ between juvenile justice and treatment providers are critical components of JDTC
implementation; however, depending on the process and system, the number of steps to
accomplish these core activities can be a barrier for youth to initiate and engage in treat-
ment (Belenko et al., 2017; Models for Change, 2007; Priester et al., 2016; reclaimingfu-
tures.org; Wasserman et al., 2003). JDTCs need the ability to respond quickly and
efficiently to ensure participants receive rapid provision of treatment services.
US federal leadership has prioritized efforts to integrate evidence-based practices by
providing considerable funding as well as guidelines to support JDTCs and effective prac-
tice. As an early joint effort, a decade after the first JDTC was established in the United
States, the Bureau of Justice Assistance, the National Council of Juvenile and Family
Court Judges (NCJFCJ), the National Drug Court Institute (NDCI), and OJJDP created
the Juvenile Drug Court: Strategies in Practice (NCJFCJ, 2014; National Drug Court
Institute and National Council of Juvenile and Family Court Judges (NDCI and NCJFCJ),
2003) to serve as a framework for planning, implementing, and operating a JDTC. The
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