Educating the “gods”: Operations, Outcomes, and Opportunities in Treatment Courts

Introduction: Treatment courts (TCs) were developed in the 1980s to address challenges facing individuals with a substance use disorder (SUD) involved in the criminal justice (CJ) system. TCs are an alternative to the punitive nature of the CJ system by joining SUD treatment with the accountability of the judicial system. TCs involve a phased approach led by a multidisciplinary team consisting of a judge, attorneys, treatment provider, and probation officer. By design, treatment court (TC) implementations are highly varied. Each implementation adopts the National Association of Drug Court Professionals (NADCP) key components that are consistent with yet bound by their community resources, values, and political realities. Goals and Methods: Using qualitative community-based participatory research, two case studies and one phenomenological study were conducted on treatment courts in a mid-Atlantic state in the USA to examine successful TC implementation. Techniques included semi-structured individual interviews with judges, TC team members, program graduates, and community stakeholders to explore their understanding of their roles relative to TC operations. Interviews were professionally transcribed and coded by the research team consistent with thematic analysis procedures. Results: Analysis revealed themes of judicial sovereignty juxtaposed with a lack of knowledge of SUDs, the importance of a fully dedicated coordinator to serve as an extension of the judge, and purposeful courtroom set-up and norms conducive to a therapeutic rather than punitive approach. An audit trail included triangulation of data and memo writing by the research team. Conclusions: Transferable recommendations in light of the highly varied nature of TCs include mandatory judicial training, evolving operations norms, values alignment among the TC team, and a TC coordinator to oversee day-to-day operations. In addition, stakeholder engagement to drive an iterative evaluation process converges with the traditions of action research in community settings.