WEB CHAT:	Helping the Justice and Child Welfare Systems Meet the Needs of Families Affected by Addiction
HOSTS:	Honorable Karen Freeman-Wilson (ret.), National Association of Drug Court Professionals and Nancy K. Young, Ph.D., M.S.W., Director of Children and Family Futures, Inc.
WHEN:	September 10, 2003, 3:00-4:00 pm EST
SPONSOR:	CSAT

You and your colleagues are invited to participate in the upcoming Recovery Month online discussion. It will be hosted by Nancy Young, Ph.D., executive director of the National Center on Substance Abuse and Child Welfare, as well as the Honorable Karen Freeman-Wilson (ret.), CEO of the National Association of Drug Court Professionals. The Web chat will focus on innovative justice and child welfare approaches to helping families affected by addiction and is designed to foster discussion on topics raised in the "Helping the Justice and Child Welfare System Meet the Needs of Families Affected by Addiction" Webcast that was broadcast September 3.

Flier for Webcast on 9/3/03 and Web chat on 9/10/03: Helping the Justice and Child Welfare Systems Meet the Needs of Families Affected by Addiction
Interested organizations and others can downloadable this flier and use it to help promote Recovery Month multimedia events. You can use this as a handout at meetings, in information racks, as well as other public venues.

MODERATOR: Welcome to the Recovery Month 2003 Web chat. Our hosts today are Nancy Young, Ph.D., executive director of the National Center on Substance Abuse and Child Welfare, and the Honorable Karen Freeman-Wilson (ret.), CEO of the National Association of Drug Court Professionals. This Web chat will focus on innovative justice and child welfare approaches to helping families affected by addiction.

Now we are ready for the first question. This question was previously submitted.

Do we have a program in place (facility) to get the children out of the home, or do we address the problem and leave the child[ren] in the home?

Dr. Nancy Young: Depending on where you're located, knowing the resources in your own community is important. There are a variety of specialized women's and children's programs for cases where the mother needs to go to treatment and the children are not at a level of risk in which they need to be removed. There are a variety of specialized programs in which women and children can stay together. Those may be residential facilities or they may be outpatient programs, in which children have programmatic strategies put in place for them. In other cases in which child welfare determines the potential risk of the child remaining in the home is too great, they would make a decision to place the child in another living environment. The determining factor for removing the child is based on an assessment of the safety versus the risk of that child staying at home.

MODERATOR: This question was previously submitted.

Women with children at home who are involved with an abusive partner often abuse drugs and alcohol [due to the] synergistic effects (drug use increasing vulnerability to violence, violence increasing the use of drugs as self-medication, and both increasing the risk for children). How can intervention best address the dual need for safety and sobriety without adding to the traumatization experienced by the affected children?

Dr. Nancy Young: Unfortunately, we have to recognize that children living with substance abusing or addicted parents do have some level of trauma that they experience. In many cases, the trauma is of a more chronic nature rather than an event that places [the child] at risk. In fact, some authors have referred to this as Chronic Trauma of Childhood. When the safety or risk assessment performed by a child welfare professional indicates that there must an intervention and the child should be removed from the home, there are some things that can be put into place to help reduce the trauma. The messages that are given to children about what is happening to their parents can indicate they are worried about that time period. The situation that they are placed in has to be one in which they can feel secure, and fell ok about the adults that are around them Thiswas a primary bond and a primary relationship that has been broken, and the hope is to reduce that trauma that the child is experiencing by the separation by his or her parents. What seems to help in this situation in particular is having a team approach that draws upon the expertise of social workers, substance abuse treatment professionals, and children's mental health specialists. This creates for the child an appropriate response. What seems critically important is the recognition that children need intervention about their status as a child of a substance abuser and about the abuse or neglect they may have suffered, regardless of the recovery status of their parents. In communities that have put these kinds of teams together, the recognition of recovery for the family can be the overall goal that these systems work together to achieve. Family recovery means that each individual has their own needs addressed for each of the substance abuse, mental health, or violent neglect issues that they are experiencing.

MODERATOR: This question was previously submitted.

As a parent in recovery, I was scared to admit that I suffered from a substance use disorder for fear of my children being taken away from me. How is the child welfare system addressing this barrier to treatment?

Dr. Nancy Young: The reasons that child welfare [professionals] may need to intervene in a particular family are related to child abuse and neglect that often co-occur with families dealing with substance abuse disorders. The key issue is the safety and wellbeing of the child. The messages to parents about the need for recovery are critical, and need to incorporate both the parents' recovery and the child's wellbeing.

MODERATOR: This question was previously submitted.

How can the justice system better meet the needs of substance affected families?

Judge Freeman-Wilson: The justice system can increase the family drug treatment courts in jurisdictions across the United States. The important aspect of family drug treatment courts is their ability to address other addiction issues. Family members and individuals go to these courts because of abuse or neglect of their children. Not only are the substance abuse issues of the parents [addressed] in these courts, but the potential substance needs of the children are addressed. In these families, the substance abuse is addressed along with health, employment, and educational issues and other social needs. Of all of the drug court models, I believe that the family court model best combines treatment and prevention in the drug court context.

Terry: How do drug courts address co-occurring disorders that affect a lot of offenders?

Judge Freeman-Wilson: Drug courts address co-occurring disorders in a number of ways. First, [they] train all treatment providers in drug courts to use assessment tools that assess the existence of co-occurring disorders. Second, [they] train all drug court team members-including judges, prosecutors, public defenders, probation officers, law enforcement officers, social welfare workers, and treatment providers-to be aware of the potential for and the presence of co-occurring disorders. Drug courts staff are not expected to be mental health experts, but we cannot afford to hide our heads in the sand and act as if we can treat addiction without addressing co-occurring disorders.

Terry: What effect do you think the President's voucher program will have on drug courts?

Judge Freeman-Wilson: I think that it will have a positive effect because it will give drug court participants more freedom and latitude to consume treatment that best meets their needs. My only concern is making sure that treatment providers who are not accustomed to providing treatment to court-involved individuals will be able to receive training so they can adjust to the special needs of individuals who are also being held accountable by the courts.

SA: As a result of the Adoption and Safe Families Act, have communities changed any of their practices when it comes to working with families involved in the child welfare system as a result of parental substance abuse, and if so, what has been done?

Dr. Nancy Young: There are many ways in which communities have come together to address the timeliness of substance abuse treatment services targeting families [that have] lost custody of a child. Many of those initiatives have focused on the need to provide services at the very first intervention point, which is often the initial court hearing after a child has come into care. Some models include having specialized workers, social workers, recovery mentors, and family advocates trained in engagement strategies using motivational interviewing techniques so that at the very beginning of the case substance abuse issues are being addressed by trained staff who specifically provide the outreach and engagement that is often needed. In addition, many communities have worked on the communication of child welfare, substance abuse and court system, and the attorneys who represent parents. By establishing communication protocols and policies that facilitate the communication between the professionals, earlier determination about the child welfare outcomes and the permanency for the child can be achieved. It is critical to recognize the role that the defense plays in this process. The attorneys that represent the parents in court play a key role in encouraging parents to participate in treatment services and emphasizing the timelines that parents must meet in communities where these programs have been put into place. Evaluations have shown that families are reunifying faster and children are achieving permanency in their living situations significantly faster than comparison groups.

Pat: How do treatment programs in prisons differ from programs for offenders who are under community supervision?

Judge Freeman-Wilson: The first difference is that you are in a controlled environment in prison, so it almost creates an artificial, sterile environment. While we understand that drugs are available in prison, they are not as available as for a person who is in an outpatient program. The other distinction is that I think the number of participants is limited in prison, so the existence of actual treatment versus NA meetings or some other type of self-help group is limited.

Terry: How are States handling the increased demand for child welfare as a result of rising drug abuse?

Dr. Nancy Young: Actually, the child welfare population [has] increased dramatically since the early 1980s. Many people have noted the drug epidemic and cocaine epidemic of the late 1980s as major contributing factors to the increase [in] child welfare cases. In the early '90s, the Federal Government, State Government, and local communities began to focus on the need to increase capacity of treatment resources for this population. Various States have had different approaches about the capacity issue, but there have also been many other kinds of reforms that have gone on within child welfare to address this population. Certainly, the focus of AFFA with ensuring timely permanency for children is playing a role in the overall case loads. In terms of the parents and adolescents with substance use disorders, several States and many communities have been very innovative in the ways in which they have used reallocations of staff across systems funding resources through TANF and Title IV-B, and other innovative funding strategies to increase the capacity of treatment resources for this population.

Pat: How are offenders screened for sentencing to drug courts, and how is it determined who goes to drug court?

Judge Freeman-Wilson: At the time of arrest, or shortly after arrest prior to and/or shortly thereafter the initial arraignment, individuals who meet court eligibility standards are assessed for drug court. Most courts require that the individual be charged with a nonviolent offense, have a history of drug addiction, not have a history of trafficking in illegal drugs, and have a desire to participate in the program. For family courts, there must be a danger of losing custody of children, or there may be an issue of neglect. The person must also be willing to engage in treatment and, of course, they cannot be charged with an offense that results in physical harm to the child. Normally, the drug court team makes the final determination as to whether an individual is allowed to participate. In some jurisdictions, prosecutors may have the ability to veto a person's participation.

Ray B.: What successes can you highlight regarding the interface between the justice and child welfare systems? Are there any model programs that you would care to cite or recommend?

Dr. Nancy Young: There are several innovations that are important for communities to be aware of. In the family treatment court arena, preliminary data has shown that participants in the family treatment court receive significantly more treatment, get treatment faster, have less criminal recidivism, and are reunified faster than a comparison group of families. Those outcomes are important for us to look at in terms of the wellbeing of the children as well as the family's overall recovery. Additionally, the cost savings to communities that have put these programs into place are being realized. Two counties in California are certainly model programs in this respect. San Diego County and Sacramento County have implemented a system-wide approach that ensures every parent with substance abuse allegations in the petition or for whom substance use disorders are determined to be a factor has immediate access to assessment, intensive case management and monitoring, and substance abuse treatment. Other communities around the country have implemented other types of models with the system-wide approach. I think that is the key for ensuring the intent of AFFA as well as reducing the trauma for children and increasing parents' ability to recover from their addictions.

Judge Freeman-Wilson: I would add a few more programs for those interested in visiting. The Manhattan Family Treatment Court in New York City; Washoe Family Treatment Court in Reno, NV; and the Family Treatment Court in Pensacola, FL, are all model programs that we use as training sites.

Dr. Nancy Young: The primary difference between those models and the system-wide approach is the ability to address every parent's needs. There are a couple of other innovations that were not based on family treatment courts that we need to be aware of. For example, Cleveland has established teams of child welfare workers and family advocates who are persons in recovery and who jointly work with parents on both the substance abuse and child welfare aspects of their cases. The State of Connecticut is another model, as is the State of Ilinois. .Both began their efforts in the 1980s to ensure that assessment case management and comprehensive services are available to parents, children, and youth with substance use disorders or related consequences. It is also important to know there are four States that received wavers in their funding under Title IV-E to address this issue. Those states are Delaware, New Hampshire, Maryland, and the most comprehensive approach has been in Illinois.

Many of the programs that Judge Freeman and I mentioned have been documented and described in two publications. "Technical Assistance Publication #27" is available from NCADI and five family treatment court models have been described in a report that Children and Family Futures did for the Federal Government. The executive summary of that report is available on the Children and Family Futures Web site or through ncsacw.samhsa.gov. We would be happy to send you a program description of the five family treatment courts.

MODERATOR: Our hour has concluded. For more information, visit CSAT's Recovery Month Web Site at http://www.recoverymonth.gov. Visit the multimedia area (http://www.recoverymonth.gov/2003/multimedia/) to see a list of upcoming Web chats and Webcasts on various topics. You also can watch the archived version of the Webcast that complements this Web chat at http://www.recoverymonth.gov/2003/multimedia/w.aspx?ID=219.

Join us next month on Sept. 24 from 3-4 p.m. EST for our next Web chat, "Business Community Voices for Recovery." Our host for this chat will be Elena Carr, director of the U.S. Department of Labor's Working Partners for an Alcohol- and Drug-Free Workplace Program.

We would like to thank our hosts, Nancy Young, Ph.D., executive director of the National Center on Substance Abuse and Child Welfare, as well as the Honorable Karen Freeman-Wilson (ret.), CEO of the National Association of Drug Court Professionals, for their participation in this online event. We also would like to thank our participants for their questions. This transcript will be available shortly so that others may benefit from the dialogue. The chat has now officially ended.