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Drug Court Monitoring

When drug courts are involved in recovery monitoring, there are many advantages to both the drug court participant and the drug court itself.  Recovery monitoring affords an opportunity to evaluate outcomes of drug court clients post discharge and correspondingly, the effectiveness of the drug court services as well as to increase the likelihood of sustained recovery rates for the participant.

The success of recovery checkups however, hinges upon the ability of the drug court to have in place the needed linkages to treatment and supportive services that enable a participant to quickly access care and reduce the likelihood of prolonged relapse periods. If the drug court is unable to respond expeditiously to participants who request help during the survey process, the credibility of the recovery management check-up process may be questionable in the mind of the participant[s].

The Recovery Maintenance Check-In Tool:  RMC-i

This checklist was developed for use by drug courts and their treatment partners as a means of monitoring drug court participants during the most vulnerable period following their discharge from services in order to offer any needed support and services and to prevent relapse/re-offense. It is also intended to provide assistance in re-integrating those in need of help into services.

The RMC-i was developed for use as a telephone contact in which interviewers call drug court graduates at periodic intervals and administer the checklist. Recommended periodic intervals based on previous research are as follows: monthly for the first six months post discharge, bi-monthly for the next twelve months and quarterly for the next eighteen months for a total of thirty-six months at a minimum. The RMC-i may be used electronically and the information stored, or it may be done with paper, pencil. It is designed for use by professionals and non-degree professionals alike and is intended to reach populations where formal education may be limited. The questions are deliberately constructed to be open-ended and to elicit conversation and whatever information the respondent chooses to disclose. The primary purpose of the questions is to identify current problems and/or issues the participant may need additional services for.

iStock_85558623_XLARGE-1-.1The domains of the checklist; Housing, Family/Social Status, Health Status, Substance Use, Financial/Occupational Stability, and Criminal Activity have been targeted based upon the research that indicates that problems in these areas are likely to undermine recovery and trigger relapse/re-offense in recovering populations. These domains were also identified for inclusion in the National Outcome Measures [NOMS] by the Center for Substance Abuse Treatment as essential to conducting outcome evaluation. By using the rating scales at the end of each domain in the text field of the checklist, a drug court may incorporate the aggregated findings into its quality monitoring or program evaluation component.

The ratings used in this tool when aggregated, are intended to give drug courts some idea about the most frequent areas of difficulty their participants experience in early recovery. By understanding these issues, the court may then wish to address these issues differently or modify their case management services for participants.

The stage of change the participant appears to be in is also included in the checklist and provides a similar opportunity for drug courts. The change classifications include five of the six developed by Prohaska and Di Clementes: Pre-Contemplation where no change is deemed to be necessary by the client, Contemplation, in which the client is beginning to think about making a change, Action which occurs when the client is in the process of making a change, and Maintenance, the stage where the client has made changes and must now sustain those changes.

When these ratings are aggregated, it may help drug courts better plan interventions to help participants maintain the gains they have made. [Maintenance Stage of Change][1] A motivational interviewing style is intended to be used when administering the survey with open-ended questions [OARS] and a warm, non-judgmental and positive interview approach.[2] When this approach is adopted by interviewers, they will find respondents to be appreciative and willing to participate.

[1] Prohaska and DiClementes  Six Stages of Change

[2]  Miller, Wm. Rollnick, Stephen; [2013] Motivational Interviewing: Helping People Change, Third Edition Guildford   Press