King County Drug Diversion Court

1. King County Drug Diversion Court Developing a Young Adult Track Detective David Doucett Thomas P. Essex King County Drug Diversion Court Treatment Manager

2. History • 2008 Landscape changed in King County Drug Court • 18-25 year old population increased dramatically • Approximately 1/3 of our current population is 18-25 • Historically poor success rate with 18- 25 year olds

3. Demographics 2010 Young Adult 2014 Young Adult • Drug of choice Marijuana • Referring charge Delivery & PWI • Race 82% of color 14% Caucasian • Drug of choice Heroin • Referring charge Property crime • Race 52% of color 48% Caucasian

4. Characteristics 2010 Young Adult 1014 Young Adult • Low Frustration tolerance • Minimal family support • Disproportionate contacts with criminal justice system • Damaging peer influence • Gang involvement • High rates of trauma and victimization • Little motivation for treatment • Low Frustration tolerance • Higher rate of family support • Disproportionate contacts with criminal justice system • Damaging peer influence • High rates of trauma and victimization • Little motivation for treatment

5. Young Adult in a Traditional Adult Model • Stalling during initial phases of treatment • Increased frequency of court ordered sanctions • Little motivation for treatment • Treatment does not match the need

6. Program development • Shorter Opt In phase 30 day target • Two week return until proven stability • One agency for optimal treatment provision • Well trained staff devoted to the needs of the young adult • Resource Specialist to support ancillary needs • Robust services including but not limited to; CD, MH, COD,CBT/MRT, OMT, Transportation, Housing, Gender specific • Rapid Response calendar • Clear and timely documentation • Open communication between the clinical team at DC and Treatment Program

7. Information gathering • Risk and Needs Screening • Global Appraisal of Individual Needs (GAIN) • Drug and Alcohol assessment • Mental health Assessment

8. Transitional Recovery Program • 60 day IOP treatment in custody • Removal from detrimental environment • Removal from damaging peer influence • Immediate detoxification • Timely treatment engagement • Access to Opiate Replacement Therapy

9. Rewards • Verbal praise from treatment, case manager, attorneys, most of all the judge • Express to front of calendar • Round of applause from peers at express hearing • Tangible rewards at promotion • Fishbowl drawing for 100% compliance

10. Identifying Behavior as Proximal or Distol • Proximalbehaviorwe can expect out of a person and therefore sanction at a higher magnitude for non-compliance. (admitting to use when confronted) • Distolbehavior not yet within the participants ability (a goal) and therefore sanctioned at a lower magnitude. (Perfect attendance)

11. Response to Behaviors/ Sanctions • Identify as a team Proximal vs. Distol behaviors for each phase. • Employ different responses to noncompliance based on the infraction and the behavior. • Use Therapeutic Intervention (TI) for noncompliance related Distol behavior. • Use Court sanction response for noncompliance related to Proximal behavior.

12. Therapeutic InterventionsFix it Tickets! • Therapeutic Interventions (TI) provide the young adult an opportunity to “fix” the problem rather than make it worse. We want to empower the young adult. • The TI is assigned by the DCCM and has a time frame for completion. • A TI may result in the loss of accrued days of abstinence but avoid a court sanction. • The number of TI’s per reporting period diminishes as participants progress through the program. • TI’s may be restricted by the court for repetitive infractions.

13. Fix It Tickets • Giving an oral presentation on step 3 of the MRT Manual • Attending an orientation at the Recovery Café • Attending an information meeting with the guidance counselor at the local college • Providing a written schedule of your week • Providing the court with a daily affirmation for each day of the week

14. Court Sanction • Response from the court for behavior that can be directly correlated to an increase in criminogenic risk. • Court sanctions are presumptively punitive and increase in magnitude as participant progresses in program. • Court Sanctions trigger the resetting of all accomplishments on a given phase. • Examples of behavior warranting a court sanction include but are not limited to; dishonesty, incomplete TI, missed UA, undisclosed positive UA, missed treatment apt, disrespectful behavior at treatment or in community, new charges.

15. Low Range Sanctions • Case Manager check-ins • Accountability Panel / Peer to Peer opportunity • Writing Assignments- relapse triggers, thinking errors • Journaling- photo, mood, medication etc. • Increased sober support

16. Mid Range Sanctions • 1-4 days Community Work Crew (CWC) • Attend 3 different meetings and write a summary of each then identify one thing that spoke to you. • Essay on thinking errors. Identify 4 thinking errors and explain each of them in your own words. • Journal 1 positive thing and one challenge that you encountered each day for 1 week. • One day of CWC followed by attending the Recovery café orientation and then a paper on which one you found more interesting and why.

17. High Magnitude Sanctions • Jail 1-6 days depending on the infraction • Community Work Crew to match the infraction • Combination of Jail & CWC • Demotion to earlier phase • Combinations of Low, Medium, High Sanction (1 day jail, a writing assignment on honesty and seven meetings in seven days)

18. Phase requirementsThe Pie Chart below depicts the requirements of each Phase of the Pilot Program. Each of the phases includes minimum requirements related to completion of components of the participant portfolio.

19. Thomas P. Essex Treatment Manager King County Adult Drug Diversion Court tom.essex@kingcounty.gov 206-477-0784