Behavioral Incentives to Increase Caregiver Engagement in Juvenile Drug Courts

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 DESCRIPTION (provided by applicant): Juvenile offenders with substance abuse problems represent a large and underserved population that is at high risk for persistent deleterious outcomes and long-term costs for themselves, their families, their communities and society. Moreover, a high percentage of juvenile offenders continue to abuse substances and engage in criminal activity into adulthood. Although one juvenile justice intervention, Juvenile Drug Court (JDC), has emerged as a promising model for reducing the cycle of drug use, crime and delinquency among youth, evidence of its effectiveness is variable. One important factor that may compromise drug court effectiveness is lack of caregiver engagement in JDC processes and concomitant adolescent drug treatment. Incorporating evidence-based incentive programs in JDCs to increase caregiver engagement may improve their effectiveness in reducing youth drug use and criminal re-offending. An extensive body of research supports the critical role that families play in the etiology, maintenance, and treatment of adolescent substance abuse. Although family-based interventions for adolescent substance abuse have been shown to be superior to other treatment modalities, parents must attend treatment and participate in meaningful ways for these superior outcomes to be realized. This R01 Stage II randomized clinical trial will examine the efficacy of a prize-based contingency management (CM) intervention for increasing caregiver engagement (attendance and participation) in JDC and adolescent drug treatment. This caregiver CM intervention (CCM) will be compared with drug court treatment as usual (TAU). One hundred and eighty youth enrolled in JDC will be randomly assigned along with a parent/caregiver to treatment as usual or CCM. Repeated measures analyses will examine the effects of CCM on measures of caregiver engagement in JDC. Analyses will also examine whether improved caregiver engagement contributes to reductions in youth substance use (urine drug screens) and criminal activity. Results from this study are predicted to demonstrate the effectiveness of CCM procedures for increasing caregiver attendance and participation in JDC and adolescent drug treatment above and beyond drug court and usual care. If effective, the CCM approach may ultimately be used to enhance JDC outcomes, thereby reducing substance use and recidivism in juvenile offenders served by this promising juvenile justice intervention. Thus this project has high significance in terms of potential public health impact and reduction in criminal justice system costs. Further, the proposed study is highly innovative because it is among the first to apply CM treatment to JDC, uses an approach designed to be easy to implement within the JDC context, and the first to examine the efficacy of CM for enhancing parental engagement in the JDC process.