Examining the Use of Visual Performance Feedback in Drug Treatment Court

说明(由申请者提供)：毒品法庭是增加治疗保留率、减少吸毒和犯罪累犯率的一项明显有效的战略。在一个PowerPoint图像被用来增强从小学演示到国会证词的一切的时代，令人震惊的是，类似的视觉辅助工具没有被视为改善毒品法庭法官和法庭客户之间沟通的一种手段。在我们简短的试点工作的基础上，这项为期两年的研究旨在进一步发展药物法庭的视觉反馈程序，并检查其可行性、可接受性和初步效果。在这一视觉反馈程序中，描绘当事人戒毒和接受治疗的纵向过程的曲线图在法庭的大屏幕上投射到他们的状况听证会上。法官使用激光笔将客户定向到图表，并识别积极和消极的行为以及行为模式(例如，每月狂欢)。在第一阶段，我们将纳入视觉学习顾问、毒品法庭工作人员和客户的反馈，以最终确定视觉反馈。在第二阶段，我们将按同等比例随机安排60名客户参加他们要求的每月听证会，无论是否有视觉反馈。所有客户以及法官和毒品法庭小组将在整个阶段完成定期评估。此外，在研究完成时，我们会与药物法庭小组进行有系统的焦点小组。我们假设视觉反馈程序将被法官和工作人员认为是可接受和可行的，它将产生比通常的听证更好的客户结果(即，尿检确认的戒酒和治疗出勤)，以及对公平(程序正义)、对计划的满意度以及与法官的合作联盟的更大感受。这是第一次以研究为基础的努力，通过使用视觉反馈来改善毒品法庭法官和客户之间的沟通和理解，积极的结果可以作为全面研究的基础。对这一视觉反馈程序的支持有可能改变毒品法庭和其他解决问题的法庭进行司法地位听证的方式。这项研究的创新之处在于，它应用了一句古老的谚语：一幅画胜过千言万语，以提高毒品法庭的效率。 公共卫生相关性：这项为期两年的研究旨在进一步开发和检查视觉反馈程序的可行性、可接受性和初步有效性，以改善毒品法庭法官和委托人之间的沟通。在这个程序中，法官在客户的状态听证过程中将他们的进展图表投射到一个大屏幕上，并将它们用作视觉辅助。对这一视觉反馈程序的支持有可能改善结果，并改变毒品法院以及其他解决问题的法院进行司法地位听证的方式。

DESCRIPTION (provided by applicant): Drug courts are a demonstrably effective strategy for increasing treatment retention and reducing drug use and criminal recidivism. In a time when PowerPoint images are used to augment everything from grade school presentations to congressional testimony, it is striking that similar visual aids have not been examined as a means to improve communication between drug court judges and clients in the court room. Building on our brief pilot work, this two-year study seeks to further develop a visual feedback procedure in drug courts and to examine its feasibility, acceptability, and preliminary efficacy. I this visual feedback procedure, line graphs depicting a client's longitudinal course of drug abstinence and treatment attendance is projected onto a large screen in the court room during their status hearing. The judge orients clients to the graphs and identifies positive and negative behaviors as well as patterns of behavior (e.g., monthly binges) using a laser pointer. In Phase 1, we will incorporate feedback from a visual learning consultant and from drug court staff and clients to finalize the visual feedback. In Phase 2 we will randomize 60 clients in equal proportions to attend their required monthly hearings with or without the visual feedback. All clients, as well as the judge and drug court team will complete regular assessments throughout this phase. In addition, we will conduct a structured focus group with the drug court team at the completion of the study. We hypothesize that the visual feedback procedure will be perceived by the judge and staff as both acceptable and feasible, and that it will result in better client outcomes (i.e., urinalysis-confirmed abstinence and treatment attendance) and greater perceptions of fairness (procedural justice), satisfaction with the program, and working alliance with the judge than hearings as usual. This represents the first research-based effort to improve communication and understanding between the drug court judge and clients through the use of visual feedback, and positive results could serve as the foundation for a fully powered study. Support for this visual feedback procedure has the potential to change the manner in which judicial status hearings are conducted in drug courts and other problem solving courts. The innovation of this study lies in its application of an age-old adage, "a picture is worth a thousan words," to improve the efficacy of drug courts. PUBLIC HEALTH RELEVANCE: This two-year study seeks to further develop and examine the feasibility, acceptability, and preliminary efficacy of a visual feedback procedure to improve communication between the judge and clients in drug courts. In this procedure, the judge projects graphs of a client's progress on a large screen during their status hearing and uses them as a visual aid. Support for this visual feedback procedure has the potential to improve outcomes and to change the manner in which judicial status hearings are conducted in drug courts as well as other problem solving courts.