Louisiana added Multisystemic Therapy (MST) to drug courts. This is why.
29% of high-school students reported drinking alcohol, and 22% said they used marijuana in 2019. However, studies show that due to COVID-19, young adults with mental health issues are more likely to report an increase in drinking; during the pandemic, the percentage of students who used alcohol rose to 30.4%. Using and abusing drugs as a minor has been shown to contribute to academic difficulties, mental-health problems, negative peer relationships, and involvement in the juvenile justice system. We know that adolescents are hard-wired to take risks. Thus, many teens will experiment with drugs and alcohol, and will not grow to abuse these substances. But what can be done to help those who escalate from experimentation to misuse, abuse or a substance misuse disorder?
Drug court as an option
Often, youth are sentenced to this type of court if they are caught breaking drug laws. These courts combine sanctions with treatment in the hope of moving youth out of the system more effectively and more permanently than they would through a traditional sanctions program such as probation.
Drug courts provide consistent monitoring and sanctions for a range of behaviors including drug use, but extending to truancy, school performance and curfew compliance. We know without question that immediate and powerful consequences will shape the choices young people make. This structure can be enough to improve behavior dramatically and decrease substance abuse, moving that youth out of the court system.
The downside is that if there are no subsequent differences in the ecology of the youth, such as changes in peer group, family warmth, discipline and monitoring, the chances of that youth maintaining the success earned in drug court are reduced. This provides an opportunity for family and community evidence-based programs (EBPs) to engage with drug courts and promote shifts in the whole ecology to support the changes the youth is making.
Evidence-based programs partner with drug courts in Louisiana
Louisiana currently has 13 juvenile drug courts and the state passed drug court standards which “prioritize the use of evidence-based programs and practices shown to identify substance related problems and improve outcomes." Most juvenile drug courts in Louisiana have access to a Multisystemic Therapy (MST) team to provide family treatment. While an exciting opportunity for collaboration, pairing drug court with EBPs does not come without its challenges.
First and foremost is the differing perspective on peer influence. Decades of research show the youth’s peer group is a primary predictor of both future delinquent behavior and substance abuse. Yet, drug courts regularly support and often require group treatment for participants while evidence-based practices, like MST, promote prosocial activities and reinforce the caregivers taking the lead in discipline.
With this stated, these differences do not need to breed conflict. If communication is consistent, each program recognizes the strengths of the other and the stakeholders are able to develop individualized treatment plans, there is substantive evidence that the long-term outcomes for that youth can be significantly improved on treatment as usual. When caregivers implement the rewards and sanctions, monitor the youth at home and in the community, support improved academic performance, and involvement in pro-social activities, with the support of the therapist, then there is a realistic expectation of improvements continuing over time. Ideally, there is a marriage between the court’s focus on the individual youth and the evidence-based practice’s support of the ecology as a whole to promote the long-term change that will keep that young person from re-entering the system after graduating from drug court.
A case example
Jose, 15, was sentenced to regular probation for vandalism. He was at risk of being sent to the Department of Youth Corrections due to multiple failed drug screens. Instead, he was sentenced to drug court. He made some strides toward being clean, but continued to be truant and broke rules at home. That is until MST was combined with drug court as the treatment component for Jose and his family. The MST therapist was able to effectively work with his parents and increase involvement in his drug-court program. Once communication between the court and his parents improved, his school attendance got better, and he spent more at home. This allowed him to join a basketball team. He did so well, he focused more on his grades so that he could continue to play and spend his free time with other players rather than his old group of friends. As his behavior improved the conflict at home decreased and his parents repeatedly reported that they could not believe he was the same child. Eventually, he graduated from drug court, completed MST treatment, and has not returned to the court system, going on to graduate from high school and get a job.
We all want the best outcomes for vulnerable youth and families. Pairing drug court with effective EBPs can be a valuable way to work with substance-misusing teens.
Multisystemic Therapy (MST) is an evidence-based alternative to incarceration. MST effectively treats at-risk youth and their families by utilizing a built-in suite of services within the home, school, and community settings. Services include but are not limited to: social skills training, drug and alcohol intervention, mental health services, and peer management.