Predictors of Appropriate Modality for Participants in Court-Mandated Treatment: Findings at the Brooklyn Treatment Court

Christine Depies DeStefano, Urban Institute
Michael Rempel, Center for Court Innovation

ABSTRACT
A critical dilemma facing court-mandated treatment programs is how to determine the appropriate modality for each participant. A literature has begun to emerge on what factors predict a greater risk of treatment dropout, but little research has tested whether these same factors predict a greater need for a more intensive inpatient modality. Such research could inform court-mandated programs and the larger treatment community. Results were analyzed at the Brooklyn Treatment Court (BTC). Measures of treatment modality were: (1) initial assignment to inpatient or outpatient, (2) proportion of treatment days spent inpatient, (3) any long-term inpatient stay (e.g., at least one year), (4) ever switched from outpatient to inpatient, and (5) ever switched from outpatient to inpatient. Analyses were supplemented by qualitative interviews with onsite clinical staff. Multivariate analyses indicated that the following consistently predicted requiring the more intensive inpatient services: higher addiction severity, primary drug of heroin, more prior treatment episodes, younger age, unstable work situation, and female sex. Although the drug use factors of addiction severity, primary drug, and treatment history were significant, these factors were weak or insignificant predictors in an earlier analysis on the predictors of dropout. Also, criminal justice factors were not significant predictors of modality needs, although they were among the strongest predictors of overall treatment outcomes.

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Updated 05/20/2006