Courts That Save Opioid Victims’ Family Life
The New York Times, September 26, 2017
One spring afternoon, Samantha Coleman’s two daughters ran across the family’s yard, chasing dozens of newly hatched chicks. Coleman, 28, ran after them. “Whoa! Child down,” she called, reaching to pick up her 2-year-old, who had managed to fall into a bush.
“This is my life,” Coleman said, laughing. “Gummy bears in my pockets, half-naked kids, spills everywhere.” She paused. “But I’m good.” Sometimes this still surprises her. Four years ago, things looked very different: Coleman was using heroin, was in a violent relationship and risked losing her older daughter to foster care.
In most places, a parent in Coleman’s position would be required to complete a treatment program ordered by a traditional Family Court as a condition of regaining custody. But the likelihood of losing one’s child is high: there’s little support for parents trying to finish treatment, and many drop out. Federal data indicate that substance abuse accounts for nearly 40 percent of all cases in which a child is removed from home, though some experts believe that the number is as high as 80 percent.
Coleman’s case was handled very differently. Chautauqua County, N.Y., where she lives, had an innovative intervention program called Family Treatment Court, which gives parents access to a wide range of coordinated services. Treatment programs are tailored to each participant’s needs, and caseworkers and a presiding judge closely track their progress. The first Family Treatment Court opened in Reno, Nevada in 1994, and there are now about 370 across the country.
The program helps parents complete drug and alcohol treatment, keeping them out of the criminal justice system and keeping their children out of foster care. National statistics are not yet available to measure the effectiveness of the programs, because studies of Family Treatment Courts have generally been limited to assessments of individual programs, which vary in their methods.
One thing that is clear is that the innovation can save governments money. A 2010 report on a Family Treatment Court in Oregon found that over a two-year period, the program reduced average criminal justice and child welfare costs by $13,000 a participant, whether or not they graduated. But those courts serve only an estimated 5 to 10 percent of families who could benefit from them.
The need is growing across the country: opioid addiction is at epidemic levels and with it has come a flood of child welfare cases. In Indiana, the number of children interacting with Child Protective Services jumped nearly 40 percent between 2013 and 2015; in 2016, the number of Massachusetts children placed in foster care reached 15,892, which Maria Mossaides, the state’s child advocate, believes is a record high.
Before entering Family Treatment Court, Coleman struggled with addiction for years. She had been prescribed opiates while recovering from an accident in which she had been severely burned and soon became addicted. Sometimes she left her firstborn daughter alone with a physically abusive boyfriend so she could get high. It was a pattern she had experienced herself, growing up in Dunkirk, in the western hills of New York State. “All I’d seen was domestic violence and chemical dependency from my mom and my whole family,” she said. “I didn’t know any other way to live.”
But when Coleman lost custody of her daughter in 2013, it was an alarm. Ever since she was young, she’d dreamed of being a mother. Now, she realized that if she “didn’t stop what I was doing I was going to destroy my daughter, and she was going to be doing the same thing I was in 10 years.”
When Coleman began Family Treatment Court, she was nervous. She didn’t want to waste her chance to get help. She decided to follow the program — “like a straight shooter” she said.
Coleman had tried to get clean in the past, but it never stuck. So how did Family Treatment Court succeed where standard child welfare casework and substance abuse treatment failed?
For nine months, Coleman attended parenting courses, drug treatment and domestic violence counseling, guided by caseworkers and service providers. She had weekly (and later, biweekly or monthly) court dates in which she and other participants met with Judge Judith Claire, who oversaw the program, to assess their progress.
She took quickly to the program’s routine. “It’s your full-time job, which is the best part,” she said. “I learned how to get out the door in the morning and get everything accomplished.”
Coleman was far from the first person in her family to appear in Family Court. Her mother, aunts, uncles, grandparents and great-grandparents had all landed in court before Judge Claire, facing charges associated with child welfare, drugs and domestic violence. (For years before starting the Family Treatment Court, Judge Claire presided over a traditional courtroom as the county’s sole Family Court justice.)
“Family Court is a revolving door,” Judge Claire says now. “Families come back again and again and again with the same problems.”
Coleman doesn’t remember her first time in court — she was a baby, and her mother was fighting to maintain custody of her. But she remembers when her younger brother was abruptly removed from the house in the middle of the night and sent to live with an aunt. Coleman was 14; her mother was addicted, working late hours at a nightclub, and Coleman’s main memory of that night is relief at knowing that her brother would be safe. Later, she recalls, her mother tried a boot-camp-style drug rehabilitation program, to no avail.
When Coleman was 17, her mother went missing for a year. When Child Protective Services found out, they separated Coleman from her brother and sister. Coleman was placed in foster care. She ran away, eventually ending up in the care of another relative. In time, she would see the inside of so many courtrooms that she no longer found herself nervous sitting before a judge. “My mom was in court so many times with us,” Coleman said. “But she never got help. There were all these child protection cases and no real intervention.”
Courts and child welfare agencies have been notoriously behind the times in their approaches to substance abuse. “The thinking goes that if parents loved their children more, they’d stop using,” said Phil Breitenbucher, a program director at Children and Family Futures, an organization that focuses on families affected by substance abuse and trauma. “Our policy and practices are still largely built on that outdated perspective.”
Addiction today is increasingly seen as a disease, rather than a moral failing. And although there are effective treatments, they rarely follow a linear or predictable course. To make matters worse, there are many barriers for those seeking help.
Parents who are required to complete treatment programs to regain custody of their children must first contend with long waiting lists just to get in. Substance abuse programs vary in quality. Although, as The Times reported recently, opioids are commonly covered by insurance plans, many addiction programs are not. And chronically overburdened social workers, lawyers and judges are often unable to provide the level of support that is generally required for someone to persist long enough overcome an addiction.
By contrast, Family Treatment Court is collaborative and hands-on, particularly when the court follows what experts consider the best practices, as was the case in Chautauqua County when Samantha Coleman started her program. The court adopted an approach called trauma-informed care, which seeks to avoid retraumatizing people through its oversight and directives. Like Coleman, many parents in family court have experienced a long history of neglect, hurt and fear. One distinctive aspect of Family Treatment Court is that participants are treated with respect and dignity, and they are supported so they can take charge of their recovery.
To counter the uncertainty and lack of control many participants experience in the child welfare system, Judge Claire provided detailed explanations about the operations of her courtroom and answered questions about the path ahead. Rather than scolding participants when they slipped up, she reminded them of how far they’d come. She encouraged participants to devise solutions to their own problems, recognizing that their ideas might be more effective than the court’s prescriptions. “The whole court changed because of trauma-informed care,” Judge Claire said. “Everybody was working harder for the children’s interests.”
Coleman noticed the differences immediately. Before Family Treatment Court, she couldn’t recall any time her family was before a judge who seemed to understand what was going on in her home. Their decisions felt hasty and arbitrary. “Judge Claire dug in and asked questions,” she said. “She tried to get to the root of the issue.”
Encouraged by the recognition that Judge Claire was intent on helping her take steps toward reuniting with her daughter, Coleman finally stopped using drugs. “That was awesome, because it usually felt like nobody wanted you to be reunited with your child,” she said. By the time she completed the nine-month program, Coleman’s daughter was back with her at home. Coleman signed herself up for counseling and began working in a restaurant and as a caretaker for the elderly. “Before, I could never have imagined I’d do that,” she said.
Family Treatment Court is still in its experimental stages. Judges are not required to use a trauma-informed approach, and even when they do, their success — which depends on their ability to build relationships with participants, lawyers and caseworkers — can seem as much like an art as a science.
“Too often, the success of specialized courts turns tremendously on who the judge is, and whether they have the personality for it,” said Jane Spinak, who directs the Adolescent Representation Clinic at Columbia Law School. A system in which a change in leadership can have such an impact on outcomes “is not a sound system for building courts in the long run.”
That critique, however, could be applied to much of the justice system, where case outcomes are regularly determined by assumptions and ambitions held by prosecutors and judges.
“There is a major need to standardize what a family treatment court is,” Breitenbucher said, so that families’ experiences become easier to predict. The Office of Juvenile Justice and Delinquency Prevention, part of the Department of Justice, has tasked Breitenbucher’s organization, Children and Family Futures, with drawing up a set of best practices for Family Treatment Court.
They will undoubtedly include the use of trauma-informed care, which Coleman credits for her success. The only negative thing about the Family Treatment Court, she said, was that she had to lose her daughter to qualify.
“Without Treatment Court, I would never know these resources existed,” she added. “It shouldn’t have to get to the point of a neglect charge to get help.”