(25) Family Dependency Drug Court Service Modifications During COVID-19

Background:
The COVID-19 pandemic is colliding with the ongoing opioid crisis, potentially worsening outcomes for people with substance use disorder (SUD). In Florida, family dependency drug courts (FDDCs) are civil problem-solving courts that facilitate parent-child reunification after governmental removal of children due to parental drug use. FDDCs have been forced to modify existing services due to COVID-19, yet little is known about FDDC modifications in response to COVID-19 and its impacts. Therefore, we sought to identify 1) how courts adapted to COVID-19 and 2) the experiences of court staff regarding the switch to virtual technology due to COVID-19.

Methodology:
We recruited all court staff from five Florida FDDC courts from June 2020 to June 2021 for in-person and virtual focus groups and individual interviews as part of a larger study evaluating their implementation of evidence-based practices. Eight focus groups with a total of thirty individuals and five individual interviews occurred. Data collection from each court occurred at two time periods: March-June 2020 and February-March 2021. Focus groups and interviews were recorded and professionally transcribed. In Dedoose software, we analyzed data using the iterative categorization approach in which a coding template is created based on the research questions, which can be modified during the consensus coding process. These coded excerpts were then labeled with summaries in spreadsheets and used to identify themes within and across codes.

Results:
FDDC service modifications involved switching to virtual court services and allowing court clients to access treatment virtually (e.g., telehealth, peer support, 12-step groups). The experiences of court staff regarding the switch to virtual technology due to COVID-19 included: 1) client engagement in virtual services has decreased; 2) client access and participation to virtual court services has increased; 3) clients may lack the technology to use virtual court services; 4) relationship between staff and clients has suffered due to virtual technology; and 5) pre-existing familiarity with technology and institutional support helped staff with adapting during COVID-19.

Discussion:
COVID-19 precipitated the justice system’s rapid modification of operations by utilizing virtual technology. This is an opportunity to implement systemic changes that could increase accessibility and efficiency in the court, which has historically been slow to embrace innovations; feasibility and acceptability of virtual services offered must be examined for each court’s need.

Conclusion:
There are still aspects of virtual services that need improvement. A client’s inability to participate in virtual services due to a lack of technology may cause negative perceptions from staff. Considering the current technological divide in the US, the incorporation of virtual services into FDDCs may negatively impact those with limited access to technology. Future research should delve into potential models for hosting in-person, virtual, or a hybrid model of virtual court services meant to maximize the benefits of both court service models.

References: Krebs, C. P., Lindquist, C. H., Koetse, W., & Lattimore, P. K. (2007). Assessing the long-term impact of drug court participation on recidivism with generalized estimating equations. Drug and alcohol dependence, 91(1), 57–68. https://doi.org/10.1016/j.drugalcdep.2007.05.011

Wolfe, E. L., Guydish, J., Woods, W., & Tajima, B. (2004). Perspectives on the drug court model across systems: a process evaluation. Journal of psychoactive drugs, 36(3), 379–386. https://doi.org/10.1080/02791072.2004.10400037

Guastaferro, K., Guastaferro, W. P., Brown, J. R., Holleran, D., & Whitaker, D. J. (2020). Drug Court as an Intervention Point to Affect the Well-Being of Families of Parents with Substance Use Disorders. Substance use & misuse, 55(7), 1068–1078. https://doi.org/10.1080/10826084.2020.1726394

Diversity, Equity, and Inclusion: This study addressed disparities of healthcare, such as medications for opioid use disorder, amongst different drug courts, and how clients in various courts may have been affected by an inability to access these life-saving medications. It also delved into access issues regarding MOUDs that may have been altered or exacerbated due to COVID-19.