The timing of the RFA """"""""Research on Drug Courts"""""""" provides an extraordinary opportunity to conduct a rigorous randomized trial to determine (a) whether a juvenile drug court improves clinical and cost-related outcomes when compared with available community services, and (b) whether the integration of an intensive evidenced-based treatment model enhances the possibly favorable outcomes of juvenile drug court. A unique opportunity to address these issues has been presented because NIAAA is about to fund (see Appendix A) a study titled """"""""MST with Alcohol Abusing Delinquents: Outcomes and Cost."""""""" The soon-to-be-funded study is a randomized trial that compares multisystemic therapy (MST, Henggeler et al., 1998) enhanced with key aspects of the community reinforcement approach (CRA; Budney & Higgins, 1998) versus current community services for alcohol abusing or dependent juvenile offenders. In Charleston, current community services for substance abusing youths identified in the juvenile justice system now consist of drug court and mandated treatment with a state provider of substance abuse services (i.e., facility-based group counseling). The present application proposes to include two additional comparison conditions-conditions that will address critical gaps in the juvenile drug court literature per the present RFA as well as enhance the contributions of the NLAAA-funded study. The two new conditions are Community Services without Drug Court and MST without the CRA enhancement. Hence, if the present application is funded, the four treatment conditions would include: 1. Community Services without Drug Court (CS), (requested from NIDA) 2. Drug Court with Community Services (DC+CS), (funded by NIAAA) 3. Drug Court with MST (MST), (requested from NIDA) 4. Drug Court with MST enhanced with CRA ~IST+CRA), (funded by NL AA) This application proposes a 4 (treatment condition: CS, DC+CS, MST, MST+CRA) x 4 (time: pretreatment [T1], 4 months [T2], 12 months [T3], 18 months [T4]) design, in which 288 juvenile offenders who meet DSM-IV criteria for substance abuse or dependence and their families will be randomly assigned to conditions. A comprehensive multimethod, multisource evaluation will address the following aims:
Aim 1. To evaluate treatment effects on adolescent alcohol and drug use, criminal activity, and mental health functioning; as well as on family relations, peer relations, and school attendance.
Aim 2. To track adolescent substance abuse and mental health service utilization, juvenile justice involvement, and out-of-home placements and their associated costs across the treatment conditions for 18 months post recruitment.
