Statewide Training: Veterans Treatment Courts

Effective Clinical Treatment for the Justice Involved Veteran Population

Suicide Awareness and Prevention in Veterans

Suicide Prevention is everyone’s responsibility. This session examines the signs, symptoms, and areas of concern that are potential risk factors for suicide. Most importantly, this session provides the VTC team member – regardless of role, the ability to take steps and actions that can significantly reduce a participant’s risk of self-harm.

Research-Driven Therapies for Survivors of Trauma

A significant portion of individuals that are in the criminal justice system has incurred a single trauma or several traumas throughout their lives. This session will focus on having a trauma-informed approach to working with these participants in your veterans treatment court. Additionally, research-driven trauma-informed services that most effectively meet the responsivity needs of the justice involved veteran will be identified and reviewed for possible consideration.

When Sanctions and Incentives Don’t Work

Incentives and sanctions, also known as contingency management, are essential to treatment court success. They are a powerful tool for improving client behavior and program outcomes when properly used. Treatment courts achieve be=er outcomes when practitioners understand the science behind behavior management and apply the principles. The research is clear— reliably impacting participant behavior requires both consistent reinforcements of positive behaviors and reliable responses to undesirable behaviors. Nonetheless, despite our best intentions (and perhaps the best intentions of the participants), some%mes incentives and sanctions ‘don’t work. For some participants, our responses to behavior seem to have no impact. This session will describe the essential elements of effective behavior modification in a treatment court and reveal what actions a program should consider when its efforts appear futile.

Learning Objectives:

• Learn the science underlying incentives, sanctions, and other responses in specialty
  courts
• Learn the essential elements of effective behavior modification in treatment courts
• Discover the four reasons contingency management doesn’t work and actions a program
  can take to address those causes of failure

Incentives, Sanctions and Therapeutic Adjustments

This presentation outlines basic behavior modification principles and their applicability in keeping participants engaged in treatment court programs and moving toward long-term recovery. It looks at how programs can use participant-driven incentives to formulate a strategy of creative responses desirable to the participant and give the participant an opportunity to be rewarded through positive and negative reinforcement. It identifies the importance of formal and informal incentives and their application in the program. The presentation recognizes the effect of immediate consequences in modifying client behavior.

Learning objectives:

• Learn how incentives motivate participants to comply with program requirements
• Identify various creative incentives that can be used to respond to a participant’s conduct
• Learn that incentives must be consistently and uniformly imposed

Impact of Motivational Interviewing for Treatment Court Professionals

Motivational Interviewing is designed to help participants see what matters to them and helps them to be engaged, feel valued, and develop a vested interest in their long-term recovery planning and case management. Through Motivational Interviewing, the participant has buy-in and a voice in identifying goals and a value system that gives them a major role in recovery
planning.

Learning objectives:

• Learn the principles and skills needed to deliver court responses effectively
• Gain an in-depth understanding of Motivational Interviewing to assist clients in changing
  their behavior

Addressing Criminogenic Risk and Need of the Justice-Involved Veteran Population

Failure to recognize and address the things that put a justice-involved veteran or service member at risk for continued criminal behavior can result in the person returning to the criminal justice system again and again. This session will focus on identifying the most significant risk factors for criminal justice involvement and actions that team members can tale to reduce a veteran participant’s likelihood of further criminal involvement.

Best Practice Standards Vol. I

In 2013, NADCP published Volume I of the ground-breaking Adult Drug Court Best Practice Standards, and in 2015, released Volume II. These standards provide practical, implementable, and enforceable guidance on how adult drug courts operate in 10 critical areas.

Learning Objectives:

• Receive a summary of each standard in Volume I and some of the fascinating research on which each standard is based
• Learn why adherence to the standards is essential for the continued success of the adult drug court model
• Learn about the adult drug court practice areas likely to be the focus of future standards

Best Practice Standards Vol. II

In 2015, NADCP released Volume II of the Adult Drug Court Best Practice Standards. The standards are derived from scientific evidence proving which practices improve outcomes, avoid harmful effects, and make optimum use of scarce resources. This presentation will review Volume II of the standards and the evidence supporting the practice recommendations.

Learning Objectives:

• Receive a summary of each standard in Volume II and some of the fascinating research on which each standard is based
• Learn why adherence to the standards is essential for the continued success of the adult drug court model
• Learn about the adult drug court practice areas likely to be the focus of future standards

Treatment Courts: Best Practices and the Opioid Crisis

Communities large and small across the United States are scrambling to respond to an opioid epidemic that President Trump has declared a “public health emergency.” Treatment courts, with their proven approaches to treatment and supervision, offer one of the best paths for healing communities broken by a complicated disease affecting so many nationwide. But with few and shrinking resources, how can courts react effectively? The Adult Drug Court Best Practice Standards provide one solution in combating the opioid epidemic within the criminal justice system by incorporating evidence-based research to reduce recidivism. These standards provide practical, implementable, and enforceable guidance on how Drug Courts provide the tools to achieve and sustain recovery. The crosswalk of national standards and state mandates provide a framework for long-term sustainability. This session will discuss how the application of the standards across programs help to increase outcomes, build program sustainability and best serve the target population.

Learning Objectives:

• Learn about resources that may exist in your community to promote recovery
• Surprising ways even the smallest of communities may utilize to treat those in need
• Learn how adherence to Best Practice Standards are essential for combating the epidemic

Drug Testing 101

Effective drug testing in treatment courts is essential to the program’s success. This session provides a comprehensive overview with information and strategies for building and maintaining a successful abstinence monitoring program. Collection strategies and result interpretation—two essential components of a credible testing program—will be discussed. You will learn the reasons for testing, how to select clients for maximum abstinence surveillance, and what specimens yield the best results. Additional focus issues will include controlling sample tampering and using creatinine measurements, the application of EtG/EtS urine alcohol monitoring, the challenges of on-site testing, dispelling popular drug testing myths, and much more.

Learning Objectives:

• Learn the basic principles of drug testing
• Gain knowledge of effective drug testing to ensure the success of abstinence monitoring
• Learn which drug testing myths are true and false

Drug Testing and Medications for Opioid Use Disorder

The number of treatment court participants addicted to opioids (e.g., heroin, morphine, prescription pain relievers) has increased. As a result, the courts include the use of medications for opioid use disorder (MOUD) to assist these clients. However, does the use of MOUD to promote recovery complicate the interpretation of drug testing results?

Learning Objectives:

• Learn how to use standard instrument-based screening immunoassays drug tests (in-lab or in-court), and understand that MOUD does not cross-react to produce false positive results
• Recognize that the cross-reactivity toward MOUD is largely unstudied when using on-site testing devices
• Confirmation testing (GX, MS, or LC/MS) resolves all cross-reactivity issues

Drug Testing Myth Busters

What is fact and what is fiction? Using the popular Discovery Channel’s show “MythBusters” as a launching point, this session will investigate and evaluate many of the popular myths associated with drug testing. This presentation aims to “prove” or “bust” the myths your clients use to rationalize unfavorable drug testing results. Learn to be savvier than your clients.

Learning Objectives:

• Review the most popular myths used to discredit drug testing results.
• Analyze how these myths are designed to confuse drug test result interpretation.
• Explore the origins of drug testing myths and why they perpetuate.

Planning for Sustainability

This session will discuss the various types of funding and resources available to drug courts. Sustainability is a major concern for many drug courts and having a plan from the beginning – as the presentation recommends – is vital to ensure long-term survival.

Learning Objectives:

• Identify the range of resources and options to support drug courts, including the sources of monetary and nonmonetary resources.
• Recognize the role of the drug court team in developing a long-term funding strategy.

Building a Community Coalition for Your Veterans Treatment Court

This session provides practical examples and engaging discussion on how to ensure that one of the most critical components of the veterans treatment court, the mentoring component, survives and thrives. The primary focus of this training is on the essential role the mentoring component provides to the veteran participant concerning continuity of support and resources long after they have completed the court program.

Evaluation 101 for Treatment Court Researchers: What to Collect and How to Measure It

Is your treatment court an effective program? Is the program reaching its goals? How do you know? In this climate of scarce public resources, monitoring and evaluation can help treatment court programs demonstrate their worth to internal and external stakeholders. Regular review of program operations and outcomes can also help improve the quality of your program. This session breaks down the major evaluation components, including what information to collect, tips for collecting data, how to develop good comparison groups, and methods for analyzing recidivism and costs.

Learning Objectives:

• Learn the standards for a treatment court evaluation
• Learn the key data to collect
• Learn valid recidivism analysis

Evaluation Boot Camp: Preparing Your Treatment Court for Outside Evaluation

Is your court ready to undergo formal evaluation? What will you gain from an evaluation? This session describes recommended procedures for conducting process, outcome, and cost evaluations of treatment courts. It outlines key data and information needed to conduct the different types of evaluation and presents potential resources to fund evaluation. Treatment court teams considering an evaluation will be able to assess the feasibility of having an evaluation conducted on their court and ways to prepare for a future evaluation.

Learning Objectives

• Differentiate between process, outcome, and cost evaluations of treatment courts in terms of their purpose and methods used
• Describe key data sources, the elements necessary for evaluation, and strategies to begin collecting data or enhance existing data collection practices
• Identify various funding opportunities to support the evaluation of your treatment court

Evaluation 101 for Non-Research Team Members: What to Collect and How to Use It for Self-Review

Is your treatment court an effective program? Are you reaching your goals for your program? How do you know? In this climate of scarce public resources, monitoring and evaluation can help treatment courts demonstrate their program’s worth to internal and external stakeholders. Regular review of program operations and outcomes can also help improve the quality of your program. This session breaks down the major components of evaluation, including what information to collect, tips for collecting data, and how you can use the information to perform a self-review of your program, no previous evaluation experience required.

Learning Objectives:

• Understand the basics of program evaluation and its importance
• Understand what data your treatment court program should collect
• Understand how you can use your data to monitor your program’s progres

Mental Health Disorders and the Justice-Involved Veteran Population

This session provides an overview of common mental health disorders, as identified in the DSM-5, that participants may be experiencing. Attendees will learn about screening and assessment interventions used to assist with identifying these potential disorders. Additionally, this session will introduce participants to how to help facilitate change through available evidence-based treatment modalities.

Cognitive Processing Therapy: A Tailored Therapeutic Response for Your Justice Involved Veteran Participant

This session focuses on Cognitive Processing Therapy (CPT), a cognitive-behavioral treatment that was initially developed for veterans with posttraumatic disorder and related problems. An overview of the therapy is shared. Areas that are covered include how it works, the goals of the treatment and what counseling sessions look like from a participant’s perspective. Case examples are shared to highlight the efficacy of the intervention. Clinicians and non-clinicians alike will find the session especially interesting.

Building a Strong Recovery Through Work With the Family

This session will provide an opportunity to learn the value of incorporating family therapy into substance use treatment and how it may provide a stronger recovery.

Learning Objectives

• Learn to distinguish between family psychoeducation, family integration, and family therapy
• Understand the value of incorporating family therapy into substance use treatment

Importance of Relationships in Recovery

This presentation will educate participants on the importance of replacing unhealthy relationships with healthy support networks in recovery. Furthermore, it will describe the dangers of a group-think mentality and the dynamics it can bring to recovery and criminal behavior, resulting in an irrational or dysfunctional decision-making process to maintain psychological homeostasis.

Learning Objectives

• Learn the importance of social groups and how they can affect recovery and criminal behavior
• Learn what happens when a group-think mentality engages and the effects it can have on moral reasoning and motivation

Revisiting the Importance of Social Connectedness in Veterans

Acknowledging that strong community and social ties are variables that contribute to a participant’s recovery as well as a law-abiding lifestyle is substantial. Even more significant, however, is when VTC teams can develop strategies and techniques that improve and enhance social connectedness between community and participant. This session focuses on combining knowledge with the strategy in a manner that will have long-term beneficial outcomes for the justice-involved veteran participant.

Recovery Management: Helping People Move from Active Addiction to Lasting Recovery

Recovery is more than abstinence. Recovery is more than remission. Recovery is a process of change through which individuals achieve remission from substance use disorder (SUD), improve their health and wellness, live a self-directed life, and strive to reach their full potential. Research demonstrates that recovery is not only possible, it’s probable. Most people living with SUD will eventually achieve stable, long-term recovery. Unfortunately, not everyone has the same likelihood of moving from addiction to recovery. This session will explore the critical steps in achieving stable recovery, the factors that differentiate those who recover from those who do not, and how treatment courts can help.

Learning Objectives:

• Understand the essence and characteristics of addiction and recovery
• Learn the five essential steps that anyone seeking recovery must accomplish
• Learn that a person’s capacity for stable recovery is measurable and can be improved through effective treatment and recovery management

Recurrence Prevention and Response in Treatment Courts

Recurrence of substance use disorder (SUD) is a persistent yet manageable risk in recovery. Managing this risk requires the concerted efforts of everyone on the treatment court team and others in the recovery community. This session will examine the prevailing views regarding the recurrence of SUD and the multidimensional aspects of effective recurrence prevention planning and programming. It will share essential information on managing the single greatest and most common danger in the immediate aftermath of a recurrence—the abstinence violation effect.

Learning Objectives

• Learn how recurrence of SUD differs clinically significantly from continued or resumed use
• Understand the essential components of successful recurrence prevention planning and programming
• Learn how to effectively reduce the risk of recurrence and minimize the harms of recurrence if it occurs

Co-Dependent Relationships

This presentation will help recognize the warning signs of potential co-dependent relationships that clients are engaged in and education on how to untangle those damaging relationships. This plenary will also define the underlying self-centeredness that co-dependency creates by examining the underlying processes that occur when one is reliant on other people for approval and a sense of identity.

Learning Objectives:

• Recognize the warning signs of co-dependency relationships.
• Learn techniques to educate clients and family members on the dynamics of co-dependent relationship

Enablement

This presentation will discuss the dynamics of enablement in substance use disorder and how it can impede recovery.  The presentation will also discuss the importance of accountability and consequences. This presentation will look at the difference between co-dependent relationships and enablement.  Finally, this plenary will look at some of the cultural ties that enablement has.

Learning Objectives:

• Learn the difference between helping behavior and enabling behavior.
• Learn the difference between abstinence and recovery.
• Learn about co-dependent relationships.

Relapse Prevention

Learn about the dynamics of substance use disorder and the relapse and support that clients will need upon entering recovery. This plenary will help you define the difference between abstinence and recovery, and it will highlight the importance of safety nets and supports systems that the substance use disorder individual will need to be successful.  Furthermore, it will develop safety plans and tools that can be utilized to help the road to recovery.

Learning Objectives:

• Learn the difference between abstinence and recovery.
• Learn the strategies to help support a person in recovery.
• Factors that can cause relapse.

Role of Law Enforcement: Part 1

This session is designed to educate law enforcement officers on treatment court programs and the role law enforcement plays on the treatment court team. Law enforcement officers will better understand treatment courts, collaborations, and interactions with team members and participants. Law enforcement officers will learn the core knowledge, skills, and information necessary to be effective as part of the treatment court team. Course modules will educate you on developing your role as a member of a treatment court team or your capacity to support safer communities through community engagement with the treatment court program in your jurisdiction.

Learning Objectives:

• Increase understanding of law enforcement’s role in identifying target populations to refer to local treatment court programs
• Identify decision points along the Sequential Intercept Model where law enforcement plays a vital role in identification, referral services, diversionary resources, recovery capital needs, and treatment court referrals
• Build collaborations between law enforcement and the local treatment court program

Multidisciplinary Team: Know Your Role

This session outlines the basic concepts of team development. It offers interactive exercises to demonstrate ways to handle team issues, such as transition and conflict management.

Learning Objectives:

• Identify the elements of effective teamwork and different teamwork models
• Understand new perspectives on effective teamwork and dynamics within your team

Prosecutor in Veterans Treatment Courts

Prosecutors in veterans treatment courts (VTCs) are part of strong, interdisciplinary teams dedicated to serving the justice-involved veteran population. Due to the unique characteristics of this population, it is incumbent on the prosecutor to understand issues common to VTC participants, including substance use disorder, PTSD, traumatic brain injury, and military sexual trauma. The prosecutor must also be familiar with the Department of Veterans Affairs, veterans justice outreach specialists (VJOs), and the veteran mentor component. This knowledge is required for the prosecutor to assist the team with assessing eligibility, determining appropriate responses to client behavior, and addressing the unique needs of justice-involved veterans.

Learning Objectives:

• Understand the unique characteristics of the justice-involved veteran population and how psychological injuries can lead to veterans’ involvement in the justice system
• Learn the importance of understanding military culture, substance use disorder, PTSD, traumatic brain injury, and military sexual trauma
• Learn the core competencies for a VTC prosecutor

Importance of Self-Care

This session will educate on the importance of self-care in the treatment court field and the steps to preserve mental and physical health. You will discover the importance of self-care, which can help boost self-esteem and produce a more productive work environment and work product. This session will teach you how to speak up for yourself and explain why your self-care needs are important.

Learning Objectives:

• Recognize the warning signs of stress
• Learn self-care techniques and strategies

Trauma Awareness and Resilience Strategies for Work and Life

Our work comes with tremendous stress, trauma, and pressure. Each day, we serve struggling people and are exposed to tremendous amounts of trauma, sadness, and dysfunction. At the same time, we face structural and systemic challenges around safety and security, funding, technological change, and a list that goes on and on. Do you ever ask yourself whether you are going to survive this work? Do you wonder if you can continue to rise to the challenge, get everything done, and stay engaged? This session will help you understand what prolonged stress and trauma exposure do to us and our teams. It will also explore research-based practices and solutions to meet these challenges and achieve ongoing health, satisfaction, and performance. We can survive and even thrive by focusing on and implementing mindful resilience strategies.

Learning Objectives:

• Learn the impact of stress, trauma, and constant pressure in our work on ourselves and our participants/clients
• Identify and begin planning how to implement clear strategies and workable solutions for improving health, performance, and resilience as people and organizations
• Learn ideas and strategies to lead our teams to be more mindfully effective, better prepared, and positioned to respond to the changes and challenges that will surely keep coming

Working Wounded: Preventing and Managing Professional Impairment

This session explores the frequently overlooked issue of impairment and burnout in helping professionals. All of us seek to balance the stresses and strains of our private lives with the need to perform effectively at work. Even in tough times most of us are able to “pull it together” long enough to get through our day. However, there are times when issues such as excessive duties, divorce, disease, substance use, depression, or other dysfunction rob us of our ability to do our jobs and/or find joy in doing so. Whether the problem results from an acute incident or is a chronic problem that has reached the breaking point, the consequences can be life- and livelihood-threatening. This session is essential for those who fear they may be impaired, want to know the warning signs of impairment, want to know how to avoid becoming impaired, or want to know how best to support coworkers or loved ones who are struggling.

Learning Objectives

• Know the warning signs of professional impairment and burnout and learn prevention strategies
• Understand the impairment continuum and most common manifestations and causes of impairment
• Develop strategies for coping with impairment to facilitate a return to full fitness for duty

Practicing Everyday Wellness for Your Mentoring Component

Through case examples, this session examines the emotional demands placed upon members of the mentoring component working in a veterans treatment court. It identifies Five Tenets of Self-Care that mentors can practice daily to prevent or reduce the likelihood of experiencing secondary traumatic stress or vicarious trauma. A self-assessment tool that can practically aid in log-term stress reduction and wellness “production” is discussed.

Gender-Responsive Programming

Historically, treatment programs treat men and women together, often providing the same services. Research shows that treatment needs for women differ from those of men and are often more complex. Research also shows that women participating in gender-specific programs have improved outcomes. A promising emerging practice addressing the specific gender needs of treatment court participants includes gender-specific treatment court programming.

Learning Objectives:

• Learn the unique needs and issues women face
• Learn the key components for building programming around women’s strengths and competencies
• Recognize the importance of developing programs that approach the treatment needs of women using a comprehensive and holistic strategy

LGBTQ Population in Treatment Court

The Adult Drug Court Best Practice Standards stipulate that those who have historically experienced sustained discrimination or reduced social opportunities because of their race, ethnicity, gender, sexual orientation, sexual identity, physical or mental disability, religion, or socioeconomic status receive the same opportunities as others. This session will explore how to determine if, on average, all participants, regardless of race, ethnicity, or gender, have an equal opportunity to participate in and succeed in treatment court. It will help practitioners ensure equivalent access, retention, treatment, incentives and sanctions, and dispositions, and stress the importance of providing team training on race, ethnicity, culture, and diversity and becoming a culturally competent and responsive program.

Learning Objectives:

• Identify indicators of racial disparities in your court program
• Describe model strategies and approaches for improving participation and outcomes for racial and ethnic groups
• Apply the Adult Drug Court Best Practice Standards to serve historically disadvantaged groups

Working With Native Populations

This presentation will teach the dynamics of working with Native American people and the history of generational trauma.  This plenary will teach the importance of working on relationships and the importance of listening to what culture is saying instead of telling them “what they need to do” Furthermore, this plenary will explain the importance of culture when working with different populations.

Learning Objectives:

• Learn the do and don’ts of working with Native American peoples.
• Learn and understand the Trauma history of Native American peoples.

Addiction and Psychopharmacology

This session outlines the effects of alcohol and drugs on the brain. It discusses the most recent research in the area and stresses the importance and effectiveness of treatment to combat addiction.

Learning Objectives:

• Describe the short- and long-term neurological effects of alcohol and drug use and their implications for treatment
• Evaluate how to apply current research findings to alcohol and drug treatment
• Recognize the short- and long-term general effects of alcohol and other drug use on brain physiology and behavior
• Learn the difference between use, misuse, and dependence/addiction, and develop appropriate and attainable expectations for offenders in your treatment court program

Developing Effective Treatment Plans for Persons With Co-Occurring Disorders

Persons with co-occurring mental health and substance use disorders are found in all treatment court types. Substance use disorder is the most common and clinically significant comorbid disorder among adults with severe mental illness. It is estimated that 70-74% of persons in the justice system are affected by co-occurring disorders. Effective treatment planning is critical to positive outcomes in treatment and court case planning.

Learning Objectives:

• Recognize the necessity of matching treatment approaches to the individual
• Recognize the necessity of providing a comprehensive continuum of treatment and ancillary services
• Learn the complex interactions between flexible treatment and case planning while following the Adult Drug Court Best Practice Standards

Developing the Treatment Continuum

This session discusses the importance of treatment to the treatment court model. Further, it describes the various treatment approaches and methods for clients in treatment court. It also discusses the various ways to continue treatment after an individual commences from treatment court and the importance of continuing care to maintain a recovery lifestyle.

Learning Objectives:

• Recognize clinical treatment services as the primary function of the treatment court model
• Learn the blending of primary clinical services with criminal justice case processing
• Define good treatment and its components
• Identify the major characteristics and advantages of standard treatment approaches
• Recognize the necessity of matching treatment approaches to the individual
• Recognize the necessity of providing a comprehensive continuum of treatment and ancillary services
• Recognize the necessity of providing continuing care after discharge from treatment court

Identifying and Understanding Common Mental Health Disorders in Treatment Court

This presentation will address the dynamics of common co-occurring disorders often related to a substance use disorder. Furthermore, it will describe common behaviors that occur with mental health disorders and the different therapies used to treat those behaviors.

Learning Objectives:

• Learn patterns of behavior that are common with certain mental health disorders
• Learn different types of therapies commonly used for mental health disorders
• Learn the dynamics of co-occurring mental health disorders

Improving Engagement in Treatment

This session will look at how to address the lack of engagement in or resistance to treatment.

Learning Objectives:

• Learn how to look at treatment resistance through lenses of opportunity
• Learn the value of creating a treatment alliance to reduce resistance
• Learn the importance of motivation and that motivation looks different for different people

Medications for Addiction Treatment

This session is recommended for full treatment court teams interested in learning about medications for addiction treatment (MAT) and specifically medications for opioid use disorder (MOUD), as well as how to incorporate the use of FDA-approved medications into their programs. Opioid use disorder has quickly become a national crisis as communities see the number of deaths from drug overdoses overtake those from car accidents. Research has shown that using MOUD, in combination with treatment for substance use disorder, is effective and can help people sustain recovery.

Learning Objectives:

• Learn the biological basis for substance use disorders
• Identify the goals for treatment
• Know the medications currently approved by the FDA for treating opioid use disorder
• Learn the key indications and contraindications for medications used to treat opioid use disorder
• Recognize how physicians decide on treatment changes and reduce the risk of medication diversion

Law School 101: Constitutional Law for Treatment Court Professionals

The law is a tool for success and should not be viewed as an obstacle. Treatment court professionals must comprehensively understand what the law will and will not allow. Learn firsthand how to face challenges relating to ethics, HIPAA, confidentiality, due process, 12-step programs, and other constitutional requirements.

Learning Objectives:

• Recognize constitutional and due process issues that affect treatment court programs
• Identify how federal confidentiality regulations are applied in the treatment court setting
• Recognize ethics laws that influence team member roles in the treatment court process