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Tribal Healing to Wellness Courts: Treatment Guidelines

Introduction

1. The goal of drug courts is to:

A. Refer eligible defendants to immediate treatment services.

B. Reduce criminal activity by promoting the recovery of the participants.

C. Monitor participant use of alcohol and other drugs through frequent random drug tests.

D. Supervise participants’ progress in treatment through frequent appearances before the drug court judge.


2. Healing to Wellness Court dockets differ from the tribal court process in all of the following ways, except:

A. Participants are required to participate in a multi-phased and individually tailored substance abuse treatment program.

B. Additional services are provided to the participant to address other needs they may have to fully recover and rejoin the community.

C. Successful completion of the program generally results in some benefits to the participant in terms of the disposition of their charge or case.

D. Participants may simply have their cases disposed of by a judge, elder, or other community leaders with a sentence of incarceration or referral to probation.


3. For an individual to be eligible for Wellness Court, they must fit which criteria for admission?

A. The legal criteria

B. The clinical criteria

C. Both the legal and clinical criteria

D. They must have the desire and will to change their behavior but are not required to meet the legal or clinical criteria


4. Healing to Wellness Courts target which particular population?

A. Those with a high criminogenic risk of reoffending and a high prognostic threat, or need, in regard to the disease of addiction.

B. Those with a high criminogenic risk of reoffending but a low prognostic threat, or need, in regard to the disease of addiction.

C. Those with a low criminogenic risk of reoffending but a high prognostic threat, or need, in regard to the disease of addiction.

D. Those with a low criminogenic risk of reoffending and a low prognostic threat, or need, in regard to the disease of addiction.


5. If possible, treatment services should be provided within a few days of the individual’s arrest or triggering referral event.

A. True

B. False


6. Substance abuse treatment is provided to reward desired behaviors or punish infractions.

A. True

B. False


7. Which of the following is a critical, yet often neglected component of the Healing to Wellness Court?

A. Family involvement

B. Case management

C. Drug testing

D. Incentives and sanctions


8. Status hearings are designed to provide the judge with the opportunity of all of the following, except:

A. Monitor the participant’s compliance with program conditions.

B. Give recognition to the participant’s efforts to recover.

C. Impose immediate sanctions for noncompliance.

D. Find adversarial facts to use in subsequent prosecution.


9. Judges who spend 30 or more minutes with the participant during status hearings have greater programmatic outcome savings that those courts where judges spend less time.

A. True

B. False


10. When a participant completes a proximal goal, they should receive a high magnitude reward, but not completing a proximal goal should receive a low magnitude sanction.

A. True

B. False


11. At minimum, the Wellness Court team should include all of the following, except:

A. Tribal judge

B. Alcohol / substance abuse counselor

C. Tribal elders

D. Probation officer


12. Which of the following is the central figure of the team?

A. Tribal judge

B. Wellness Court coordinator

C. Case manager

D. Treatment provider


Key Issues in Developing Treatment

13. Most people begin to use alcohol and other drugs:

A. To feel better

B. For recreation

C. To rebel

D. As medication


14. An individual’s vulnerability to use can be increased based on risk factors, such as easy access to inexpensive substances, low parental monitoring, a family history of substance use or mental disorders, high levels of family conflict or violence, low involvement in school, a history of abuse and neglect, and a history of substance use during adolescence.

A. True

B. False


15. All of the following describe addicts, except for:

A. Relationships and work or school performance are negatively affected.

B. Substance use leads to legal, financial, or law enforcement problems.

C. Substance use can be sporadic giving the appearance of maintaining control over their life.

D. Substance use leads to reckless behavior.


16. All of the following are indicators of addiction, except for:

A. Binging

B. Craving

C. Compulsion

D. Tolerance


17. Addicted participants who are not strictly sanctioned may attempt to manipulate the system.

A. True

B. False


18. American Indian and Alaska Native youth have higher rates of substance abuse problems than any other ethnic group.

A. True

B. False


19. Increased sense of guilt and shame about using alcohol and/or other drugs is seen in which stage of use, abuse, and dependency?

A. Experimental use

B. Regular use

C. Abuse

D. Dependency


20. The younger an individual is at the onset of substance use, the greater the likelihood that a substance use disorder will develop and continue into adulthood.

A. True

B. False


21. The majority of adults with current substance use disorders started using before age:

A. 13

B. 15

C. 18

D. 21


22. It takes approximately _____ to rewire the neuro-chemical changes in the brain that result from alcohol and other drug abuse.

A. 6 months

B. 1 year

C. 3 years

D. 5 years


23. Recent research has found _____ use to influence alcohol consumption, and when used together appear to interact in a way that may intensify the effect of each substance compared to if used alone.

A. Tobacco

B. Cannabis

C. Cocaine

D. Heroin


24. Some researchers have estimated an individual’s genetic history to account for up to 90% of an individual’s risk category for developing abuse of various categories of drugs.

A. True

B. False


Developing a Wellness Court Treatment Program

25. The treatment approach for juveniles will need to focus on all of the following, except for:

A. Developing alternative activities and interests that enhance self-concept and capacity to live drug free.

B. A fear of hitting bottom.

C. Education relating to addictive behavior.

D. Developing positive identities.


Adapting State Drug Court Treatment Components

26. Drug courts should immediately place participants in drug court treatment and avoid delays of more than several days between admissions screening and engagement in treatment services.

A. True

B. False


27. Treatment in drug courts should include evidence-based interventions, such as all of the following, except:

A. Motivational enhancement therapy

B. Contingency management

C. Medication-assisted treatment

D. Boot-camp disciplinary programs


28. Ideally, legal screening and referrals should reflect more of a discretionary case-by-case process and less of an automated process.

A. True

B. False


29. The screening and assessment process should pay particular attention to the presence of mental disorders and history of trauma and PTSD, given the high rates of these disorders among offenders.

A. True

B. False


30. The goal of independence for a person with FASD is independent living.

A. True

B. False


31. All of the following should be addressed at intake, except for:

A. Offer examples of other participants who are further along in the treatment program or who have successfully completed it.

B. Diagnose the substance use disorder and determine a level of care.

C. Clarify schedule requirements and program rules / sanctions / incentives with the participant.

D. Provide the participant with team members’ contact information and clarify questions they may have.


32. Due to confidentiality laws, the treatment plan should not be shared with the Wellness Court team.

A. True

B. False


33. The first phase of Wellness Court should focus primarily on all of the following, except:

A. Developing a support network.

B. Meeting participants’ basic housing needs.

C. Stabilizing mental health symptoms.

D. Addressing symptoms of addiction such as cravings or withdrawal.


34. Providing too much treatment or too much supervision can increase crime or substance abuse.

A. True

B. False


35. All of the following are essential elements of individual therapy, except for:

A. Providing a safe place for the individual to tell their story.

B. Assisting the individual in translating ideas and goals into action.

C. Helping the individual candidly assess their progress or lack of progress.

D. Providing a place for “reality” testing.


36. Understanding the individual’s relationship with alcohol and other drugs is a topic addressed in which group process?

A. Process groups

B. Cognitive behavioral groups

C. Educational groups

D. Support groups


37. Great care should be exercised in considering family therapy sessions in situations involving:

A. Dishonesty

B. Domestic violence

C. Destructive motivation

D. Family secrets


38. Which of the following is generally the primary barrier for most Wellness Court participants?

A. Motivation

B. Affordability

C. Housing

D. Juvenile dependents


39. All of the following are the goals of adventure-based programming, except:

A. Developing self-confidence

B. Developing skills that promote responsibility and social functioning

C. Participating in activities that serve the group / community

D. Recognizing physical symptoms of alcohol or other drug use


Special Considerations for Treatment Services

40. It has been found that the more often caregivers attend status hearings, the less often the youth are late or absent from school, miss treatment sessions, or receive sanctions for behavioral infractions.

A. True

B. False


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