Methods: The study participants include 123 African American and 970 Caucasian female participants who exited from a DTC program across the state of Missouri between 2012 and 2015. The age of the participants ranged from 17 to 69 with an average age of 30.8 (Caucasian females: 30.7, African American females: 31.1). Using the Risk and Needs Triage (RANT®), prior felony convictions, onset age of regular substance use, onset age of criminal activity, amount of interactions with people engaged in criminal activity, DSM-5 Axis I mental disorder diagnosis, DSM-5 substance use disorders, and prior substance abuse treatments were measured as independent variables. Program graduation status was a dichotomous variable: 1=successful graduation and 0=other exit statuses for those who did not successfully graduate (e.g., termination, transfers). Multiple logistic regression models were used to estimate the relative effects of all independent variables in the prediction of graduating from a DTC program.
Results: Slightly more than half (52%) of the Caucasian female participants graduated from a DTC program whereas more than one-third (37%) of the African American female participants graduated. Compared to African American participants, Caucasian participants were significantly more likely to report interactions with people who were engaged in criminal activity, to have experienced prior substance abuse treatments, to meet the criteria for DSM-5 substance use disorders, to start using substances early in life, and to engage in criminal activity early in life. Results of regression models show that age and number of months engaged in regular employment increased the odds of graduation whereas number of prior felony convictions, and amount of interactions with people engaged in criminal activity decreased the odds of graduation among Caucasian females. Amount of interactions with people engaged in criminal activity was the only significant predictor of a decrease in the odds of graduation among African American females. We explored moderation effects, but no significant interaction effects were found.
Conclusions and Implications: Drug treatment courts have been one of the most successful interventions for individuals in the criminal justice system but the stories of success have been largely about men. The dialogue needs to expand to include the voices of all women as well. This study suggests that DTC programs consider differences in criminogenic factors associated with successful graduation between Caucasian and African American women. More research is needed to distinguish the experience of African American and Caucasian female DTC participants by adding omitted variables that are not available in our study such as racism and sexism.