Substance use treatment completion does not mediate the relationship between family treatment court participation and reunification: Results from five courts in the Southwestern U.S.

• NCJ Number: 310825
• Journal: Drug and Alcohol Dependence Volume: 276 Issue: 1 Dated: November 2025
• Author(s): Margaret Lloyd Sieger; Jessica Becker; Jon D. Phillips; Cindy Nichols; Elizabeth J. Goldsborough; John Prindle
• Date Published: November 2025
• Grant Number(s): 2018-DC-BX-0007
• Agencies: NIJ-Sponsored
• Publication Type: Research (Applied/Empirical)
• Award: Oklahoma Multi-Site Family Drug Court Model Standards Study (OKMSS)

Abstract

Background
Family treatment courts (FTC) apply judicial theory and behavioral economics to increase parent substance use treatment completion and family reunification for families in foster care due to parental substance use disorder. Dozens of quasi-experiments and case studies suggest FTC programs outperform traditional child welfare courts. However, methodological limitations in earlier research limit causal inference.

Study purpose
The current study aimed to examine the relationship between FTC participation and family reunification, and to investigate whether substance use treatment completion mediates this relationship.

Methods
Foster care, substance use treatment, and FTC administrative records from 2018 to 2022 were probabilistically linked across six counties in a Southwestern U.S. state. The final sample included 200 FTC-involved and 1367 comparison child/caregiver dyads. To address selection bias, we applied inverse probability weighting based on propensity scores. The weights balanced the treatment and control groups based on fifteen covariates, including demographic characteristics, child welfare system involvement, and novel substance use treatment metrics such as caregivers’ Addiction Severity Index scores, level of care recommendation, and primary substance of choice.

Results
Applying the weight, our logistic regression model revealed that FTC-involved dyads’ odds of reunification were 66 % greater compared to dyads served in traditional settings (OR = 1.66, 95 % CI: 1.14–2.40). The mediation model revealed that the effect of FTC participation on reunification was independent of treatment completion.

Conclusions
FTC demonstrates its own treatment effect on family reunification, above and beyond substance use treatment experiences. These findings point to a “value added” for FTC participation. In an area of practice characterized by low rates of success, identifying effective, real-world interventions for families is significant.

(Publisher abstract provided.)