JUSTICE PROGRAMS OFFICE

SCHOOL OF PUBLIC AFFAIRS

BUREAU OF JUSTICE ASSISTANCE (BJA) DRUG COURT CLEARINGHOUSE/TECHNICAL ASSISTANCE PROJECT FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants Subject: From: Date:

Exit Surveys for Drug Court Participants BJA Drug Court Clearinghouse/Technical Assistance Project (October 9, 2012). August 20, 2014 (rev.)

1. In September 2012, Shirl Page, Criminal Justice/Drug Court Coordinator for the Sebastian County Drug Court in Fort Smith, Arkansas, submitted an inquiry regarding exit surveys. Seeking information from drug court programs that had developed exit surveys for their participants, Ms. Page asked the following questions: Questions (1) What information do you try to obtain in the survey? (2) At what point in the program does a participant receive and complete the survey? (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? (4) How do you use the information obtained from the Survey?

Responses to Ms. Page’s inquiry were received from twenty two programs across eleven states, including Arizona, Delaware, Illinois, Massachusetts, Missouri, New Hampshire, Nevada, Oregon, South Dakota, Texas, and Washington, as well as The National Drug Court Institute, and an international program in Australia. A large number of programs had exit surveys, and used them to collect information regarding participants’ satisfaction with the program overall, as well as suggestions on how to improve the program. General practice was for participants to be given the exit survey close to graduation, and it was equally as likely for the program to require participants to identify themselves as it was to give the option of answering the survey anonymously. A few programs indicated that their exit surveys were conducted in-person, although this practice was not as frequent. 2. In July 2014, Pamala Washington, York County Adult Drug Treatment Court Case Manager in Biddeford, Maine, followed up on Ms. Page’s inquiry, requesting additional examples of exit surveys used by other drug court programs. Ms. Washington’s inquiry was as follows: Question “Would anyone happen to have a few ideas on exit interview questions? I have been transferred to a new court and they do not have specific questions or an after care plan that clients complete upon graduation and I would like to be a little more creative.”

To date, responses to Ms. Washington’s inquiry have been received from eight programs across eight states, including California, Florida, Georgia, Maryland, North Dakota, Ohio, Tennessee, and West Virginia). All eight respondents provided a sample of the survey they use. Three of the eight surveys focused on collecting information regarding participants’ satisfaction with the program overall, as well as suggestions on how to improve the program, while the remaining five asked more questions regarding both the participant’s experiences in the program and their intentions/motivation to maintain a sober lifestyle once they graduate from the program. Differing from what was evidenced in responses to Ms. Page’s September 2012 inquiry, only two of the eight surveys were anonymous; similarly, however, responses to both inquiries indicated that it was common practice for services to be given close to graduation. Responses to both Ms. Page’s September, 2012 inquiry, and Ms. Washington’s July, 2014 inquiry are compiled below. All sample materials provided by respondents are appended. Included in the appendix of this report are the following: (A) Yuma County, AZ, Drug Court – Pre-Graduation Information/Requirements and PreGraduation Questionnaire (B) Maricopa County, AZ – Consent to Future Contact from the Adult Probation Department and Drug Court Exit Survey (C) Yavapai County, AZ, Therapeutic Courts – Application for Graduation (D) Yavapai County, AZ, Drug Court – Evaluation Questionnaire (E) Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application (F) First Step of Sarasota, Inc., FL – Transition Survey (G) Mountain Judicial Circuit, GA, Accountability Court – Commencement Requirements (H) Concord, MA, Drug Court Program – Commencement Aftercare Plan (I)

St. Mary’s County, MD, Drug Court – Program Survey

(J) 39th Circuit, MO – Drug Court Exit Interview (K) DULT Drug Court, MO – Participant Satisfaction Survey (L) South Central, ND, Juvenile Drug Court – Exit Questionnaire (M) Ohio Drug Court Participant Satisfaction Survey (N) Benton County, OR – Drug Treatment Court Exit Interview (O) STOP DUI Program (Court), SD – Exit Interview Questions (P) Cumberland County, TN – Recovery Court Questionnaire (Q) 4C/SAFPF Re-Entry Court, TX – Client’s Exit Interview (R) Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview (S) Yakima County, WA, Drug Court – Exit Interview Questionnaire (T) Snohomish County, WA, Superior Court – Drug Court Exit Interview Procedures (U) Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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(V) Snohomish County, WA, Juvenile Offender Drug Treatment Court – Specific Exit Interview Questions (W) Snohomish County, WA, Juvenile Offender Drug Treatment Court – Parent Exit Interview Questions (X) West Virginia Adult Treatment Courts (Mental Health Court and Drug Court) – Exit Interview

RESPONSES ARIZONA Susan Alameda (Response to September, 2012 inquiry) Treatment Specialist Arizona Supreme Court Adult Probation Services Division Phoenix, AZ [email protected]

I apologize for my delay in forwarding this information to you. I hope it’s still of use to you. Please see the attached. (See responses below) We would also love to have a copy of what you collected from other states for us to review and possibly use as good examples as we continue to refine our DC Exit process. Ryan “Mike” Byrd (Response to September, 2012 inquiry) Drug Court Coordinator Yuma County Superior Court Yuma, AZ [email protected]

Here you go Susan. Hope this helps. (See Appendix A: Yuma County, AZ, Drug Court – PreGraduation Information/Requirements and Pre-Graduation Questionnaire) (1) What information do you try to obtain in the survey? We ask a variety of questions in an attempt to gauge the participant’s grasp of recovery concepts, identify the accomplishments they have achieved during their recovery, and pros/cons of their participation and the program itself. (2) At what point in the program does a participant receive and complete the survey? Our program is an 18 month, 6 phase program divided into 4 primary phases over approximately 12 months and 2 aftercare phases over approximately 6 months. The participants “graduate” from the primary phase of the program after completing Phase 4. We hold 4 graduations per year and any participant having completed Phase 4 is eligible for the current graduation ceremony. Prior to actually participating in the graduation, each participant is provided the attached PreGraduation Questionnaire. The questionnaire must be completed and returned one week prior to the graduate’s exit interview. The exit interview panel usually consists of all the Drug Court team members and lasts approximately ½ hour. (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? No, the responses are not anonymous.

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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(4) How do you use the information obtained from the Survey? First and foremost we are trying to ensure the graduate has demonstrated a recovery program stable enough for graduation. Although few and far between, participants have been kept from graduating as a result of information collected from their exit interview/Pre-Graduation Questionnaire. An example would be, determining the participant has not completed all of his/her required pre-graduation program requirements. Additionally, we use this information to gather knowledge on things such as growing drug trends in the community, program positives and negatives as seen by the participants, as well as ideas for new/different incentives (and sanctions) to improve the program. Ultimately, the participant is provided a forum to outline (in writing and in person) his/her recovery and his/her future plans to the Drug Court Team as well as to provide feedback to the team that may help improve the quality of service the program provides. Steve Lessard (Response to September, 2012 inquiry) Drug Court Coordinator Maricopa County Phoenix, AZ [email protected]

(1) What information do you try to obtain in the survey? Program feedback and input from clients regarding curriculum, sanctions, incentives, staff, and other areas of the program that could use improvement. Looking for improvements in the clients and how it has impacted their life. (2) At what point in the program does a participant receive and complete the survey? At graduation. (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? Choice (4) How do you use the information obtained from the Survey? Make changes to the program as needed. Here is a copy of the survey (See Appendix B: Maricopa County, AZ – Consent to Future Contact from the Adult Probation Department and Drug Court Exit Survey) Randy Meyers (Response to September, 2012 inquiry) Drug Court Coordinator Yavapai County Probation Office Prescott, AZ [email protected]

Hope your vacation was fun. Please see the attached files above. Those are the two exit interviews we use. By the way, we are working on refining ours as well. Would you request copies of the ones American University receives and forward them to me? Thanks. (See Appendix C: Yavapai County, AZ, Therapeutic Courts – Application for Graduation; and Appendix D: Yavapai County, AZ, Drug Court – Evaluation Questionnaire) We have the clients fill them out at the end of DC and they are not confidential.

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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CALIFORNIA Paddy Michalski (Response to July, 2014 inquiry) Program Coordinator, Therapeutic Courts Superior Court, County of Mendocino Ukiah, CA [email protected]

I’m attaching our “Graduation Questionnaire”. Hope it helps. (See Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application)

DELAWARE Carmen Facciolo (Response to September, 2012 inquiry) Special Projects Analyst State of Delaware Administrative Office of the Courts Wilmington, DE [email protected]

We have not developed exit surveys in Delaware. However, we do conduct post-graduation interviews. I would definitely enjoy seeing samples of exit surveys from other jurisdictions. I am reaching out for additional information on the exit groups. I know that in the Mental Health Courts, Probation and Parole and Treatment Access Center (Court Treatment Services) staff meet with participants prior to exit and assess the participant's continuing needs. During graduation ceremonies, our judicial officers conduct informal exit interviews to determine what contributed to a participant's success and to solicit advice for other participants. If you have any questions, please do not hesitate to ask. Best, CJF

FLORIDA Fred Span III (Response to July, 2014 inquiry) Program Director DUI Court Sarasota, FL [email protected]

This is our exit survey (See appendix F: First Step of Sarasota, Inc., FL – Transition Survey)

GEORGIA Jackie Roberts (Response to July, 2014 inquiry) Coordinator Mountain Judicial Circuit Accountability Court Clarkesville, GA [email protected]

Attached is a packet we use. Hope this will help. (See Appendix G: Mountain Judicial Circuit, GA, Accountability Court – Commencement Requirements)

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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ILLINOIS Del Ryan (Response to September, 2012 inquiry) Drug Court Coordinator Champaign County Drug Court Urbana, IL [email protected]

The Drug Court of Champaign County has done little in terms of using an exit survey information. I will forward any information on this topic from the past that I can uncover. In the meantime, I welcome hearing what your investigation uncovers. I’m sure we will develop something in the near future to evaluate our clients Drug Court experience.

MASSACHUSETTS Kerin Raymond (Response to September, 2012 inquiry) Massachusetts State Drug Court Coordinator Advocates, Incorporated Ayer, MA [email protected]

I am unsure if this is what the requesting party is looking for but here is our commencement application. My clever spin is to call it a commencement petition....commencement to end or begin and we honor their success of completing and recognize their new journey (non-mandated) begins. I hope this is helpful. We also do client satisfaction surveys throughout the program. When I get to my desktop I will forward a copy of it as well. I am sure it can be modified. When a client graduates they also have to do an interview with the whole team in our staffing prior to court. We always ask: what did you like / didn't like, what should we change, what was the most valuable resource in each phase, how can we improve etc. The clients are very responsive and have given some great ideas that we have implemented. (See Appendix H: Concord, MA, Drug Court Program – Commencement Aftercare Plan)

MARYLAND Pete Cucinotta (Response to September, 2012 inquiry) Program Manager & Coordinator Juvenile Drug & Adult Recovery Court St. Mary's County, MD [email protected]

Here is one we use (See Appendix I: St. Mary’s County, MD, Drug Court – Program Survey)

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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MISSOURI Angela Plunkett (Response to September, 2012 inquiry) Treatment Court Coordinator Court Business Services Division Office of State Courts Administrator Jefferson City, MO [email protected]

Please see responses from Missouri below. Have a great day! (See Appendix J: 39th Circuit, MO – Drug Court Exit Interview; and Appendix K: DULT Drug Court, MO – Participant Satisfaction Survey) (1) What information do you try to obtain in the survey? Satisfaction/dissatisfaction with the program and what about the program was helpful in their sobriety. (2) At what point in the program does a participant receive and complete the survey? Just prior to graduation (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? The participants have a choice to include their name (4) How do you use the information obtained from the Survey? To improve the program or see if there are issues with the program or team members

NEW HAMPSHIRE Robert Gasser (Response to September, 2012 inquiry) Drug Court Coordinator/Clinical Director Office of the Administrative Judge Concord, NH [email protected]

Hello Jen, Please provide Caroline with ours. (Jennifer Stone did not respond)

NEVADA Toni R. Barden (Response to September, 2012 inquiry) Judicial Executive Assistant Henderson Municipal Court Henderson, NV [email protected]

Here is the information from A.B.C. Court, sorry for the delay. (1) What information do you try to obtain in the survey? What they found to be most helpful and least helpful in the program; what their future goals are after graduation; whether they intend to stay abstinent from drugs and alcohol after graduation; how their recovery has affect their relationship with other loved ones; how they cope with stressful situations now that they have learned how to cope; how involved they are with community based support groups and whether they intend to continue with any commitments they have made; if reunification took place with their child(ren), regardless of the age; what recovery step they worked, if any and was a sponsor helpful to them, if they had one; description FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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of the support system they developed while in the program; employment record; educational or vocational goals, if any; a description of how their life is different today. (2) At what point in the program does a participant receive and complete the survey? During their last month of the program. (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? Participant includes name. (4) How do you use the information obtained from the survey? We use it to determine readiness to graduate and whether there may be other issues they may need assistance with prior to graduation, such as whether they have a good understanding as to whether they have the foundation to continue in their recovery, and they may need to understand that their counseling agency has an open door policy for them to continue to receive treatment for as long as they feel they need it.

NORTH DAKOTA Marilyn Moe (Response to July, 2014 inquiry) Program Manager North Dakota Supreme Court Bismarck, ND [email protected]

Attached is an Exit Questionnaire for Juvenile Drug Court in North Dakota. (See Appendix L: South Central, ND, Juvenile Drug Court – Exit Questionnaire)

OHIO Margaret C. Baughman Sladky (Response to July, 2014 inquiry) Senior Research Associate Begun Center for Violence Prevention Research and Education Cleveland, OH [email protected]

(See Appendix M: Ohio Drug Court Participant Satisfaction Survey) Here is what we use since we are program evaluators, there are projects that we do not collect names/ identifiable information of participants but use an identification system so you will notice the top of the survey collects date and ID- not client name. The de-identified survey also promotes the ability for the participant to freely critique the various aspects of the program without being concerned their responses will be linked to them. We often supply an envelope for them to seal their completed survey in and we enter the data into the system. Feel free to tweak- we explore satisfaction in the following areas: 1) Judge & Court Hearings; 2) Case Management; 3) Substance Use Staff; 4) Mental Health Staff; 5) Probation Staff

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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OREGON David Clark (Response to September, 2012 inquiry) Drug Treatment Court Coordinator Benton County Circuit Court Corvallis, OR [email protected]

Answers below, survey attached. (See Appendix N: Benton County, OR – Drug Treatment Court Exit Interview) (1) What information do you try to obtain in the survey? We try to obtain constructive criticism from successful participants. We ask about the process and the personal goals. (2) At what point in the program does a participant receive and complete the survey? At the end just before graduation. (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? Anonymous. (4) How do you use the information obtained from the Survey? It is compiled and presented to the staffing team once a year.

SOUTH DAKOTA Helen Jane Paxton (Response to September, 2012 inquiry) Capitol Area Counseling STOP DUI Program (Court) Pierre, SD

[email protected] Please see my responses in your email below. I also attached a copy of our exit interview questions. The final question reads, "What does your bumper sticker read now?"...our Judge asked everyone this question on their first day in the program, as well as graduation day. It was always impromptu and unscripted, so it was very interesting to hear the responses! (See Appendix O: STOP DUI Program (Court), SD – Exit Interview Questions) (5) What information do you try to obtain in the survey? We try to get very open, honest answers from the clients about what worked, what didn't, what they feel should be changed to be more effective in treatment, supervision, Court sessions, etc. We like to know what incentives/sanctions were beneficial and which ones weren't. We ask what advice they would give to newcomers and plans for continuing AA or other recovery groups after the program. They are allowed to be very frank, yet must be respectful as well. (6) At what point in the program does a participant receive and complete the survey? Participants receive the exit interview questions with their graduation packets when they initially request to graduate the program. We do not administer the interview until after graduation has occurred. We set up the interview shortly after graduation, sometimes even the same day. (7) Are responses anonymous or does the participant have a choice as to whether to include his/her name? The interview is conducted in person. Typically the entire Team is present. FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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(8) How do you use the information obtained from the Survey? The information is shared and discussed at our Team staffing and we implement those ideas that are reasonable and may be more beneficial and effective for the program and clients.

TENNESSEE Nancy Fallows (Response to July, 2014 inquiry) Program Development Coordinator Tennessee Community Services Agency Cookeville, TN [email protected]

I have developed the attached questionnaire to give to clients who are approaching graduation. It enables us (the Drug Court Team) to determine if they are ready to leave the close structure of Drug Court. If we do not think that they are, based on these answers and our interview with them, they may be continued for a little longer and assisted in developing a clearer plan for their future. If they are ready, then the answers assist us in developing an after-care plan with them. Our after-care lasts for 6 months and can be longer if they need it. (See Appendix P: Cumberland County, TN – Recovery Court Questionnaire)

TEXAS Roger Henderson (Response to September, 2012 inquiry) Supervisor 4C SAFPF Re-Entry Court Dallas, TX [email protected]

My name is Roger Henderson and I'm the Supervisor for the 4-C SAFPF Re-Entry Program in Dallas, TX that is presided by Judge Robert Francis. (1) What information do you try to obtain in the survey? We try to obtain the client's honest thoughts while in the program. (2) At what point in the program does a participant receive and complete the survey? The participant completes the Exit Interview a couple of days after they graduate from the program. (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? The responses are not anonymous, the only people that conducts these interviews are my Assistant Supervisor and myself. We explain to the client that the information is confidential. (4) How do you use the information obtained from the Survey? We use the information in the Exit Interview to make minor adjustments to our program. For example, many clients stated that it was not fair for the Judge to deal with the bad clients before he dealt with the good clients. Based on what many clients stated in the Exit Interview, Judge has changed court and now he deals with the sanctions at the end of court and the good clients given praises at the start of court and sometimes they are given the opportunity to leave court early. Also, I have attached a copy of our Exit Interview questions. Please feel free to let me know if you have any questions. (See Appendix Q: 4C/SAFPF Re-Entry Court, TX – Client’s Exit Interview)

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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Georgia B. Kimmey (Response to September, 2012 inquiry) Coordinator Angelina County Drug Court Lufkin, TX [email protected]

When our Drug Ct was in the formative stages of our first year, our team visited Judge Cruezot’s program in Dallas. We were able to observe court proceedings as well as a team staff meeting, an impact meeting, and an exit interview. We all agreed to incorporate the Exit Interview into our program too. Whenever a participant graduates (completes their first year of sobriety and moves into the second year of aftercare), as many members of our team as we can gather, meet with the participant to discuss: their opinion of the program, what worked well for them, where we could improve, what was their most memorable experience, what their plans are now that they’re leading a sober life, etc. It allows the participant to vent if they want to, give us suggestions or praise, and in general helps us fine tune our policies. We take their comments seriously and share them at our monthly policy meetings. They enjoy being able to give feedback for change instead of us telling them what to do. Anissa Vila (Response to September, 2012 inquiry) Drug Court Coordinator for Texas Office of the Governor – Criminal Justice Division Austin, TX [email protected]

FYI….. (See Georgia Kimmey’s response above)

WASHINGTON Earl Long (Response to September, 2012 inquiry) Behavioral Health Criminal Justice Administrator Division of Behavioral Health and Recovery Olympia, WA [email protected]

Dear Washington Problem Solving Courts: Please respond per Caroline Cooper’s request (See responses below) Marianne L Clear (Response to September, 2012 inquiry) Mental Health Court/Veterans Court Program Manager Thurston County District Court Olympia, WA [email protected]

Thurston County Mental Health and Veterans Court uses the attached Exit Survey. It is provided at graduation, or shortly following termination of participation. There is no spot for a name to be written, although they can write their name if they choose. We currently are using the information to identify that each individual has the opportunity to provide feedback to the program. (See Appendix R: Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview)

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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Gloria J. Roybal (Response to September, 2012 inquiry) Program Specialist Yakima County Courthouse Yakima, WA [email protected]

Please see my responses below. I’ve also attached the Exit Interview document our court utilizes. I hope this helps. (See Appendix S: Yakima County, WA, Drug Court – Exit Interview Questionnaire) (1) What information do you try to obtain in the survey? We are mostly interested in what their short and long term goals are and how they hope to achieve them. Plus what their likes and dislikes were while in the program. (2) At what point in the program does a participant receive and complete the survey? The survey is given to the participant a week before their exit interview. The exit interview is scheduled one week prior to their graduation date. (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? No, anonymity is not a choice as their written responses are reviewed during an in-person interview with the Drug Court team. (4) How do you use the information obtained from the Survey? We see if there are more participants with similar responses. If so, we discuss their validity; could the program, overall, benefit from change or offering additional assistance or treatment. Janelle Sgrignoli (Response to September, 2012 inquiry) Program Administrator –Specialty Courts Snohomish County Superior Court Everett, WA [email protected]

(1) What information do you try to obtain in the survey? We collect information on their satisfaction on various aspects of our drug court including treatment, incentives, sanctions, etc. We also ask for feedback on ways we can improve our drug courts. For our juvenile drug courts, we also have a parent exit interview and program specific youth forms. All participants are required to complete the drug court exit interview. (2) At what point in the program does a participant receive and complete the survey? The exit interview is completed prior to their graduation or termination – usually a week or so prior. (3) Are responses anonymous or does the participant have a choice as to whether to include his/her name? Participants are required to complete the form including their name. However, the drug court teams do not see the individual surveys. They are submitted to me, Program Administrator, and I compile the results and provide summaries only to the drug court teams. (4) How do you use the information obtained from the Survey? We use it for program improvement and participant satisfaction. I’ve attached our exit interview procedure and forms. Please feel free to call me if you have any questions. Thanks (See Appendix T: Snohomish County, WA, Superior Court – Drug Court Exit FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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Interview Procedures; Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire; Appendix V: Snohomish County, WA, Juvenile Offender Drug Treatment Court – Specific Exit Interview Questions; and Appendix W: Snohomish County, WA, Juvenile Offender Drug Treatment Court – Parent Exit Interview Questions)

WEST VIRGINIA Lora Maynard (Response to July, 2014 inquiry) Deputy Director of Adult and Juvenile Drug Courts Administrative Office of the Courts, Division of Probation Services Charleston, WV [email protected]

WV uses this form approved by the State Supreme Court. (See Appendix X: West Virginia Adult Treatment Courts (Mental Health Court and Drug Court) – Exit Interview)

NATIONAL DRUG COURT INSTITUTE Sonya L. Harper (Response to September, 2012 inquiry) Project Director of NDCRC NDCI – The Professional Services Branch of NADCP Alexandria, VA [email protected]

Hi Caroline – The question Ms. Page of Arkansas posed about exit interviews made its way here to the National Drug Court Institute so I wanted to take the opportunity to provide some assistance and also introduce the field to the National Drug Court Resource Center (NDCRC). Thanks! Exit interviews are used by a number of courts throughout the country and the way you design your exit interview will depend heavily on why you want to collect the information and how you intend to use it. Some courts utilize exit interviews as a way to gauge the overall welfare of their clients at the time of discharge whereas others implement more of a “customer satisfaction” type interview to get an idea of what participants think about the program. Regardless of which type of survey is used, the information collected can help you identify the strengths and weaknesses of your program. Most drug courts conduct the exit interview at the time of discharge. However, it is important to note that if you intend to interview persons who do not successfully complete your drug court, you may be met with resistance. However, some courts conduct a follow-up interview at the 6-month or halfway mark to determine if any adjustments should be made to the participants’ service plan or if the client is in need of any ancillary services. Whether or not the exit interview should be anonymous will again depend on what type of information you are looking to gather. If you are gauging the client’s overall wellbeing at the time of discharge, then you would obviously want to conduct the interview person-to-person. If you are conducting a “customer satisfaction” survey, you don’t have to ask client’s to identify themselves. Also, you may receive more candid responses if the participants know the survey is anonymous. Below is a link that will provide you with sample exit interviews and exit surveys that we have posted on the NDCRC website. http://www.ndcrc.org/search/apachesolr_search/Exit%20Interviews?filters=type%3Aform I would recommend that you review some of the forms to get a feel as to the type of survey you would like to design and deliver. Also, feel free to reproduce any of the information you find on our site and would like to use. In addition, if you are ever looking for any type of information pertaining to drug courts, I would recommend that you check out the NDCRC. It is your “one stop shop” for all FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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things drug court. Since its inception, the NDCRC has served as the central repository of drug court information for the latest research findings, funding opportunities, available trainings, breaking news, announcements, networking and support. The NDCRC has been designed to allow drug court practitioners collect information in a quick and coordinated manner. A quick and simple search will give you instant access to a plethora of factsheets, forms, case law, newspaper articles, monographs and research materials. Stay up-to-date and receive firsthand information from experts in the field with NDCI’s Tune in on Tuesday webinar series. Sign up for online training, participate in advanced subject manner courses, request on-demand education or receive guidance on implementing innovative practices by visiting a mentor court. The NDCRC was designed with the drug court practitioner in mind. It is a resource that brings data, research, documents, training and technical assistance directly into the offices of over 2,600 operational drug courts throughout the country. If you are in need of any kind of information on drug courts, I encourage you to check us out at www.ndcrc.org. Should you ever have any questions or require assistance, please feel free to contact me. Also, if there is anything else I can do to help as you move forward with developing your exit survey, just let me know.

AUSTRALIA Elizabeth Moore (Response to September, 2012 inquiry) Tasmania, Australia [email protected]

Hi Caroline and Shirl, we don’t conduct a formal exit interview with our drug court participants here in Tasmania but one aspect of the Masters in Criminology and Corrections that I’m currently working on is to survey participants (current or recently completed) to find out about their experience of the program. This is really as a means of trying to determine what measures of success we should be looking for, but it could also be useful in terms of implementing feedback from participants about the program in general. I'm asking some very open questions about what benefits they can attribute to program participation, and what suggestions they would make for the future of the program. I haven't started this component of the research yet, but it may be that it develops into some form of exit survey that we can apply more generally. I'll keep you posted, and I look forward to seeing what other responses you get.

************************ We welcome any additional information and/or perspective readers may have on this topic. BJA Drug Court Clearinghouse Justice Programs Office, School of Public Affairs American University 4400 Massachusetts Avenue NW, Brandywine, Suite 100 Washington D.C. 20016-8159 Tel: 202/885-2875Fax: 202/885-2885 e-mail: [email protected] Web: www.american.edu/spa/jpo

FREQUENTLY ASKED QUESTIONS SERIES: Exit Surveys for Drug Court Participants. BJA Drug Court Clearinghouse/Technical Assistance Project. American University. (October, 9 2012) August 20, 2014 (rev.)

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Appendix (A)

Yuma County, AZ, Drug Court – Pre-Graduation Information/Requirements and Pre-Graduation Questionnaire

(B) Maricopa County, AZ – Consent to Future Contact from the Adult Probation Department and Drug Court Exit Survey (C) Yavapai County, AZ, Therapeutic Courts – Application for Graduation (D) Yavapai County, AZ, Drug Court – Evaluation Questionnaire (E) Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application (F) First Step of Sarasota, Inc., FL – Transition Survey (G) Mountain Judicial Circuit, GA, Accountability Court – Commencement Requirements (H) Concord, MA, Drug Court Program – Commencement Aftercare Plan (I)

St. Mary’s County, MD, Drug Court – Program Survey

(J) 39th Circuit, MO – Drug Court Exit Interview (K) DULT Drug Court, MO – Participant Satisfaction Survey (L) South Central, ND, Juvenile Drug Court – Exit Questionnaire (M) Ohio Drug Court Participant Satisfaction Survey (N) Benton County, OR – Drug Treatment Court Exit Interview (O) STOP DUI Program (Court), SD – Exit Interview Questions (P) Cumberland County, TN – Recovery Court Questionnaire (Q) 4C/SAFPF Re-Entry Court, TX – Client’s Exit Interview (R) Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview (S) Yakima County, WA, Drug Court – Exit Interview Questionnaire (T) Snohomish County, WA, Superior Court – Drug Court Exit Interview Procedures (U) Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire (V) Snohomish County, WA, Juvenile Offender Drug Treatment Court – Specific Exit Interview Questions (W) Snohomish County, WA, Juvenile Offender Drug Treatment Court – Parent Exit Interview Questions (X) West Virginia Adult Treatment Courts (Mental Health Court and Drug Court) – Exit Interview

Appendix A: Yuma County, AZ, Drug Court – Pre-Graduation Information/Requirements and Pre-Graduation Questionnaire

YUMA COUNTY DRUG COURT Pre-Graduation Information/Requirements Participant:

D.O.B.:

Case Manager: Primary Counselor: Graduation Review Panel Date: GENERAL INFORMATION The Graduation Review Panel (G.R.P.) will usually consist of the following: 1.

Participant

2.

Yuma County Superior Court Drug Court Judges

3.

Drug Court Case Managers

4.

Counselors

5.

Program Coordinator

6.

Public Defender

7.

Prosecutor Attorney

As a prospective Drug Court Program graduate, you must complete the Pre-Graduation Questionnaire (P.G.Q.) and return it to your case manager one week prior to the formal Graduation Review Panel. The Graduation Review Panel will ask you questions about your responses to the Pre-Graduation Questionnaire and your overall plan for continued sobriety. Your Pre-Graduation Questionnaire is to be taken seriously. Answer all questions completely and as thoroughly as possible. Punctuality, personal appearance, and the neatness

of your P.G.Q. responses will be considered indicators of the depth of your commitment to your sobriety. This questionnaire is intended to assist the Graduation Review Panel in making a fair determination of your readiness to graduate from the Drug Court Program and continue with Aftercare. You will have the opportunity to address the Graduation Review Panel in support of your belief that you are ready to graduate.

Appendix A: Yuma County, AZ, Drug Court – Pre-Graduation Information/Requirements and Pre-Graduation Questionnaire

GRADUATION REQUIREMENTS Graduation requirements for the Drug Court Program are not negotiable. Each petitioning graduate must meet the following requirements as a minimum prior to meeting the Graduation Review Panel: 1.

Have consistently participated in one group counseling session per week.

2.

Have attended 12-step or other recovery groups once per week.

3.

Have completed and presented your Autobiography to your peers.

3.

Have completed Recovery/Relapse prevention plan.

4.

Have attended Drug Court every month.

5.

Have been clean and sober for the last consecutive 180 days.

6.

Have all outstanding legal problems resolved, or a plan in place.

7.

Have all fees and restitution payments current, or a payment plan must be in place.

8.

Have a mentor/sponsor.

9.

Demonstrate a sincere and honest attempt to remain clean and sober, with minimal supervision.

2

Appendix A: Yuma County, AZ, Drug Court – Pre-Graduation Information/Requirements and Pre-Graduation Questionnaire

YUMA COUNTY DRUG COURT PROGRAM Pre-Graduation Questionnaire On separate paper, please answer the following questions: It is to your advantage to provide as much detail and information as possible. ONLY TYPE WRITTEN RESPONSES WILL BE ACCEPTED. 1. Describe your experiences being clean and sober and what changes it has created in your life? 2. What character defect(s) have you identified and what have you done to change/address them? 3. What have you accomplished since being placed in Drug Court and starting your recovery program? 4. How has a mentor/sponsor been helpful to your sobriety? 5. Discuss how and why you made amends to anyone? (No specific details required) 6. Tell us about a memorable court appearance. 7. Explain what sanctions influenced you the most. 8. Tell us about your education and employment history and current status. 9. How has your support system helped you with your sobriety? 10. What techniques did you learn to avoid relapse? Give three examples of how your techniques have helped you maintain your sobriety. 11. Explain three ways Drug Court has changed your life. 12. Are you involved in the Alumni Program? Discuss Why or Why Not? 13. What did you like least about the Drug Court program? Discuss your answer. 14. What did you like most about the Drug Court program? Discuss your answer. 15. Discuss why you feel you are ready to begin your After-Care Program? You will need to include/address the components of your After-Care Program and areas of your recovery that require additional focus, support and/or accountability. 16. How would you describe your overall experience in the Drug Court Program and how would you describe the Drug Court Program to others? 3

Appendix A: Yuma County, AZ, Drug Court – Pre-Graduation Information/Requirements and Pre-Graduation Questionnaire

17. List and explain any changes you would recommend to improve the Drug Court Program. 18. What are your future goals? How do you plan on accomplishing these goals? What have you done to start accomplishing these goals?

When you have completed your answers to these questions, please return the entire package and your responses to your case manager.

4

Appendix B: Maricopa County, AZ - Consent to Future Contact from the Adult Probation Department and Drug Court Exit Survey

Consent to Future Contact from the Adult Probation Department Maricopa County

YOU ARE UNDER NO OBLIGATION TO COMPLETE THIS FORM I, _________________________________, CR#_______________________________, (Please print name) consent to the Maricopa County Adult Probation Department contacting me after completion of the Drug Court Program. The information I submit is confidential and will be used for program evaluation purposes only.

__________________________________ Signature

_________________________________ Date

________________________________________________________________________ Address ________________________________________________________________________ City, State, Zip ________________________________________________________________________ Telephone Number Message Number

I am interested in being contacted regarding the Maricopa County Drug Court Alumni Association – “Offering a Hand in Sobriety.”  Yes

 No

________________________________________________________________________

Appendix B: Maricopa County, AZ – Consent to Future Contact from the Adult Probation Department and Drug Court Exit Survey

Drug Court Exit Survey Name: ________________________________

Date of Graduation: _____________________

Probation Officer:________________

Age: _________

Marital Status: __________ Ethnic Descent: __________

Sex: _________

Number of Children: _____

Please check any of the following that you experienced while in the Drug Court program. 

Attended GED classes



Obtained a GED



Attended college classes



Attended Parenting classes



Attended Anger Management classes



Attended Budgeting classes



Attended a Financial Assessment



Received Vocational Training



Met with the Job Developer



Gained employment



Employed at graduation



Gained housing



Completed Residential Treatment



Completed treatment other than Drug Court



Attended support group meetings, what type?____________________



Attended gender specific treatment (all female or all male groups)



Became pregnant



Gave birth to a drug-free child



Other____________________________________________________________ ________________________________________________________________ ________________________________________________________________

2

Appendix B: Maricopa County, AZ – Consent to Future Contact from the Adult Probation Department and Drug Court Exit Survey

Your Input Is Valuable to Improve The Drug Court Program The best part of the Drug Court program is: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ What I would change about the Drug Court program is: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ My opinion about how my Probation Officer helped or did not help me succeed is: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ My opinion about how my Counselor helped or did not help me succeed is: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ My opinion about the curriculum (workbook) is: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ The reward or sanction that I found most valuable to my success was: ___________________________________________________________________________ ___________________________________________________________________________ _________________________________________________________ Any additional comments: ___________________________________________________________________________ ___________________________________________________________________________ _________________________________________________________

THANK YOU! 3

Appendix B: Maricopa County, AZ – Consent to Future Contact from the Adult Probation Department and Drug Court Exit Survey

First Name________________________ Age____________________ Drug Court Graduation Date__________________________ One change I made in my life that really helped me to stay sober was: _______________________________________________________________________ _______________________________________________________________________ ________________________________________________________________________ The best thing about being free from drugs is: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

The Drug Court Team proudly congratulates this graduate. We encourage you to continue your success in remaining drug free. Your family, your friends, and your community all benefit from your efforts. 4

Appendix C: Yavapai County, AZ, Therapeutic Courts - Application for Graduation

APPLICATION FOR GRADUATION YAVAPAI COUNTY THERAPEUTIC COURTS

DATE: _______________

NAME: _______________________________________

DOB: ________________ADDRESS: ____________________________________ PHONE: ______________

CITY/AZ: __________________________ ZIP: ______

HOW LONG HAVE YOU BEEN IN DRUG/DUI COURT: __________________________ HOW LONG HAVE YOU BEEN SOBER? ___________________________________ NAME OF EMPLOYER: __________________________________________________ HOW LONG HAVE YOU BEEN AT THIS JOB? ______________________________ HOURLY WAGE _______ DO YOU PLAN TO CONTINUE WITH THIS JOB? _____ WHO DO YOU LIVE WITH? ______________________________________________ IS THIS A SOBER LIVING ENVIRONMENT? ________________________________ IF YOU REMAIN IN A COUNSELING PROGRAM AFTER GRADUATION, WHICH ONE? ___________________________________________________________________

FILL OUT THE NEXT 3 PAGES WITH AS MUCH EXPLANATION AS POSSIBLE

Appendix C: Yavapai County, AZ, Therapeutic Courts - Application for Graduation

WHAT HAVE YOU LEARNED WHILE YOU HAVE BEEN IN DRUG/DUI COURT?

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

2

Appendix C: Yavapai County, AZ, Therapeutic Courts - Application for Graduation

HOW HAS DRUG/DUI COURT HELPED YOU?

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

3

Appendix C: Yavapai County, AZ, Therapeutic Courts - Application for Graduation

WHAT ARE YOUR PLANS FOR THE FUTURE?

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

4

Appendix D: Yavapai County, AZ, Drug Court – Evaluation Questionnaire

Evaluation Questionnaire In order for Drug Court to improve over time, we request your assistance in evaluation of your experience in the program by responding to the following questions. The questionnaire requires no name identification and will have no impact on your case or graduation. Thank you for your feedback. 1.

Would you recommend the Drug Court program to other alcohol/drug dependent defendants? Yes

If yes, why?

No 2.

Do you plan to stay involved in recovery activities after graduation? Yes

3.

If yes, why?

No Have the frequency and amount of your alcohol or drug use… stayed the same? increased? decreased? decreased substantially? stopped entirely?

4.

Do you think the program staff was supportive of your recovery? Yes

If yes, how?

No 5.

Do you think the other participants took the program seriously? Yes No

6.

Do you think your health is better today than when you started Drug Court? Yes

If yes, how?

No 7.

Is your employment more stable than when you started the program? Yes No

Appendix D: Yavapai County, AZ, Drug Court – Evaluation Questionnaire

8.

9.

What component of the program had the greatest impact on you? the judge

counseling

probation

urinalysis/breath tests

support group activities

other

Is your recovery having a positive impact on others? Who?

10. What did you like most about Drug Court?

11. What did you dislike most about Drug Court?

12. How would you recommend changing the program?

13. How has Drug Court been most helpful to you?

Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

Mendocino County Therapeutic Courts Superior Court of California, County of Mendocino 100 North State Street 707-463-4793 (phone) * 707-463-4424 (fax)

Mendocino County Drug Court Graduation Application Instructions Please legibly hand-write your responses to the following questions directly on these pages. If the application is not handwritten it will be returned to you without a deadline extension. It is important that you make sure your answers are detailed. Your name and the date your application is submitted must be on the first page. Your application is to be submitted to the Therapeutic Courts Office (Drug Court Office). You have 30 days to complete your application. This may be before or after your next court date. It is your responsibility to submit your application on time. If your application is late, a sanction or delay of graduation may be imposed. Spelling and grammar are not taken into consideration during the review. The Therapeutic Courts Administration Office and your primary counselor will review your application. If after review, areas of the application require clarification, you may be asked to provide more information. If you need additional space, you may add pages to this application. Please write the number of the question you are continuing. If you have any questions about the application, please contact the Therapeutic Courts Administrator. This application will be returned to you at graduation. This information is for the Drug Court Team and participant reflection only, not intended for public distribution.

Application Essay

Your Name: Date Received: Date to be Returned to the Therapeutic Courts Office:

I would like my first name to be listed on the graduation ceremony invitation along with other grads. Please do not print my name on the invitations.

Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

Past, Present and Future 1.

Where were you in your life before beginning the Drug Court program?

2.

Describe one or more challenges, or barriers to success, that you experienced in the Drug Court program.

3.

Describe something that happened while you were in Drug Court that made a lasting impression, and helped with your recovery.

4.

Describe some personal victories you experienced in the Drug Court program.

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

5.

What are two other things you learned from the program? a)

b)

6.

Where do you see yourself right now?

7.

Describe one or more challenges that you foresee in the next six to twelve months.

8.

Life plans/goals—please fill out the grid below. Here are the questions that match each box in the grid: a) What do you want to be doing next year (in each of the areas in the left column)? b) In five years, what do you want to have accomplished? c) Who will help? d) Name one of the steps you need to take toward each goal.

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

a) Goal in One Year

b) Goal in 5 years

c) Who will help?

d) Step 1

Where you live

Relationships

Family

Health

Education

Free time

Job skills/ Work

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

9.

How do you see yourself contributing to the local community, now that you have done so much work on yourself?

Aftercare Plan 10. Describe a situation when you would use your support system.

11.

Where do you keep the names and phone numbers that you need for support?

12. Have you replaced activities when you used to use with new ways to use your time and socialize? . a) What new interests and activities have you added to your life so far?

b) Describe how these new interests and activities help you with your recovery.

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

c) What interests and activities do you plan to add to your life after you graduate from Drug Court?

13. What meetings (such as NA, AA, CODA, Al-Anon) most support your continued recovery?

a) What do you gain from these meetings?

b) Do you plan to continue attending meetings after you have completed Drug Court? . How often?

14. Health, nutrition and physical exercise play a large role in continued recovery. a) Describe something specific you do for your health that you learned by going through the Drug Court program.

b) Describe your plan to stay healthy, including your plan for regular and continuing exercise.

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

15. If you relapse during Phase VI, what do you think the consequence should be?

Relapse Prevention Plan 16. Describe some specific things you have been doing to remain clean and sober.

17. Explain how you will support your recovery after leaving structured, court-supervised treatment. Be specific.

18. Triggers and how you handle them a) What do you say and do when you see acquaintances and former friends who are still using? Be specific.

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

b) What can you do to avoid triggers that might come up in social events (holidays, etc.) where you used to use? Be specific.

c) Describe what you will do when you are unhappy, stressed or angry.

d) Describe what you will do if you have a tragedy, loss or major disappointment that you would not have done before the Drug Court program.

e) Name two additional triggers that are tough for you to handle, explain how they affect you. Describe what you do when faced with those triggers, and what thoughts and feelings you call upon. 1.

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

2.

19. Describe some specific things you will do to get yourself back on track if you relapse.

20. If there is anything you want to add, please write it below or attach another sheet of paper. (Then, continue on; there is one more question!)

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Appendix E: Mendocino County, CA, Therapeutic Courts – Mendocino County Drug Court Graduation Application

Feedback 21. Please describe how you think the Drug Court could be more effective. Your answers will help the team and other participants by helping to improve the program. We appreciate your feedback! The program could have worked better for me if…

Overall Program

Treatment

Probation

Court

Other

Thank you, from the Adult Drug Court Team.

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Appendix F: First Step of Sarasota, Inc., FL – Transition Plan

Concord Commencement 1

Appendix F: First Step of Sarasota, Inc., FL – Transition Plan

Concord Commencement 2

Appendix F: First Step of Sarasota, Inc., FL – Transition Plan

Concord Commencement 3

Appendix F: First Step of Sarasota, Inc., FL – Transition Plan

Concord Commencement 4

Appendix G: Mountain Judicial Circuit, GA, Accountability Court – Commencement Requirements

COMMENCEMENT REQUIREMENTS Upon completion of Phase 5, you will be eligible for graduation. However, several requirements must be met: 1. Write a letter to the Judge regarding your progress in the Accountability Court Program, letter must be submitted to and approved by Coordinator, and must include the following:  Background: Life before Accountability Court  Arrest situation  Reflections on Accountability Court success and struggles  Plans/Goals for future: personal and recovery 2. Complete Giving Back Project  Project/Site to be approved by Accountability Coordinator  Minimum of 24 volunteer hours  Documentation must be verified by Coordinator  Submit to Coordinator a written summary of how/why project was chosen, feelings while completing project, personal reactions after project completion 3. All Accountability Court/Treatment fees must be paid in full or substituted community service work must be completed 4. Complete recovery plan with assistance of treatment staff and submit to Coordinator.

5. Provide certification of having GED, high school diploma, or other educational improvements records.

6. Meet with Accountability Court Coordinator or designated staff to review completed requirements. After you have completed the above requirements, the Accountability Court Coordinator will recommend your graduation from the program to the Treatment Team. Successfully completing the Mountain Judicial Circuit Accountability Court Program will result in your original charges being dismissed; or, if you are on probation, it will reflect satisfactory completion of that condition of your probation. This process will be facilitated by the District Attorney’s Office or the Probation Department and will be granted by the Mountain Judicial Circuit Accountability Court Judge. 7. 150 days of clean alcohol/drug screens and no sanctions. 8. Completion of Phase 5 Program. Once you have completed the 150 days clean & all above criteria is completed you will no longer be required to attend treatment sessions or pay monthly court fees. However, you will be required to drug screen and/or report until the formal commencement date.

Appendix G: Mountain Judicial Circuit, GA, Accountability Court – Commencement Requirements

Recovery Plan for Graduation (attach additional pages if necessary)

List five things you have learned in the Accountability Court Program and describe how these things will benefit you after graduation: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

Identify five risk factors/indicators/triggers for you and explain your plan for remaining clean and sober in the face of each temptation: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

List at least five people that are involved in your recovery that you could access at any time should you need them, explain their impact on your recovery: ________________________________________________________________ ________________________________________________________________

Appendix G: Mountain Judicial Circuit, GA, Accountability Court – Commencement Requirements

________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Discuss three relationships that are important to you and tell how they have improved since you stopped drinking and using: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ What can we do to improve the Accountability Court Program? What suggestions do you have that might help us help others in the program? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

Appendix G: Mountain Judicial Circuit, GA, Accountability Court – Commencement Requirements

GIVING BACK PROJECT LOG VOLUNTEER HOURS: 24

NAME: ____________________________

AGENCY: ______________________________________________________________________ SUPERVISOR’S NAME/TITLE/CONTACT INFORMATION: ______________________________________________________________________ ______________________________________________________________________

DATE

AGENCY

IN

OUT

HRS

PARTICIPANT’S SIGNATURE

SUPV. INITIALS

TOTAL

_______________________________ Accountability Court Coordinator

________________ Date

Appendix H: Concord, MA, Drug Court Program – Commencement Aftercare Plan

Concord Drug Court Program Advocates 179 Great Road

Acton, MA

Commencement Aftercare Plan Name: Address and Phone : Date Submitted: Alumni Drug Court Group: I will voluntarily commit to attending at least _______ Drug Court group(s) per month. I understand that maintaining contact with the program will help support my recovery. Commencement Follow-up: I agree to provide updated information concerning my abstinence at the follow-up intervals of 3, 6, and 12 months post discharge from treatment as required by the Drug Court Program. This information will be used to help determine the effectiveness of the Drug Court Program model and is required by Substance Abuse and Mental Health Association for continued funding. Professional Counseling: I will continue with my individual counseling on intervals determined by my counselor. If treatment is complete please indicate so. Counselors Name / Number: Additional Professional Contact /Number: Self-help Programs / Group Name, Day & Time: I plan on continuing to attend at least ______ self-help meeting (s) per _____. Group Name: Location: Time: Group Name: Location: Time: Sponsors Name / Number: Name / Number (s): Additional contact info:

Concord Commencement 1

Appendix H: Concord, MA, Drug Court Program – Commencement Aftercare Plan

Important Persons /Emergency Contacts / Numbers: Name / Number (s): When to contact: Name / Number (s): When to contact: Name / Number (s): When to contact: Employment: I am currently employed full-time / part-time Current Employer / Supervisor: Work Schedule: Contact Information including phone: Educational / Vocational Services: I am currently enrolled in an educational or vocational program: Currently enrolled in: School Schedule: Advisors Name / Number:

 NO  YES

 NO  YES

Legal / Probation Requirements: Please list all open court matters (such as administrative supervision)and include all fines, restitution, probation supervision fees and to which court you are obligated: Court: Obligation(s): Court: Obligation(s): Spiritual Development: I will continue to work on my spiritual development (as I choose it to be) and rely on it for help and guidance in my life and in my sobriety. Leisure Activities: I will avoid boredom, isolation and complacency and keep myself busy by: 1. 2. 3. 4. 5.

Concord Commencement 2

6. 7. 8. 9. 10.

Appendix H: Concord, MA, Drug Court Program – Commencement Aftercare Plan

Family: I have identified my family as playing an important role in my recovery process. Understanding that this influence can be both negative and positive, I plan involving (or not involving) my family in my recovery process by: 1. 2. 3. 4. Do you have children and have you regained custody , visitation or started paying child support payments ?  NO  YES If yes, please explain: Medication: I have learned that I need to be careful about the medication I take as certain over-thecounter (OTC) medications as well as some prescribed medications have the potential to be abused. I also know that it is important to take all medication as prescribed as to avoid the potential for abuse. I will make an effort to protect my recovery by discussing all prescribed and OTC medications with my doctor prior to use. High Risk Management: I have identified the following 3 situations as high risk for my recovery. In order to protect my recovery I have devised an intervention plan that will help me manage the situations if they arise: 1.High Risk Situation: Warning Signs: Consequences / things you will risk or lose: How to prevent / avoid / correct the situation:

2. High Risk Situation: Warning Signs: Consequences / things you will risk or lose: How to prevent / avoid / correct the situation: 3. High Risk Situation: Warning Signs: Consequences / things you will risk or lose: How to prevent / avoid / correct the situation:

Concord Commencement 3

Appendix H: Concord, MA, Drug Court Program – Commencement Aftercare Plan

Additional High Risk Management Plans:

Relapse Management: While it seems like a simple decision to maintain your abstinence rather than using, you must remember that right now you most likely have a clear head and a commitment to sobriety. That won’t be the case when you wake up the morning after a night of drinking or using. The fuzzy thinking, the guilt, and the shame can motivate you to continue drinking or using. And if you do, the cycle will begin again and that single use episode will most likely become the first of a hundred more. Just as you most likely have smoke detectors in your home to protect against fire, you can also have a plan of action in case you were ever to drink or use again. Remember, all relapses start somewhere so you will need to retrace your steps. This is why it is important to share your relapse with someone else, openly and honestly. Here is my plan: If I were to relapse it would be important for me to tell these people and why: 1. 2. 3. 4. If I were to relapse, here are the steps I should take to regain my sobriety and make certain it doesn’t happen again: 1. 2. 3. 4. Additional Relapse Intervention Information:

Concord Commencement 4

Appendix H: Concord, MA, Drug Court Program – Commencement Aftercare Plan

Personal Statement Please take a moment to reflect on your involvement with the Drug Court Program and how your choice to participate has impacted your life.

______ Petitioner’s Signature / Date

Concord Commencement 5

Drug Court Coordinator Signature / Date

Appendix I: St. Mary’s County, MD, Drug Court – Program Survey

ST. MARY’S COUNTY DRUG COURT PROGRAM SURVEY

Strongly Agree (1)

Agree Uncertain (2) (3)

Strongly Disagree disagree (4) (5)

Please indicate how much you AGREE or DISAGREE with each statement. Place an X in the circle of your answer to each question. 1. You trust the Drug Court Team.

O

O

O

O

O

2. Time schedules for Drug Court, Counseling, etc. are convenient for you.

O

O

O

O

O

3.It’s always easy to follow or understand what Drug Court staff is trying to tell you.

O

O

O

O

O

4. This program expects you to learn responsibility and self-discipline.

O

O

O

O

O

5. Your Drug Court staff is easy to talk to.

O

O

O

O

O

6. You are willing to talk about your feelings during counseling.

O

O

O

O

O

7. This program is organized and well-run.

O

O

O

O

O

8. You are motivated and encouraged by your Drug Court staff.

O

O

O

O

O

9. You have made progress with your drug/alcohol problems.

O

O

O

O

O

10. You are satisfied with this program.

O

O

O

O

O

11. You have learned to analyze and plan ways to solve your problems.

O

O

O

O

O

12. You have made progress toward your treatment program goals.

O

O

O

O

O

Appendix I: St. Mary’s County, MD, Drug Court – Program Survey

Disagree Strongly (1)

Disagree Uncertain Agree (2) (3) (4)

Agree Strongly (5)

13. You always attend the counseling sessions scheduled for you.

O

O

O

O

O

14. The Drug Court team recognizes the progress you made in this program.

O

O

O

O

O

15. Your counselor is well organized and prepared for each counseling session.

O

O

O

O

O

16. The Drug Court is sensitive to your situation and problems.

O

O

O

O

O

17. Your treatment plan had reasonable objectives.

O

O

O

O

O

18. The Drug Court team views your problems and situations realistically.

O

O

O

O

O

19. Other clients at the counseling program care about you and your problems.

O

O

O

O

O

20. You have stopped or greatly reduced your drug use while in this program.

O

O

O

O

O

21. The Drug Court program has helped you develop confidence in yourself.

O

O

O

O

O

22. You always participate actively in your counseling sessions.

O

O

O

O

O

23. You have made progress in understanding your feelings and behavior.

O

O

O

O

O

Appendix I: St. Mary’s County, MD, Drug Court – Program Survey

Disagree Strongly (1)

Disagree Uncertain (2) (3)

Agree Agree Strongly (4) (5)

24. Other clients in Drug Court are helpful to you.

O

O

O

O

O

25. You have improved your relations with other people because of this program.

O

O

O

O

O

26. The Drug Court staff is good doing their jobs.

O

O

O

O

O

27. You are similar to (or like) other Drug Court clients.

O

O

O

O

O

28. You have made progress with your emotional or psychological issues.

O

O

O

O

O

29. The Drug Court staff respects you and your opinions.

O

O

O

O

O

30. You have developed positive, trusting friendships in Drug Court.

O

O

O

O

O

31. You give honest feedback during counseling.

O

O

O

O

O

32. You can depend on your counselor’s understanding.

O

O

O

O

O

33. There is a sense of family (or community) in this program.

O

O

O

O

O

34. You can get plenty of personal counseling in Drug Court.

O

O

O

O

O

35. You have followed your counselor’s guidance.

O

O

O

O

O

Appendix I: St. Mary’s County, MD, Drug Court – Program Survey

1. In what ways could the Drug Court program be improved?

2. What parts of the program helped you follow the rules and stay drug/crime free? (ie: drug testing, counseling, court appearances)

3. Any additional comments?

Thank you.

Appendix J: 39th Circuit, MO - Drug Court Exit Interview

Drug Court Exit Interview Date of Graduation _________________ (mm/dd/yyyy)

BY COMPLETING THIS SURVEY, YOU HAVE THE OPPORTUNITY TO HELP THE ENTIRE DRUG COURT PROGRAM. YOU SHOULD ALSO KNOW THAT NOTHING YOU REPORT CAN OR WILL BE USED TO AFFECT YOUR SUCCESSFUL COMPLETION OF THE PROGRAM.

1)

Check all drugs that you were actively using within the 90 days prior to entry into drug court.

o

Marijuana

o

Heroin

o

Cocaine

o

Alcohol

o

MDMA

o

Methamphetamine

Prescription Drugs

2)

o

Benzodiazepines (Xanax)

o

Buprenorphine

o

Opiates

o

Tramadol

o

Methadone

o

Propoxyphene

Is entry into the drug court program the first time you received substance abuse treatment for drug or alcohol abuse?

o o 3)

Yes No

On a scale of 1 to 5, rate the overall quality of your life when you entered drug court (Circle one):

o o o o o

1- Poor 2- Below Average 3- Average 4- Above Average 5- Excellent

Appendix J: 39th Circuit, MO - Drug Court Exit Interview

4)

On a scale of 1 to 5, rate the overall quality of your life today (Circle one):

o o o o o 5)

2- Below Average 3- Average 4- Above Average 5- Excellent

Please select the two areas of your life in which you believe you have seen the greatest improvement since participating in drug court (check one)?

o o o 6)

1- Poor

Family Life Job Financial

o o o

Friends Health Education

One a scale of 1 to 5, please rate the following areas of drug court in terms of their quality: Substance Abuse Treatment

o o o o o

Poor Below Average Average Above Average Excellent

Probation Supervision

o o o o o

Poor Below Average Average Above Average Excellent

Employment Assistance

o o o

Poor Below Average Average

Appendix J: 39th Circuit, MO - Drug Court Exit Interview

o o

Above Average Excellent

Personal Problem Assistance

o o o o o

Poor Below Average Average Above Average Excellent

Drug / Alcohol Testing

o o o o o 7)

Above Average Excellent

Yes No

Yes No

Was AA/NA very helpful?

o o o 10)

Average

Do you feel that the sanctions for program violations were imposed fairly?

o o 9)

Below Average

Was positive behavior rewarded?

o o 8)

Poor

Yes No I did not attend

If you did attend AA/NA, do you plan to continue attending?

o o

Yes No

Appendix J: 39th Circuit, MO - Drug Court Exit Interview

11)

Do you currently have a sponsor?

o o 12)

Group Counseling Family Counseling

Yes No

Not including AA/NA, do you attend any support group meetings held within your community?

o o 15)

Individual Counseling (One on One)

Has anyone in your family gone into recovery because of your participation in the drug court program?

o o 14)

No

Which type of substance abuse treatment do you feel was most important to your ability to remain drug and alcohol free?

o o o 13)

Yes

Yes – If yes, where or which one? _________________________________ No

During each of the following time periods and while you were participating in drug court, select the most important item for each time period that caused you to NOT use drugs and/or alcohol. Months One (1) through Four (4)

o o o o o o

Drug/Alcohol Testing Substance Abuse Therapy/Treatment Mental Health Therapy Monthly Court Appearances Peer Pressure from other participants Personal Commitment

Months Five (5) through Eight (8)

o o o

Drug/Alcohol Testing Substance Abuse Therapy/Treatment Mental Health Therapy

Appendix J: 39th Circuit, MO - Drug Court Exit Interview

o o

Peer Pressure from other participants Personal Commitment

Months Nine (9) through Twelve (12)

o o o o o

Drug/Alcohol Testing Substance Abuse Therapy/Treatment Mental Health Therapy Peer Pressure from other participants Personal Commitment

Twelve (12) Months and After

o o o o o

Drug/Alcohol Testing Substance Abuse Therapy/Treatment Mental Health Therapy Peer Pressure from other participants Personal Commitment

16) Would you be interested in a drug court alumni group?

o o

Yes No

17) Were you able to use drugs and/or alcohol during the drug court Program and NOT get caught?

o o

Yes No

If you answered Yes to Q#17, please indicate approximately how many times you used without being caught during the time you were in drug court:

o o o

1 – 3 times 4 – 6 times More than 6 times

Appendix J: 39th Circuit, MO - Drug Court Exit Interview

18) Based on your experience in the drug court program, which statement best describes how you feel about recommending drug court to other people in situations similar to yours?

o o o o o

Strongly Recommend Recommend No Opinion Would Not Recommend Strongly Not Recommend

19) Can we contact you about your responses to the questions above?

o o

Yes No

If you circled Yes to Q#19, please indicate the best method to get in contact with you? E-mail address:

_________________________________________

Phone (home)

(

) _______ - ___________

Phone (cell)

(

) _______ - ___________

20) What would you do to improve drug court? __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

Appendix K: DULT Drug Court, MO - Participant Satisfaction Survey

DULT DRUG COURT PARTICIPANT SATISFACTION SURVEY Now that you are familiar with the Drug Court Program, we would like to know more about your opinion. Your responses will be CONFIDENTIAL and will only be used to help better serve the Drug Court in the future. Date____/____/____ 1. Overall, I think the treatment services for the Drug Court are: O Excellent O Fair O Very Good O Poor O Good Please give examples (good or bad). 2. The treatment provider is available to answer my questions and help me with substance abuse related problems: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad). 3. I am treated as an individual with unique needs and concerns by the treatment provider: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad). 4. The treatment provider is courteous and has treated me with respect: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad). (5) The treatment provider has been punctual for my appointments: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad). (6) My probation officer has responded promptly to my concerns: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad). (7) My probation officer has been punctual for my appointments: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad).

Appendix K: DULT Drug Court, MO - Participant Satisfaction Survey

(8) My probation officer has treated me with respect: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad).

(9) I have been treated with dignity by the Drug Court Team: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad). (10) Even though trackers perform undesirable duties (searching of homes or conducting urinalysis) they have treated me with respect and have not destroyed my property: O All of the time O Sometimes O Most of the time O Rarely or never Please give examples (good or bad).

(11) This program has helped me deal with my substance abuse issue: O A great deal O A little bit O Somewhat O Not much Please give examples (good or bad). 12. After graduation, I plan to utilize the skills I have obtained while in the Drug Court Program: O All of the time O Sometimes O Most of the time O Rarely or never 13.

If you could change something about the Drug Court what would it be? If you need additional space please write on the back of this sheet of paper. _____________________________________________________________________ _____________________________________________________________________

14. Additional comments: ________________________________________________________________________

THANK YOU for taking the time to complete this survey.

Appendix L: South Central, ND, Juvenile Drug Court – Exit Questionnaire

South Central Juvenile Drug Court Exit Questionnaire

Please answer each question with complete honesty. This questionnaire is intended to assist the NEC Juvenile Drug Court in evaluating their program.

1. Name:__________________________________________ Were you a volunteer or court-ordered participant? If court-ordered, how do you feel about that? ____________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 2. How long have you been in the program?_________________________________ 3. Describe your life prior to your entry into the program? _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________ ____________________________________________________________________

4. Describe your life now that you have completed the program? _________________ _____________________________________________________________________ ______________________________________________________________________ ____________________________________________________________________ _____________________________________________________________________

5. What did you like most about the Juvenile Drug Court Program? _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Appendix L: South Central, ND, Juvenile Drug Court – Exit Questionnaire

6. What did you like least about the Drug Court Program? _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ___________________________________________________________________ 7. Describe how your sobriety has affected your relationship with others (include your family and close friends). ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ _________________________________________________________________ 8. Who do you feel was most helpful in you successfully completing the drug court program? And why? ____________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ___________________________________________________________________ 9. What are your plans for the future? ______________________________________ ______________________________________________________________________ ______________________________________________________________________ ___________________________________________________________________ 10. Other comments: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ _________________________________________________________________ Please return in the stamped envelope. Thank you!

Appendix M: Ohio Drug Court Participant Satisfaction Survey

Drug Court Participant Satisfaction Survey Date ___________

ID________________________

Introduction: The project evaluators from Case Western Reserve University are asking you to complete this satisfaction survey to gather your feedback about the services you received from the Drug Court Program. Please know that all of your responses are confidential and your individual answers are not shared with the court so please be honest with your answers. The following questions are referring to Drug Court Team Members you had contact with during your program experience, this may include the judge assigned to your case, the probation officer, case manager and treatment staff that you had contact with throughout your program. Directions: Please complete all information belo w. Your answers are important to us, BUT you DO NOT have to answer any questions that you do not want to. Response Categories= 0= Strongly Disagree, 1=Disagree, 2= Neither, 3= Agree, 4= Strongly Agree, DK= Don’t Know, NA= Not Applicable, RF= Refused to Answer

The following questions pertain to the judge and court hearings….. Strongly Disagree 0

Disagree

Neither

Agree

DK

NA

RF

3

Strongly Agree 4

1

2

7

8

9

1

The judge is knowledgeable about your case

2

The judge knows you by name

0

1

2

3

4

7

8

9

3

The judge is intimidating or unapproachable

0

1

2

3

4

7

8

9

4

The judge remembers your situation and needs from hearing to hearing

0

1

2

3

4

7

8

9

5

The judge gives you a chance to tell your side of the story

0

1

2

3

4

7

8

9

6

The judge can be trusted to treat you fairly

0

1

2

3

4

7

8

9

7

The judge treats you with respect

0

1

2

3

4

7

8

9

8

You felt too scared or intimidated to say what you really felt in court

0

1

2

3

4

7

8

9

9

People in court spoke on your behalf

0

1

2

3

4

7

8

9

10

You felt you had enough control over the way things were run in court

0

1

2

3

4

7

8

9

11

You understood what was going on in court

0

1

2

3

4

7

8

9

12

You felt people who committed the same offense were treated the same way by the courts

0

1

2

3

4

7

8

9

13

You were disadvantaged by the courts because of your age, income, sex, race, or some other reason

0

1

2

3

4

7

8

9

14

During court hearings you felt you were pushed into things you did not agree with

0

1

2

3

4

7

8

9

15

You feel you were treated with respect by the court

0

1

2

3

4

7

8

9

Appendix M: Ohio Drug Court Participant Satisfaction Survey

The following questions are referring to case managers (if these services were part of the program for the client, if not, circle 8 (NA)). Case Management staff…………… 1 2 3 4 5 6 7

Are knowledgeable about my case Know you by name Help you to succeed Emphasize the importance of treatment Give you a chance to tell your side of the story Can be trusted to treat you fairly Treat you with respect

Strongly Disagree 0 0 0 0 0

Disagree

Neither

Agree

DK

NA

RF

3 3 3 3 3

Strongly Agree 4 4 4 4 4

1 1 1 1 1

2 2 2 2 2

7 7 7 7 7

8 8 8 8 8

9 9 9 9 9

0 0

1 1

2 2

3 3

4 4

7 7

8 8

9 9

DK

NA

RF

7 7 7 7 7

8 8 8 8 8

9 9 9 9 9

7 7

8 8

9 9

The following questions are referring to substance abuse treatment staff. 1 2 3 4 5 6 7

Substance Abuse Program staff…………… Are knowledgeable about my case Know you by name Help you to succeed Emphasize the importance of treatment Give you a chance to tell your side of the story Can be trusted to treat you fairly Treat you with respect

Strongly Disagree 0 0 0 0 0

Disagree

Neither

Agree

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

Strongly Agree 4 4 4 4 4

0 0

1 1

2 2

3 3

4 4

The following questions are referring to mental health treatment staff (if these services were part of the program for the client, if not, circle 8 (NA)). 1 2 3 4 5 6 7

Mental Health Program staff…………… Are knowledgeable about my case Know you by name Help you to succeed Emphasize the importance of treatment Give you a chance to tell your side of the story Can be trusted to treat you fairly Treat you with respect

Strongly Disagree 0 0 0 0 0

Disagree

Neither

Agree

DK

NA

RF

3 3 3 3 3

Strongly Agree 4 4 4 4 4

1 1 1 1 1

2 2 2 2 2

7 7 7 7 7

8 8 8 8 8

9 9 9 9 9

0 0

1 1

2 2

3 3

4 4

7 7

8 8

9 9

DK

NA

RF

7 7 7 7 7

8 8 8 8 8

9 9 9 9 9

7 7

8 8

9 9

The following questions are referring to probation officers….. Probation staff…………… 1 2 3 4 5 6 7

Are knowledgeable about my case Know you by name Help you to succeed Emphasize the importance of treatment Give you a chance to tell your side of the story Can be trusted to treat you fairly Treat you with respect

Strongly Disagree 0 0 0 0 0

Disagree

Neither

Agree

1 1 1 1 1

2 2 2 2 2

3 3 3 3 3

Strongly Agree 4 4 4 4 4

0 0

1 1

2 2

3 3

4 4

Appendix N: Benton County, OR, Drug Treatment Court – Exit Interview

Benton County Drug Treatment Court: Exit Interview Name_______________________________________ Date________________________

Address:_________________________________________________ (Would you like to stay in touch?) Yes___ No___ The information from this survey will help us to improve this program. Please feel free to offer comments for any of the questions below.

1. Have the goals for your recovery program been clear?

Comments:

1__________2___________3__________4__________5 No Sort of Absolutely

2. Were the rewards/incentives in this program effective for you?

Comments:

1__________2___________3__________4__________5 No Sort of Absolutely

3. Were the sanctions effective for you?

Comments:

1__________2___________3__________4__________5 No Sort of Absolutely

4. Were the court sessions helpful?

Comments:

1__________2___________3__________4__________5 No Sort of Absolutely

5. Were your treatment sessions helpful?

Comments:

1__________2___________3__________4__________5 No Sort of Absolutely

6. Please rate your progress in the following categories. (1 = poor, 5 = excellent)

Comments:

a. Stable Housing _____

c.

Education ______

b. Employment/Income ______

d. Relationships ______

Appendix N: Benton County, OR, Drug Treatment Court – Exit Interview

7. What were the greatest obstacles to your success in this program?

8. What part of the program provided the most help for you?

9. What part of the program was the least helpful for you?

10. What person in this program was the most helpful for you? Why?

11. What was the easiest part of the program for you?

12. What was the hardest part of the program for you?

13. What was the most important part of the program for you?

14. How would you improve the program?

15. What would you recommend to a new person in this program?

Appendix O: STOP DUI Program (Court), SD – Exit Interview Questions

Exit Interview Questions: 1. List 1-5 things for each of the following: a. Easiest parts of the program b. Hardest parts of the program c. Best things about the program d. Worst things about the program 2. If you could go back in time, what would you say to yourself in the months before you started the program? 3. What advice do you have for someone just starting the program? 4. If you could go into the future, what will you say to yourself 2 years from now? 5. What does recovery mean to you? 6. What are your plans to continue AA or recovery groups after the program? 7. What were the most effective/least effective: a. Incentives while in the program b. Sanctions while in the program 8. On a scale of 1-3, rate each of the following on it’s usefulness to your sobriety and success in the program: (3 being the highest) _____ 27/7 Program

_____ Inpatient Treatment

_____ Random UA’s

_____ Intensive Outpatient Treatment

_____ Court Sessions

_____ Aftercare/MRT

_____ Other STOP participants

_____ AA/Support Groups

_____ Transit

_____ Individual therapy

_____ Curfew

_____ Weekend POC’s

_____ Incentives

_____ Team members

_____ Sanctions

_____ Interaction with Judge

9. What can you say to convince the community you will never drink and drive again? 10. What does your bumper sticker read now?

Appendix P: Cumberland County, TN – Recovery Court Questionnaire

Cumberland County Recovery Court Pre-Graduation Questionnaire Name:____________________________________________________ Date:____________________ Address:___________________________________________________________________________ City:______________________________________ State:______________: Zip:_________________ Phone:_______________________________________ or ___________________________________ Scheduled Date for Completion:te:________________________

Each person must ultimately determine his or her own recovery path. It will require careful planning and personal commitment. Every successful recovery effort includes four key ingredients: 1) Motivation; 2) Humility (including willingness to reach out for help when needed); 3) Sustained effort; and 4) Restoration of life’s meaning and purpose. This form is designed to identify those ingredients in your life and give assurance to the Recovery Court Team that you are ready to leave the program and maintain your recovery.

Motivation: 1.

Describe briefly your motivation for continuing a clean and sober life:

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

Appendix P: Cumberland County, TN – Recovery Court Questionnaire

Humility: 1. What do you see as your most likely areas of weakness—areas in which you may need assistance from recovery court staff or others: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 2. Define the individuals, groups, or institutions from which you can receive help and support and describe what help each may be able to provide for you. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

Sustained Effort: 1. Describe your plan for continuing to benefit from Recovery Court services and staff during your after-care program: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

Appendix P: Cumberland County, TN – Recovery Court Questionnaire

_____________________________________________________________________________ _____________________________________________________________________________ 2. Describe your plan for using other community programs and services (e.g., NA/AA, church, community assistance programs, other support groups, recovery court programs/staff, etc. a) During your after-care period__________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ _________________________________________________________________________ b) Following your after-care period_________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

Restoration of Life’s Meaning and Purpose: 1. Describe how being clean and sober had improved your life. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ 2. Describe your goals for the future and the steps you plan to take to attain them. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

Appendix P: Cumberland County, TN – Recovery Court Questionnaire

_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 3. If you were to write a Mission or Vision statement for your life, what would it be?______________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 4. What can you say to the Drug Court Team to assure them that you are ready to leave Recovery Court and continue you’re your sobriety? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

Appendix Q: 4C/SAFPF Re-Entry Court, TX – Client’s Exit Interview

Client’s name: Client’s Exit Interview



How has being in the 4C program affected your life?



If you could change anything about the 4C program what would it be?



Can you tell me three things the 4C program helped you with?



What did you like or dislike about the program?



What aspects of the program were not helpful or a hindrance to improving your life?



How would you describe your relationship with your officer?



Did you feel comfortable sharing with you counselor?



Was your counseling helpful?



Did you enjoy reporting to court?



Describe how attending AA/NA meetings assisted in your recovery



What do you wish we could have offered to you that were not offered?



Would you be interested in participating with the 4C Alumni?

Appendix R: Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview

THERAPEUTIC SPECIALTY COURTS (TSC)—EXIT INTERVIEW What program did you participate in? Mental Health Court

Veterans Court

Please place an “X” in the appropriate box of how you are leaving the program Graduating the Program:

Terminated:

Opting Out:

Entry Process 1. How did you first learn that this program was an option for you? Attorney

Friend

Probation Officer

Family

Court

Peer

In custody

Other: _________________________ 2. Did you start this program in custody or were you out of custody and pending your charges? In Jail when I entered Out of custody (Jail) when I entered N/A 3. How long did it take for you to get into this program from the time your legal proceedings began until the time you opted in? Less than one month Between 1 -2 months 3 months or longer Unknown or can’t remember 4. Why did you originally choose to come into this program? To get out of jail

Treatment available

Less incarceration time

Support/structure

Financial benefit

Keep license

Resources available

No conviction

Other ___________________________________________________________ THERAPEUTIC SPECIALTY COURTS EXIT INTERVIEW – Page 1

Appendix R: Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview

Court Aspect of This Program 5. During orientation, was all the necessary information about program rules, regulations, and expectations explained to you? Please score how much information you knew about the program and the rules before you started the program. Not at all

fair

average/decent

good

explained well

6. What aspects of the Court supervision do you feel is helpful to you (Please check ALL that you feel motivates you)? Positive interaction with the Judge Positive interaction with the Prosecutor Meeting with court clinical staff Sobriety coins Urine Analysis (UAs) Rewards/Incentives for doing well for the week Community Service / Work Crew Extra support meetings Home visits Writing assignments / Essays Increasing court reporting Jail or threat Jail 7. What aspects of the Court supervision do you feel is LESS helpful to you in motivating you (Please check ALL that apply)? Positive interaction with the Judge Positive interaction with the Prosecutor Meeting with court clinical staff Sobriety coins Urine Analysis (UAs) Rewards/Incentives for doing good for the week Community Service / Work Crew Extra support meetings Home visits THERAPEUTIC SPECIALTY COURTS EXIT INTERVIEW – Page 2

Appendix R: Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview

Writing assignments / Essays Increasing court reporting Jail or threat of Jail

Treatment Aspect of This Program 8. What aspect of treatment do you feel really HELPED you? Please list/explain your answer below. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 9. What aspect of treatment do you feel was LEAST helpful to you? Please list/explain your answer below. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 10. Which outpatient treatment center did you attend? St. Peter’s Behavioral Health Resources Private Counseling Seeking Safety Other: __________________________________________ 11. While you have been in this program, have you been referred to Inpatient treatment? No I wasn’t referred but I went to inpatient on my own Yes, and completed inpatient Yes, but never went to inpatient Yes, and went to inpatient but did not complete Yes, and went to inpatient twice List Inpatient Treatment Center Name and length of stay (# of months) _____________________________________________________________________________ THERAPEUTIC SPECIALTY COURTS EXIT INTERVIEW – Page 3

Appendix R: Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview

12. Prior to this program, have you had any contact with any of the following? Probation/Parole

Out-patient treatment

In patient treatment

Other Court program

DSHS/CPS

Personal Experience in This Program 13. Do you feel comfortable enough to be able to talk to at least one person on the TSC team? Please select each member on the Team that you feel comfortable sharing information. Treatment Counselor / Case Manager (MH) Child Worker / CPS

Specialty Court Coordinator

Defense Attorney

Prosecuting Attorney

Probation Counselor / DOC

Other Counselor (CD, DV, etc)

Judge

Educator

I don’t feel comfortable sharing with anyone at this time Other (please specify) _____________________________________ 14. Did you receive sanction(s) while in this program? Please check ALL that apply to you. Community Service / Work Crew YES

extra meetings

Jail

written assignment

warrant issued

# of hrs _____

NO Other (please specify) ________________________________________ 15. Did you receive rewards while in this program? YES NO If YES, what did you receive? _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

________________________________________________________________ THERAPEUTIC SPECIALTY COURTS EXIT INTERVIEW – Page 4

Appendix R: Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview

16. What difficulties/barriers have you experienced while in this program? Transportation

Childcare while in services

Obtaining Driver’s License

Finances

Education

Employment

Mental Health Counseling

Lack of family/peer support

Making appointments

Obtaining State ID

Medications

Clean and sober housing

Relating to/trust of staff

Medical/Dental issues

Other counseling/classes

Changing attitude/beliefs

Recovery environment Other (please specify) _____________________________________ 17. Did you receive any extra services or help to overcome some of these barriers while in this program? YES NO If YES, what did you receive? ________________________________________________

_________________________________________________________________________ 18. Which community support groups do you attend? Alcoholics Anonymous Narcotics Anonymous Church / Youth Group Bible Study Celebrate Recovery Domestic Violence support Organized clean and sober activities (bowling, softball, retreats, campouts, etc) Other (please specify) _____________________________________

19. How long have you been in this program (# of months)?

THERAPEUTIC SPECIALTY COURTS EXIT INTERVIEW – Page 5

Appendix R: Thurston County, WA, Therapeutic Specialty Courts (TSC) – Exit Interview

20. While in this program, did you go to an inpatient facility? YES and completed YES and did not completed NO

21. In your opinion, what are YOU most proud of in your life today? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 22. What comments and/or changes would you like us to know about or think about for the program? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

THERAPEUTIC SPECIALTY COURTS EXIT INTERVIEW – Page 6

Appendix S: Yakima County, WA, Drug Court – Exit Interview Questionnaire

Yakima County Drug Court Exit Interview Questionnaire Name:

Date:

Please answer the following questions. It is to your advantage to provide as much detail and information as possible. 1. How long have you been clean and sober? ____________________________________ 2. Do you have a 12-Step sponsor? ____________________________________________ What 12-Step meetings are you attending? ___________________________________ Do you have any commitments in the 12-Step community? ______________________ 3. How long have you had this sponsor? ________________________________________ 4. What step are you working on currently? ______________________________________ 5. Has having a sponsor been helpful to you? _____________________________________ 6. Describe your relationship with your sponsor? __________________________________ 7. Besides your sponsor, describe your support system. _____________________________________________________________________ _____________________________________________________________________ __________________________________________ 8. Are you currently employed? ________________ Where?_______________________ 9. How long have you been employed/unemployed? _______________________________ 10. What kind of work do you do, or could you do? ________________________________ 11. Is there room for advancement in your work? __________________________________

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Appendix S: Yakima County, WA, Drug Court – Exit Interview Questionnaire

12. What are your educational plans or goals? _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ______________________________________________________ 13. Describe your life prior to your entry into the Drug Court Program. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ___________________________________ 14. Describe how your life is different today after Drug Court. ____________________________________________________________________ _____________________________ 15. What did you like the most about the Drug Court Program? Why? _____________________________________________________________________ _____________________________________________________________________ _____________________________ 16. What did you like the least about the Drug Court Program? Why? _____________________________________________________________________ _____________________________________________________________________ _____________________________ 17. Please describe in detail the following: *Two of your 90 day goals _____________________________________________________________________ _______________________________________________________ *Two of your 6 month goals _____________________________________________________________________ ______________________________________________________ *Two of your 1 year goals _____________________________________________________________________ ________________________________________________________ *Do you have life goals? How do you intend to attain them? ____________________________________________________________________ _______________________ 18. Do you intend to stay drug/alcohol free? How?_________________________________ 19. Do you intend to stay crime free? How? ______________________________________

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Appendix S: Yakima County, WA, Drug Court – Exit Interview Questionnaire

20. Describe how your recovery has affected your relationships with others? (Include your husband/wife, children, parents, sisters/brothers and close friends) _____________________________________________________________________ _____________________________________________________________________ _________________________________ 21. How do you handle stressful situations? _______________________________________ 22. Where do you live? Who lives with you? _____________________________________ 23. Are you willing to release your picture and/or comments for publication? Yes___ No____

Your current mailing and contact information: Street Telephone

City

State

Zip

E-Mail

Contact information of another person: Name Street

City

Telephone

E-Mail

State

When you have completed these questions, please return to the Judge.

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Zip

Appendix T: Snohomish County, WA, Superior Court – Drug Court Exit Interview Procedures

Snohomish County Superior Court Drug Court Exit Interview Procedures This applies to all Superior and Juvenile drug courts. Purpose: To interview all drug court participants being discharged to acquire information for program improvement and statistical review. Procedure: 1. The assigned JPC or Drug Court Coordinator will provide a copy of the Drug Court Exit Interview questionnaire and any drug court specific exit interview questionnaire to any participants leaving the program prior to their discharge. This includes those participants graduating/completing commencement, terminating or opting out. 2. Participants will be asked to complete the form(s) prior to their discharge and return them to the Program Administrator. 3. Forms may be completed immediately and returned to the JPC/Drug Court Coordinator who will place them in the Program Administrator’s mail box. They may also be completed at a later date and returned to either DJJC or Superior Court to the attention of the Program Administrator. 4. Information collected will be entered into a tracking system and aggregate data will be generated for each drug court. 5. Exit interview questions will be reviewed annually and updated as needed.

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Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire

Snohomish County Superior Court Drug Treatment Court Participant Discharge Questionnaire Opening Comments: This Questionnaire was designed to help our court gain insight on your experience with our program. Your honest and candid responses regarding the following questions would be greatly appreciated. The information that you provide will in no way be used against you and will solely be used to help the future of our program. Feel free to add any additional information or clarification to any question. Thank you for your time.

Court: (select one)

ADTC

FDTC

JODTC

Name: Length of time in program:

Graduating the Program:

ARYDTC

Date: Clean/Sober Date:

Terminating:

Opting Out:

Entry Process 1. How did you first learn that this program was an option for you? Attorney

Friend

Probation Officer

Family

Court

Peer

In custody

Other: _________________________ 2. Did you start this program in custody or were you out of custody and pending your charges? In Detention/Jail when I entered Out of custody (Detention/Jail) when I entered In residential treatment N/A 3. How long did it take for you to get into this program from the time of your arraignment until the time you opted in? Less than one month Between 1 -2 months 3 months or longer Unknown or can’t remember

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Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire

4. Why did you originally choose to come into this program? To get out of jail

Treatment available

Less incarceration time

Support/structure

Financial benefit

Keep license

Resources available

No conviction

Avoid prison commitment

Avoid jail time

Get children back Other ___________________________________________________________

Court Aspect of This Program 5. During orientation, was all the necessary information about program rules, regulations, and expectations explained to you? Please score how much information you knew about the rules of drug court before you started the program. Not at all

fair

average/decent

good

explained well

6. What aspects of the Court supervision do you feel was most helpful to you (Please check ALL that you feel motivates you)? Positive interaction with the Judge Sobriety coins Phasing up certificates Rewards/Incentives for doing well for the week Community Service / Work Crew Extra support meetings Home visits Writing assignments / Essays Increasing court reporting Detention/Jail or threat of Detention/Jail School attendance supervision Assistance with educational/vocational goal setting and planning Drug Testing Other __________________________________________

7. What aspects of the Court supervision do you feel was LESS helpful to you in motivating you (Please check ALL that apply)? Positive interaction with the Judge Sobriety coins

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Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire

Phasing up certificates Rewards/Incentives for doing well for the week Community Service / Work Crew Extra support meetings Home visits Writing assignments / Essays Increasing court reporting Detention/Jail or threat of Detention/Jail School attendance supervision Assistance with educational/vocational goal setting and planning Drug Testing Other ____________________________________________________

Treatment Aspect of This Program 8. What aspect of treatment do you feel really HELPED you? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________ 9. What aspect of treatment do you feel was LEAST helpful to you? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________ 10. Which outpatient treatment center did you attend? Catholic Community Services Lakeside-Milam Evergreen Manor Other: __________________________________________

11. While you have been in this program, have you been referred to Inpatient treatment? No I wasn’t referred but I went to inpatient on my own

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Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire

Yes, and completed inpatient Yes, but never went to inpatient Yes, and went to inpatient but did not complete Yes, and went more than once to inpatient List Inpatient Treatment Center Name and length of stay (# of days/months) _______________________________________________________________________ 12. Prior to this program, have you had any contact with any of the following? Probation/Parole

Out-patient treatment

Inpatient treatment

Other Drug Court program

DSHS/CPS

13. Did you receive family counseling services? If yes, how helpful was it? ________________________________________________________________________ ________________________________________________________________________ ____________ 14. Did you receive mental health counseling services? If yes, how helpful was it? ________________________________________________________________________ ________________________________________________________________________ ____________

Personal Experience in This Program 15. Which team members did you feel most comfortable sharing information. Treatment Counselor / Case Manager

Child Worker / CASA

Specialty Court Coordinator

Defense Attorney

Coordinator’s Assistant

Prosecuting Attorney

Probation Counselor

Other Counselor (MH, DV, etc)

Judge

Educator

I didn’t feel comfortable sharing with anyone Other (please specify) _____________________________________

16. Did you receive sanction(s) while in this program? Please check ALL that apply. YES

NO

Community Service Work Crew/DCAP

# of hours/days 0-10 hrs 11-20 hrs 0-3 days

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4-10 days

20+ hrs 10+ days

Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire

Extra Meetings Jail/Detention

0-3 days

4-10 days

10+ days

Writing Assignment Increased Drug Testing Fines Other (please specify) ________________________________________ 17. What sanctions were the most effective for you? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________ 18. What sanctions were the least effective for you? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ __________________ 19. Did you receive incentives while in this program? Please check all that apply. Praise from the Judge

Applause

Leave Court early (expedited)

Reduced hearing dates

Reduced drug testing

Gift Card

Other ________________________________________________________________________ ________________________________________________________________________ ____________ 20. Which incentives were the most effective? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ __________________ 21. Which incentives were the least effective? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ __________________ 22. What difficulties/barriers have you experienced while in this program? Transportation

Childcare while in services

Obtaining Driver’s License

Finances

Education

Employment

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Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire

Mental Health Counseling

Lack of family/peer support

Making appointments

Obtaining State ID

Medications

Clean and sober housing

Relating to/trust of staff

Medical/Dental issues

Other counseling/classes

Changing attitude/beliefs

Recovery environment Other (please specify) _____________________________________ 23. Did you receive any extra services or help to overcome some of these barriers while in this program? (Example job training, educational support, etc.) YES NO If YES, what did you receive? _____________________________________________________ ________________________________________________________________________ _________ 24. Which community support groups do you attend? AA, NA, CA or other sober support groups Church / Youth Group Organized clean and sober activities (bowling, softball, retreats, campouts, etc) Other (please specify) ________________________________________________________ 25. In your opinion, what are YOU most proud of in your life today? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ______________________________ 26. Would you recommend this program to others? Why or why not?

_____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ____________

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Appendix U: Snohomish County, WA, Superior Court – Drug Treatment Court Participant Discharge Questionnaire

27. What comments and/or changes would you like us to know about or think about for the program? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ____________________________________

Please return the completed survey, including the supplemental questions if applicable, to either location:

Janelle Sgrignoli Program Admin. Specialty Courts 3000 Rockefeller Avenue, M/S 502 Everett, WA 98201

Janelle Sgrignoli Program Admin. Specialty Courts DJJC 2801 10th Street Everett, WA 98201

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Appendix V: Snohomish County, WA, Juvenile Offender Drug Treatment Court – Specific Exit Interview Questions

Juvenile Offender Drug Treatment Court Specific Exit Interview Questions

Participant Name: ________________Clean and Sober Date: _______________

1. Has your relationship with your family improved? How? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ _________ 2. Was there an improvement in your education or employment while in the program? What was most helpful? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________

3. Did you obtain a sponsor? Will you continue to see your sponsor? ________________________________________________________________ ________________________________________________________________ ______ 4. What are your goals related to your continued sobriety? What is your plan for achieving your goals? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ _________ 5. What aspects of the drug court program were most helpful? ________________________________________________________________ ________________________________________________________________ ______

Appendix V: Snohomish County, WA, Juvenile Offender Drug Treatment Court – Specific Exit Interview Questions

6. What aspects of the drug court program were least helpful? ________________________________________________________________ ________________________________________________________________ ______

7. What would have helped you to be successful earlier in the program? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ _________

8. Would you recommend this program to others? Why or why not? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ _________ 9. Do you have any other comments or suggestions that will help us to improve our program? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ____________ Please return your completed survey to either address: Janelle Sgrignoli Program Admin. Specialty Courts 3000 Rockefeller Avenue, M/S 502 Everett, WA 98201

Janelle Sgrignoli DJJC 2801 10th Street Everett, WA 98201

Appendix W: Snohomish County, WA, Juvenile Offender Drug Treatment Court – Parent Exit Interview Questions

Juvenile Offender Drug Treatment Court Parent Exit Interview Questions Youth Name: __________________________ Parent(s) Name: ________________________

Date Completed: ____________

1. How long has your son/daughter participated in drug court? ________________________________________________________________ _______________________________________________________________ 2. Did you attend drug court hearings on Fridays? If yes, how often did you attend? If no, please share your reasons for not attending. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 3. Did you attend the Friday Parent Support Group or treatment family support group? If yes, was it helpful and how often did you attend? If not, please share your reasons for not attending. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 4. Did you attend game nights and other pro social events? If yes, do you think it was beneficial to your child’s recovery? If no, please share your reasons for not attending. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 5. Has your relationship with your son/daughter improved? If yes, please provide examples that demonstrate the improvement. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

Appendix W: Snohomish County, WA, Juvenile Offender Drug Treatment Court – Parent Exit Interview Questions

6. What changes have you noticed in your son/daughter? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 7. What did you find helpful about the program? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 8. What did you find not helpful about the program? ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 9. Please share any suggestions or comments you have to help us improve our program. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

Thank you for taking the time to complete this survey. Your responses will be kept confidential and only shared in as part of an overall summary of all responses received. Please return your completed survey to either address: Janelle Sgrignoli Program Admin. Specialty Courts 3000 Rockefeller Avenue, M/S 502 Everett, WA 98201

Janelle Sgrignoli DJJC 2801 10th Street Everett, WA 98201

Appendix X: West Virginia Adult Treatment Courts (Mental Health Court and Drug Court) – Exit Interview

MHCT

DCT

WEST VIRGINIA ADULT TREATMENT COURTS (Mental Health Court and Drug Court)

EXIT INTERVIEW Participant: [print name]________________________________________________

Date of Exit Interview:

_______/_________/_________

Intent to Continue Treatment? □ No, Not Needed □

□

Yes [If yes, check all that apply] □ For MI □ □ For SA □

No, but Recommended/Should Be Why Not? _____________________________ Outpatient Inpatient

□ □

Local MH facility Private Provider

Intent to Continue Attending Community Support Program(s)? □ No, Not Needed □ No, but Recommended Why Not? _____________________________ □ Yes [If yes, check all that apply] □ NAMI □ AA □ Other: [Identify] □ WVMHCA □ NA ____________________ Intent to Further Education Post Program? □ No □ Yes [Check All Applicable] □ HS/GED □ College Classes □ College Degree seeking (List) ________________________________________ □ Certificates seeking (List) ___________________________________________ □ Vocational Classes (describe type) ____________________________________ How would you rank the Treatment Court you participated in on a 1 to 10 scale, one being the lowest and 10 being the highest? _________ Name of Treatment Court: _____________________________________________ How do you respond to the following statements? SA= STRONGLY AGREE A= AGREE N= NEITHER AGREE NOR DISAGREE D= DISAGREE SD= STRONGLY DISAGREE SCA Treatment Court Form 107 (Revised 11/07/2011)

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Appendix X: West Virginia Adult Treatment Courts (Mental Health Court and Drug Court) – Exit Interview

MHCT

DCT

[Circle Response Given]

• • • • •

•

MHCT/ DCT changed my life for the better. I would recommend the program to others. The program helped me while I was participating in it. The program has helped prevent my becoming involved in other criminal activity. The program has helped me re-establish relationships with family, friends or others in my community. I left the program better than when I came into the program.

SA SA SA

A A A

N N N

D D D

SD SD SD

SA

A

N

D

SD

SA

A

N

D

SD

SA

A

N

D

SD

The most helpful part of the MHCT/DCT program for me was: [Have exiting participant finish this sentence.]______________________________________________________________________________ __________________________________________________________________________________________

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ The

program could be improved by: [Have exiting participant finish this sentence.]_________________________________________________________________________________ _________________________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

Interviewer: [signature]________________________________________________________ [Copy of completed form is to be forwarded to MHCT/DCT Project Director, West Virginia Supreme Court of Appeals Administrative Office]

SCA Treatment Court Form 107 (Revised 11/07/2011)

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