Los TTAs desde los componentes sanitario y jurídico (arranque del programa)

Marco conceptual para una Discusión orientada al Tratamiento .. Contexto de fondo Participantes Corte de drogas Resultados Entorno Local Aspectos demográficos Patrones de uso de las drogas Cultura político/legal Actitudes de las partes involucradas (Fiscalía, Defensoria, Jueces y Tratamiento) Componentes de la Corte de Drogas Identificación temprana Tratamiento Coerción Legal (e.g., miedo al encarcelamiento) Interacción Judicial Recompensas Sanciones Enfoque multidisciplinario Manejo de caso Pruebas de antidopaje Servicios adyacentes (empleo, salud mental, housing, etc.) Divulgación comunitaria Información/Evaluación Recuperación Motivación y Cambio conductual Perfil del participante Aspectos demográficos Status socioeconómico Vínculos Familia/comunidad Historial de tratamiento por uso de drogas Antecedentes criminales Graduación Corte de drogas Elegibilidad para la Corte De Drogas (cargos, historial criminal, y severidad de la adicción) Resultados de Rehabilitación • Reducción del delito y del uso de drogas • Otros resultados (por ejemplo, relacionados a empleo y salud) Beneficios sociales • Seguridad pública • Menor encarcelamiento • Ahorro de costos MODELO DE LA CORTE DE DROGAS* *Center for Court Innovation

Incorporación de la evidencia meta análitica Empezando De "El método C.A.S.E." A Incorporación de la evidencia meta análitica

Empezando. Discutir 7 puntos.. Guía de Discusión: 1. La integración del equipo del tribunal de drogas, 2. Aclarar la misión y los objetivos del programa, 3. Identificar la población meta para el programa, 4. Especificar los criterios para graduación y expulsión, 5. Desarrollar la estructura de las fases, 6. Agrupar recursos comunitarios y 7. Evaluar las operaciones del programa.

Oficiales de reinserción social 1. Equipos USA Chile México (Monterrey) Juez Abogados Oficial de Probatoria Tratamiento Administrador de casos Oficiales del orden Coordinador del programa Dupla psicosocial Oficiales de reinserción social

2. la misión y los objetivos del programa Resultados de Rehabilitación • Reducción del delito y del uso de drogas • Otros resultados (por ejemplo, relacionados a empleo y salud) Beneficios sociales • Seguridad pública • Menor encarcelamiento • Ahorro de costos

3. identificar la población meta para el programa Entorno Local Aspectos demográficos Patrones de uso de las drogas Cultura político/legal Actitudes de las partes involucradas (Fiscalía, Defensoria, Jueces y Tratamiento) Elegibilidad para la Corte De Drogas (cargos, historial criminal, y severidad de la adicción) Perfil del participante Aspectos demográficos Status socioeconómico Vínculos Familia/comunidad Historial de tratamiento por uso de drogas Antecedentes criminales

4. especificar los criterios para graduación y expulsión 5. desarrollar la estructura de las fases

Dos puntos que van de la mano. La aportación del Area sanitaria descansa en el conocimiento del proceso de tratamiento.

(Stages of Treatment) Stage 1—Treatment engagement Stage 2—Early recovery Stage 3—Maintenance Stage 4—Community support

Stage 1—Treatment Engagement Goals— - Initiate a treatment contract - Resolve acute crises - Engage in a therapeutic alliance - Involve clients in preparing a treatment plan.

Stage 1—Treatment Engagement Duration—A few days to a few weeks.

Stage 1—Treatment Engagement Counselor activities— - Confirm diagnosis, eligibility, and appropriate placement in this level of care - Assess biopsychosocial problems and match services to the most pressing problems - Provide assessment feedback - Explain program rules and expectations - Address acute crises Counselor activities— - Confirm diagnosis, eligibility, and appropriate placement in this level of care - Assess biopsychosocial problems and match services to the most pressing problems - Provide assessment feedback - Explain program rules and expectations - Address acute crises - Resolve scheduling, payment, and counselor assignment issues - Obtain medical and psychological diag- noses and treatment history, including pharmacotherapy - Foster therapeutic alliances between client and counselor and client and group members - Begin psychoeducational activities - Identify sources of social support - Initiate family contacts and education (with client’s permission).

Stage 1—Treatment Engagement Cont.. Counselor activities - Resolve scheduling, payment, and counselor assignment issues - Obtain medical and psychological diag- noses and treatment history, including pharmacotherapy - Foster therapeutic alliances between client and counselor and client and group members - Begin psychoeducational activities - Identify sources of social support - Initiate family contacts and education (with client’s permission).

Stage 1—Treatment Engagement Completion criteria— - Completed assessment process and orientation - Completed withdrawal from substance use - Resolved immediate crises - Established a treatment plan - Attended scheduled sessions.

Stage 2—Early Recovery Goals— - Maintain abstinence - Sustain behavioral changes - Identify relapse triggers and develop relapse prevention strategies - Identify and begin to resolve personal problems - Begin active involvement in a 12-Step or other mutual-help program.

Duration—6 weeks to about 3 months. Stage 2—Early Recovery Duration—6 weeks to about 3 months.

Stage 2—Early Recovery Counselor activities— - Help clients follow their plans to sustain  abstinence - Assist in identifying and developing strategies  for relapse triggers - Initiate random drug tests and provide rapid  feedback of results - Help clients and families integrate into  mutual-help programs - Assist in developing and strengthening positive social support networks - Continue appropriate pharmacotherapy, medi- cal, and psychiatric treatments.

Stage 2—Early Recovery Completion criteria— - Sustained abstinence for 30 days or longer - Completed treatment plan goals - Created and implemented a relapse preven- tion and continuing care plan - Participated regularly in a support group - Maintained a sober social support network - Resolved medical, psychiatric, housing, and personal situations that may trigger relapse.

6. agrupar recursos comunitarios

Core IOT Services Provided On Site • Group counseling and therapy • Individual counseling • Psychoeducational programming • Pharmacotherapy and medication management • Monitoring alcohol and drug use • Case management • 24-hour crisis coverage • Community-based support groups • Medical treatment • Psychiatric examinations and psychotherapy Vocational training and employment services Family involvement and counseling* • Comprehensive biopsychosocial screening and assessment† • Program orientation and intake/admission† • Individual treatment planning and review† • Transition management and discharge planning

Enhanced IOT Services Delivered On Site or Via Functional Linkages • Adult education Transportation services Housing and food • Recreational activities • Adjunctive therapies • Nicotine cessation treatment • Licensed child care • Parent skills training

7. evaluar las operaciones del programa

Incorporando la evidencia meta análitica Se ha publicado mas investigación sobre las cortes de drogas (sin incluir a otras cortes de resolución de conflictos) que virtualmente todos los demás programas correccionales combinados.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.

Drug Courts Today and the Promise of Tomorrow ©Douglas B. Marlowe, Ph.D., J.D.