State of the Field: Veterans Treatment Courts

Dr. Christina L...:              Welcome back to the Justice Healing Podcast, I am Dr. Christina Lanier, one of the co-directors of the National Drug Court Resource Center. Here in the studio with me today is Dr. Kristen DeVall, the other co-director of the center.

Dr. Kristen DeV...:            Hello.

Dr. Christina L...:              We are really excited today to have our guests, Dr. Julie Baldwin, a research professor of the Department of Justice, Law, and Criminology at American University. Welcome Dr. Baldwin.

Dr. Julie Baldw...:             Hi, thank you so much for having me today.

Dr. Christina L...:              Today's podcast is another installment of our seven part series looking at the state of the field. Today, we will be talking about veteran's treatment courts with Dr. Baldwin. Julie, if you could tell us a little bit about yourself and how you got into researching veteran treatment courts.

Dr. Julie Baldw...:             Sure. So a large portion of my time and effort is dedicated to research on and partnerships in a variety of capacities with treatment courts, especially veterans treatment courts. So I've been researching and working with veterans treatment courts specifically since 2010, so that's more than a decade now. My VTC work really began with my dissertation and it just never stopped. Of my current funded projects, seven are completely focused on VTCs. I've produced a number of peer reviewed publications, technical reports, and resources for VTCs, including worksheets, questionnaires, templates, resource lists, as well as white papers and briefs for state representatives and legislatures. I serve as a subject matter expert for VTCs for federal and state agencies, other researchers, state legislatures, nonprofit, and research organizations and courts. I work closely with more than 20 VTC programs across the country and I visited more than 50. Big proponent of researcher practitioner partnerships.

Dr. Kristen DeV...:            Dr. Baldwin, can you talk about when and where veterans treatment courts started, just a brief history.

Dr. Julie Baldw...:             So the most chronical and publicized veteran's treatment court is Judge Russell's Buffalo Veterans Treatment Court, which he started in 2008. In my research, I have discovered VTC programs and especially veteran specific dockets dating back further. So the first documented VTC is the Alaska Veterans Treatment Court, which was established by Judge Murphy in 2004 in Anchorage, Alaska. And all of these were really developed to assist veterans and service members who are just as involved.

Dr. Christina L...:              So when it comes to veterans treatment courts, we know that they've grown over the years rather quickly, as you've spoken about often in your research or written about. But I think one of the questions that often arises when we talk to people about courts and again, in this, the state of the field and the reason why we're doing it is. How do veterans treatment courts, how are they different from the well known adult drug court model, which we always refer back to over and over again. So can you talk a little bit about the difference between those two court types? I know there are some similarities as well, obviously, but how they compare.

Dr. Julie Baldw...:             Sure. So actually some people describe veterans treatment courts as a hybrid between drug court and mental health court. And I really prefer to describe the model not in this way. I believe it is very distinct from both for several reasons. And it just really describes how the veteran's treatment court is and operates. So really the first thing is that it's target population. This is the first time where we're seeing a treatment court who's target population is essentially status based, specifically employment based. I'm sure we'll talk a little bit more about this later, but really the one consistent factor across all veteran's treatment courts is that the participants have to have some type of military service, so some type of employment in the military. And so this is the first time that we've seen that in a treatment court. Oftentimes it's offense based or what I call extra legal issue based, so a substance misuse problem or substance use disorder or mental health issue.

                                             But veterans treatment courts target a wide variety of issues, but really the one consistent factor across all of the programs, the participants have to have some type of military history. So then another issue is the offenses. As you see in some drug courts, the offense has to be related to a substance use disorder or a substance misuse issue or the offense itself has to be a drug offense. In veterans treatment court, they pretty much take any type of offenses. It's really just based on what their military history was if they had a military history. The team is also different. So this is the first time we're seeing a new player to the treatment court table, and that is going to be the Department of Veterans Affairs. And that is through the veterans justice outreach specialist, so this the VJO, so that's the veteran justice outreach specialist.

                                             They are employed by the VA but they often sit on the VTC team to work as basically a liaison between the program and the VA. So they'll report and track the treatment services provided by the VA for the offenders. They can also look up military history for eligibility, get their DD 214, all of these things that are required for the court programs. The services are also a little unique. So because these aren't necessarily targeted to substance use disorder or just mental health issues, your services are essentially more expansive in these programs. So they cover oftentimes SUD, behavioral health, mental health issues, but also employment, relationship building.

                                             But one of the big things that you'll see that is different is that a lot of programs offer traumatic brain injury or post traumatic stress disorder treatment specifically for the participants. And then another factor that's different is peer mentorship. So a lot of veterans treatment court programs have some type of peer component to it. And so that is where veterans or service members who have either previously graduated from the program itself or have just opted to volunteer and potentially never been justice involved volunteer to basically partner up with the participants to assist them and provide support in various ways.

Dr. Kristen DeV...:            So Julie, given that description of the veterans treatment courts, and I think that you did a great job of differentiating the two models, who are veterans treatment courts intended to serve? So you talked a lot about that, the status in terms of the employment piece, but what else do you think are some factors that specify the target population?

Dr. Julie Baldw...:             So one of the things that I find extremely interesting about VTC programs is that they are so different from each other. And I didn't have the feeling it's probably going to come up a lot in our conversation today. So when I was referring to earlier that the one consistent elements across all veteran's treatment courts is that their target population at its most basic level is their participants have some type of military service history. And essentially in my research and work with a variety of these programs, that is literally the one thing-

Dr. Christina L...:              The only.

Dr. Julie Baldw...:             ... that is consistent across.

Dr. Christina L...:              That's a-

Dr. Julie Baldw...:             So the other things that are used to determine eligibility would be their type of what I call extra legal and legal factors and then a nexus factor. So your legal factors are the courts will have their own stipulations for what types of offenses, they'll also have eligibility requirements related to criminal history. So those types of things, so that's in your legal bucket. And then your extra legal bucket are going to be your behavioral health issues, so substance use disorder, your mental health issues, all of these non-legal issues that could be related to your underlying criminal behavior basically. And then housing instability is another one. And then your third [inaudible] we call basically this nexus requirement. And so some programs will require that their issue in one of the other buckets is directly related to their military service.

                                             So an example of the nexus requirement maybe that the program requires, the participant must have PTSD that is related to their substance abuse and their PTSD is a result of their military service. So it's some type of relationship between the other bucket or buckets and military service. So that is the best way that I can describe the target population. Because each program is so different. And they're also in some states they are held to state statute for who can be eligible to be in their treatment court program. And that typically has to do with types of offenses and things like, that legal bucket. So each program is extremely different in how they piece together their eligibility requirements for on these different buckets essentially.

                                             But the one factor that is the same across everyone is that they have to have some type of military service history. And I say it as broad and generally is that because programs will then stipulate what type of service history. So a lot of programs will actually also say that they have to be VA eligible, and that's particularly because I think they get only their services from the VA that particular program. Whereas other programs will take VA eligible and ineligible, but then also have to have partnerships with community treatment providers for those VA ineligible. And then some programs will say, you have to have an honorable discharge status. So that's why we say just very broadly history of military service is the one factor that's consistent across target populations.

Dr. Kristen DeV...:            I know one question that is asked all the time is the preclusion of folks with a violent offense history. So can you speak to that with regard to veterans treatment courts and if that is something that's replicated within this model?

Dr. Julie Baldw...:             Absolutely. So the VTC model is a little bit more loose when it comes to that. Violent histories are often excluded from say the drug court model, we see that all the time. Veteran's treatment courts are not structured in this way. And even federal funding for this gives a usually different category for VTC programs that do have those in their target population with violent histories. So that is something that we see that is different. Oftentimes these programs are still restricted by their state statute. So there are plenty out there that still will not take those with a violent history. But I think this really stems from, the reason for this difference, for VTCs accepting these individuals into their programs, I think it stems from the idea that they have been trained in a certain way, they have experienced potentially certain situations where they're going to react in a certain way, which may result in some type of violent charge in their criminal history.

Dr. Kristen DeV...:            So, Julie, in order to identify the target population, given all of these different factors, do you have recommendations for risk need assessments that programs could utilize in order to do just that?

Dr. Julie Baldw...:             Sure. So the risk need assessments issue is a pretty hot topic right now, and has been for a couple of years. So currently there are no veteran specific risk need assessment tools that programs are using. So currently I recommend using anything that is already validated. I'm actually working on a project that's funded by the Bureau of Justice Assistance and had some support from the National Institute of Corrections previously on developing a veteran specific risk need assessment tool, which is a multi-phased project that will produce a validated veteran specific risk need assessment tool in the future, which should be really helpful for the field.

Dr. Christina L...:              Julie, so we've talked a little bit about the target population and you spoke about this when you were talking about the difference between adult drug courts and veteran treatment courts. But maybe you can elaborate a little bit on the treatment needs that may vary for veterans treatment courts. And perhaps how does that play into the challenges for veterans treatment courts when it comes to treatment and being able to access that treatment for the participants?

Dr. Julie Baldw...:             So one of the biggest things we see is TBI specific and PTSD specific, so traumatic brain injury and post traumatic stress disorder treatments for VTC participants. So these are offered primarily through the VA in a lot of instances, but some community treatment providers will also provide these services for the VA ineligible veterans. So those are some of the probably more prevalent, unique treatments for VTC programs. One of the things that I found interesting in my dissertation work, and then also with the NIJ study, what we're finding is both of these studies, let me just say involved a large amount of one-on-one interviews with VTC participants, so that's where this information is coming from. And one of the things in the section of these instruments that we talked about, their treatment experience, what we found is that they reported they don't particularly like to mix with non-military or mixed with civilian participants in their treatment because the experiences are so different. But they also don't particularly like to be grouped in with other veterans or service members who may have issues that are just too dissimilar from their own.

                                             The participants particularly like to be grouped in their treatment groups with other veterans or service members who have similar issues. So we found that was very interesting. And one other thing I want to say about treatment is there is a domestic violence and interpersonal violence intervention. So there is a program called Strength at Home, and it is typically offered by the VA at some VA clinics and medical centers to address this in their veteran populations. One of the things that's really interesting right now is we're doing the first external evaluation of Strength at Home. It's previously been only evaluated by researchers at the VA. So this is the first time we're doing an external evaluation, it's being offered in a veteran's court in Oregon. So we're pretty excited about that. But that's another specific treatment that varies from adult drug courts that we're seeing in veterans treatment courts right now.

Dr. Christina L...:              I would imagine that one of the challenges, and you mentioned this earlier, is the whole VA eligible, non-VA eligible for court. Do you have any idea, and this might be a question that can't be answered, how many courts do limit to VA eligible versus non?

Dr. Julie Baldw...:             So I think from the last survey that I had done, the majority required VA eligibility. And I think that is still the trend that I'm seeing just in my experience, not from another national survey. And I really think that relates to the fact that you have the VA as a partner that can automatically provide services to part of your target population. And it's just easier than also trying to find a variety of community treatment providers. So I think it's just automatically, you have a partner that provide a whole bunch of services versus also trying to get community treatment providers to then offer the services for the VA ineligible.

Dr. Kristen DeV...:            That'll be exciting to see the evaluation results for the Strength at Home.

Dr. Julie Baldw...:             I'm really excited about that.

Dr. Kristen DeV...:            keeping with the trend of some challenges associated with VTCs, Julie, what would you say are some common themes that programs have reported with regard to serving the population?

Dr. Julie Baldw...:             So some challenges I've seen with programs being the population are, one of the things that I've seen is identifying potential participants. This is a huge issue. And one of the early that we see that have come out of the NIJ study. We have a paper devoted to identification, basically military status people involved in the justice system. So programs often have a hard time figuring out who their potential participants would even be because military status and not one of the basic questions that are asked, say at intake or pretrial services. So identification is a big thing. And then also having other players in the criminal justice system. So with Tardy, knowing about the program to even refer them over to it, if they even find out that their clients has a history of military service. So identification is a huge issue.

                                             There are two non-self-report I believe mechanisms to identify a history of military service. One is the VRSS, which the Veterans Reentry Search Service. Typically the jail can keep a list of the individuals who are booked. So that is actually submitted through this system and it cross references it basically with the VA to determine if the individuals have a history of military service and it can pop back a list for those that flagged. The second one is SQUAREs, I think they have SQUARES 2.0 right now, and that's a web based tool. So that is typically for users can submit identity attributes for homeless individuals, and then SQUARES will return information regarding their veteran status and eligibility for homeless program services. So those are two ways that are just not self-report, but everything else to determine veteran status is primarily self-report. And really VRSS is only a few veterans treatment courts across the country are using that.

Dr. Kristen DeV...:            Was just going to ask.

Dr. Julie Baldw...:             And it's primarily the VJOs that are using them. But by and large it's not being used, but it's the only non self report way right now for programs to identify.

Dr. Kristen DeV...:            That a free service?

Dr. Julie Baldw...:             Yes, it is.

Dr. Kristen DeV...:            That's great. I mean, for any jurisdiction could use one or both of those mechanisms to better identify who is in our criminal justice system. That's excellent. I wasn't aware of either of those.

Dr. Julie Baldw...:             Yeah, most people aren't. And we're really trying to get the word out about those resources that programs can use. So you can take a look, I think it's in the executive summary for the NIJ study, the executive summary talks a little bit about those and also provides the links for those to find more information. So one of the challenges that we see for participants or what participants often report their return to society from their service. So if you think about it, billions of dollars are spent in the military institutionalization of these individuals. And they are in this whole military culture for oftentimes many years. But then when they exit service, there's no real transition or support for transition from military culture back into civilian life. And so they're cut off from their routines, their often support system, some their peers in service.

                                             And so it's difficult for them as they often report to navigate and just come back to civilian life. So oftentimes they're isolated, they will use a variety of substances to try and cope and those types of things. So it's really that return to society that can be very difficult for many. That's one of the things that these programs are really trying to address through peer mentorship, support, structuring, or doing certain things in the program itself during court sessions themselves to mimic or draw upon that [inaudible]. So using specific terminology, having the flags out, doing color guard, all of these things to try and bridge that difficult transition, that gap from service to civilian life.

Dr. Kristen DeV...:            Just in thinking about that transition, I was not in the military, but I can imagine being cut off from the military world, because you're no longer acting, you're not living on base or you're not seeing those folks day in and day out. But then also not fitting in with your family and community. So really this limbo period that I imagine doesn't have a lot of support in place.

Dr. Julie Baldw...:             Absolutely. And if you think about it too, so say someone joined when they turned 18. They've always had a paycheck, typically assigned place to live, those types of things. So even things like balancing checkbooks and financial literacy, those things are often new and difficult challenges to certain individuals.

Dr. Christina L...:              What about the fact that the programs are different, as you've been talking about, as a challenge? And do you think that's a challenge for...

Dr. Julie Baldw...:             Yeah, go ahead.

Dr. Christina L...:              Do you think they should be more similar I guess is really my question? Is this diversity among the programs a good thing because they can make their own rules, I guess, and decisions or would it benefit the field or benefit all the VTCs for there to be more uniformity in some ways?

Dr. Julie Baldw...:             So I want to talk about this from actually two different angles, from the practitioner on the ground angle and then also from the researcher angle because this is a really question. First, obviously from the research angle, that's the easiest to answer, is yes, it would be so much easier if all these programs were the same to research and figure out the effects. But from the research angle, because they're so different, we have to have process and implementation evaluation in hand with outcome and impact evaluations. And I can talk a little bit more about that later. But really you have to take into account exactly what the program is doing, the one that you are evaluating and measuring because [inaudible] is so different. So the interpretation of results by researchers and practitioners, it's really important to pay attention to what type of program a study is actually looking at.

                                             From on the ground standpoint, I think it's actually good that programs are so different. And the reason I say that is... But it's really for something that's actually not being done. So I am really urging programs to do a needs assessment before implementing a veteran's treatment court. So that's taking the temperature of the pulse to understand what your veteran population looks like in your area, what are their actual needs, what are the services that should be provided, do you have the treatment capacity to address those issues. So doing a needs, excuse me, needs assessment before starting a new program in an area would be really important.

                                             Also doing needs assessment for programs currently operating is important. What I've seen oftentimes is a program starting up in an area and they've been in operation for three or four years now and they have five participants. So doing that needs assessment I think, is really important. With that, building your program based on those results you're going to have more individuals, you're going to make sure that you have the resources to address their needs. But with those different needs assessment, each program is still going to be different, which I think is fine. I think if it's done that way, they can really address the issues in their area for their veteran population.

Dr. Christina L...:              That makes sense for sure. One of the things that we have at NDCRC is we have an interactive map on our website that shows court counts and shows veteran treatment courts. And one of the pages also shows just the percentage of the population that our veterans at the county level. So we always said that would probably be a good place to start when you're talking about a veteran's treatment court. Like let's go see if my county has veterans and how many. Obviously it would need to go further than that but that seems like a starting point. Do we even have veterans in our community?

Dr. Julie Baldw...:             And that's a great resource and I love, love that map by the way.

Dr. Kristen DeV...:            Thank you.

Dr. Christina L...:              Good. So do we, for sure.

Dr. Kristen DeV...:            Can I just want to ask one question that came up as you were talking, but this actually goes back to the treatment needs varying and that the participants don't like to be mixed, they want to be with similar folks that have had similar experiences. Would you say that aligns with combat experience non-combat like having experienced combat non?

Dr. Julie Baldw...:             So I don't want to say yes or no to that. It has come up in some of the interviews, but I would say not the majority really say combat or non combat. And one of the things that's difficult to find is oftentimes combat versus non-combat. So sometimes you'll have people that get hazard pay and that can be considered combat, sometimes it's considered having seen any fire action. And you don't have to necessarily be in a combat zone to experience that. So the combat non-combat is a little difficult. Even though some programs actually use that in their eligibility criteria, which is quite interesting.

Dr. Kristen DeV...:            That is interesting.

Dr. Julie Baldw...:             And how they define that.

Dr. Christina L...:              So it sounds like veteran's treatment courts are definitely in need of additional research, just given some of these questions that you're talking about and what do we know about them and the needs assessments and those types of things. You mentioned when you were talking about yourself, the idea of the research practitioner relationship, and that's one of the things that the NDCRC is really our foundation, is linking research and practitioners to be able to improve programs and services and such. So if we can shift gears a little bit for the researchers or perhaps the practitioners as well that are listening, can you talk a little bit about the... We talk about outcomes all the time, I would assume that some of the outcomes for veteran treatment courts are very similar to those of adult drug courts. But talk a little bit about what are the outcomes of interest and maybe what do we know about them and maybe what do we need to know about them?

Dr. Julie Baldw...:             Okay, great. So two of the main outcomes of interest that we always hear about or ask about, and it's not specific to veterans treatment courts and so other treatment courts are graduation rates, so successful program completion and recidivism. So graduation, as I said, is successful program completion. If they've made it all the way through the program, people like to talk about those rates. And then also recidivism, which is thrown around a lot, but whenever you hear recidivism, everyone should be asking themselves, well, what type of recidivism? So are we actually... Recidivism needs to be specifically defined. So are we talking about re-offending in general, re-offending for the same type of offense that the individual went to the treatment court for? Are we talking about re-arest? Are we talking about re-incarceration, re-conviction? So recidivism really needs to be specifically defined. All of those graduation and recidivism in general are two of the biggest outcomes that we're asked about.

                                             Other outcomes of interest or that I find important should be time to reoffense, time to re-arrest, time to reincarceration, treatment, engagement, and retention. So we definitely need more research in this area. Mental health improvements, time to return to substance misuse, that timeframe, family relationships, social integration, housing stability, employment, all of these different domains where improvements can be made because that's what these programs are trying to address, these underlying issues for the criminal behavior. So all of these outcomes are important for us to really be looking at. And to be honest, there's not a lot of veterans treatment court research out there. I think the outcome research is starting to emerge.

                                             The impact research will be even more important, but that is taking longer to actually do as it should. But really we just don't have the research out there. And like I said before, I started focusing and working with specifically VTCs in 2010 and I pretty much know everybody else in the field that is doing veteran's treatment court research, which one person cannot know that many people. So it shows you there's not that many people out there specifically doing this work. And it's really important work that needs to continue and is slowly growing. But definitely needs to grow, I think much broader and faster than it has been because these courts are just growing exponentially across the country.

Dr. Christina L...:              I know in some of your work you talk about the lack of evaluation of these courts before they start springing up. So obviously that relates back to what you were talking about before with the needs assessment and those types of things. Do you have any ideas as to why there's not a lot of research? We have so much research on adult drug courts and most of the other court types are lacking in specific research for sure. So it's not really a problem unique to veterans treatment courts. But do you have any ideas or hypotheses about why there's this lack? They have been around for how many years now? So officially we say 2008, but that's a while.

Dr. Julie Baldw...:             It is a while. I think that the same with other treatment court research, so even like mental health courts, I think a lot of people just rely on the drug court research and often think that these programs are just a tweaked version of an adult drug court, which as I said before, I argue against. I think all of these types of specialized courts or treatment courts need robust research on them specifically. I think just pulling from another type of treatment court isn't sufficient for a variety of reasons, and we talked about how different veterans treatment courts are from say drug courts or mental health courts. So I think that might be why just pulling from the abundance of literature that is out there for drug courts.

                                             I think also that these programs are so different from each other, that it does make them difficult to research appropriately. And when you're doing an outcome or an impact evaluation, that's time consuming enough, especially the impact evaluation, what I'm proposing and what we found because of the NIJ study. And some of my other work is that these courts are so different you really have to do also a process evaluation. Right. And all impact studies also need to have an implementation evaluation with them. So I think just doing the search itself is time and resource consuming. And so I think that's why not a lot is really done and is out there right now.

Dr. Christina L...:              Because I guess if they're so diverse, then you've got to really learn each one specifically. Obviously with adult drug courts as well. But you have to identify what are the differences, what are the similarities, those types of issues. I think I wanted to go back to one other thing you were talking about, is these other outcomes that we talk about. When we say other outcomes, Kristen and I we're referring to all the things other than recidivism. Because we focus so much on that, the funders want to know recidivism, the state legislatures want to know recidivism. Which okay, yes, we want to know that, I guess, but it's these other factors we call social determinants of health or if I don't have someplace to sleep and I don't have a job, the likelihood that I'm going to be successful we know is lower, that's a given.

                                             So I think focusing on these other things, and I think as a whole, I think the entire field, not just veteran treatment courts needs to shift their focus to some of these other things. We talk a lot about the lack of, and you mentioned it previously, is there's not a lot of research on treatment, there's not a lot of research on how does treatment work, as you talked about earlier, the engagement, the retention. We have all this research for years and years and years about these courts, we know they work as a whole, but what about them works perhaps better? So what are the outcomes that we might need to say, okay, these are the things we need to be looking at? Because if we don't know anything about say treatment and engagement and retention, as you mentioned previously, then we're just doing treatment for the sake of treatment, we're just doing it but we don't really know what it's doing, if that makes sense.

Dr. Julie Baldw...:             So if we see that recidivism rates are going down but you're not measuring these other things, it's like, well, why are these programs working? So we need to be measuring all of these things that are theorized and hypothesized related to that criminal behavior that is trying to be reduced. And it's these things, these extra legal factors that these programs are trying to address. So in addition to reduce recidivism, so they themselves need to be studied. So we do need to be studying wellbeing and mental health and substance use disorders and the outcomes in those areas are extremely important.

Dr. Christina L...:              One of the things that I saw in the literature that I was hoping you could talk about a little bit was there was a call for research looking at military socialization. And while it might hinder in some ways, is there a way for it to help? Is that something that should be measured? How military culture influences veteran treatment court outcomes, if that makes sense. Like how is it integrated into the program? For instance, one study was just talking about that on the positive side, they have structure, they know when they start veteran's treatment court and they have to do all these things and they have to do them on a certain time and they have to make sure they're done, that military culture can actually assist in some ways because they're used to that, there were orders, they had to follow the orders. Obviously we have the other side of the coin that you spoke about earlier, leaving that military culture and coming into civilian culture. So I didn't know if that was an area that could be looked at or flushed out a little bit more.

Dr. Julie Baldw...:             I think that's definitely an area that still needs more research. And I think it's like two VTCs obviously. And that can go in hand with your process and implementation evaluation and then also your impact evaluation. So understanding what elements of military culture are being carried over into the VTCs and how those might be affecting participants. And really when I say participants, I also mean specific types of participants. Because these target populations the individuals in them can be so varied. So you can have different subgroups within your target population. So really understanding what works for whom is really important. Because I think once we understand that, then programs can replicate what's worked for certain participants if those participants are in their target population.

Dr. Christina L...:              Sure.

Dr. Julie Baldw...:             That's ultimately, I think, one of the biggest goals for research and VTCs, is figuring out what works for whom. Because every program's going to be different. And if we figure out some of that, then really programs to say, oh, this worked for these types of individuals. And we have these types of individuals in our program, do we have these same types of services or things that we could do to hopefully make our program more successful?

Dr. Kristen DeV...:            I'm thinking, as you were talking, the notion of asking for help, that's not seen as a weakness in this program. But that's certainly something that's not encouraged in military culture.

Dr. Julie Baldw...:             There's two things. So one, there's a culture shift that they're trying to make in the military for making sure that asking for help is not a weakness. And for those that have gone through their military experience and they feel that that is the case, it's this treatment court, this program that has to re-socialize them to understand that asking for help is not a weakness, it's really what you need to do to improve yourself. So the asking for help is a big thing that needs to shift.

Dr. Kristen DeV...:            Be cool if we could have some instrument. Okay, what does your thoughts around asking for help, how does that pre-post?

Dr. Julie Baldw...:             Exactly.

Dr. Kristen DeV...:            And how has that shifted?

Dr. Julie Baldw...:             I want to say something about employment and maybe measuring. I had mentioned employment being an outcome to maybe look at, but I did want to make a comment about that. And employment in the veterans treatment court participant population is going to be a little bit different than looking at employment in drug court or maybe mental health court. And that I think has to do with disability status. So a lot of participants in treatment court do have some type of disability status or percentage with the VA. And that will affect oftentimes whether they can be employed or not be employed. So just looking at the outcome of employment, I think people have to take into account the issue of disability status and their VA percentage when looking at that. So just unemployed isn't really a good measure of failure or success. So that's important to take into account with this population.

Dr. Christina L...:              One of the programs that we've worked with in the past when we've measured employment, unemployment, et cetera, we've always separated out somebody who went from unemployed to disability because we see that as a success. So they didn't know perhaps that they could get disability and so the program staff assisted them with getting disability. So to us, that's a separate category when they're out. So that's a great point and that really applies to this group for sure.

Dr. Kristen DeV...:            So getting programs to think about how they're measuring what are the possible categories of employment for the veteran participants. That's a really good point. And seeing that as success. That is if you're securing disability benefits, that's going to be a stabilizing factor moving forward. So Julie, we'd like to provide our listeners with a call to action of sorts. So what do you want listeners to take away from today's episode?

Dr. Julie Baldw...:             So really the biggest takeaways I would say is the understanding that programs vary so widely. So remembering about eligibility, target population, services provided. Each program is really unique, even though they may be called a veteran's treatment court or they are a veteran's treatment court. And so because of that, study result and policy and practice recommendations must be interpreted carefully. So when looking at studies or any type of program [inaudible], taking into account where those are coming from. So understanding what type of program, what that program look like that those recommendations and results are coming from. For impact evaluations, relatedly, process and implementation must be accounted for.

                                             Another takeaway that I wanted to say was that, so all of that's lumped together, but the second one would be the effect of these programs is largely unknown. So although the intent is for everyone running these programs and creating these programs, the intent is to do good and to help veterans and service members, we really need to see if this is the actual effect. And so hoping that the research will continue to grow in this area, as these courts are also growing is really important. And so with that, relatedly data needs to be collected. So this is biggest obstacles because of resources such as time and personnel and not knowing what data information must be collected. So these programs don't always have the resources and know exactly what needs to be collected and how it needs to be collected, how often.

                                             So one of the biggest things that I advocate for are research practitioner partnerships. So I'm a huge proponent of these and I spend significant time working in and for these. I think they really advance the field for practitioners and researchers and have advantages for both. I could talk with you guys all days about researcher practitioner partnerships. But that is one way for programs to understand what data needs to be collected, they can learn how to collect the data from these collaborations. And then after the collaboration is over, if it does end, then the program does have the tools and the understanding how to collect data and what to do with it on some level after that partnership may be over.

Dr. Kristen DeV...:            And do you have any thoughts around publications or monographs that folks could be on the lookout for coming in the near future?

Dr. Julie Baldw...:             Yes, I am so excited to say that the research and literature on veteran's treatment courts is definitely expanding. We have several publications from the NIJ, the National Institute of Justice. Multi-site evaluation of veteran's treatment courts that are coming out. So currently there's just an article on identification that I referenced earlier, the identification of potential VTC participants. And that was actually in a previous issue of the Drug Court Review, which DCRC runs. And then we'll have the executive summary actually by the time this comes out. The executive summary and the research abstract will be available from the NIJ study as well as the final report. The first batch of non-report articles that will join the Identification publication will be addressing eligibility and admission. We found that that's different from just identification. So we're going to specifically address that. We also have fidelity of implementation and novel substance misuse.

                                             And then two other things that are related would be the Veterans Re-entry Publication. This is funded by the National Institute of Corrections. Basically, there's a compendium of these publications. This is the last issue in the series. And it highlights a variety of programs and efforts to assist veterans and service members who are justice involved. And this specific issue, I've organized to follow the sequential intercept model. So it will include [inaudible] and tips for developing and enhancing these types of services and support in the reader's own areas. Then finally, what we mentioned was the veteran's risk assessment, that's being funded by the Bureau of Justice Assistance. So that's the multi-faced project to develop and validate a risk and need assessment tool specifically for veterans and service members. And that will be an amazing resource for read across the country once that is complete.

Dr. Kristen DeV...:            Absolutely.

Dr. Julie Baldw...:             Lots of exciting stuff going on that I think is going to be really great for the field.

Dr. Kristen DeV...:            Absolutely. Well, thank you, Julie, for joining us today. This was great. I think a wealth of information for both researchers and practitioners, which is exactly who we're targeting through the podcast. So thank you for joining us.

Dr. Julie Baldw...:             Thank you. I hope it was helpful because I really enjoyed speaking with you both today about this important topic.

Dr. Kristen DeV...:            And to our listeners. Thank you for being here. We hope you learned something new about veteran's treatment courts and ways that you can incorporate this into already existing programs. Or if you're planning to start and implement a veteran's treatment court, that we've given you some things to think about. Please join us on the ndcrc.org Justice to Healing discussion board to continue the dialogue. And please join us next month for another episode of Justice to Healing and always remember to do better.

Speaker 4:                          To our listeners, we thank you for listening. And we hope you enjoy the show. Be sure to his subscribe to stay updated on the podcast. Follow us on Facebook, Twitter, and LinkedIn to stay engaged with us. And check out our website, ndcrc.org. Thanks again. Catch you next time on Justice to Healing. The justice to healing podcast is presented by the National Drug Court Resource Center and was supported by the grant number 2019–DC–BX–K002, awarded by the Bureau of Justice Assistance, which also includes the Bureau of Justice Assistance, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime , and the Smart Office. Points of view or opinions in this podcast or those of the author and do not necessarily represent the official position or policies of the United States Department of Justice.