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Founders
of the Anchorage Wellness Court: Former
Anchorage Municipal Prosecutor John Richard; District
Court Judge James Wanamaker; and Janet McCabe, Partners
for Progress, Inc.
"Cooperation
beats every other strategy, hands down":
Interview with Judge James Wanamaker, Anchorage Wellness
Court
Anne Skove,
Problem-Solving CoP, March 3, 2004
Q.: What led you to
create the Wellness Court? I understand the involvement
of Partners for Progress was instrumental. However, I am
interested to know what drove you to take this idea and
institute it.
A.: In 1997 I went to
judges school at the National Judicial College. One of
the teaching judges said: "There is a wonderful new
pharmaceutical called ‘Naltrexone,' which is very
useful in curing alcoholism; check it out on the
Internet." I did check it out and found there were
numerous medical studies attesting to the effectiveness
of Naltrexone: I tried to get local treatment providers
to use naltrexone, but I had zero success. In 1999, I
learned about Judge Darrel Stevens, a superior court
judge in Chico, California, who used a court-ordered
plan whereby defendants were required to take Naltrexone
as a condition of probation. In July 1999, Judge Stevens
was invited to Anchorage and gave a seminar on the
method which he used. In August 1999, I applied Judge
Stevens's method for the first time. I required
that a felony DUI defendant take Naltrexone in
conjunction with treatment as a condition of bail. That
worked very well and the defendant demonstrated a long
period of sobriety prior to her guilty plea and
sentencing. Other cases followed.
In 2000, I learned about
the drug court method and I could see how that would
work very well in addressing alcohol addiction. Over the
next few months we implemented most of the components of
the drug court model plus a couple innovations of our
own.
Looking back on this, it
was a huge effort. One reason I stayed with the project
was the great success: 3 out of 4 participants gained
lasting sobriety and avoided further crime. Nationally
the success rate is 25%.
Q.: NDCI published the
now-famous "key components" of drug courts.
What are some of the hallmarks of the Wellness Court?
A.: I think the
monograph, which sets forth the ten key components, is
brilliant. We have studied it and done our best to
implement those principles.
The hallmarks of the
Wellness Court are:
1) Naltrexone-everyone
takes one 50-mg. pill of Naltrexone each day for 120
days to reduce the cravings for alcohol. The pill
doesn't work unless you swallow it, so the taking of the
medication is monitored by an independent party, usually
a pharmacist. I am convinced Naltrexone has greatly
helped the success of the Wellness Court.
2) MRT® (Moral
Reconation Therapy)-This is a workbook system developed
by Dr. Ken Robinson. Every participant must
complete MRT. It is very useful in correcting criminal
thinking errors and building personal responsibility. It
supplies the habilitation which most of our participants
need.
3) NALGROUP®-Mike Krukar
wrote a postgraduate thesis on the Wellness Court to
obtain his master's degree in mental health. He also
developed a system of Nalgroup meetings, which
participants attend each week where their treatment
progress and the benefits of naltrexone are discussed.
This is in addition to regular treatment meetings.
4) Cognitive
Treatment-Alaska Human Services, which is the principal
treatment provider, uses cognitive treatment methods.
5) Work-Every participant
must maintain full-time employment
6) Self-pay-Participants
pay their own costs of treatment and doctor and costs of
Naltrexone. "Grubstake Grants" of up to ¼ of
treatment costs are available to the indigent in order
to get started. After that, they pay their own way.
7) 18 Months
Duration-Participants must fulfill all requirements of
the treatment plan for 18 months.
8) Sobriety is monitored
by modern technologies. SCRAM-a device which
monitors for alcohol 24/7 and reports by telephone
modem. Sobrietor-a device which tests defendant for
alcohol through a telephone hookup at his own home.
9) Individual
Responsibility-In court, participants go to a podium
just 15 feet from the judge and make their personal
report to the court. This emphasizes personal
responsibility.
Q.: What are the special
challenges you face as a judge in the Wellness Court?
A.: The biggest challenge
is to get the Wellness Court to institutional status,
where it will sustain itself after my retirement in
January ‘05. The last position which needs to be put
in place is a program manager. We have a grant
application to NHTSA (National Highway Traffic Safety
Administration) to fund that position.
Q.: Problem-solving
courts have had bipartisan support, and are touted by
judges, defense counsel, and prosecutors alike. Some
counsel, however, cannot imagine-ethically or
socially-sitting down and working as a team with the
"other side." Can this be done? Are there
ethical issues involved? How are the cultural hurdles
overcome?
A.: Most lawyers
understand the idea of sitting around a table and
solving the problem of alcoholism. Some, however, remain
in adversary mode, and it is very disruptive until the
lawyer catches on. The biggest problem comes when an
applicant is denied admission in the Wellness Court, or
admission is conditioned on stringent treatment
requirements such as not residing with an abusing
spouse, or a requirement that a defendant have full-time
employment. Sometimes lawyers will demand admission for
their client on the client's terms. The court's response
has been that this is a voluntary plan which is in
addition to the usual case-processing system: if
defendant wants to accept the plan as laid out, that is
fine, and he will be enrolled. If not, then he can have
his case processed in the usual manner.
Q.: Problem-solving
courts are interdisciplinary and collaborative in many
other ways. There is a convergence of the medical and
legal fields, nonprofits and government, and others
involved. What are some of the challenges and rewards of
working collaboratively with practitioners from a
variety of fields?
A.: Cooperation beats every other strategy, hands down.
Our most successful
collaboration has been with a local hospital which has
set up a regular procedure for participants to visit a
doctor, have the examination, and obtain and fill the
Naltrexone prescription on an expedited basis.
Another example is sober
housing provided by Oxford House, a national
organization. We have worked with them closely and they
now have four Oxford Houses in Anchorage.
Q.: What are the greatest
rewards for you as a judge on the Wellness Court?
A.: Graduation Day is a
great reward; these are dramatic stories of lives
redeemed from the living hell of alcoholism.
When I am out in the
community, many times graduates or family of graduates
will come up to me and say "Thanks" for the
Wellness Court, and tell me how their lives have changed
for the better.
The Anchorage Wellness Court
A Few Facts
80% of crime in Alaska is linked to the consumption of
alcohol.
Cost of incarcerating one defendant for one year in
Alaska: $41,000.
Cost of treating one defendant for one year in the
Wellness Court: $5,000.
Length of Wellness Court program: 18 months.
Participating in the
Wellness court program is tougher than doing time.
Defendants must:
• Stay alcohol and drug free
• Be monitored for sobriety
• Attend treatment for their addiction
• Take Naltrexone for the first four months
• Attend a weekly group for people on Naltrexone
• Attend a weekly workbook-based cognitive
behavioral group
• Attend AA
• Appear before the judge at regular intervals
• Be rewarded or sanctioned for progress
• Be employed
• Pay restitution
• Pay most of treatment costs
Primary ethnic makeup of
Wellness Court participants: Alaska natives and
Caucasians.
The average recidivism
rate for DUI courts nationwide is 67%. In
2003, none of the graduates of the Anchorage Wellness
Court went back to their old ways of behaving.
Top
Finding
Problem-Solving Court Information Online
The Knowledge and Information Services (KIS) office at
the National Center for State Courts maintains
CourTopics, an online list of over 100 topics containing
resources related to court management. Within CourTopics
are several subtopics related to problem-solving courts.
Following is a quick "cheat sheet" to help
users navigate the problem-solving waters of CourTopics.
What
Are CourTopics?
Each
discrete CourTopic contains the following components:
• Overview-a
short description of the definitions, major issues, and
other general information about the topic
• Frequently Asked Questions (FAQs)-answers to
questions asked to KIS analysts, who provide technical
assistance to 1,200 requesters each year and track
trends, legislation, court cases, news, and other
information that affect court management
• Resource Guide-links to online publications,
NCSC Library holdings, and cites to other relevant
resources
• NCSC Documents-a central location by which
users may link to online NCSC publications on a topic,
including memoranda, Court Executive Development Program
papers, research monographs, newsletters, and tables
Many topics
contain state links. State links include state-by-state
information, including annotated links, to particular
courts and programs. The existence of state links for a
particular topic is indicated by an "S" in the
alphabetical list of CourTopics. State links are
enormously popular with our constituents, receiving the
most "hits" by far of any other type of
resource on the site.
Best
practices are incorporated into each topic. Their
existence is signified by a "B" in the
alphabetical list. Some are standalone documents; others
are included in resource guides and FAQs. The best
practices were compiled at the behest of the Best
Practices Institute at NCSC.
Problem-Solving
Courts in CourTopics
Creating a
topic for problem-solving courts was a difficult task.
Only recently have researchers attempted to uncover the
elements of problem-solving courts other than drug
courts. Moreover, problem-solving courts are by
definition multidisciplinary. See
David Rottman and Pamela Casey, Problem-Solving Courts:
Models and Trends (Williamsburg, VA: National Center for
State Courts, 2003).
There is
also the issue of crossover (or lack thereof) between
specialized and problem-solving courts. Gun
courts, for example, may be streamlined specialty courts
without therapeutic components; however, some types,
such as youth gun courts, may use a problem-solving
approach.
New types
and permutations of problem-solving courts are always
arising (for example, family drug court or teen tobacco
court). Thus, many different subcategories can be
examined when researching a particular type of
problem-solving court. The following list of subtopics
is a guide to our resources on problem-solving courts:
Specialized
and Problem-Solving Courts: http://www.ncsconline.org/wcds/Topics/topic1.asp?search_value=Specialized%20and%20Problem-Solving%20Courts.
This section serves as a catchall for therapeutic
jurisprudence as well as specific types of
problem-solving courts.
Drug Courts:
http://www.ncsconline.org/WCDS/Topics/topic1.asp?search_value=Drug%20Courts.
Family
Violence: http://www.ncsconline.org/WCDS/Topics/topic1.asp?search_value=Family%20Violence
Mental
Health: http://www.ncsconline.org/wcds/Topics/topic1.asp?search_value=Mental%20Health
Alcohol
Offenses: http://www.ncsconline.org/WCDS/Topics/topic1.asp?search_value=Alcohol%20Offenses
Submit
Your News to the Problem-Solving Reporter
The Conference of Chief Justices and the Conference of
State Court Administrators' Committee on Problem-Solving
Courts is exploring whether and how practices commonly
used in problem-solving courts (e.g., community courts,
drug courts, family courts) could be adapted for courts
more generally and what policy leaders of the state
courts could do to encourage and support adaptation
where appropriate. Some examples of these practices are
integration of treatment services with judicial case
processing, ongoing judicial intervention, close
monitoring of and immediate response to behavior,
multidisciplinary involvement, and collaboration with
community-based and government organizations. If your
jurisdiction already employs some of these principles in
a traditional court context, please let us know by
emailing us at problemsolving@ncsc.dni.us.
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