This brief highlights common themes regarding treatment trajectories among participants in the Tompkins County Family Treatment Court and describes their feedback for the program.

1. RESEARCH BRIEF SERIES
Tompkins County Family Treatment Court
Participant Trajectories and Feedback Opioids and Family Life Project
EXECUTIVE SUMMARY
The Tompkins Family Treatment Court (FTC) provides assessment, referrals to services, and ongoing
monitoring for families involved in neglect proceedings related to parental substance misuse. Researchers
from the Cornell Project 2Gen Opioids and Family Life Project interviewed 21 current and former
participants (15 women and six men) to learn about their experiences. This brief highlights common themes
regarding treatment trajectories and offers feedback for the program. Key findings include:
• Respondents found initial involvement with Family Treatment Court uniquely challenging because it
required adjusting to much more structure in their lives, often while going through withdrawal.
• Respondents’ program adherence and attitudes toward Court staff generally improved as they
progressed through the program. Many expressed that full program benefits could only be realized
with participant buy-in.
• Respondents expressed frustration when progress did not feel like a fair or accurate representation
of effort. However, many ultimately believed the Court had acted in their best interests and with
attention to their unique circumstances, and the vast majority felt the program had been worth it.
• Respondents generally preferred Cayuga Addiction and Recovery Services (CARS) for outpatient
treatment. They described CARS as supportive, effective, and better staffed than the alternative, the
Alcohol and Drug Council (ADC). Most ADC participants gave negative reviews.
• Substance misuse treatment taught respondents to be mindful of the people, places, and things they
associated substance misuse. Sometimes Court requirements, like attending group meetings, meant
contact with these triggers.
• Respondents liked working with service providers who had personal experience with addiction. They
believed providers without personal experience were ineffective and lacked empathy. They wanted
the Court to be more affirmative, especially of small and partial successes.
• Respondents benefited from the Court’s relationships with other providers, but also observed ways
greater coordination could improve service delivery.
• The Court could do more to prepare participants for the unique challenges of parenting after
regaining custody.
• The Court could to more to help participants understand and navigate employment challenges
associated with neglect charges.
• The Court should consider how alternative approaches—like the virtual sessions it is offering due to
the coronavirus pandemic—can continue to promote confidentiality and accessibility going forward.

2. PARTICIPANT TRAJECTORIES
Before beginning with Family Treatment Court, participants knew little about it. While most agreed the
Court’s expectations were generally clear1
, one respondent encouraged the program to do more to orient
participants at the very beginning. Specifically, they suggested the Court provide a comprehensive welcome
packet and walk participants through it:
“When you sign into Family Treatment Court I think you should get a packet that has a directory of
everybody's phone number, free food pantries, AA groups, a Court calendar. I think it should have all
your steps in it. Like altogether. [And] other resources, because a lot of people don't really know
about a lot of resources in our county . . . And I think that [they] should . . . do an orientation kind of
thing where they would give this packet out and explain all the rules of what's expected.”
An orientation packet and walk-through might help participants better navigate initial program involvement,
which several respondents identified as the most difficult part of their Court experience. They found the
period uniquely challenging because it required adjusting to significantly more structure in their lives, often
while going through withdrawal. In the words of one respondent:
“The beginning . . . that was the hardest. It's hard to keep hope when you don't know what – when
it's so open-ended, whether – whether and when you're gonna get your kids back. It's hard to wanna
keep working toward that when you don't feel like you're making any concrete progress . . . And
that's also the foggiest time, because it's a drug fog in your brain. And that's also when they keep you
the busiest and have the highest expectations and the most pressure to put on you to be where
you're supposed to be at the right times and such . . . You've been out fucking off forever. Like, you're
not used to having to be at day reporting by 8:30. So that – that was really hard.”
Early program adherence was shaped by these challenges, and frequently characterized by resistance and
resentment. As one participant remembered, “I was angry. I was very angry and very stubborn and in
denial.” With time, most participants demonstrated greater program adherence, though with varying
degrees of enthusiasm. Some actively embraced the Court’s philosophy: “Family Treatment Court is a guide
to how to live your life, a clean, sober life. It really is. It teaches you the aspects of it all. I hear people talk
shit about the program all the time and about the people, and I used to be one of those people . . . until it all
clicked in my head.” Others were less enthusiastic, but realized compliance was required to progress: “Bite
down and bear it, and do what you got to do to get through the program . . . If you're going to fight with
them, it's going to take you years.”
Some participants expressed frustration that greater compliance did not always translate to faster progress
because of milestone waiting periods. One respondent recalled, “I'd be done with a milestone, I'd have
everything on the checklist done and they were like, well, they don't want you to move any faster than a
month so we gotta wait another week or two... That wasn't okay with me.” Another agreed, “They'd be like,
well, you need to wait. It hasn't been 60 days yet. I'm like I don't care. I've already completed everything.”
But, this respondent was not unequivocally negative; they also noted that milestones “gave you enough
time to get everything done.” Another respondent reflected similar ambivalence, specifically about certain
hard-to-quantify requirements the Court had for participants to progress between milestones:
“I like clear guidelines . . . It was really hard for me to be like, ‘What the [explicative] else do you want
me to do?’ . . . [But] it’s a hard balance . . . it’s not just the checking off the box of each thing, but
there has to be a change in thinking . . . They can’t write that in a pamphlet.”
1
This is discussed further under “Transparency” in the companion brief, “Family Treatment Court: Trauma-Informed Care.”

3. While respondents agreed compliance with Court milestones was necessary to progress through the
program, many did not believe it was sufficient, at least not for participants to reap full benefits. That, they
felt, required buy-in:
“You get what you put in. You really do. If you don't want the recovery, you're not gonna get it, and
that's what Family Treatment Court needs to understand.”
“Family Treatment [Court] is a really good program, I think. They have a lot of things. If you don't ask
for these things . . . then I feel like you won't like the program. But if you sit there and you actually
open yourself up and say, ‘Hey, I need help with this,’ or, ‘I need help with that,’ they will help you.”
“When they put me in Family Treatment Court, I was good and ready . . . So I think that that's why
some people are successful and some people aren't. And I think that that's why I've done well so far.”
Like program adherence and buy-in, feelings toward Court staff tended to improve as participants
progressed. Many expressed gratitude for how much they ultimately felt the Court Coordinator Mindy
Thomas and Judge John Rowley cared. For example, one participant reflected that they “really hated [Mindy]
at first,” but, when asked about the most helpful or supportive part of the experience, described her as “an
asset” who “really holds the program together.” Another remembered how “When [Judge Rowley] would
come to court, I feel like I wasn't just a case number to him. I feel like he really took into consideration . . . all
the aspects that went into what I was dealing with.” One likened their evolving feelings to a parent-child
relationship: “At the end, you look at it almost like when you grew up. Like, you should have listened to your
parents . . . If you actually listen to Family Treatment Court and do it, you're gonna feel great in the end.”
Ultimately, the vast majority of respondents—including several who offered constructive criticisms of the
Court—felt going through the program had been worth it. A participant who did not complete the program,
and was still separated from their children at the time of the interview, was the only respondent to report it
lacked any value. Another two respondents valued the program for facilitating reunions with their children,
but believed it harmed them in other ways. Specifically, one was deeply affected by the program’s decision
to delay their graduation: “I feel like they’re contradicting what they stand for by keeping me in and
struggling.” The other resented that a neglect charge they were “made to feel . . . [they] had to [accept] or
else,” despite believing it unwarranted, limited their career prospects. The rest of respondents were
unequivocal about the program’s value. Several reflected they might not even be alive, let alone reunited
with their children, were it not for the Court’s services.
TREATMENT AND RECOVERY
Outpatient treatment for substance misuse was a major component of most participants’ Family Treatment
Court experiences. Cayuga Addiction and Recovery Services (CARS) participants described the program as
supportive, effective, and better staffed than the alternative, the Alcohol and Drug Council (ADC).
Meanwhile, most ADC participants gave negative reviews. For example, one described the experience as
“nasty.” Another noted:
“I don't recommend ADC. There is nice people there and all, but like they just put you in a group and
kind of forget about you . . . [A]nd then [they] got – tried to get me into a rehab, and then they finally
got me into one, [but] I ended up having to get myself there. It was a joke.”
In contrast, this same participant “really highly recommend[ed]” CARS, though they added that “it sucks they
don't have a detox department.” Another participant with experience in both programs liked that CARS was
longer: “It wasn't just, ‘Oh, you're in, you're out.’ No. They really worked with you with your problems.”

4. Participants also distinguished between aspects of treatment within each program. For example, one
participant called the suboxone group she participated in at ADC “so stupid . . . the most worthless group
ever,” but credited her ADC counselor, along with Alcoholics Anonymous, for helping her cope when she was
struggling the most. Similar positive feelings about individual counselors and one-on-one treatment were
common, while experiences with group treatment were more mixed. Some participants liked group
meetings, while others thought they were a waste of time. Proximity to fellow former users was a common
complaint among group treatment critics. One respondent reflected:
“We’re all downtown at the same damn time every single day and having to go to meetings . . . I get
that there's probably no way to separate us like that. But . . . putting somebody's problems with
other people's problems expecting them to get clean . . . you gotta have a really high mentality and
really focus to actually do that I feel like. It's a problem . . . I don't think it's good or healthy.”
Participants also shared that FTC programming sometimes required spending time in places and around
things they found triggering. For example, one participant described the challenge of waiting for the bus
downtown, a former “using ground,” following check ins at the courthouse. Another reflected on treatment
group discussions: “[W]hen you're sitting there and you're talking about your issues, and you're talking
about all these drugs, and all this drug use, it's like . . . ‘I don't wanna talk about it because then I'll think
about it.’”
In addition to individual and group outpatient treatment, some participants also spent time at inpatient
facilities. Frequently, these stays were turning points. Multiple respondents believed FTC should move more
quickly to get those struggling with sobriety into rehab to help them progress more quickly and reunite with
their children:
“I struggled through seven months before I got my crap together . . . If you can't start peeing clean
within the first four weeks I think it should be automatic rehab. Be able to help people get through
the program a lot faster, and hopefully wizen them up quicker.”
“[S]end them to rehab in the beginning. How about that? . . . So that month that I wasn't able to see
[my son], how about you could have been like, ‘Go into a rehab for a month and get clean, and then
you can go right into having your kid full-time or more than two hours for two days a week’?”
With substance misuse treatment, and with Court programming more broadly, participants liked working
with service providers who had personal experience with addiction. For example, one participant reflected
on their time in outpatient:
“I definitely felt like they weren't judgmental . . . A lot of the people there were recovering addicts,
which makes so much sense . . . It feels a lot better to talk to somebody who knows what I'm going
through versus somebody who read a book.”
Another added, “Knowing the people that work at FTC are in recovery themselves, that they know to some
extent how your mind's working, that helped.” Providers without personal experience, in contrast, were
often seen as ineffective and lacking empathy. For example, one respondent described a frustrating
outpatient experience:
“I don't think that the counselors really knew what they were talking about all the time. I feel like if
they had family members that had been through it, they would know more. I could probably go there
and teach better than they can.”

5. A few respondents offered similar, though milder, critiques of the Court. For example, one shared, “I feel like
sometimes they don't give you the credit that you deserve . . . I do think it's because some of them haven't
been ex-users, so they don't know how hard it truly is.” This respondent went on to suggest the Court should
be more affirmative, especially of small and partial successes:
“When you go in there, and you've done three out of the five things that they want, and they're just
ragging on about the two things that you didn't do, it's like, ‘Okay, but look at what I did do this
week.’ And this is also going on in my life, and that's going on in my life, like, I achieved more than
half. And I deserve that credit for that half. And they don't necessarily do that.”
Another reflected that emotional support from the Court was important given “a lot of people don't have
family to go through [the challenges of recovery with].” This respondent felt being more affirmative was
“the only thing” FTC could do better.
OTHER FEEDBACK AND SUGGESTIONS2
Respondents benefited from the Family Treatment Court’s relationships with other service providers and
recognized the Court’s location in resource-rich Tompkins County as an asset. For example, two respondents
reported Court involvement helped them secure housing more quickly, while another believed FTC’s
reputation influenced a local criminal court to put them on probation instead of in jail. Another reflected, “I
don’t think Family Treatment Court will work as well in other areas, not for any other reason but the lack of
resources that are in those communities.” And, as mentioned above, one respondent encouraged the Court
to compile a resource directory for participants to receive at the beginning of the program.
However, respondents also saw room for more coordination between service providers. For example, while
one respondent felt the Court did a “really good” job of “guiding people to CARS or . . . to ADC,” another felt
Family Treatment Court and CARS needed more of “a direct connect” to get participants into treatment
faster. They reported, “It's so hard to get into a rehab. It's hard. Even when you're mandated.”
Respondents felt that services for children would also benefit from greater coordination. For example, one
reflected that “DSS is definitely not on the same page as Family Treatment Court. They will tell people one
thing and then they do another.” Another felt providers should do more to coordinate their communications
with the different adults in children’s lives:
“I think Family Treatment Court can definitely benefit by the law guardians, CPS, and all the workers
not talking to parents and guardians separately. So everybody is on the same page. I don't think it's a
good idea to go to the grandparent or the foster parent, have a conversation with them, and then
have a conversation with the parent. Because I feel like even if they are saying the same thing the
perception can be totally different. And then that causes a lot of conflict.”
As described in Project 2Gen’s “Parenting Experiences and Parenting Education” Family Treatment Court
brief, co-parenting with relatives or resource families was a common challenge, and many respondents
continued to experience parenting challenges after regaining full custody of their children. Specifically,
parents frequently felt separation had undermined their authority. They struggled to reestablish routines
and to provide appropriate structure. Sometimes, feelings of guilt appeared to motivate permissive
parenting choices. No current FTC programs adequately prepare parents for the unique challenges of post-
separation parenting. We encourage the Court to explore ways to help families rise to these challenges.
2
See the companion brief, “Family Treatment Court: Trauma-Informed Care,” for additional feedback and suggestions.

6. The Court could to more to help participants understand and navigate they employment challenges their
neglect charges pose. For example, one respondent expressed frustration that she “was never told at the
beginning” that her neglect charge “would prevent [her] from getting a job at a school or getting a job at a
retirement home or a nursing home.” Another believed FTC should help qualified participants clear or seal
their charges: “You shouldn’t have to go out on your own and do that.”
Finally, respondents strongly disliked the weekly Family Treatment Court sessions held in downtown Ithaca
prior to the coronavirus pandemic; they felt the public proceedings were inappropriate and frequently
humiliating. Several noted that the sessions, along with FTC’s many other requirements, also posed
scheduling and transportation challenges, especially for participants living outside of Ithaca. The Court
should consider how alternative approaches—like the virtual sessions it has started offering due to the
pandemic3
—can promote confidentiality and accessibility going forward.
3
Project 2Gen Opioid and Family Life Project researchers finished conducting interviews before the Court introduced virtual
sessions, so we cannot speak directly to whether they better meet participants’ needs. We encourage the Court to seek
participant feedback on the new approach.