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Drug courts have been recognized and empirically supported as an effective means of reducing recidivism and use of substances for both juveniles and adults. The paper reports the results of an outcome evaluation of a juvenile drug court in the Upper Cumberland area of Middle Tennessee. As with previous studies, the program showed impressive outcomes for many juveniles. Improvements, however, may be possible. Adding a residential component similar to the one for adults currently operated by the Davidson County Drug Court might enhance program retention, provide housing opportunities during treatment for neglected and abused youth, and offer opportunities for more regular and intensive supervision of specific juveniles. Such programs would likely be both practical and fundable, and should be considered by courts and treatment providers. (Contains 1 table.)

This paper explores historical and recent trends in the delivery of residential adolescent substance abuse treatment, looking specifically at the impact of managed care on the service delivery system. Three historical eras are conceptualized by the authors: (1) an era prior to managed care in which services were provided on a fee for service basis by health insurance companies and lengths of stay were relatively longer; (2) an era of managed care in which services were funded through managed care organizations and lengths of stay were significantly reduced; and (3) the current era in which residential services are provided through self-pay and through other service systems. Awareness of these changes is important for all practitioners who provide services to adolescents and demonstrate the need to advocates for residential substance abuse services for all adolescents.