Programmatic, counselor, and client-level comparison of rural versus urban drug court treatment.

Despite a number of recent evaluations demonstrating the effectiveness of "drug court" programs for reducing both substance abuse and criminal behavior, some authors have recently called for more thorough process evaluations (inside the "black box" of treatment) of these programs. Specifically, this article describes the need for thorough process evaluation to examine differences in program implementation across rural and urban drug courts. The delivery of substance-user treatment and allied social services is examined in a sample of four adult drug courts (two urban and two rural), using a direct observation methodology, as well as traditional surveys and interviews of treatment staff and administrators. Results reveal that there are, in fact, differences in implementation, and staff and client characteristics between courts in each type of geographic region and suggest that these differences may impact the effectiveness of the court programs in meeting their goals of reduced substance use and criminal behavior.