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Problem-solving courts (PSCs) operate according to the premise that participant behavior can be modified through the use of incentives and sanctions. The purpose of this study is to explore how PSC personnel perceive the implementation of sanctions, incentives, and therapeutic adjustments; team dynamics; and program success across PSC programs within one midwestern county. Approximately twenty semi-structured interviews were conducted with PSC personnel, including program coordinators, prosecutors, public defenders, probation officers, case managers, and house managers. Results suggest that most of the PSC personnel perceive a lack of incentives. More specifically, most reported more sanctions than incentives, which contradicts the National Drug Court Professionals guidelines of four incentives to every one sanction. Further, PSC personnel varied in their views regarding the effectiveness of jail sanctions, as well as in their understanding of how sanctions and therapeutic adjustments differ. Additionally, personnel believe their courts are successful, however, the definition of “success” varies depending on the personnel’s role in the court (e.g., prosecutor, house manager). Our findings underscore the importance of continually monitoring and assessing use of sanctions, incentives, and therapeutic consequences within PSCs to ensure alignment with research-informed practices.