Capacity of juvenile probation officers in low-resourced, rural settings to deliver an evidence-based substance use intervention to adolescents.

Abstract

Substance use is a major public health problem with a host of negative outcomes. Justice-involved youth have even higher risks and lack access to evidence-based interventions, particularly in rural communities. Task-shifting, or redistribution of tasks downstream to an existing workforce with less training, may be an innovative strategy to increase access to evidence-based interventions. Initial findings are presented from a services research trial conducted primarily in rural communities in which an existing workforce, juvenile probation/parole officers (JPOs), were randomized either to learn and deliver contingency management (CM) or to continue delivering probation services as usual (PAU). This study used the prevailing version of CM for adolescents, that is, family-based with behavior modification and cognitive behavioral components. Data included JPOs’ self-reports, as well as audio-recorded youth/family sessions with JPOs rated by expert and trained observational coders. Data also included ratings from a comparison study in which therapists were trained and supervised by experts to deliver CM to justice-involved youth/families. Results showed JPOs can feasibly incorporate CM into their services. When adherence of CM JPOs was compared against CM therapists, JPOs delivered significantly more cognitive behavioral components of CM and similar levels of behavior modification components of CM. These findings suggest that JPOs can be leveraged to provide evidence-based substance use interventions like CM in similar, or even greater, capacities to clinically trained therapists. This task-shifting approach could dramatically expand service access for these high-risk youth, particularly in rural areas where substance use services are limited or nonexistent.

Redesigning Juvenile Probation to Align With Behavioral Health and Positive Development Principles: A Quasi-Experimental Study

“…In the present study, this approach was used to accommodate the still-developing capacities of adolescents to shape their behavior to achieve long-term goals by breaking tasks into short-term, weekly assignments. Our study's findings also add support to the feasibility and benefit of implementing contingency-like schedules into juvenile probation routines (Schwalbe, 2012;Sheidow et al, 2020). While other studies have found positive outcomes of implementing contingency schedules on recidivism in adult probation (Rudes et al, 2012;Trotman & Taxman, 2011), this study demonstrates the benefit of a contingency-like schedule on youth recidivism as well.…”

“…The model highlights the importance of youth experiencing success shortly after initiating probation, progress over perfection, and increased interaction with positive peer groups. Two recent studies found behavioral modification using positive reinforcement in juvenile probation was acceptable to probation officers (Rudes et al, 2021; Sheidow et al, 2020). Sheidow and colleagues (2020) found that juvenile probation officers trained in contingency management (i.e., a behavior modification approach using reinforcement principles) were able to deliver this approach as well or better than trained psychotherapists.…”

“…Two recent studies found behavioral modification using positive reinforcement in juvenile probation was acceptable to probation officers (Rudes et al, 2021; Sheidow et al, 2020). Sheidow and colleagues (2020) found that juvenile probation officers trained in contingency management (i.e., a behavior modification approach using reinforcement principles) were able to deliver this approach as well or better than trained psychotherapists. Rudes and colleagues (2021) reported that juvenile probation officers who used contingency management reported stronger relationships with youth on probation, as well as more positive perceptions and increased confidence in their work.…”

Introduction to the special issue in honor of the life and work of Dr. Nancy Petry.

“…The four articles in this section represent diverse research designs, from a randomized trial to a theoretical review. The first study (Sheidow, McCart, Chapman, & Drazdowski, 2019) randomized juvenile probation officers (JPOs) to either learn and deliver family-based CM or to continue to deliver probation as usual (PAU). Results supported the high feasibility of training JPOs to deliver CM as they showed greater implementation of CM than those assigned to PAU and comparable to (and in some comparisons better than) trained clinicians in a prior study.…”

Feasibility and acceptability of a brief suicide intervention for youth involved with the family court

“…When resources are limited, the responsibility of conducting brief interventions may be assigned to nonclinical staff (Christl et al., 2010; Sharp, Pineros, Hsu, Starks, & Sales, 2004). Often called task shifting, this practice has been used to lighten the workload of clinicians and other providers (O'Neil et al., 2019) and has recently been expanded to JJ settings (Sheidow, McCart, Chapman, & Drazdowski, 2020). It has been recommended that nonclinical staff and JJ stakeholders (e.g., probation officers, bachelor’s level social workers, legal professionals, etc.)…”