Juvenile probation officers' perceptions on youth substance use varies from task-shifting to family-based contingency management

Abstract

The majority of justice-involved youth have problems with substance use, but juvenile justice agencies face numerous barriers to providing evidence-based treatments for these youth. Task-shifting is one strategy for increasing access to such treatments. That is, training juvenile probation officers (JPOs) to deliver substance use treatments, such as contingency management (CM) could improve youths' motivation and behavioral outcomes. However, probation traditionally emphasizes sanctions over incentives, so JPOs must alter their perspectives to accept protocols such as CM for substance use. Using mixed focus group and survey methods at baseline and one year later, this randomized study examined heretofore unstudied JPO perceptions during a task-shifting experiment in which JPOs were asked to start delivering CM for youth substance use, compared to a control group of JPOs who did not change their practices. At baseline, JPOs expressed a perception of hopelessness about their work with substance-using youth and their parents, but they generally held positive views toward use of tangible incentives. One year after randomization to participate in CM training and delivery, JPO perceptions changed positively about working with youth and their parents, substance use programs and resources, and whether they believed tangible incentive programs were worthwhile. Over the same time, there was a perceptual stasis in hopelessness for JPOs randomized to deliver probation services as usual, and there was degradation in their previously positive perception toward tangible incentives. The study advances thinking regarding tools that JPOs can use for working with youth and families and the role that task-shifting can play in both increasing access to evidence-based treatments and improving attitudinal outcomes of JPOs.