Teen Success Project (JPO-CM)

Improving Access to Substance Abuse Evidence-Based Practices for Youth in the Justice System: Strategies Used by JPOs

The purpose of this study is to examine the effectiveness of Juvenile Probation Officers (JPOs) delivering Contingency Management (CM) to teens on their caseload who have problems with drug use. CM has already been shown to be effective at helping teens with drug problems but CM has never been delivered by JPOs. This study will test how well it works to have JPOs deliver CM during their regular meetings with teens.

The overarching purpose of this study is to increase justice-involved youths' access to an evidence-based practice for substance abuse, specifically Contingency Management (CM). This randomized controlled trial will examine the effectiveness of using juvenile probation officers (JPOs) to deliver CM to youth (aged 12-17 years) on their caseloads. CM is an evidence-based practice for substance abuse. The Investigators posit that JPOs are in an ideal position to deliver an evidence-based practice such as CM to youth because of their intensive involvement and frequent contact with the youth offenders under their supervision. The study randomizes 36 JPOs to 2 conditions: CM versus control (usual JPO services), and then randomizes 504 drug-abusing adolescent probationers across those 2 conditions. The research team will work with JPOs employed by the Department of Youth Services (DYS) in various counties in Oregon. JPOs will participate in focus groups and research interviews and will submit monthly audio-tapes of sessions with participating youth. JPOs randomized to the CM condition will receive training in how to deliver CM. As stated, participating youth will also be randomized to CM or control and assigned to a JPO in the same condition. For those in the CM group, the delivery of CM will be added to their regular meetings with their JPO. Research data will be collected from families via audio-taped interviews and questionnaires from youth and one caretaker. Urine samples for drug testing will also be collected from youth. Lastly, arrest records will be collected on youth for the 18 months pre- and post-entry into the study. The study involves 2 types of participants: youth (n=504) and juvenile probation officers (n=36), for a total of 540 anticipated participants.

This group will receive regular probation services but will also receive the Contingency Management program for substance abuse from their juvenile probation officer during regular meetings.

Contingency Management (CM) utilizes behavior modification & cognitive behavioral strategies to target adolescent alcohol or other drug (AOD) use. Protocol components are as follows: (a) The provider introduces CM to the family and engages them in the intervention; (b) The provider conducts Antecedent-Behavior-Consequence (ABC) assessments of the youth's AOD use with the youth and caregiver; (c) Based on the results of the ABC assessments, self-management planning and drug refusal skills training are implemented by the provider in collaboration with the caregiver; (d) Concurrently, a point and level system contract is filled in by the family, which provides rewards/privileges for negative drug and alcohol tests and disincentives (e.g., extra chores) for positive tests. Until continued abstinence is achieved, components "b" through "d" are repeated; (e) The provider collaborates with the family to develop plans for sustaining long-term abstinence. Typical duration of CM is 12-16 weeks.

Standard services that a young person would receive while under probation supervision in the state of Oregon.

Changes from Baseline scores compared to 9 months post-Baseline Urine Drug Screens (measured at 0, 3, 6 and 9 months).

The number of positive drug screens from toxicology testing for tetrahydrocannabinol (THC), synthetic THC, amphetamines, methamphetamines, opiates, phencyclidine (PCP), cocaine, benzodiazepines and alcohol metabolites (Ethyl glucuronide, Ethyl sulfate ).

Changes from Baseline scores compared to 9 months post-Baseline Substance Use and Problems (measured at 0, 3, 6 and 9 months).

Frequency of substance use and substance-related problems self-reported on the Global Appraisal of Individual Needs.

Changes in number and severity of criminal charges in official records in the 18 months pre-Baseline compared with 18 months post-Baseline.

Changes from 18 months pre-Baseline in offending, measured in the number and severity of offenses in official arrest records compared to 18 months post-Baseline.

Changes from Baseline scores compared to 9 months post-Baseline Delinquent Behaviors (measured at 0, 3, 6 and 9 months).

Changes from Baseline scores compared to 9 months post-Baseline Sexual Risk Behaviors (measured at 0, 3, 6 and 9 months).

Changes from Baseline scores compared to 9 months post-BaselineTreatment Usage (measured at 0, 3, 6 and 9 months).

The number of courses of in-patient and out-patient treatment obtained by youth for substance abuse as measured by the Structured Adolescent Interview (conducted with youth and caregiver together).

Changes from Baseline scores compared to 9 months post-Baseline Internalizing and Externalizing Behaviors (measured at 0, 3, 6 and 9 months).

The frequency of youth's internalizing and externalizing behaviors as measured using the Brief Problem Checklist (self- and parent-report).

Changes from Baseline scores compared to 31 months post-Baseline Contingency Management (CM) Adherence (measured monthly for 31 months).

Adherence to CM practices by juvenile probation officers as measured using the CM-Therapist Adherence Measure (CM-TAM) (Self-report version, Tape Coding version and Youth/Caregiver versions).

Changes from Baseline in Training Needs and Training Satisfaction scores compared to 31 months post-Baseline (measured at 0,16 and 31 months).

Scores in training needs and training satisfaction as measured by the Organizational Readiness for Change-Criminal Justice Version (completed by participating juvenile probation officers).

Changes from Baseline in attitudes towards using rewards in substance abuse treatment compared to 31 months post-Baseline (measured at 0,16 and 31 months).

Ratings on attitudes towards using rewards in substance use treatment as measured by the Provider Survey of Incentives (completed by participating juvenile probation officers).

Changes from Baseline in attitudes towards Contingency Management (CM) compared to 31 months post-Baseline (measured at 0,16 and 31 months).

Ratings on attitudes towards Contingency Management as measured by qualitative ratings of audio-taped and transcribed focus groups (focus groups involve participating juvenile probation officers).

There are 2 types of participants in this study: youth and juvenile probation officers. Inclusion Criteria for youth: Newly opened probation case (can have previous cases) 12-17 years old Diagnostic and Statistical Manual-5 (DSM-5) substance use disorder Exclusion Criteria for youth: Pervasive developmental disorder Active psychotic disorder Severe/profound mental retardation Inclusion Criteria for juvenile probation officers: Employed as a juvenile probation officer with the Department of Youth Services in a participating county in Oregon Serving clients aged 12-17 years old with a substance abuse problem Exclusion Criteria for juvenile probation officers: Not employed as a juvenile probation officer with the Department of Youth Services in a participating county in Oregon Not serving clients aged 12-17 years old with a substance abuse problem