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BACKGROUND: Probation is the most common form of community supervision in the United States and in New York City. As with all criminal legal involvement, probation disproportionately affects people with behavioral health needs. Mental health and substance use treatment are commonly included as conditions of probation. This care occurs in the community (as opposed to jails or prisons), yet most community providers who operate at the intersection of health care and legal supervision do not understand probation or the challenges and nuances of delivering services in this context.

The therapeutic alliance is one of the most robust predictors of clinical outcomes for people in behavioral health treatment; a core feature of success is that goals are mutually agreed upon rather than unilaterally imposed. Research to date indicates that even in coercive or mandated situations, a therapeutic relationship that is perceived as fair and trusting is more important for treatment engagement than the specifics of the mandate. Research has also shown that smaller probation caseloads, relevant training of probation officers, and coordination between clinicians, probation officers, and clients improves the chance that a client will successfully complete their probation sentence. However, confidentiality of the treatment process remains a central concern amongst both clients and providers, along with confusion about specific goals of treatment. A coordinated, multi-systemic, person-centered, and trauma-informed approach, informed by the perspectives of everyone involved, is clearly needed.