BACKGROUND: Probation is the most common form of correctional supervision in the United States and in New York City. As for all criminal justice involvement, probation disproportionately affects people with behavioral health needs. Mental health and substance use treatment or monitoring are commonly included as conditions of probation. Health care for people on probation occurs in the community (as opposed to jails or prisons), yet most community providers who operate at the intersection of clinical 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, with a core feature of success 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 core concern amongst both clients and providers, along with confusion about specific goals of treatment. A coordinated, person-centered, and trauma-informed approach, informed by the perspectives of everyone involved, is clearly needed.