Program Profile: Probation Case Management for Women Charged With Drug-Involved Offenses (San Francisco, Calif.)

This intervention for drug-involved females who have been convicted of an offense incorporated elements of substance abuse treatment, intensive supervision probation, and case management. The program is rated Ineffective. There were no statistically significant differences between the probation case management group and the standard probation group on measures of incarceration rates, substance abuse, psychiatric symptoms, or service use at the 12-month follow up.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s).

Program Goals/Target Population

Probation Case Management (PCM) was a case management intervention that provided customized services for drug-involved women who were convicted of an offense. The PCM model incorporated elements of substance abuse treatment, intensive supervision probation (ISP), and case management. The goal of PCM was to improve services for drug-involved females who were convicted of an offense by providing treatment and related services as a means to reduce drug use, criminal recidivism, and incarceration of persons on probation.

Key Personnel

The PCM model was part of the San Francisco (Calif.) Network Project, which operated from 1995 to 2001. This project was designed to address the health and social needs of drug-involved women who have been convicted of an offense by providing case management services to them and creating a relationship between the Probation Department and community services. The PCM model required recruitment and training of probation officers at the San Francisco Adult Probation Department to serve as case managers for substance abusing female clients. Probation officers still retained the responsibility of probation supervision of clients while they provided additional case management services. Case managers were also clinically supervised by an outside consultant. In the first 2 years of the project, case managers were supervised weekly, then biweekly in the 3rd year, and monthly in the 4th year.

Program Components

PCM case managers performed therapeutic and advocacy activities as well as case management activities for their clients. Therapeutic and advocacy activities included providing clients with gender-specific education about addiction, offering additional counseling for clients, and being more accessible to clients by phone and in person. Case management activities included attending treatment planning meetings at the client’s treatment program, going to court or to the housing authority with clients, making home visits, and attending medical appointments with clients.

PCM differs from standard probation in a number of ways. First, the caseload of case managers was restricted to no more than 50 clients at any time. Decreasing the caseload was designed to increase the frequency and length of client visits. Case managers maintained contact with their clients at least twice a month through field visits, through office appointments, or by phone. Second, case managers used a uniform client screening and assessment procedure. This ensured that the drug-involved clients were matched to their appropriate need for substance abuse treatment.

Finally, clients were provided with referrals to needed services. Case managers used referral resources, such as health and mental health services, child care and child reunification services, educational and employment counseling, and assistance with housing needs. The extent to which a case manager used the referral resources was dependent upon their individual approach with each client.

Study

Chan and colleagues (2005) employed a quasi-experimental design to compare the outcome of drug-involved women who were assigned either to probation case management (PCM) or to standard probation, based on availability of case management services (i.e., as long as slots were available for PCM, eligible participants were assigned to receive PCM). Women were recruited between June 1997 to February 1998 and were eligible to participate in the study if they:

• Were residents of the City and County of San Francisco, Calif.
• Were 18 years of age or older
• Had a substance abuse problem
• Were involved in the criminal justice system (either incarcerated, presentence, or on probation/parole)

Women also had to show a willingness to participate in PCM and substance abuse treatment. Women were excluded if they were currently involved in a drug court or were court-ordered to receive PCM services. This exclusion criterion was necessary to ensure that all eligible women had an equal probability of being assigned to either probation condition, based only on availability of PCM slots; women who were court-ordered were excluded because they had no probability of assignment to standard probation.

Eligible women were placed into the PCM treatment group until all slots were filled (n=65). Women who met eligibility had the choice of entering the study in the comparison condition (n=44) and could receive PCM services on completion of the 12-month follow-up study interview. The treatment group members had an average age of 31.8 years, and were 60 percent African American, 32 percent white, 3 percent Hispanic, and 5 percent “other.” The comparison group members had an average age of 33 years, and were 66 percent African American, 14 percent white, 9 percent Hispanic, 5 percent Asian, and 7 percent “other.” There were no statistically significant differences between the groups on age, education, major drug problem, or history of incarceration. Treatment group members were more often white, more often reported a history of injection drug use, were more likely to be on probation or parole, and had a higher number of prior drug treatment episodes.

The outcome measures of interest included scores on the Addiction Severity Index (ASI), the Beck Depression Inventory (BDI), the Brief Symptom Inventory (BSI), the Social Support Evaluation List, and a questionnaire developed for the study that measured women’s needs. The ASI composite score measured the problem severity in seven areas (medical, employment, legal, alcohol, drug, social, and psychological) over the previous 30 days. The BDI and BSI measured depression and psychiatric symptoms, respectively, in the past 7 days. The Social Support Evaluation List asked questions about self-esteem, emotional support, and social interactions. The women’s need questionnaire was designed to address gender-specific problems, such as child custody issues. Data was collected from study participants at baseline and at 6-month and 12-month follow-up periods.

Change over time in the outcome scores was assessed within and between groups using generalized estimating equation (GEE) and mixed effects regression. The GEE analyses were applied to ASI scores, because outcome measures were dichotomized, and showed the probability of having a high versus a low ASI score. The mixed effects regression analyses were used for the BDI, BSI, and Social Support scores because they were continuous outcome measures. In the analysis of each outcome, time was treated categorically and included main effects for group (PCM versus standard probation); time (baseline, 6-month follow-up, and 12-month follow-up); and group by time interaction.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Chan, Monica, Martha A. Jessup, Rosemary Prem, T. Revels, and Jospeh Guydish. 2002. Case Management Process Evaluation Report. The San Francisco Women’s Network. Project Evaluation Report No. 7. San Francisco, Calif.: University of San Francisco, Institute for Health Policy Studies.

Guydish, Joseph, Monica Chan, Alan Bostrom, Martha A. Jessup, Thomas B. Davis, and Cheryl Marsh. 2011. “A Randomized Trial of Probation Case Management for Drug-Involved Women Offenders.” Crime & Delinquency 57(2):167–98. (This study was reviewed but did not meet CrimeSolutions criteria for inclusion in the overall program rating.)

Following are CrimeSolutions-rated programs that are related to this practice:

Rehabilitation Programs for Adults Convicted of a Crime

This practice includes programs that are designed to reduce recidivism among adults by improving their behaviors, skills, mental health, social functioning, and access to education and employment. They may become participants in rehabilitation programs during multiple points in their involvement with the criminal justice system. This practice is rated Promising for reducing recidivism among adults who have been convicted of an offense.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?