By Jean Rhodes
In a recent publication, Sam McQuillin and colleagues discuss two concepts that should become household words in mentoring: task-shifting and Just-in-Time Training (JITT). Together, they could help bridge the gap between the demand for and supply of effective mental health and educational services, especially in low-resource communities.
Neither are new concepts. In fact, task-shifting has roots that stretch back to the 1960s. It involves redistributing tasks typically performed by highly trained professionals to volunteers and others who, with training and supervision, can provide evidence-based care. This approach has seen success in various global health crises, notably in the treatment of HIV/AIDS in sub-Saharan Africa, where it has significantly increased access to care. As well as in mentoring where trained paraprofessionals have proven to be effective in providing trauma-informed care. Indeed, decades of research have shown that, with the right training and support, volunteer and paid mentors and other paraprofessionals can deliver interventions just as effectively as professionals—if not more so. This is important given that less than a third of children and adolescents who need mental health and related care actually receive any services–and most of the services they do receive are not empirically supported.
The second big idea is Just-in-Time Training (JITT), which can be traced to the efficiency-driven manufacturing floors of the 1950s. JITT is an on-demand, efficient training method that provides individuals with the necessary skills precisely when they are needed. This method contrasts to the traditional, often inefficient “Just-In-Case” or nice-to-have mentor training which front loads a grab bag of ideas into pre-match trainings on the off chance they might be needed. At the heart of JiTT lies a feedback loop. Mentors complete brief (often asynchronous online) trainings, quizzes, and etc. which can prime them for nuanced, personalized discussions and problem-solving with their supervisors. Recent research shows that quizzes are more effective than rote memory because they lead the learner to activate retrieval processes. JITT methods are built on body of research including the National Research Council’s seminal work, “How People Learn.” The best learning environments, they note, are assessment-centered, and provide students with immediate feedback that allows them to adjust their thinking just before they need to apply it. For those intrigued by the promise of JiTT, a wealth of resources and examples are available on the Just-in-Time Teaching website, and MentorPRO Academy, which is built on the idea of providing specialized trainings to suit specific needs and goals of entors.
The synergy of task-shifting and JITT could be a game-changer for expanding and strengthening the number of mentors who are capable of providing services to children and adolescents. Indeed, McQuillin et al., have already successfully shifted counseling and academic support services to paraprofessional mentors in a school-based mentoring program for middle school students in low-resource urban environments and have forthcoming evidence for JITT videos about motivational interviewing for youth mentors (Hart et al., in preparation). . As McQuillin et al note, their goal for task-shifting is not to “replicate all of the practices of professional providers, which are often eclectic and not well-specified. Rather, we hoped to target the functions of their services related to motivating students to succeed in school and assisting students with executive functioning tasks..” As they note, ethical and practical considerations must be carefully weighed, and there is apressing need to expand the science of JITT and to anticipate how these strategies will function in the context of often rigid mental health service systems.
There’s also a pressing need to design better, bite-sized trainings that are dynamic and engaging and can hold the attention of today’s learners. But as mentoring programs struggle to deliver evidence-based services, the integration of task-shifting and JITT offers a beacon of hope. It promises a more adaptable, efficient, and scalable model of service delivery that could significantly expand and improve the quality of services for the nation’s youth.