Purpose: Substance abusing families in the child welfare system often report co-occurring problems. Integrated service models have emerged in response to such problems. Yet, little is known about the effectiveness of these integrated services models. Do integrated models improve outcomes in child welfare? Do integrated models improve outcomes in other problem areas? The current study focuses on co-occurring problems for substance abusing caregivers involved with public child welfare. Specifically, the current study investigates the effects of matching specific services with specific needs. The purpose of this study is to determine if a match between services and needs increases the likelihood of completing substance abuse treatment for parents in child welfare.

Methods: The sample includes 607 substance abusing parents involved in public child welfare. Data on individual needs and individual services were gathered through monthly assessment completed by child welfare caseworkers. The current study focuses on the following problem areas: education, housing, family counseling, job training, mental health and parenting skills. The completion of substance abuse treatment is defined as the successful termination from all required (assigned) levels of care. Our analytic techniques include cross tabulations and Cox regression. Findings: Approximately 95% of parents reported experiencing multiple problems. The most frequently reported need involved parenting skills (89.8%), followed by family counseling (72.2%), job training (58.8%), housing (58.3%), education (48.8%) and mental health (45.1%). The crosstab and chi-square analyses indicate that unmet needs (where problems were reported and no services provided) significantly reduced the likelihood of completing substance abuse treatment. The Cox regression analyses indicate that controlling for a wide range of socio-demographic characteristics, responding to housing and mental health needs are most important. Specifically, when housing and mental health services are provided (for families with these individual problems) the odds of completing substance abuse treatment is increased by approximately five times.

Implications: Substance abusing families in child welfare are experiencing multiple problems simultaneously. The current study indicates that treatment outcomes are dependent upon a service plans that address the families wide range of problems. The current study also provides evidence that individualized treatment plans work. That is, if social services providers are interested in improving treatment outcomes, the provision of specific services must reflect the individual needs of clients. For substance abusing caregivers in child welfare, this is especially true for the areas of housing and mental health.