Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: This qualitative study examined the relationships between welfare reform, substance abuse, and child welfare. Under welfare reform, state and local welfare providers implemented a variety of policies that impact substance-abusing clients, including compulsory and voluntary substance abuse treatment, federal aid restrictions for convicted drug felons, work requirements, time limits, and economic sanctions for non-compliance. Because of the considerable overlap between the welfare and child welfare caseloads, these substance abuse-related policies also impact the child welfare system and the families it serves. The overall purpose was to better understand the system-level issues that posed challenges to integrating welfare, child welfare, and substance abuse treatment services at the local-level.

Methods: Qualitative methods through grounded theory were utilized to conduct semi-structured, in-depth interviews with 40 service providers from the welfare, child welfare, and substance abuse treatment systems in one California county. Interview questions were designed to elicit providers' views on substance abuse, work routines, and interagency collaborations during welfare reform. Interviews were tape-recorded, transcribed, and entered into NVivo to facilitate qualitative data analysis by organizing, searching, and coding data as well as generating theory. Coding occurred throughout the research process in an iterative process.

Results: Key findings revolve around four key themes that emerged from the interviews. First, under welfare reform, there were new or ongoing attempts at collaboration among the welfare, child welfare, and substance abuse treatment systems. Findings indicated an increase in communication among service providers in these three systems. Workers were often invited to multidisciplinary case meetings when a parent with substance abuse problems is involved in multiple service systems. Second, differences in service providers' views of addiction in their clients' lives contributed to how they worked with their clients. Welfare and child welfare workers tended to see their clients as choosing substance use as part of their lifestyle. Treatment providers, however, viewed their clients' addiction as a disease, rather than a choice. These differences in perspectives can sometimes trap substance-abusing parents at the intersection of conflicting agency policies and practices that may undermine parents' attempts at their recovery. Third, different service systems that share the same clients with substance abuse problems may use similar language, but their meanings may not be the same. This lack of shared meaning may be one of the reasons why public services for families are fragmented and why interagency collaborations are often challenging. Lastly, variation in perspectives and approaches to working with parents with substance abuse problems are influenced by different vantage points. A combination of personal and professional experiences, work responsibilities, and organizational philosophies influenced the ways that service providers worked with their clients.

Implications: Study findings provide a better awareness of some of the issues that may arise when agencies collaborate to serve families with substance abuse problems. One of our key findings related to the lack of shared meanings around substance abuse, recovery, and relapse will be helpful in improving substance abuse-related policies and cross-training in the welfare, child welfare, and substance abuse treatment systems.