Bridging Disciplinary Boundaries (January 11 - 14, 2007)

The complex nature of substance abuse problems and the overwhelming burden of caseloads with substance abuse problems in child welfare contributed to the growing interests in the potential benefits of using additional case management in child welfare. While caseloads related to parental substance abuse are growing, caseworkers suffer from insufficient expertise in substance abuse, and lack of training in identifying and addressing substance abuse problems. To respond this complex problem more effectively, case management with a substance abuse background has been proposed in various child welfare settings. However, the evaluation of such attempts is in its initial stages in child welfare. The current study focuses on service utilization for substance abusing caregivers involved with public child welfare. Specifically, the current study investigates the effects of the use of the additional case management (called Recovery Coaches). The purpose of this study is to examine the efficacy of Recovery Coaches in improving the overall child welfare service and substance abuse treatment utilizations for substance abusing families in child welfare.

The sample includes 457 female substance abusing mothers who were enrolled in the Illinois Title IV-E Waiver Demonstration. Mothers were randomly assigned to either a control (n=122) and experimental (n=355) group. Mothers in the experimental group received the services of a Recovery Coach. The Recovery Coaches assist mothers with obtaining needed services. The current study focuses on the following service areas: education, legal, housing, family counseling, job training, mental health, domestic violence counseling, parenting skills, and substance abuse treatment. The analytic techniques include cross tabulations and logistic regression. In addition to intent-to treat (ITT) approach, this study also utilizes treatment-on-the-treated (TOT) analysis using Propensity Score Matching (PSM). This TOT approach focuses on the non-random sample set of mothers who are highly exposed to Recovery Coaches. PSM allows me to restore some of statistical equivalence that is sacrificed by comparing control cases to only experimental case highly exposed to Recovery Coaches.

Bivariate analyses indicated that mothers in the experimental group were more likely to receive needed legal services (45.2% vs. 25.0%) (X2 = 3.317, df =1, p < .1). Unexpectedly, mothers in the control group were more likely to receive transportation services (69.4% vs. 53.6%) (X2 = 3.943, df =1, p < .05). Despite the statistical insignificance, mothers in the experimental group were more likely to receive needed services in housing, education, parenting, family counseling, childcare, mental health, and AODA services. The results of logistic regression analyses indicated that mothers in the experimental group were more likely to receive legal services controlling for mothers' characteristics and drug use patterns. The results from TOT analysis using PSM matching indicated that mothers with highly exposed to Recovery Coaches were more likely to receive services in family counseling and AODA.

Using an experimental design as well as TOT analysis, the current study indicates that the use of Recovery Coaches in child welfare improved the service utilizations, especially in legal, family counseling and substance abuse treatment services. The implications of these findings for substance abusing mothers are discussed.