Research That Matters (January 17 - 20, 2008)

Purpose: A primary goal for child welfare for substance abusing families is to improve the likelihood family reunification through increasing service utilization and completion. This is especially true for substance abusing caregivers – a group that often has the lowest rates of reunification. The underlying assumption behind service utilization and completion is that this will increase the chances of recovery, decrease the continued threat of maltreatment, and thus increase the likelihood of family reunification. Such assumptions are in part supported by prior studies of substance abuse treatment and child welfare outcomes. Yet little is known about how much contribution substance abuse treatment makes to the reunification decision. Similarly, little is known about other factors that may help explain the reunification decision within the context of a substance abusing family. The current study addresses this gap in the literature. Specifically, we seek to understand the role of substance abuse treatment (participation in and completion of) in achieving family reunification.

Methods: The sample includes 269 substance abusing mothers associated with 452 children in a large and diverse public child welfare system. The data include a wide variety of child and caregiver demographics, patterns of drug use, and substance abuse treatment records. The completion of substance abuse treatment is defined as the successful termination from all required (assigned) levels of care including detoxification, residential, intensive outpatient, outpatient, recovery home, and support group. Analytic techniques include cross tabulation and Hierarchical non-Linear Modeling (HLM).

Findings: Approximately 14 % of caregivers completed the assigned treatments. The crosstab and chi-square analyses indicate that substance abuse treatment completion significantly improved the likelihood of family reunification both at the mothers' level (25.6% vs.11.3%) (X2 = 5.913, df =1, p < .05) and at the children' level (32.1% vs. 9.2%) (X2 = 30.376, df =1, p < .001). HLM analyses indicate that mothers' treatment completion increased the odds of family reunification by four times. HLM analyses also indicate that mothers' primary drug of choice, previous substance abuse treatment episode, and previous mental health treatment episode were significantly associated with the likelihood of family reunification.

Implications: Children from substance abusing caregivers are more likely to be placed in foster care and less likely to return to their biological parents as compared with children not involved in substance abusing families. The current study indicates that treatment completion is an important predictor of achieving family reunification. Another finding of interest is that despite the importance of treatment completion, approximately 86% of substance abusing caregivers did not complete treatment. This is concerning and highlights the need to continually develop innovative strategies aimed at increasing the engagement and completion of substance abuse treatment.