Increasing Access and Providing Comprehensive Social Services to Promote Substance Abuse Treatment Completion for Mothers in Child Welfare

Background and Purpose: Substance-abusing families in child welfare often experience co-occurring problems. Comprehensive service strategies have emerged in response to such problems. Although prior research suggests that a comprehensive service response to clients' multiple needs improves various treatment outcomes, little is known about the effectiveness of such approaches on treatment completion for mothers in child welfare. In particular, we do not know yet what components of comprehensive services improve the likelihood of treatment completion. The purpose of this study is to understand the relation between the use of access services, concrete services, counseling services and the likelihood of treatment completion for mothers in child welfare. Specifically, this study attempted to answer the following research question: What is the impact of access services, matched counseling services and matched concrete services on the likelihood of treatment completion?

Methods: The sample includes 269 substance-abusing mothers in child welfare. Data on individual needs and services were gathered through quarterly assessments completed by child welfare caseworkers, and data on treatment completion were measured by substance abuse treatment providers. The completion of substance abuse treatment in this study was defined as the successful termination from all assigned levels of care, including detoxification, residential, intensive outpatient, outpatient, recovery home and support group. This study conceptualized comprehensive services as the provision of access services, matched counseling services and matched concrete services. Access services include services in transportation and child care. Counseling services include services in family counseling, domestic violence counseling, mental health counseling and substance abuse treatment counseling. Services in housing, legal, job training, parenting and education were categorized as concrete services. To measure matched services, this study used the ratio between a total number of services needed (as assessed by service providers) and a total number of services received. Analytic techniques include bivariate analyses and a series of regressions (both linear and logistic) to test a path model.

Results: Approximately 95% of mothers reported experiencing multiple problems. The regression analyses indicated that controlling for a wide range of socio-demographic characteristics and drug use patterns, access services (β = 3.995), counseling services (β = 3.690) and concrete services (β = 3.420) were significantly related to treatment completion (p < 0.001). Additionally, findings indicated that an increase in access services resulted in an increase in receipt of matched concrete services (β = 0.437) and matched counseling services (β = 0.401) (p < 0.001).

Conclusions and Implications: Substance-abusing families in child welfare experience multiple problems simultaneously. This research supports the value of comprehensive services and indicates that treatment completion is dependent upon service plans that address multiple needs. If social services providers are interested in improving treatment completion, the provision of comprehensive services should include assessment of individual client needs and provision of services to meet those needs.