Substance Abuse Treatment Completion In Child Welfare: Does Substance Abuse Treatment Completion Matter In the Decision of Family Reunification?

The question of why and under what circumstances family reunification takes place in the context of the child welfare system is a complex one and the presence of substance abuse only further complicates the picture. Past studies have explored a multitude of factors that are associated with family reunification among caregivers and children engaged with the child welfare system. These studies have demonstrated that various demographic factors, co-occurring problems, and particular services received are related to reunification. Although somewhat limited, there is some literature which provides evidence that parental participation in substance abuse treatment is also a significant predictor of family reunification Yet the mechanism between treatment completion and family reunification has not been thoroughly explored yet. This study attempts to fill this gap by investigating to what extent treatment completion is related to the likelihood of family reunification. The current study utilized a sample of 858 mothers of substance abuse problems and 1,548 children. The mothers and children were part of the Illinois Title IV-E Alcohol and Other Drug Abuse (AODA) waiver demonstration. The current study utilized a variety of survey and administrative data sources, including screening assessments of caregiver problems, detailed records of treatment services, and official reports of placement outcomes. We utilized descriptive analysis and hierarchal nonlinear models (HNLM) to understand the effects of treatment completion on reunification. The sample consisted of 78% African American mothers, and 56.5 % of mothers completed at least a single episode of treatment. Approximately 54% of children were boys and 26.1% children were reunified with their biological mothers. The bivariate analysis showed that mothers' age at screening, mental health problems, education, treatment completion, and child's handicap status were associated with reunification. More specifically, older mothers with high school educations or above had a higher reunification rate. Mothers with mental health problem and children with a handicap status had a lower reunification rate. A mother's progress in substance abuse also improved the family reunification rate. Regarding treatment completion, both a single episode of treatment completion, the total number of treatment completions, and a ratio between the total number of treatment referrals and the total number of treatment completions were associated with higher rates of reunification. The findings from HNLM indicate the ratio between the total number of treatment referrals and the total number of treatment completion significantly improved the likelihood of family reunification. Children whose mothers had a higher treatment completion ratio were 12 times more likely to reunify with their biological mothers. Mothers' mental health and having a prior substance exposed infant were negatively associated with the likelihood of family reunification. This current study provided important empirical evidence for the link between family reunification and treatment completion. Given the importance of treatment completion to child welfare outcomes, the need for improved service access and retention is clear. Implications of these findings for improvements in the way that treatment services are provided to mothers in child welfare are discussed.