Do You See What I See: Exploring Perceptions of Parental Substance Abuse in Cross-Systems Collaboration Between Child Welfare, Alcohol and Other Drugs, and Court Organizations

Purpose:  Families involved in child welfare (CW) systems due to parental substance abuse face a myriad of challenges including having lengthier stays in out-of-home placement and lower rates of reunification.  CW systems are implementing innovative cross-system collaborative strategies to address the multi-systemic needs of these families. This includes adopting integrated practices such as co-location of alcohol and other drugs (AOD) specialists in CW offices, joint case-planning, and cross-systems training between CW, AOD and court organizations. Emergent literature suggests that differing organizational beliefs and perceptions (i.e. criteria used for reunification) between CW, AOD, and court systems may hinder collaboration. This study aimed to empirically test the association between system types (CW, AOD, and court) and perceptions of parental substance abuse, including: a) perceptions of substance abuse as a disease that needs treatment, b) substance abuse and parenting effectiveness, c) substance abuse and reunification. Findings from this study have wide generalizability as data was collected from regions throughout the US.

Methods:  Secondary data was obtained from the National Center for Substance Abuse and Child Welfare. This descriptive study consisted of 1619 respondents from CW (n = 1044), AOD (n = 276), and court (n = 299) organizations from over twelve states.  Individual level data was aggregated to represent the three systems. Bivariate analysis and logistic regression were used to analyze association and the probability of the outcome variables in relationship to system types, controlling for age, gender, ethnicity, and staff position.  

Results:  There were significant differences in perceptions of parental substance abuse between CW and AOD staff. Compare to CW staff, AOD staff were: a) more likely to agree that parents with substance abuse problems would not be able to provide effective parenting (OR = 1.64, 95% CI = 1.21 – 2.22), b) more than twice as likely to agree that full abstinence should be a standard used to determine reunification decisions (OR = 2.28, 95% CI = 1.67 – 3.10), and c) less likely to agree that some parents cannot succeed in treatment (OR = 0.37, 95% CI = 0.27 – 0.52). CW and court staff had few differences in perceptions of parental substance abuse, with the exception that, compared to CW staff, court staff were more likely to agree that parents who abused AOD would not be able to provide effective parenting  (OR = 1.46, 95% CI = 1.09 – 1.95).

Implications:  Identifying areas of commonalities and differences across CW, AOD, and courts systems provide insight for identifying challenges to be addressed in the collaborative process.  Distinct differences in perceptions of parental substance abuse, such as the differing beliefs of substance use disorders as a disease or the use of abstinence as criteria for reunification decisions, may create conflict in joint-case planning, as well as in determining timeframes allotted for reunification services. Implications from these findings suggest that policies and protocols should be developed in order to preemptively address differing perceptions relating to parental substance abuse, as incongruence in these values and beliefs may hinder the collaborative process.