Family Drug Courts: An Innovative Service Delivery Strategy for Child Welfare-Involved Substance-Affected Families

Purpose:Substance abuse affected families are frequently cited as the most challenging families to serve within the child welfare context. These families typically experience lower child reunification with birth parents, longer stays in foster care, and greater likelihood of reunification failure. Historically, these cases have been adjudicated in traditional child welfare courts.  Given the complexities of families with substance abuse, traditional courts may be insufficient for handling these hard-to-treat cases and Family Drug Courts (FDCs) are proliferating as an alternative to traditional courts.  A growing body of evidence suggests that FDCs may be more effective than their traditional counterpart at reunifying these families; however, prior studies have been limited in their methodological rigor.  The purpose of this study is to rigorously examine whether participation in a Family Drug Court is associated with improved outcomes. 

Method:This study used treatment and comparison data to test reunification patterns of these highly vulnerable families. Treatment group data was collected on a sample of 214 children with open dependency cases in an integrated Family Drug Court in a midsized Midwestern city.  From a pool of 3,827 children in the State’s child welfare database, propensity score matching on thirteen predictive variables was used to generate a comparison group.  Stata version 12.0 was used for propensity score nearest neighbor one-to-two matching within a caliper, with 0.25 of a standard deviation as calpiar size (Guo & Fraser, 2009).  This resulted in a matched comparison group of 418 children.  This study used life tables to examine the rate at which FDC participants reunified over time.  Additionally, a Cox regression model with hazard ratio evaluated reunification likelihood between groups, controlling for 16 variables previously found to influence reunification rates. 

Results: Outcome data suggest that FDC participation significantly influenced reunification outcomes.  Life tables indicate that substantially more FDC children achieved reunification than the comparison group.   At 401-600 days after removal, 46% of the FDC group reunified compared to 17% of comparison cases.  At 601-800 days after removal, 54% of the FDC group versus 21% of the comparison group were reunified.   The Cox regression indicates that FDC children were significantly more likely to reunify than comparison cases (H.R.=2.78, p<.001; median effect size: 2.50-4.00), after controlling for covariates.  The hazard ratio reveals that FDC children were 1.78 times more likely to reunify than comparison group children.   

Implications: Using the most rigorous evaluation tools at the disposal of researchers in child welfare—a setting where randomized controlled trials are often unfeasible—this study adds to the growing body of literature suggesting that Family Drug Courts are an effective service delivery strategy for meeting policy driven goals with this challenging population.  As Family Drug Courts continue to expand, the role of social work within the court structure, and implications for social work practice models need to be the subject of future research.