Facilitators and Barriers to Interagency Collaboration within Mother-Child Residential Treatment Programs

Background and Purpose:   Interagency collaboration is imperative to address the multiple and co-occurring needs of youth and families impacted by substance abuse. Mother-child residential treatment programs represent a unique program model where success often hinges on collaboration between substance abuse agencies and other service providers. Little is known, however, about the facilitators and barriers to implementing these programs. In addition, little is known regarding whether the influences on interagency collaboration within these programs might differ based on their stage of development. The purpose of this study was to address these gaps and answer the following research questions: 1) What are the facilitators and barriers to interagency collaboration between substance abuse agencies and other agencies as they implement mother-child residential treatment programs? 2) Do these identified influences on interagency collaboration within mother-child residential treatment programs differ based on the developmental stage of the collaborative? Methods: This qualitative study was conducted within six mother-child residential treatment programs in one southeastern state that were in different stages of development. Two were in the formation stage, three were in the implementation stage, and one was in the engagement/maintenance phase. Data were collected through field notes documented through site visits to each agency and through interviews with agency stakeholders. Interview questions included “What has excited you about the program so far?” and “What challenges do you anticipate?” Twenty-six stakeholders participated in 17 interviews. Qualitative data were inductively analyzed through first-cycle and second-cycle axial coding to differentiate and organize codes according to facilitators and barriers to interagency collaboration (Saldana, 2009). Results: Three overarching themes emerged from the data that represented both facilitators and barriers, including 1) Knowledge and Processes for Collaborative Work (e.g., knowledge of and commitment to the client population), 2) Continuity of Care across Agencies (e.g., resistance or conflict among partners or other stakeholders across agencies), and 3) Clarity, Credibility, and Support for the Model (e.g., impressions about the effectiveness of the program). When examining these areas according to developmental stage of the collaborative, knowledge and processes for collaborative work was discussed the most by stakeholders involved in programs in the implementation stages. Clarity, credibility, and support for the model was discussed most by stakeholders involved in the program in the engagement/maintenance phase. Conclusions and Implications: Study findings suggest that many of the facilitators and barriers to interagency collaboration around mother-child residential treatment programs are similar to those faced by other collaborative programs with the exception of billing policies, which appeared unique to this program model. Our findings also support the theoretical frameworks on interagency collaboration advanced by others (e.g., Reilly, 2001), particularly with regard to influences differing based on stage of program development. This study has implications for organizational and individual capacity-building within mother-child residential treatment programs, as well as for policies related to funding collaborative programs. Future research around this program model will be discussed, particularly in relationship to exploring organizational and individual-level influences on interagency collaboration and the extent to which these vary based on the stage of the collaborative.