An Evaluation of Family-to-Family Model Interventions for Families with Substance Use Problems

Background:  It is estimated that parental substance use problems exist in 40% to 60% of child welfare cases (Brook et al., 2010) This often results in longer stays in the foster care system for children, decreases the likelihood of reunification, and increases the potential of re-entry(Brook & McDonald, 2009).  Families with problematic substance use are at greater risk of receiving fewer services and are subject to harsher interventions even when the child safety risks are similar to those with non-using caregivers (Berger et al., 2010).  The complex needs of these families require comprehensive interventions.

Methods: A non-equivalent groups design was used to evaluate a pilot program.  A sample of 59 families (27 intervention and 32 comparison)were matched using five criteria: 1) a substantiated child maltreatment allegation, 2) primary caregiver had substance use problems, 3) at least one child was removed from the family home 4) families had not received prior child welfare services, and 4) the same caseworker provided services to both groups. The independent variables were: 1) number of workers assigned to the family for the life of the case, 2) number of worker visits with the family; and 3) number of days between a referral to service and the client’s admission into the service.  Primary dependent variables were 1) the number of days the case was open, 2) the child placement at case closure and at one-year follow up, 3) the number of days the children were in placement, 4) subsequent substantiated child maltreatment reports at one year.

Results: Bivariate analysis revealed a significant difference between the intervention families and the comparison families for the days the children were in placement.  Chi square analysis found that at case closure 37% of the intervention families’ children remained out of the home compared to 69% of the comparison families’ children.  At one year, 63% of the intervention families had their children at home compared to 25% of the comparison families.  A regression model revealed that when the mother’s race, age, and primary drug was controlled for, the number of caseworkers assigned to the family independently accounted for 34% of the variance in the number of days the kids were in placement and 30% of the variance in the number of days the case was open.  

Implications:The data suggest that a community partnership model that incorporate family engagement, enhanced service provider accessibility, reduced caseloads, and one caseworker for each family can produce successful and stable reunification outcomes for families affected by substance use problems.

Berger, L. M., Slack, K. S., Waldfogel, J., & Bruch, S. K. (2010). Caseworker-perceived caregiver substance abuse and child protective services outcomes. Child Maltreatment, 15(3), 199-210.

Brook, J., McDonald, T. P., Gregoire, T., Press, A., & Hindman, B. (2010). Parental substance abuse and family reunification. Journal of Social Work Practice in the Addictions, 10(4), 393-412.

Brook, J., & McDonald, T. (2009). The impact of parental substance abuse on the stability of family reunifications from foster care. Children and Youth Services Review, 31(2), 193-198.