Matching Needs and Services Among Families with Complex Needs: Examining the Impact of Needs on a Service Match and a Match on CPS Recidivism

Background and Purpose:

Families with complex needs related to domestic violence, mental health, and substance use are often stigmatized and have some of the worst child protective services (CPS) outcomes. Many of these families are identified during CPS investigations and provided services matched to their needs to prevent future maltreatment. Although studies indicate that matching needs and services may reduce substance abuse and recidivism, matching services continues to be problematic for families with complex needs as they often do not receive a match or receive unneeded services. In response, this study examined the relationship between needs and matched services and whether a match decreased the likelihood of a re-report to CPS among families with complex needs.

Methods

The sample consisted of 836 families with complex needs related to domestic violence, mental health, and substance use whose children remained at home after an initial CPS investigation. Eligible families had a child 5 or younger, an unfounded or inconclusive CPS investigation between July 2006 and December 2010, and were at moderate to high risk of future maltreatment. The Family Assessment Form measured need in three areas (concrete, clinical, and educational/parenting), and families received concrete, educational/parenting, and/or clinical services.  A match was indicated if a caregiver had need in the aforementioned areas and received a matched service. Caregiver demographics included ethnicity, age, income, number of caregivers and children, and history of abuse. Pearson Chi-2 analyses were used to examine what needs were associated with a match and a multivariate logistic regression determined the impact of different areas of need on a services match and of a match on a subsequent CPS report while controlling for demographics.

Findings

Families received services matched to their needs and oftentimes services they did not need. Concrete need related to financial conditions was associated with increased odds of a concrete services match (OR = 1.63; 95% CI = 1.05, 2.52); educational need related to caregiver–child interactions (OR = 4.28; 95% CI = 2.55, 7.19) and developmental stimulation (OR = 13.8; 95% CI = 7.64, 24.8) was associated with increased odds of an educational services match. Caregivers with clinical need related to mental health had increased odds of receiving a clinical services match (OR = 1.81; 95% CI = 1.06, 3.10); clinical need related to domestic violence and substance use was not significant. Only matched educational/parenting services was associated with reduced odds of a subsequent CPS report (OR = 0.60; 95% CI = 0.42, 0.85).

Conclusion and Implication

Considering that families with complex needs are often the most difficult to engage, it is promising that they received matched services to address their multiple needs and that receiving matched educational/parenting services reduced the likelihood of a subsequent CPS report. Although many families with complex needs received unneeded services, this may have served as an engagement strategy (Kemp et al., 2009). Future researchers should examine how matched and unmatched services affect engagement and child welfare outcomes, especially for families with complex needs who tend to be the most stigmatized.