Identifying Families at Risk of Maltreatment Following a CPS Investigation: A Comparison of Families with and without Complex Needs

Background and Purpose:

One neglected area of research involves families referred for home-based, post-investigation services (HBPS) following a child abuse investigation. National reports on child maltreatment do not account for these families as they are no longer followed by Child Protective Services (CPS) agencies after an investigation. Research comparing families with substantiated and unfounded CPS reports (i.e., there was no evidence of maltreatment) indicate that families at-risk for maltreatment have comparable need for services regardless of substantiation. Furthermore, many studies indicate that families referred for HBPS do not receive services addressing their needs, especially for families with complex needs related to mental health, domestic violence, and substance use. Thus, this study compared families with and without complex needs to understand their unique profiles related to demographics, needs, and postinvestigation outcomes.

Methods

The sample consisted of 2,008 families with children who remained at home after an initial CPS investigation between July 2006 and December 2010. Eligible families had a child 5 or younger, an unfounded or inconclusive CPS investigation, and were assessed to be at moderate to high risk of future maltreatment. The Family Assessment Form was utilized to indicate need in three areas (concrete, clinical, and educational/parenting need), and families received one or more of the following HBPS: case management, concrete, educational, and clinical services.  Caregiver demographics consisted of ethnicity, age, income, number of caregivers, number of children, and history of abuse. In order to understand the experiences of families with complex needs, comparisons were made between families with (n=836) and without (n=1,172) need related to substance use, domestic violence, and/or mental health. Comparisons were made using Pearson Chi-2 analyses and Two-sample T Tests.

Findings

Only two significant differences emerged with respect to demographic characteristics—more families with complex needs had 2-3 caregivers at home, 34% versus 28% (χ2=6.9, df=1, p<.01), and more had abuse histories, 52% versus 17% (χ2=268.2, df=1, p<.001). With respect to need, families with complex needs had more needs in multiple areas that were greater in severity. For example, 26.3% of families with complex needs had 3-5 needs and nearly half (46%) had 6-8 needs; this was 9.5% and 2.8% for families without complex needs, respectively (χ2=800.4., df=2, p<.001).  Slightly more families with complex needs received educational/parenting services and clinical services, 68.7% versus 63.1% and 65.6% versus 63.6%, respectively (χ2=6.6, df=1, p<.010 & χ2=21.5, df=1, p<.001); fewer families with complex needs received 1-2 services whereas more of them received 3-4 services (χ2=13.6., df=3, p<.001). Last, more families with complex needs had subsequent CPS involvement, 6.1% versus 2.1% of families without complex needs (χ2=21.3, df=2, p<.001).

Conclusion and Implication

Although families referred to HBPS appear to be similar with respect to demographic characteristics, families with complex needs related to domestic violence, mental health, and substance use differ in important ways as they have more needs in multiple areas and worse outcomes. These findings highlight the importance of ensuring accurate screening of families referred for HBPS following a CPS investigation to identify and treat families with complex needs.