Matching Services to Reduce Need Among Families at Risk of Maltreatment with Complex Needs

Background and Purpose:

Matching needs and services for families with complex needs (i.e. mental health, substance use, and domestic violence) is difficult because many families may not engage in services because they feel stigmatized, coerced, or unready to address identified needs. Several studies have revealed that matching needs and services is associated with important child welfare outcomes including decreased substance abuse, lowered rates of maltreatment, and increased family reunification. However, few of these studies have examined whether matching services reduces the different areas of need that service matching targets. In response, this study examined the change in need among families with complex needs that received matched services following a CPS investigation.

 Methods

The sample consisted of 836 families with complex needs related to mental health, substance use, and domestic violence that had an unfounded or inconclusive CPS investigation between July 2006 and December 2010.  Eligible families had a child five or younger that remained at home after an initial CPS investigation and were at moderate to high risk of future maltreatment. The Family Assessment Form (FAF) was used to indicate need in three areas (concrete, clinical, and educational/parenting) and families received an array of services including concrete, educational/parenting, and/or clinical services.  A match was indicated if a caregiver had an aforementioned need and received a corresponding service. Reduced need was indicated by a change from a mean score of 3 or more (problematic functioning) on the FAF to a mean score of 3 or less (adequate functioning). Paired sample t-tests and Pearson Chi-2 analyses were used to examine bivariate associations between matched services by area of need and reduced need. Multivariate logistic regressions were conducted to determine the impact of matched services on overall reduced need while controlling for demographic characteristics including ethnicity, age, income, number of caregivers and children, and history of abuse.

Findings

Bivariate analyses indicated that receiving matched concrete and educational/parenting services was significantly associated with reduced need. For matched clinical services, this pattern was found for mental health and substance use but not for domestic violence. Multivariate analyses indicated that receiving matched concrete services was associated with an increased likelihood of overall reduced need (OR = 1.65; 95% CI = 1.02, 2.64). This pattern was similar for educational need related to caregiver–child interactions (OR = 1.77; 95% CI = 1.05, 2.99). For clinical need, receiving matched clinical services for domestic violence (OR = 1.79; 95% CI = 1.07, 2.97) and mental health (OR = 2.42; 95% CI = 1.57, 3.74) was associated with an overall reduction in need but not for substance use.

Conclusion and Implication

Matching needs and services for families with complex needs involving mental health, substance use, and domestic violence remains an important function of CPS agencies in conjunction with community-based agencies. Findings from this study highlight that matching services can reduce individual areas of need and overall need as well as how providing matched services can serve as a catalyst for change in other areas of need.