Interventions to Promote Successful Reunification Among Families of Children Ages 0-5

Background: Up to one-third of children who reunify with a biological parent from foster care re-enter the child welfare system because of continued exposure to child maltreatment. For infants and young children, this is particularly detrimental because of crucial brain development that occurs during the first three years of life. Yet, few studies have examined interventions to foster successful, or permanent, reunification. This is particularly important given the recent Families First Act that prioritizes evidence-based practices in child protective services (CPS), and to address economic inequalities and barriers families in child welfare systems face. This study examined the impact of diverse interventions on successful reunification for families with children ages 0-5 who reunified from CPS.

Methods: Secondary data analyses were run using data from the National Survey of Child and Adolescent Wellbeing II (NSCAW-II), a nationally representative survey of families referred to child protective services. The analytic sample for this paper included N=916 children ages 0-5 years who were in out-of-home care during wave one (2008) and had reunified by wave two (2009-2010). Data were collected at wave three (2011-2012) to compare those that had subsequent contact with CPS to those without. Survival analyses were run to examine the impact of diverse interventions on the time to unsuccessful reunification (e.g., subsequent contact with CPS). Survival analyses allowed the research team to examine the relationship between each intervention and time-to-contact, while controlling for cases that successfully reunified (e.g., no subsequent contact with CPS). Weights were incorporated into all analyses to account for the complex survey design.

Results: Overall, 12.1% of the sample experienced subsequent contact with CPS after reunification. Similar proportions of parents who successfully and unsuccessfully reunified had histories of drug use, alcohol use, mental health issues, and interpersonal violence. The only parental risk factor that was higher among those who unsuccessfully reunified was unemployment; only 15.8% of parents who successfully reunified experienced unemployment, compared with 39.2% of those who unsuccessfully reunified (X²=4.1, p<.05). Parents who successfully and unsuccessfully reunified had high rates of participation in drug rehabilitation (87.1% vs. 99.1%) and parent management training (62.3% vs. 86.7%). The only intervention that impacted unsuccessful reunification was parent management training (HR=8.0, 95% CI=2.2=29.2, p<.01).

Conclusion: Economic inequality, specifically unemployment, was higher among families of infants and young children who unsuccessfully than those who successfully reunify. Despite high rates of service utilization among families with children ages 0-5 who have reunified from child welfare systems, the impact of these services on successful reunifications is unclear. Indeed, the only intervention that impacted successful reunification was parent management training, which had a detrimental effect. Despite limitations including small sample size, these findings highlight the need for future research that evaluates how well interventions are meeting families’ needs. As the Families First Act begins to shape child welfare systems, policies, and practices, child welfare agencies should carefully select the interventions they utilize with families and continuously monitor their impact to ensure that target goals, such as successful reunification, are met.