Trauma and Depressive Symptomology of Parents Involved in a Child Welfare Parenting-Skills Intervention: Did Participation Help?

Background/Purpose: There is a limited body of research that investigates the mental health (MH) of caregivers seeking reunification. Research shows that parents who use substances often have comorbid MH issues, and that children removed from substance-affected households are less likely to experience reunification and more likely to remain in FC for longer periods of time. For child welfare-involved, substance-affected families, acknowledging trauma and depressive symptomology of caregivers may enhance intervention engagement and promote quicker reunification. Adding to the field, this study examined if substance-affected caregivers, who were randomized and agreed to participate in the Strengthening Families Program: Birth-to-Three (SFP-B-3), exhibited improvements in trauma symptomology (e.g., dissociation, anxiety, depression, sexual abuse trauma, sleep disturbance, and sexual problems), as measured by the Trauma Symptoms Checklist-40 (TSC-40), and depressive symptomology (e.g., presence and severity), as measured by the Center for Epidemiological Studies-Depression (CES-D), from program start to finish.

Methods: The study sample included caregivers with young, substance-affected children in FC with a case plan goal of reunification who were randomly selected to receive SFP B-3. All participants completed a 14-session parenting-skills intervention over 16 weeks; parents with data available at both timepoints (e.g., baseline and program exit) on the TSC-40 (N=203) and CES-D (N=202) were eligible for inclusion. Paired t-tests analyses were conducted to determine if there was a statistically significant mean difference between caregiver trauma and depressive symptomology at baseline compared to program exit. For both measures, caregivers who completed the program, when compared to program dropouts, had statistically significant differences in income level and relationship status.

Results: For both measures, participants were primarily single (54%), White (73%), non-Hispanic/Latino (86%), and female (55%). Results indicated statistically significant decreases in trauma symptomology from program start to finish on the following scales: dissociation (t(202)=-2.45, p<.05), anxiety (t(202)=-2.65, p<.05), depression (t(202)=-3.73, p<.05), sexual abuse trauma (t(202)=-2.15, p<.05), sleep disturbance (t(202)=-2.79, p<.01), and total score(t(202)=-3.29, p<.01). The sexual problems scale had non-significant results.

For the CES-D, results revealed statistically significant differences in mean scores when examined continuously (t(201)=-1.97, p<.05), indicating improvements in depressive symptomology among caregivers. However, when examined categorically, the statistical significance did not maintain (t(201)=-152, p<.05).

Conclusion/Implications: Caregivers who completed SFP-B-3 reported statistically significant improvements in trauma and depressive symptomology suggesting participation in SFP-B-3 may improve the MH of caregivers who are substance-affected and seeking reunification. As these findings are limited by the omission of a control group to rule out confounding factors, future studies are needed to corroborate these findings. However, these findings do provide initial support for the concept that child welfare parenting-skills interventions that target the MH of caregivers have the capacity to improve the quality of life for both the caregiver and their children by enhancing parenting skills and mitigating MH symptomology that may negatively impact family functioning once reunified. Potential practice implications include incorporation of MH topics, specifically for substance-affected, child-welfare involved caregivers. Needed are studies evaluating the effectiveness of SFP B-3 on enhancing caregiver MH.