(see Poster Gallery) Betrayal Trauma and Parental Substance Misuse Impact the Hazards of Reunification Among Child Welfare-Involved Families

Background and Purpose: Childhood betrayal trauma, (the degree of closeness/dependency between a victim and a perpetrator) can have a detrimental impact on trajectories of health and development, especially among families with child protective services (CPS) involvement. Parental substance misuse, a leading factor contributing to recent increases in foster care caseloads, can also negatively affect family well-being. Children’s recovery from betrayal trauma is contingent upon relationships with an attuned caregiver. However, childhood betrayal trauma and parental substance misuse are both associated with consequences that negatively influence chances of reunification. To date, there have been no studies that specifically compare the effects of child abuse involving betrayal trauma versus non-betrayal trauma abuse on the likelihood of reunification, nor on how parental substance misuse could influence these relationships among CPS-involved families. The purpose of our study is to address this gap.

Methods: Secondary data analyses were run using data from National Child Abuse and Neglect Dataset (NCANDS) and the Adoption and Foster Care Analysis System (AFCARS). Both datasets are collected annually; NCANDS captures all reports referred to CPS and screened in for an investigation during the fiscal year, and AFCARS captures all children who were in foster care at any point in time during the previous fiscal year. We took a cohort of children referred to CPS in FY 2015, who entered foster care as a result of the referral, who had experienced physical or sexual abuse, and who had data listed on the perpetrator of abuse. We followed this cohort of children for four years (through FY 2019) to compare those who reunified at any point during the study period to those who did not (e.g., remained in care or were discharged to a different exit such as emancipation or adoption). Our final analytic sample consisted of 1,6630 children. Demographic statistics and bivariate correlations were analyzed. Survival analyses were conducted to observe the relationship between betrayal trauma and reunification, while adjusting for other factors that could impact reunification. Analyses were run using Stata version 16 SE.

Results: Overall, 47.67% of the sample reunified during the study period. Most of the sample experienced betrayal trauma (87.67%) in that a parent or primary caregiver was identified as the perpetrator of abuse. Among those that experienced betrayal trauma, approximately one third (33.39%) also had been exposed to parental substance use, while the remaining two thirds (65.47%) did not have parental substance use exposure. Children who experienced both betrayal trauma and parental substance use had lower hazards of reunification (HR=0.62, p<.001) than those who experienced betrayal trauma but no parental substance use, and also compared to those who experienced non-betrayal trauma abuse concurrent with parental substance misuse (HR=0.62, p<.001).

Conclusions: Our findings reveal that betrayal trauma can uniquely impact reunification success, particularly in the context of parental substance misuse. Reunification is more likely when parents are referred to services that meet their unique needs. Future studies should focus on whether relationships between betrayal trauma parental substance misuse impact parental treatment referrals and subsequent reunification success.