Strengthening Competence for Working with Families Affected By Addiction: A Preliminary Assessment of a Fellowship for Child Welfare Professionals

Background: Families involved in the child welfare system are disproportionately affected by alcohol and other substance use disorders (AOSUDs). Despite this, child welfare workers often lack specialized training in AOSUD knowledge and evidence-based interventions. To address this critical gap, we recruited social work graduates from Title IV-E programs in Virginia to participate in a fellowship with focused AOSUD training, clinical supervision, and guided complex case discussions. This program aims to build child welfare workers’ competence and confidence in supporting families affected by AOSUDs. In the current study, we examined year-one outcomes for the fellows in the first cohort.

Methods: Seven child welfare caseworkers participated in cohort 1. They were all female and racially and ethnically diverse (57.1% White, 28.6% Black, 14.3% Latina), represented all five regions of the state, and all worked in federally designated mental health professional shortage areas. At baseline, fellows estimated that 20% to 100% of the families on their caseload were affected by a caregiver with AOSUD. The current study compares baseline (T1) and one year follow-up data (T2) using four standardized measures: the Substance Use Stigma Scale (measuring perceived stigma toward individuals with AOSUD), the Motivation for Change Readiness Scale (assessing motivation to engage families with substance use concerns), the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ; evaluating willingness, satisfaction, self-esteem, role adequacy, and role legitimacy toward working with families affected by alcohol use), and the Drug and Drug Problems Perceptions Questionnaire (DDPPQ; evaluating role adequacy, role legitimacy, support, self-esteem, and satisfaction in working with families affected by drug use). Paired t-tests examined changes in perceived stigma, motivation, and professional attitudes between the two time points. When changes were found to be statistically significant, mixed effects models for repeated measures were used to identify variables moderating T1-T2 changes.

Results: While positive trends were observed across multiple domains, statistically significant improvements based on paired t-tests were identified in perceptions of role adequacy. SAAPPQ-adequacy scores increased from T1 (M=4.43, SD=1.51; range:2–6) to T2 (M=6.00, SD=0.58; range:5–7), t(6)=3.27, p=0.017, indicating enhanced confidence in working with families affected by alcohol use. Similarly, DDPPQ-adequacy scores improved from T1 (M=14.14, SD=4.34; range:7–19) to T2 (M=20.86, SD=1.21; range:19–23), t(6)=4.45, p=0.004, reflecting greater perceived competence when supporting families dealing with substance-related challenges. Based on mixed effects repeated-measures models, interaction effects were identified between time and the percentage of caregivers with AOSUD on fellows’ caseload for SAAPPQ-adequacy, b=-0.01, SE=.007, p=.102 (trend), and DDPPQ-adequacy, b=-0.01, SE=.006, p=.057. Specifically, fellows with lower percentages of caregivers with AOSUD on their caseload demonstrated greater increases in adequacy scores compared to those with higher percentages.

Implications: Findings suggest that AOSUD-focused programming can strengthen child welfare workers’ perceived role adequacy in addressing substance use issues within their caseloads, with particularly strong benefits observed among those with less prior experience working with AOSUD-affected families. Future research with additional and larger cohorts should reexamine these relationships and examine sustained impacts on practice behaviors and family outcomes.