Jody Brook

Evaluating the Effects of Comprehensive Substance Abuse Intervention on Successful Reunification

Objective: This study examines permanency outcomes of families with children in foster care who participated in a comprehensive service-delivery program designed to assist families and communities in dealing with alcohol and other drug (AOD) problems. Method: Survival analysis is used to measure the impact of program participation on family reunification and re-entry of children into foster care. Results: The results of this study are that, contrary to initial expectations, participants move more slowly to reunification, although the group differences are not statistically significantly different, and re-entry rates are significantly higher among those children whose parents participate in this service. Conclusions: AOD abuse recovery is a long-term process. More intensive service interventions may not automatically produce better permanency outcomes.

Social Work at the Heart of the Medical Team

Abstract This paper proposes one model of hospital social work delivery services that places social work in a facilitative role within the medical team, and describes a pilot project designed to evaluate these services. Social works role in this teaching hospital setting was tailored to provide patients and medical staff access to social work services upon admission, rather than at the time of discharge. This change places social work at the pivotal juncture to improve medical care and addresses the social, cultural and environmental concerns as they surface during patient stay. Unique to this demonstration model is the added advantage of placing the social worker at the hub of the physician-led medical team. Medical students, residents, and attending physicians all learn, observe, and experience the advantages social workers bring to the process. Educating medical students on teams with social workers bodes well for the profession. The authors summarize the program design, results and implications for social work practice in a teaching hospital setting.

Examining the role of methamphetamine in permanency: A competing risks analysis of reunification, guardianship, and adoption.

Parental methamphetamine use has drawn significant attention in recent years. Despite prior research that shows that parental substance abuse is a risk factor for lengthy foster care stay, little is known about the effect of specific types of substance use on permanency. This study sought to compare the impact of parental methamphetamine use to alcohol use, other drug use, and polysubstance use on the timing of 3 types of permanency: reunification, guardianship, and adoption. Using an entry cohort of 16,620 children who had entered foster care during a 5-year period, competing risks event history models were conducted for each permanency type. Findings showed that, after controlling for several case characteristics, parent illicit drug use significantly impacted the timing of the 3 types of permanency, but alcohol use did not. Methamphetamine, other drug, and polysubstance with methamphetamine use were associated with lower rates of reunification and higher rates of adoption. Guardianship was also predicted by other drug and polysubstance use without methamphetamine; however, methamphetamine use was not associated with guardianship. Notably, the methamphetamine groups comprised the youngest children and had the shortest median time to adoption. Results suggest that type of parental substance use is predictive of permanency exits and that parental illicit drug use may require tailored strategies for improving permanency outcomes. Further implications of the findings are discussed.

Substance Use and Abuse for Youths in Foster Care: Results From the Communities That Care Normative Database

This study uses the Communities That Care Normative database to examine the prevalence of drug and alcohol use and abuse among foster care youths in comparison to youths not living in a foster home setting. The foster youths were more likely to have used all of the examined illicit substances, and these differences generally remained after controlling for a number of demographic differences between the two groups. These negative differences appear to be amplified for females in foster care. The overall high-risk profile of foster youths makes them an especially important population for targeted prevention.

Screening for Substance Use Disorders as a Supplement to Caseworker Assessment Among Foster Care–Involved Families

Parental substance abuse is a major factor in families experiencing foster care placement, yet little is known about the potential of screening in determining risk or identifying subpopulations for which elevated risk occurs. One Midwestern state recently implemented screening. This research uses information gathered as part of the screens implementation to conduct a latent class analysis. The research was extended to provide a detailed examination of differences in child and family characteristics across classes, and to compare the screen results with caseworker impressions. Three distinct typologies emerged, with the high-risk and moderate-risk designations comprising only one quarter of the cases.

Solution-Focused Brief Therapy With Substance-Using Individuals: A Randomized Controlled Trial Study

Objective: This study examined the effectiveness of solution-focused brief therapy (SFBT) intervention on substance abuse and trauma-related problems. Methods: A randomized controlled trial design was used to evaluate the effectiveness of SFBT in primary substance use treatment services for child welfare involved parents in outpatient treatment for substance use disorders. Mixed linear models were used to test within- and between-group changes using intent-to-treat analysis (N = 64). Hedges’s g effect sizes were also calculated to examine magnitude of treatment effects. Results: Both groups decreased on the Addiction Severity Index-Self-Report and the Trauma Symptom Checklist-40. The between group effect sizes were not statistically significant on either measures, thus SFBT produced similar results as the research supported treatments the control group received. Conclusion: Results support the use of SFBT in treating substance use and trauma and provide an alternative approach that is more strengths based and less problem focused.

Effect of a Parenting Intervention on Foster Care Reentry After Reunification Among Substance-Affected Families: A Quasi-Experimental Study:

Although parental substance abuse has been identified as a risk factor for poor foster care outcomes, current research on effective interventions is limited. A few studies have shown that parenting interventions improved parenting skills and family functioning and decreased time to reunification among children in foster care due to parental substance abuse. However, more research is needed to evaluate whether these interventions positively impact reentry rates. Using propensity score analyses to establish a matched comparison group, survival analyses evaluated the relationship between participation in a parenting intervention, the Strengthening Families Program (SFP), and reentry among a sample of 493 children previously reunified with their parents. The overall reentry rate was 20.9%. Analyses indicated that there was no difference in reentry rates between the SFP (23.7%) and comparison groups (18.6%). Significant predictors of reentry were child behavior problems, family poverty, and reunification between 15 and 18 months from removal.

Typologies of Children in Foster Care for Reasons Other than Abuse or Neglect

In Kansas, 45% of foster care placements occur for reasons besides child abuse or neglect. Yet little is known about their critical characteristics. By learning more about these cases, policies and practices can be tailored accordingly. This research utilized a statewide random sample (n = 254) of target children entering care in 2005. Two-step cluster analysis was used to generate typologies. Comparisons were made relative to child, parent/caretaker, and child welfare service variables. The analyses yielded five distinct clusters: infants, preschoolers, grade-schoolers, adolescents without prior abuse/neglect, and adolescents with a history of abuse/neglect. Our findings indicate that these cases represent a variety of individuals with different service needs, only a minority of whom fit the structures traditionally designed for abuse/neglect cases.

A study in contrasts: Supports and barriers to successful implementation of two evidence-based parenting interventions in child welfare

Although evidence-based interventions (EBIs) are spreading to child welfare, research on real-world dynamics of implementation within this setting is scarce. Using a six-factor implementation framework to examine implementation of two evidence-based parenting interventions, we sought to build greater understanding of key facilitators and barriers by comparing successful versus failed EBI implementation in a child welfare setting. Semi-structured interviews were conducted with a purposive sample of 15 frontline practitioners and state-level managers. Interviews were transcribed verbatim and data analysis used a modified analytic approach. Our results showed the successful EBI was viewed more positively on all six factors; however, implementation was multidimensional, multilevel, and mixed with accomplishments and challenges. An accumulation of strengths across implementation factors proved beneficial. Implementation frameworks may be advantageous in organizing and explaining the numerous factors that may influence successful versus failed implementation. While encountering obstacles is largely inevitable, understanding which factors have shaped the success or failure of EBI implementations in child welfare settings may optimize future implementations in this context.

Engaging substance-affected families in child welfare: parent perspectives of a parenting intervention at program initiation and completion

ABSTRACT Families affected by substance abuse are at an increased risk of child welfare involvement and poor child welfare outcomes. One strategy to improve outcomes among these families is evidence-based parenting interventions. While these interventions show the potential for advancing the child welfare field, they have not been widely and rigorously evaluated with birth parents, especially those affected by substance abuse, who face marked vulnerability and marginalization. We sought to draw on parents’ expertise and to understand their first and changing impressions throughout involvement in a parenting intervention, as well as overall impressions at program completion. Semi-structured interviews were conducted with a purposive sample of 10 parents who were involved in child welfare and a family drug treatment court. All parents were affected by parental substance use and had recently completed the Strengthening Families Program. Interviews were transcribed verbatim and analyzed for prominent themes. The study’s findings showed that parents described four key themes that influenced their perspectives of the parenting intervention: program reputation as communicated by peers, relevance and applicability of the program, children’s involvement and enjoyment of the program, and program structure issues that pointed to the need for high-quality group facilitation. Implications for practice and research are discussed.