Joseph P. Ryan

Completing substance abuse treatment in child welfare : The role of Co-occurring problems and primary drug of choice

A significant number of substance-abusing parents in the child welfare system do not complete substance abuse treatments. Consequently, their children experience longer stays in substitute care settings, and the risk of the termination of parental rights is increased. This study identifies and determines the specific factors that explain the completion of substance abuse treatment for substance-abusing caregivers in child welfare. The sample includes 871 caregivers enrolled in the Illinois Alcohol and Other Drug Abuse waiver demonstration. Approximately 22% of these caregivers successfully completed all required levels of substance abuse treatment. The multivariate models indicate that age, employment status, and legal involvement were significantly associated with the likelihood of completing substance abuse treatment. Heroin users were significantly less likely to complete treatment as compared with alcohol, cocaine, and marijuana users. The findings are discussed in terms of policy and practice implications for public child welfare systems.

Dependent Youth in Juvenile Justice: Do Positive Peer Culture Programs Work for Victims of Child Maltreatment?

Objective: The purpose of this study is to identify and determine the individual and group-level factors associated with recidivism for children in a long-term Positive Peer Culture (PPC) program. The current study focuses specific attention on the role of child maltreatment in understanding the risk of recidivism. It is widely accepted that victims of child abuse and neglect are more likely to engage in delinquent behavior as compared with their nonmaltreated counterparts. Yet little is known about dependent youth in the juvenile justice system. The maltreatment-delinquency literature focuses almost exclusively on the initial risk of juvenile or adult offending. Moreover, the comparison groups are always children in the general population rather than children in the juvenile justice system. Method: The sample includes 286 adjudicated delinquent offenders. Hierarchical nonlinear modeling is used to partition effects at the individual and group levels. Results: Overall, 117 (41%) of the sample was arrested. Youth with a history of physical abuse and neglect were more likely to have a subsequent arrest (50% vs. 37%). Conclusion: PPC programs may not be the most effective strategy for dependent youth in the juvenile justice system.

Placement and Permanency Outcomes for Children in Out-of-Home Care by Prior Inpatient Mental Health Treatment

Objective: This longitudinal study followed 5,978 children in out-of-home care to examine whether placement and permanency outcomes differ between children with and without a history of inpatient mental health treatment. Method: Data were drawn from child welfare and Medicaid records from the state of Illinois. Logistic regression and survival analysis were applied. Results: A history of inpatient mental health treatment preceding out-of-home placement was associated with an increased risk for placement instability for White children and a decreased likelihood of achieving permanency for African American children. Conclusions: Children with an inpatient mental health treatment episode may benefit from assessment of service needs upon their entry into out-of-home care and continued follow-ups for reducing placement disruptions and facilitating timely permanence.

Recovery coaches and substance exposed births: an experiment in child welfare.

OBJECTIVES Substance exposed infants present a major challenge to child welfare and public health systems. Prenatal substance exposure and continued substance abuse in the home are associated with a wide range of adverse social, emotional, and developmental outcomes. The objective of the current study is to evaluate the use of recovery coaches in child welfare. METHODS The current study is longitudinal and utilizes an experimental design. The sample includes 931 substance abusing women enrolled in a Title IV-E Waiver Demonstration, 261 in the control group, and 670 in the experimental group. Women in the experimental group received traditional services plus the services of a recovery coach. Administrative records are used to indicate substance exposure at birth. RESULTS Of the 931 women enrolled in the waiver demonstration, 21% of the control group and 15% of the experimental group were associated with a subsequent substantiated allegation indicating substance exposure at birth. Cox proportional hazards modeling indicates that women in the experimental group were significantly less likely to be associated with a new substance exposed birth. CONCLUSIONS The use of recovery coaches in child welfare significantly decreases the risk of substance exposure at birth. Integrated and comprehensive approaches are necessary for addressing the complex and co-occurring needs of families involved with child protection.

Reintegration Services and the Likelihood of Adult Imprisonment: A Longitudinal Study of Adjudicated Delinquents

Objective: This study used longitudinal data to identify the factors associated with adult imprisonment for adjudicated delinquent males following long-term residential care. Method: Logistic regression and survival models were developed to examine the effectiveness of reintegrational services. The sample included 397 adjudicated delinquents released between 1992 and 1993 from a residential treatment facility in Michigan. The Michigan Department of Corrections provided incarceration data approximately 5 years after residential release. Results: At the time of follow-up, 28% had experienced incarceration as an adult. The youths who received reintegration services within a single organization were less likely to experience incarceration as an adult. Ethnicity, number of prior adjudications, and frequency of out-of-home placement were associated with adult imprisonment. Conclusions: In part, it is the plan-full reintegration process that enables youths to achieve better long-term outcomes. The implications for social policy and social work practice are discussed.

Substitute Care in Child Welfare and the Risk of Arrest: Does the Reason for Placement Matter?

This study sought to investigate whether the reason for placement was associated with the subsequent risk of arrest. The author has focused on youth entering care for reasons of maltreatment and for child behavioral problems. The author stratified the sample based on a history of juvenile delinquency. The sample was diverse and included youth between 8 and 16 years of age with at least one episode in a substitute care child welfare setting (n = 5,528). Approximately 23% of youth were placed in child welfare for reasons others than maltreatment; specifically child behavioral problems. Youth placed for behavioral problems were significantly more likely to live in congregate care facilities, experience placement instability, and more likely to experience at least one arrest. A prevailing argument is that child welfare offers a broader range of family-based services as compared with the secure settings of juvenile justice. High rates of congregate care placement reported in the current study indicate that family-based services are infrequently associated with youth placed for behavioral problems in child welfare. High rates of subsequent arrest indicate that the congregate care approach for youth with behavioral problems in child welfare is limited.

Termination of Parental Rights for Parents with Substance Use Disorder: For Whom and Then What?

The purpose of this study is to investigate the correlates of termination of parental rights (TPR) for parents with substance use disorder (SUD) and to determine what happens with regard to permanency once a TPR decision is made. Bivariate techniques and hierarchical nonlinear modeling are used. Parents of older youth, boys, and Hispanics were less likely, whereas parents who failed to make progress in substance use treatment and parenting skills are more likely to experience TPR. At follow up, 85% of the children were adopted, 7% remained in a substitute care settings, and 7% were reunified with their parents. Concerns remain for children without a permanent home setting.

The effect of recovery coaches for substance-involved mothers in child welfare: Impact on juvenile delinquency

Despite the documented relationship between parental substance abuse and youth delinquency, the effects of parental interventions on delinquency outcomes are unknown. Such interventions are particularly vital for families in the child welfare system who are at heightened risk for both parental substance involvement and youth delinquency. The current study tested the impact of intensive case management in the form of a recovery coach for substance-involved mothers on youth delinquency outcomes among a randomized sample of 453 families involved in a Title IV-E experimental waiver demonstration in Cook County, Illinois. In comparison to control group participants, families enrolled in the Alcohol and Other Drug Abuse (AODA) waiver demonstration experienced a lower rate of juvenile arrest, net of factors such as demographic characteristics, primary drug of choice, and time spent in substitute care. Findings support efforts to curb delinquency among child-welfare involved youth by providing recovery coaches to their substance abusing or dependent parents.

Re-arrest among juvenile justice-involved youth: An examination of the static and dynamic risk factors

The purpose of this study is to investigate the static and dynamic risk factors for re-arrest among detained youth by examining gender, race/ethnicity, age, special education, and mental health variables (i.e., anger/irritability, depression/anxiety, somatic complaints, suicide ideation, thought disturbances, and traumatic experiences). The demographic profiles of detained youth with one admit were also compared with those with multiple admits to the juvenile detention center. With regard to static risk factors, older, White, and special education were significantly at risk of re-arrest. Concerning dynamic risk factors, only anger/irritability predicted re-arrest. Practice implications are also discussed.

The Discontinuity of Offending among African American Youth in the Juvenile Justice System.

Little is known about what factors contribute to African American youth desisting from offending. Participants were 3,230 moderate- to high-risk adolescents from Washington State who completed a statewide risk assessment to assess the likelihood of recidivism. Participants were screened by juvenile probation officers between 2003 and 2010. Researchers investigated whether youth possessed protective factors and whether developmental change took place after contact with the juvenile justice system. It was hypothesized that having protective factors would decrease the likelihood of recidivism and the impact of each factor would differ by gender. Findings indicate African American youth have protective factors across a range of domains. However, little developmental change occurs after contact with the juvenile justice system. Impulse control, parental supervision, and pro-social peers were important for reducing recidivism. Problem solving was more influential for African American males, while impulse control and parental supervision were more influential for African American females. Implications for practice and policy are discussed.