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Journal ArticleDOI

Collocation: Integrating Child Welfare and Substance Abuse Services

21 Feb 2009-Journal of Social Work Practice in The Addictions (Taylor & Francis Group)-Vol. 9, Iss: 1, pp 55-70
TL;DR: Findings suggest that clearly defined procedures and sufficient staffing of qualified substance abuse counselors could lead to better programs.
Abstract: This article presents findings from a process evaluation of a pilot program to address parental substance abuse in the child welfare system. By placing substance abuse counselors in a local child welfare office, the collocation program was designed to facilitate early identification, timely referral to treatment, and improved treatment engagement of substance-abusing parents. Frontline child welfare workers in 6 of the 7 pilot sites endorsed the program as they found that the collocated substance abuse counselors provided additional resources and facilitated case processing. Findings suggest that clearly defined procedures and sufficient staffing of qualified substance abuse counselors could lead to better programs.

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Citations
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Journal ArticleDOI
TL;DR: A review of empirical literature reveals improvements in service utilization and outcomes for women when substance abuse and child welfare services are integrated, and strategies developed provide useful guidelines for developing components of effective, evidence-based programs for substance-involved women in the child welfare system.

97 citations


Cites background from "Collocation: Integrating Child Welf..."

  • ...Whereas collocation initiatives are still early in an evaluation process, initial evaluation findings suggest that the approach can lead to increased understanding among child welfare and substance abuse staff, improved relationships among service providers, and better coordination of services for clients (Lee et al., 2009; McAlpine et al., 2001)....

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Journal ArticleDOI
TL;DR: Preliminary outcomes from a pilot study of Multisystemic Therapy-Building Stronger Families support the viability of a more rigorous (i.e., randomized) evaluation of the MST-BSF model.

59 citations

Journal ArticleDOI
TL;DR: Analysis of data from a national, longitudinal study of families involved with the U.S. child welfare system suggests that child welfare agency collaboration with schools has a significant effect on children's use of both school-based and outpatient mental health services.
Abstract: This article uses data from a national, longitudinal study of families involved with the U.S. child welfare system to examine how collaboration between local child welfare agencies, schools, and co...

31 citations


Cites background from "Collocation: Integrating Child Welf..."

  • ...Co-location of staff ensures that staff in different agencies are operating in the same physical space, which inherently provides staff with increased opportunities for communication and can help reduce service fragmentation (Ginsburg, 2008; Lee et al, 2009)....

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Journal ArticleDOI
TL;DR: The Sobriety Treatment and Recovery Teams (START) as discussed by the authors is an integrated model that pairs child protective service workers with family mentors and partners with treatment providers, and the results support START as an effective integrated program.
Abstract: Families with child maltreatment and parental substance use disorders are a growing population with complex needs. The Sobriety Treatment and Recovery Teams (START) is an integrated model that pairs child protective service workers with family mentors and partners with treatment providers. This is a prospective naturalistic evaluation comparing rates of adult sobriety and child placement in state custody using provider-collected data merged with state administrative data sets. All families in the served and comparison groups had equal risks to child safety. Mothers achieved sobriety at 1.8 times the rate of typical treatment; children were placed in state custody at half the rate expected. These results support START as an effective integrated program.

31 citations

Journal ArticleDOI
TL;DR: In this article, the authors explore factors that facilitate or impede collaboration in a Canadian context and highlight the importance of examining cross-system collaboration specific to regional policy contexts, such as British Columbia's harm reduction approach to substance use and addiction.
Abstract: The aim of this study was to explore factors that facilitate or impede collaboration in a Canadian context. Qualitative in-depth interviews were conducted with a purposive sample of 24 managers and direct service staff from substance use treatment and the child welfare fields in different regions of a Canadian province. Findings underscore the importance of examining cross-system collaboration specific to regional policy contexts, such as British Columbia's harm reduction approach to substance use and addiction. At the same time, many of the barriers and driving forces for collaboration found in this study echo the experiences of other countries.

23 citations

References
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Journal Article
TL;DR: Results suggest that cases with indications of AOD use are more likely to be substantiated than cases without; and increasing numbers of children and younger maternal ages are risk factors for CPS involvement among AOD-using women.
Abstract: This article includes two separate studies: the first explores the impact of caregiver AOD use on CPS case substantiation; the second compares CPS-involved and CPS-noninvolved females in AOD treatment systems. Results suggest that cases with indications of AOD use are more likely to be substantiated than cases without; and increasing numbers of children and younger maternal ages are risk factors for CPS involvement among AOD-using women. Related findings are also presented, followed by implications for practice and research.

50 citations

Journal ArticleDOI
TL;DR: This paper proposes a treatment model, drawn from the child maltreatment literature, that is also strongly supported by substance abuse research, and barriers within the substance abuse field to the adoption of treatment methods suggested by this model are considered.

46 citations

Journal Article
TL;DR: This article stresses the importance of combining perspectives, calling for the child welfare and alcohol and other drug abuse treatment systems to deal with both the mother's recovery and the child's well-being.
Abstract: Child welfare practice and substance abuse treatment have become overlapping areas for many human service professionals. This article stresses the importance of combining perspectives, calling for the child welfare and alcohol and other drug (AOD) abuse treatment systems to deal with both the mother's recovery and the child's well-being. Changes in attitudes, knowledge, and skills are required on the part of both the child welfare practitioner and the AOD abuse treatment worker.Substance abuse treatment and child welfare are overlapping areas of practice, but have not been viewed as such traditionally. Alcohol and other drug (AOD) abuse treatment programs and child welfare services have tended to remain relatively separate from one another, ignoring the likelihood that they share a population of clients. Since child welfare workers have generally had limited training in AOD abuse treatment, they are often ill equipped to assess the level of risk and to develop appropriate case plans for substance-involved families. Workers individually tend to focus on what they know best, ignoring other family considerations [Thompson 1990]. At an organizational level, agencies focus on mandated services with little or no orientation to the nature of alcohol and other drug treatment services [CWLA North American Commission on Chemical Dependency and Child Welfare 1992].Despite the long-standing assumption that AOD has an impact upon the family, few treatment facilities approach women as mothers as well as individuals, or deal with matters of parenting and the well-being of children [Kumpfer 1991]. In fact, few treatment programs provide women the opportunity to bring their children into treatment with them or to discuss parenting or family reunification [Gustavsson 1991]. Rarely do staff members at alcohol and other drug abuse treatment programs have any training in parenting skills, recognizing or treating child maltreatment, or child welfare, so this kind of helping is seldom offered to women in treatment.Each service system--child welfare and AOD abuse treatment--brings a unique perspective to understanding and dealing with substance-involved families. This article stresses the importance of combining perspectives, calling for the child welfare and AOD abuse treatment systems to deal with both the mother's recovery and the child's well-being. Changes in attitudes, knowledge, and skills are necessary for practitioners in both arenas. The scope of the problem and the impact of maternal addiction on the child welfare and the AOD abuse service systems are discussed first, followed by challenges practitioners face in their efforts to protect children while preserving families and encouraging sobriety. Recommendations for learning objectives and experiences for practitioners in both service systems conclude the article.IMPACT OF SUBSTANCE ABUSE ON THE CHILD WELFARE SYSTEMMaternal substance abuse* is but one challenge facing an already stressed child welfare system. In the last decade, reports of child maltreatment and child fatalities and the numbers of children in out-of-home care placements have increased [Gittler and McPherson 1990; McCullough 1991]. The National Committee for Prevention of Child Abuse [NCPCA] estimates that 675,000 children are maltreated each year by a chemically dependent caregiver [NCPCA 1989]. Among confirmed cases of child maltreatment, 40% nationwide involve substance abuse [Daro and McCurdy 1991]. Local estimates of the proportion of new protective services cases involving drug use are as high as 80% [Feig 1990].Although the numbers appear striking, it is important to point out that the observed relationships between child maltreatment and AOD abuse are correlational in nature [Williams and Collins 1986]. Nevertheless, a number of impacts on the delivery of child welfare services have been reported as a result of maternal substance abuse.REASONABLE EFFORTSTo address family circumstances placing the child at risk, child welfare workers must be capable of assessing parental AOD abuse problems. …

45 citations


"Collocation: Integrating Child Welf..." refers background in this paper

  • ...Child welfare workers whose primary focus is the safety of children are also not experienced in helping parents with substance problems (Marsh & Cao, 2005; Tracy & Farkas, 1994) and view substance-abusing parents as difficult to treat (Semidei et al., 2001)....

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Journal Article
TL;DR: Findings indicate that nearly half of the participants were able to complete addiction treatment and achieve sobriety, and those who used the program's child day care component were three times more likely to complete treatment.
Abstract: The authors present finding from their study of a placement prevention program designed to facilitate addiction treatment for substance-abusing mothers and other primary caregivers reported for child maltreatment. Relationships between involvement in the program, the status of addiction treatment, and the variety of outcomes for caregivers and their children were tested. Findings indicate that nearly half of the participants were able to complete addiction treatment and achieve sobriety. Those who used the program's child day care component were three times more likely to complete treatment. Implications for confronting the problem of substance-abusing caregivers in the child welfare system are drawn.

43 citations


"Collocation: Integrating Child Welf..." refers background in this paper

  • ...…research suggests collaboration between substance abuse treatment and other social service systems improves treatment outcomes, especially for women (Dore & Doris, 1998; Kraft & Dickinson, 1997; Marsh, D’Aunno, & Smith, 2000; Randolph & Sherman, 1993; Walsh & Young, 1998; Young & Gardner, 1998)....

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  • ...Dore and Doris (1998) found that nearly half of the women in their study were able to complete treatment through a placement prevention initiative staffed by both child welfare workers and substance abuse specialists....

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Journal Article
TL;DR: Conurrent treatment of depressed patients is common in the community, but these treatments are less interactive and collaborative than the treatment models proven effective in randomized controlled trails.
Abstract: BACKGROUND In randomized controlled trials, patients with major depression who receive broad-based collaborative treatment by both primary care physicians (PCPs) and mental health providers (MHPs) have better outcomes than patients who receive usual care. However, little is known about the concurrent treatment of patients with depression in the community. This study describes the perceptions of PCPs of the frequency of concurrent treatment in community settings, the degree of collaboration between co-treating providers, and factors associated with greater interaction and collaboration. METHODS A survey was distributed to a stratified, random sample of 276 eligible family physicians in Michigan. Primary analyses were descriptive statistics (point estimation) of PCP practice patterns. Secondary analyses explored predictors of collaboration with multivariable regression. RESULTS A total of 162 eligible PCPs (59%) returned the survey. PCPs reported that they co-treated approximately 30% of their depressed patients with MHPs. They made contact with co-treating MHPs in approximately 50% of shared cases; however, provider contact seldom included joint treatment planning. PCPs perceived collaborative treatments to be more problematic when patients were enrolled in managed care programs. In multivariable regression, co-location of MHP and PCP practices (in the same building) was strongly associated with increased interaction and collaboration (P <.001). CONCLUSIONS Concurrent treatment of depressed patients is common in the community, but these treatments are less interactive and collaborative than the treatment models proven effective in randomized controlled trails. If concurrent treatments are to become more collaborative-with regular contact and effective communication-co-location of practices appears important.

40 citations


"Collocation: Integrating Child Welf..." refers background in this paper

  • ...…Y o r k a t A l b a n y ] A t : 2 3 : 0 4 6 M a y 2 0 0 9 providers in buildings of primary care physicians for the treatment of depressed patients (Valenstein et al., 1999), and substance abuse providers in departments of social services for the assessment of Temporary Assistance to Needy…...

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  • ...providers in buildings of primary care physicians for the treatment of depressed patients (Valenstein et al., 1999), and substance abuse providers in departments of social services for the assessment of Temporary Assistance to Needy Families (TANF) recipients (Center on Addiction and Substance Abuse, 1999)....

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Findings suggest that clearly defined procedures and sufficient staffing of qualified substance abuse counselors could lead to better programs.