Evaluation Study of Parental Substance Abuse & Child Maltreatment:Project First Step
Summary. Dr. Glenda Kaufman Kantor, Family Research Laboratory, UNH, is the Principal Investigator overseeing this demonstration project evaluation, under contract with the State of New Hampshire’s Division of Children Youth & Families.
Goals and Objectives
The major aims of this five year project, conducted November 1999 to Spring 2005, are to:
- Identify and address parental substance abuse problems that may place children at-risk and result in the placement of children in foster care, or the placement of children with their parents in residential treatment facilities
- Reduce the substance abuse risk behaviors of the parent (caretaker)
- Prevent or shorten placement of the children in foster care
A key component of this project was the inclusion of a Licensed Alcohol/Drug Abuse Counselor (LADC) skilled in the areas of substance abuse and child protective services. The project specialist conducted substance abuse assessments of parents referred for reasons of abuse or neglect of their children when the use of alcohol or other drugs was believed to be a contributing factor.
When substance abuse interventions were deemed necessary on an ongoing basis, the specialist assisted demonstration project families in accessing intensive, community-based services, and assisted the Child Protective Services Case Worker by provide ongoing, intensive case management services to targeted families. The underlying assumption of the project was that if given immediate and intensive services, targeted families will become better able to manage their substance abuse behaviors in order to provide a safe, nurturing environment for their children. This should result in the prevention of placement or a reduction in the length of stay of children in out-of-home care.
An experimental evaluation design was used to test the hypothesis that improved assessment and services will result in a reduction of length of stay for children in out-of-home placement, and ultimately improved well-being for children and families.
This evaluation was conducted in two NH cities, Nashua and Manchester. Included were families with reports of abuse/neglect that are determined as: 1) Credible and therefore assigned to district offices for assessment and 2) Involving substance abuse as a factor in the alleged abuse/neglect.
Approximately 400 families meeting the study criteria were asked to participate in special treatment or a standard services group in each of the two districts where the demonstration project was conducted. The major difference between the interventions being provided to the enhanced and comparison groups, was that the enhanced group was able to get assessment and ongoing case management by the substance abuse specialist. No child or adult was deprived of needed substance abuse services because of this project.
To date over 200 baseline and 150 follow-up interviews have been conducted. Follow-up interviews were focused on assessing the well-being of parents and children, parent’s utilization of services, and experiences with DCYF.
Key Results for Project First Step
Parents in the enhanced group were more likely to be involved in the following services or supports:
- Community Mental Health
- In home counseling (home based services)
- Any substance abuse treatment, including:
- Short Term Detox
- Short Term In Patient Treatment
- Long Term Inpatient Treatment
- Supports related to domestic violence
- Employment or vocational training
Outcomes for children (4-17 yrs old):
Children in Enhanced Groups had greater declines in 7 of 8 problem categories:
- Anxiety & Depression
- Somatic Problems
- Attention Problems
- Aggressive Behavior
- Thought Problems
- Rule Breaking
Family Involvement with DCYF and Placement Permanency
Without regard to site, children in the enhanced group had a lower chance of being involved in subsequent substantiated assessments than those in the standard group (18.47 v 22.79%) and a lower chance of involvement in subsequent substantiated assessments resulting in services (7.5 v 10%).
In the Manchester District Office the difference in the percent of overall subsequent substantiated referrals in enhanced families were also lower (14.15 v 17.33), as were subsequent substantiated referrals “opened” for services (4.6 v 10.5%).
Children in enhanced service families spent less time in out of home placement and fewer placement transitions than children in standard groups regardless of district office. Those children in the enhanced group who could not be safely reunified reached TPR sooner than those in the standard group. Mean days in care for enhanced children, and average time to TPR were both shorter in Manchester and Nashua, but Nashua enhanced children experienced fewer placement transitions than Manchester enhanced children. Children in the Nashua enhanced group were more likely to have TPRs than enhanced children in Manchester.