Rethinking Child Welfare to Keep Families Safe and Together: Effective Housing-Based Supports to Reduce Child Trauma, Maltreatment Recidivism, and Re-Entry to Foster Care

By Rivera, Marny; Sullivan, Rita | Child Welfare, July 1, 2015 | Go to article overview

Rethinking Child Welfare to Keep Families Safe and Together: Effective Housing-Based Supports to Reduce Child Trauma, Maltreatment Recidivism, and Re-Entry to Foster Care


Rivera, Marny, Sullivan, Rita, Child Welfare


In pursuit of the protection and best interests of children, the state has a right to intervene in the private affairs of families by removing from their home children who are neglected or abused and placing them into protective custody, often in a foster care placement. This initial intervention can be critical to ensure the child's safety, but historically child welfare agencies have not been structured in a way that focused sufficiently on the longer-term well-being outcomes for children. Households in which parents abuse substances have an increased likelihood of providing chaotic environments for children. Rife with conflict, poor super vision, and insufficient emotional attention, the home lives created by parents with substance use disorders pose risks and safety factors too often requiring protective placements for children (Donahue, Romero, & Hill, 2006).

Child welfare policies have historically aimed to reduce these risks and increase safety by removing children from homes with parents who have a substance use disorder. For decades, the short-term gains of these child welfare policies may have been offset by long-term consequences of trauma associated with removal of children and placement in out-of-home care. This trauma can be avoided with appropriate resources to ensure that the children can safely remain with their parents while the family addresses the myriad problems they may be experiencing. Due to a lack of resources and other practice and policy concerns, child welfare agencies and substance abuse treatment communities have worked separately to assist a shared population that experience co-occurring problems. This recognition was made in our county in the late 1980s and resources began to be allocated to programs for the provision of integrated services.

Improved policies and systems change across the nation have contributed in part to the decline in the number of children in foster care: between 2004 and 2013 the number decreased by more than 22 percent (Child Welfare Information Gateway, 2015). Despite this drop large numbers of children continue to be removed from their families and placed into foster care, over 250,000 annually between 2009 and 2013, and many removals are for maltreatment secondary to parental substance use disorders (Child Welfare Information Gateway, 2015; Department of Health and Human Services [DHHS], 2014). This article presents the evaluation of a pilot project-a family-focused, housing-based, drug treatment program with wraparound services provided through a collaboration involving child protection and substance abuse treatment-that reduced reliance on out-of-home care and the trauma associated with the child's removal. An underlying premise of the program is that reducing intergenerational transmission of substance use disorders and child maltreatment requires efforts to improve the parents' ability to parent while safely keeping families together or reunifying them as quickly as possible. This program model is offered to other jurisdictions to effect the systems change needed to treat parental substance abuse problems associated with child maltreatment.

Literature Review

Parental substance use is a significant risk factor for children and increases the likelihood of both child maltreatment and child welfare system involvement. Data documenting the existence of parental substance use disorders in child welfare cases is not consistently collected. However, a prospective longitudinal study identified maternal substance use as one of five key factors that increased the odds of a report to child protection services (Dubowitz et al., 2011). Higher rates of child neglect or abuse are likely consequences of parents who are impaired and prioritize their substance use (seeking, using, and recovering from intoxication) over the needs of their children. Parents with a substance use disorder parent ineffectively when their addiction contributes to a chaotic home life with few positive role models, poverty, and many moves. …

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