"Nothing about Me without Me": Leading the Way to Collaborative Relationships with Families

By O'Connor, Lisa A.; Morgenstern, Jon et al. | Child Welfare, March/April 2005 | Go to article overview

"Nothing about Me without Me": Leading the Way to Collaborative Relationships with Families


O'Connor, Lisa A., Morgenstern, Jon, Gibson, Fay, Nakashian, Mary, Child Welfare


This article discusses the National Center on Addiction and Substance Abuse's CASA Safe Haven(sm), an evidence-based, community-driven intervention program for children and families in child welfare whose lives have been adversely affected by substance abuse, and for staff in the agencies that work with them. CASA Safe Haven(sm) builds collaborative relationships that feature a blend of multidisciplinary teams that share responsibility for helping families; family group conferencing, in which families are equal and welcome participants in designing and driving a service plan; and the influence of family court to hold families and service providers accountable for progress. CASA Safe Haven(sm) is a framework for collaboration.

Substance Abuse and Child Welfare

In 2002, an estimated 19.5 million Americans (8.3% of the population) were users of illicit drugs, and 14.9 million were dependent on or abused alcohol (U.S. Department of Health and Human Services [DHHS], 2002). We see the result of this level of illicit drug use and alcohol dependence in all aspects of our society, but the danger it creates for children is possibly most extreme.

When parents abuse drugs or alcohol, their judgment and priorities may be impaired and their ability to provide appropriate care for their children may result in instances of abuse or neglect (National Center on Addiction and Substance Abuse [CASA], 1999; National Committee to Prevent Child Abuse, 1998). In 2002, of the 2.6 million reports of abuse and neglect filed with state child welfare agencies, caseworkers determined that an estimated 900,000 children were victims of child abuse or neglect (Administration for Children and Families [ACF], 2003). Eighty percent of the perpetrators of the abuse and neglect were parents; women, mostly mothers, comprised 58% of perpetrators (ACF, 2003).

Parental substance abuse contributes to or exacerbates at least 7 of 10 child welfare cases (CASA, 1999) and 52% of out-of-home placements (Child Welfare League of America [CWLA], 1998). Other reports estimate that 40% to 80% of families involved with child welfare have substance abuse problems (CWLA, 2004a; Young, Gardner, & Dennis, 1998). Children whose parents are substance involved are three times more likely to be abused and more than four times more likely to be neglected than children whose parents do not abuse drugs and alcohol (Kelleher, Chaffin, Hollenberg, & Fischer, 1994).

Parents who have alcohol and other drug problems and who are involved with child protective services are themselves in crisis and have multiple complex problems. Many of them suffer from mental health problems (depression or anxiety), are unemployed or have inconsistent work histories, have health problems like HIV/AIDS, have insecure housing, and are involved in chaotic or violent relationships (DHHS, 1999; Morgenstern et al., 2001; Wells & Tracy, 1996; Woolis, 1998), all of which pose challenges to parenting and family stability.

The Problem

Complicating the overlap of substance abuse and child maltreatment is that child welfare professionals, those most likely to come into contact with families with serious alcohol and drug abuse, are not equipped to deal with substance-involved clients (CASA, 1999; CWLA, 1998; Dore, Doris, & Wright, 1995; McAlpine, Marshall, & Doran, 2001). Child welfare staff estimate that 67% of the parents involved with their agencies require alcohol and other drug treatment, yet these agencies could provide services for only 31% of those in need (CWLA, 1998). Despite the high level of parental substance abuse in child welfare cases, little collaboration has taken place between child welfare agencies and alcohol and drug treatment programs (CWLA, 2004b).

Families involved with child welfare systems and alcohol or drugs often receive services from other public agencies. Because many families who are involved with child welfare agencies also receive benefits from Temporary Assistance to Needy Families (TANF), welfare reform and its mandates have a significant effect on child welfare and treatment activities. …

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