Impact of intensive case management on child welfare system involvement for substance-dependent parenting women on public assistance

Abstract

This study examined the impact of intensive case management (ICM) on decreasing child welfare system involvement in a sample of substance-dependent parenting women who participated in a welfare demonstration study comparing ICM to usual screen-and-refer models employed in welfare settings. Previous research established the effectiveness of ICM in both increasing engagement in substance abuse treatment and in promoting abstinence, and the current study tested whether ICM had downstream impacts on child welfare outcomes not directly targeted by the intervention. The sample included 302 mothers recruited from welfare offices and their 888 minor children. Child welfare outcomes were available from administrative records for four years following study entry and included incident reports and out-of-home child placements. An initial positive effect of ICM was found on child placements, but its impact lessened over time and was likely due to the increased contact with case managers that occurred early in the study. Overall, minimal benefits of ICM were found, suggesting that while ICM was effective in the areas of treatment engagement and abstinence, there were no downstream benefits for child welfare outcomes. Implications of findings in terms of increased need for cross-system collaboration are discussed.

Interventions to address parenting and parental substance abuse: Conceptual and methodological considerations

“…Child welfare agencies are financially and politically pressured to find permanent placements for children who have been removed from their homes within an expedited time-frame, but successful SA treatment requires parents to devote a sufficient amount of time to recovery (Dauber et al, 2012). Policies that require parents to decide between fulfilling child care goals and completing drug treatment place them in the unfortunate situation where either choice may be considered wrong by influential authority figures (Jansson & Velez, 1999).…”

“…Parents with SUD often do not seek out SA treatment or leave treatment early for fear that they will lose custody of their children or face criminal prosecution (Niccols & Sword, 2005). Child services agencies are financially and politically pressured to find permanent placements for children who have been removed from the home within an expedited time-frame, but successful SA treatment requires a sufficient amount of time to devote to recovery (Dauber, Neighbors, Dasaro, Riordan, & Morgenstern, 2012). Policies that require mothers to decide between caring for their children and completing drug treatment represent significant barriers that place mothers in the unfortunate situation where either choice may be considered wrong by influential authority figures on who’s opinion both the mother and child’s futures depend (Jansson & Velez, 1999).…”

Identifying alcohol and other drug use during pregnancy: outcomes for women, their partners and their children

“…In addition, a lower proportion of children were removed from participants in the ICM condition compared to usual care, but this effect decreased over time. Overall, however, they found minimal benefits from case management in terms of child protection outcomes but it was effective in the areas of treatment, engagement and abstinence (Dauber et al, 2012).…”

“…The literature supports case management as an integral part of a comprehensive treatment plan for substance use disorders in pregnant women (Jones & Kaltenbach, 2013). It has produced positive outcomes for vulnerable substance abusers facing multiple barriers, including pregnant women and mothers of young children, building on the knowledge that women have historically not responded well to traditional substance abuse treatment models that focus on abstinence alone, without incorporating services for problems in other areas (Dauber, Neighbors, Dasaro, Riordan & Morgenstern, 2012).…”

Alcohol-related child maltreatment

“…Therefore, collaboration between the addiction treatment and the child protection systems should be regulated at the state level, ensuring the organisational, geographical, and financial accessibility of the services. Research in countries where such changes have already been made confirms that such steps have improved parenthood and children's wellbeing (Dauber, Neighbors, Dasaro, Riordan, & Morgenstern, 2012;Marsh, Smith, & Bruni, 2011;Neger & Prinz, 2015;Osterling & Austin, 2008). These steps towards better child protection should also be taken in Lithuania.…”