The issue of substance abuse in families is of particular concern when compound with the effect on child well being and family unification. Children of families involved with substance abuse are not only considered to be at higher risk for abuse and maltreatment, but are also more likely to be placed in foster care, and experience longer placements as a result of substance issues. Although treatment for substance abuse has been shown to have a positive correlation to family reunification in these circumstances, as well as improved child wellbeing, treatment completion rates for families in the child welfare system are dramatically low. Authors Sam Choi and Joseph P. Ryan discuss this issue as it relates specifically to the population of substance abusing parents in the child welfare system in their article Completing Substance Abuse Treatment in Child Welfare: The Role of Co-Occurring Problems and Primary Drug of Choice.
Choi and Ryan specify the role and priority of the child welfare system as “protecting children from risks of maltreatment” and “strengthen families to care for children”. As such, treatment completion for substance abuse among this population is paramount to the cause of the child welfare system. However, the authors reveal that success rates are under %25. So the authors consider characteristics of co occurring problems that may explain these statics in hopes of offering new insight toward improving the rates.
The authors note previous literature identifying such characteristics that seem to predict outcomes of treatment completion. Along with drug preference and dependence level, the authors state that “age, race, gender, education level, and employment”, as well as “presence of co-occurring problems at intake” are all correlated with completion outcomes. In their own study, the authors found that demographic characteristics reflected that white participants had higher rates of treatment completion at %28, compaired to non white participants. A high school education was also correlated with improved completion rates at just over %26 compared to %19. And any level of employment was an even stronger predictor with a %28 completion rate again compared to %19.
Of the authors sample, identified co-occurring problems that correlated to treatment completion rates. Medical problems reflected as a barrier for treatment completion, with an %18 rate compared to an almost %25 rate of completion of participants with out this co occurring problem. Surprisingly, participants who had ongoing legal issues had a better treatment completion rate at just under %30 compared to only %20 of those who were not involved with the court. In terms of mental health, depression was also surprisingly correlated with better completion rates, with just under %30 completing treatment programs.
In terms of substance as a factor influencing treatment completion, the authors found that greater level of dependency was strongly correlated as a barrier. Substance preference also marked a spectrum of completion. The authors cite that completion rates for marijuana users was the highest at %34, followed by alcohol at %26 and cocaine at %20. Heroin users had the lowest completion rate at %13.
Of this wide range of variables influencing treatment completion by substance using parents involved with child welfare services, the authors suggest that specified treatment programs could very well improve completion rates and better serve the prerogative of child welfare services in their mission. Contrast to typical one size fits all programs describe by the authors, alternative treatments could specify by substance preference using modalities already proven to be effective among given groups. Further, individualized program plans to address co existing problems could further boost treatment completion rates. The authors suggest that because mental health, poverty, and child management skills are such frequent issues among the topic population, the low rates of treatment compellation can partly be improved by addressing these challenges.
Discussion Questions.
1. The authors explain that parental substance abuse is recognized as a measure for increased risk for child maltreatment. Do you think foster placement is an appropriate action based solely on risk if there was no actual maltreatment or abuse? Consider that family reunification becomes more challenging after this action, and the effects that may have on children and families.
2. The authors specified that along with substance related barriers for treatment completion, age, education, gender, and poverty also contributed to completion rates. Why might these classifications have so much influence in a person’s ability to complete a substance treatment program?
3. The authors found that ongoing legal problems, as well as symptoms of depression reflected improved rates for treatment completion. What might account for this?
Citation
Choi, S. & Ryan, J. P. (2006). Completing substance abuse treatment in child welfare:
The role of co-
occurring problems and primary drug of choice. Child Maltreatment, 11(4) , 313-325. DOI: 10.1177/1077559506292607
Michael Whelan
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