Using child welfare assessments and latent class analysis to identify prevalence and comorbidity of parent service needs

Data collected through Illinois's Integrated Assessment (IA) program—an assessment and service coordination program incorporating clinical assessments of both parents following a child's placement in foster care—offers a unique opportunity to examine the service needs of parents within a family context. Between January 2007 and June 2010, integrated assessments were completed with 4089 families in which at least one parent participated in the assessment. Utilizing these data, this study employs a Latent Class Analysis approach to identify the patterns of service needs of parents with children entering foster care. Latent class models were generated for mothers and fathers who participated in comprehensive family assessments based on identified service needs. Models revealed “low need” and “high need” classes among both mothers and fathers. A distinct class characterized by substance abuse needs emerged among fathers and a similar class among mothers was characterized by both substance abuse and mental health needs. A mental health needs class was identified among fathers while a similar class among mothers was characterized by both mental health needs as well as trauma symptoms. In examining the distribution of classes among families where both parents were present, the largest groups of families were those in which both parents fell into the “low need” classes, those in which the father fell into the “low need” class and the mother fell into the “substance abuse and mental health” class, and those in which both the mother and the father fell into the “substance abuse” classes. Implications for case assignment practices, father engagement, and addressing comorbid service needs are discussed.     

Abusers gaining custody in family courts: A case series of over turned decisions

Abstract

This article presents findings and recommendations based on an in-depth examination of records from 27 custody cases from across the United States. The goal of this case series was to determine why family courts may place children with a parent that the child alleges abused them rather than with the nonoffending parent. We focused on “turned around cases” involving allegations of child abuse that were at first viewed as false and later judged to be valid. The average time a child spent in the court ordered custody of an abusive parent was 3.2?years. In all cases we uncovered the father was the abusive parent and the mother sought to protect their child. Results revealed that initially courts were highly suspicious of mothers' motives for being concerned with abuse. These mothers were often treated poorly and two-thirds of the mothers were pathologized by the court for advocating for the safety of their children. Judges who initially ordered children into custody or visitation with abusive parents relied mainly on reports by custody evaluators and guardians ad litem who mistakenly accused mothers of attempting to alienate their children from the father or having coached the child to falsely report abuse. As a result, 59% of perpetrators were given sole custody and the rest were given joint custody or unsupervised visitation. After failing to be protected in the first custody determination, 88% of children reported new incidents of abuse. The abuse often became increasingly severe and the children's mental and physical health frequently deteriorated. The main reason that cases turned around was because protective parents were able to present compelling evidence of the abuse and back the evidence up with reports by mental health professionals who had specific expertise in child abuse rather than merely custody assessment.     

Alcohol and drug abuse among young adults who grew up in substitute care — Findings from a Swedish national cohort study

To what extent substitute long term care modifies intergenerational transmission of substance abuse has rarely been investigated. Using register data, we followed a national cohort born 1973–1985 consisting of 1012 national adoptees, 2408 former children from long term foster care, 348/846 environmental siblings of adoptees/foster children, and 952,935 majority population peers, from their 15th birthday to age 27–35. Using Cox regression, we calculated hazard ratios (HR) for hospital care and criminality associated with illicit drug/alcohol abuse, with adjustments for socio-demographic indicators of caring families, and substance abuse in caring and birth parents.     

Post Adoption Service Need and Use as Predictors of Adoption Dissolution: Findings From the 2012 National Adoptive Families Study

Data from the 2012 National Adoptive Families Study (NAFS) were used to examine the relationships between adoptive parents' need for and utilization of post-adoption services and adoption dissolution. NAFS was an online survey administered to adoptive parents (N = 437) who had adopted a child from the United States foster care system. The study found that needing and accessing post-adoption services predicted 26% of the variance in dissolution. Substance abuse treatment, educational advocacy, and parent support groups were the only significant predictors of adoption dissolution. Both needing and accessing substance abuse treatment increased the likelihood of adoption dissolution. Needing educational advocacy increased the likelihood of dissolution, but actually accessing it decreased the likelihood of dissolution. Accessing parent support groups similarly decreased the likelihood of dissolution. Policy and practice implications of the findings are discussed.     

Parental Illicit Drug Use and Family Life: Reports From Those Who Sought Help

Family histories of abuse and neglect are common among persons with substance addictions. Clearly such family backgrounds impact on future lifestyle choices. How this early life experience then impacts on the substance user as a parent and on their children has not been considered in the literature in any detail. Clients of local community drug services were invited to participate in a study evaluating the family life of parents who were dependent on illicit substances. Fifteen parents participated in a qualitative, longitudinal study about their family life, treatment and drug of choice. Four aspects of parental perception of family life were examined: the perceived impact of the family of origin on the parent drug user, self‐perception, the impact of parental illicit drug use on the family environment, the impact of parental illicit drug use on children. For parents struggling with a substance addiction, it would seem that recovery has much to do with differentiation and gaining a sense of agency.     

Exploratory analysis of child protection mediation permanency placement outcomes

Using a merged data set constructed from empirical data obtained from Child Protective Services (CPS) and a nonprofit agency tasked with conducting an evaluation of a child protection mediation pilot project in the state in which this study was conducted, this study (N = 311) explores how various child and family factors in child protection mediation cases affect placement outcomes for children in care. Results of the multinomial logistic regression (MLR) analyses found that children for whom parent/caregiver substance abuse and/or mental illness was an issue were less likely to be reunified with their parents than remain in care. Those children who experienced a higher number of placements and those who were male were less likely to be placed with relatives. Children whose parents experienced mental health issues were less likely to be placed with a relative. With regard to the permanency outcome of adoption, the findings showed that as the age of the child at time of removal increased, children were less likely to be adopted than remain in care. Additionally, African American children in the sample were less likely to be adopted.     

Substance Abuse among African-American Children: A Developmental Framework for Identifying Intervention Strategies

Abstract

Substance abuse has devastating effects on the lives of African-American children and adolescents who are both directly and indirectly victims of this problem. This article discusses child and adolescent substance abuse from a psychosocial developmental perspective within an Africentric paradigm. The authors explore contributing and intervention factors related to substance abuse that impact developmental milestones. They delineate preventive tactics for addressing the problem of substance abuse and delineate implications for social work practice.     

Family Unity Meetings: Decision Making and Placement Outcomes

ABSTRACT

The sample consisted of all families (747) who were invited to receive a Family Unity Meeting from a Public Child Welfare Agency in a large urban county. Data was derived from the review of agency case files. The design was a retrospective case review with an embedded prospective study. This study describes factors that distinguish between CPS clients who accept an invitation to participate in a Family Unity Meeting (FUM) and those clients who decline to participate. The meeting process is described, and logistic regression is used to identify variables that predicted successful outcomes FUM meetings.

Families with reunification as a goal were the most likely cases to agree to participate followed by Voluntary and Permanency Planning cases. Cases with severe neglect were the least likely group to participate in a meeting process. Approximately nine people attended an average meeting. Maternal relatives were more likely to attend than paternal relatives.

Empirical evidence was found to support the notion that FUM expands the notion of family. Only 38% of children were placed with a parent after a meeting, but 82% of children were placed with a family member. Children were not placed with either the parent or family if the social worker had placement as a goal before the meeting. Cases with permanency plans were also less likely to be placed with the family. Social workers were more likely to agree with a placement with relatives if they had a concern about parental drug abuse. Having a maternal aunt in attendance at the meeting was predictive of having a child placed with the family.

Social workers and families stated concerns prior to the meeting diverged. Families were more concerned with economic and financial issues than were the social workers. Social workers were more concerned with child protective service issues (type of abuse, placement issues, etc.) and the behavior of the parent (substance abuse, mental health, etc.) than was the family. Paying attention to family issues such as finances may be a necessary precursor to families focusing on more complex matters like substance abuse or parenting practices.

Placement outcomes were consistent with worker's goals stated before the meeting. If a social worker said they wanted to place a child with the family before the meeting, that placement was most likely the outcome of the meeting. Social workers may be guiding the decisions of the family. If this interpretation is correct then it raises questions about who makes decisions at the meeting. An alternative conclusion is that the social workers are good diagnosticians who know prior to the meeting if placement is necessary, and know what decisions the family will make.     

Alcohol consumption, alcohol-related problems, and other substance use among lesbian and bisexual women

Relationships between sexual orientation and a wide range of substance use and problem variables were examined based on data from the 2000 National Alcohol Survey. Lesbians, bisexuals, and heterosexually identified women who report same-sex partners were compared to exclusively heterosexual women in relation to alcohol consumption, use of tobacco and other drugs, bar-going, alcohol-related problems, and past substance abuse treatment. Substance use patterns were complex and varied between sexual orientation groups. These differences underscore the importance of developing lesbian- and bisexual-sensitive prevention and treatment services and of including measures of sexual orientation identity and behavior in population-based surveys.     

Effective Recruitment for Parenting Programs Within Ethnic Minority Communities

This article describes the results of a demonstration project which focused on exploring recruitment and retention of ethnic minority families to a parent training program aimed to prevent substance abuse among their children. The Parenting for Drug-Free Children project sought to deliver a curriculum to parents from several ethnic groups in an urban setting. The targeted ethnic communities were African American, Latino, Native American, and Samoan. The project successfully recruited diverse groups of families to participate in a drug prevention program, many of whom had never participated before in a parenting program. The identification of key individuals for recruiting and accessing networks of potential participants proved to be an effective means of recruitment.     

‘No one believed us: no one came to help’: caregivers' experiences of violence and abuse involving children with fetal alcohol spectrum disorder

Child and adolescent-to-parent violence and abuse (CAPVA) refers to abusive and violent behaviours by children towards their parents or primary caregivers. The abuse and harmful behaviours can include a full range of physical, emotional, verbal, financial, and material actions over prolonged periods of time, from childhood to young adulthood. Parents and caregivers of children with neuro-developmental conditions are vulnerable to CAPVA, and little research has been undertaken exploring the experiences of caregivers of children with fetal alcohol spectrum disorder (FASD). In Aotearoa New Zealand, 56 caregivers were interviewed using semi-structured interviews, and over half identified significant levels and impacts of CAPVA, including dealing with physical violence and frequent emotional abuse. Health and stress issues were present in all caregivers interviewed. Caregivers also identified how systemic ignorance and a lack of understanding from caring professionals led to parent blaming, a sense of shame and isolation. Yet, caregivers also showed resilience and implemented strategies of de-escalation and distraction. More specialised practice is needed in this emerging field of family violence and in how to support families with children who have FASD.     

Substance use in youth adopted from foster care: Developmental mechanisms of risk

Children who enter foster care are at unique risk for developing substance abuse due to experiencing early life stressors. A large body of research has revealed robust effects of various stressors on later substance use, implicating the role of early neurobiological changes that create chronic internalizing problems. However, less literature has investigated externalizing behavior as a mechanism underlying this relationship. Moreover, few studies have examined these mechanisms through a model of cumulative risk. The present study examined whether the prospective association between cumulative pre-adoptive risk (e.g., maltreatment, age at placement, foster placement instability, ever having lived with birth parent) and adolescent/young-adult substance use was mediated by childhood internalizing and externalizing problems in youth adopted from foster care. Participants included 82 adoptees, most with histories of prenatal substance exposure (72%). We tested parent-rated internalizing and externalizing problems across 5 years in childhood as simultaneous mediators of cumulative risk and level of substance use 11–15 years later. Bootstrapping mediation procedures, controlling for age, prenatal substance exposure, adolescent/young adult mental health symptomatology, and youth participation in follow-up, revealed a significant indirect effect of cumulative risk on substance use through childhood internalizing problems, but not externalizing problems. These results underline the importance of mitigating early risk for children in the child welfare system and call for targeting childhood emotion dysregulation to reduce likelihood of substance abuse among previously high-risk adoptees. Nevertheless, low rates of substance use overall in the present sample underscore the positive impact of adoptive placement on mitigating risk for substance abuse among foster youth.     

Characteristics and factors impacting reunification outcomes among Vietnamese immigrant families in the child welfare system

Using a mixed methods approach, this study examined reunification processes and outcomes among Vietnamese immigrant families involved in the child welfare system. A quantitative design was used to describe characteristics and reunification outcomes of Vietnamese immigrant children and families who are involved in family reunification services. Qualitative methods were used to explore factors that may influence reunification outcomes among Vietnamese families.The quantitative portion of the study included an exploratory design using administrative data from one county in the Northern California. The quantitative sample (N = 32) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 from child welfare administrative data (CWS/CMS) which was merged with eligibility data (CalWIN) in order to obtain parent and child place of birth to determine country of origin. The qualitative study included an exploratory design using interview data from child welfare workers (N = 8) and Vietnamese immigrant parents who had successfully reunified (N = 7).Quantitative results indicated that the most common type of maltreatment leading to entry into care was caretaker absence or incapacity, an abuse category that is often used in cases of parental substance abuse. 53.8% of Vietnamese immigrant children in the quantitative sample reunified with their parents, which is close to the national rate of reunification. Qualitative findings pointed to the importance of the following factors within reunification: acculturation-related issues, parental substance abuse, child welfare worker cultural competency and issues related to service availability and effectiveness. Implications for social work practice and policy are discussed.     

Addressing substance abuse treatment needs of parents involved with the child welfare system

The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed home-based substance abuse treatment interventions appear the most effective at improving substance abuse treatment initiation and completion in child welfare populations. Research is needed to compare the efficacy of these two approaches, and examine cost and child well-being indicators in addition to substance abuse treatment and child welfare outcomes.     

Parent Marital Quality and the Parent–Adolescent Relationship: Effects on Adolescent and Young Adult Health Outcomes

Although a number of studies examined the implications of marital disruption for adolescent well-being, few studied the implications of marital relationship quality on health outcomes for children in married-couple families. The present study examines how parent marital quality among intact families interacts with the quality of parent–adolescent relationships to predict physical health, mental health, and substance use in middle adolescence and early adulthood. The study uses data from the NLSY97 cohort, a nationally representative sample of adolescents who are being followed into adulthood. Predictors include the quality of the parent marital relationship, the quality of the parent–adolescent relationship, marital structure, and a number of contextual covariates and control variables. Combined parent marital quality and parent–adolescent relationship groups were developed using latent class analyses and were used to predict positive and negative health behaviors during the teen and early adult years. Results indicate that adolescents in families experiencing poor marital quality fared worse on physical health, mental health, and substance use outcomes. In addition, adolescents who reported poor relationships with at least one of their parents fared worse on outcomes. Adolescents whose parents have low-quality relationships and also have poor parent–adolescent relationships tended to fare least well across health measures. Adolescents whose parents have a high-quality relationship and who have a good parent–adolescent relationship with both parents consistently had the best outcomes. Overall, poor relationships consistently undermine mental health, physical health, and substance use. Family religious activities also consistently predict better health outcomes.     

Behind the cycle of violence, beyond abuse history: a brief report on the association of parental attachment to physical child abuse potential

Although the concept of a cycle of violence presumes that the transmission of violence is expressed directly across generations, the role of the overall quality of the parent-child relationship may ultimately be more influential in later parenting behavior. This study investigated whether mothers' poorer attachment to their parents was associated with their current increased child abuse potential and dysfunctional disciplinary style independent of a personal history of child abuse. A sample of 73 at-risk mothers raising children with behavior problems reported on their parental attachment, abuse potential, dysfunctional parenting style, and personal abuse history. An at-risk sample, rather than a sample of identified abuse victims or perpetrators, was studied to better examine the potential continuity or discontinuity from history of abuse to current abuse risk, allowing consideration of those who may break the cycle versus those who potentially initiate abuse in the absence of a personal history. Findings indicate that poor attachment significantly predicted both dysfunctional parenting practices and elevated child abuse potential, controlling for personal child abuse history. Such results highlight the importance of the overall quality of the relationship between the parent and child in potentially shaping future abuse risk. Findings are discussed in terms of continuity or discontinuity in the cycle of violence and future directions for research on attachment in relation to the development of later child abuse risk.     

Perspectives of college students and their primary health care providers on substance abuse screening and intervention

The authors conducted a needs assessment among students and health-care providers of a southwestern university health center with the goal of developing health-care-provider training addressing substance-abuse screening and intervention. They collected data from focus groups of undergraduate students and structured interviews and questionnaires with health-care providers. They identified gaps in provider and student perspectives on the extent of substance abuse on campus and the perceived roles of health-care providers and patients in screening and conducting interventions for substance abuse. These findings suggest that training for college health-care providers regarding substance-abuse brief screening and intervention should emphasize confidentiality of student medical records, the importance of nonjudgmental attitudes toward students, and the role of the provider as one who is competent and appropriate to address substance abuse. Such training should also educate providers about the types of substances students are using.     

How child protective services investigators decide to substantiate mothers for failure-to-protect in sexual abuse cases

The purpose of this study was to determine how Child Protective Services (CPS) investigators decide to substantiate mothers for failure-to-protect from sexual abuse. A case-comparison study was used to compare 31 mothers who were and 62 mothers who were not substantiated for failure-to-protect by CPS. The multivariate analysis showed that mothers who did not consistently believe the sexual abuse occurred and who did not consistently act protectively were more likely to be substantiated. In addition, if they knew about the abuse from more than one source were less supportive of the children; and had a substance abuse problem, a mental health problem or were being battered, then they were more likely to be substantiated. Investigators appear to apply criteria consistently to substantiate mothers. doi:10.1300/J070v15n04_04.