When Home Is Still Unsafe: From Family Reunification to Foster Care Reentry

Reuniting children with their families is the preferred outcome of foster care, yet many children reunited with their families reenter foster care. This study examined how parental substance abuse and mental health problems, and the time allotted for reunification, are associated with reentry risk. We used a complete cohort of children who entered the Texas foster care system in fiscal years 2008 and 2009 to identify the risk of foster care reentry within 5 years of reunification using selection‐adjusted multilevel survival analysis. Approximately 16% of reunified children reentered care within 5 years. Substance abuse and mental health problems predicted higher rates of reentry. Reunification after 12 months was associated with increased reentry risk overall, but not among children commonly exempted from federal permanency timelines. Permanency guidelines that restrict the length of time to achieve reunification may have the unintended consequence of pushing reunification before maltreatment risks have been resolved.     

Parental substance abuse and the development of children in family foster care

To determine the impact of parental substance abuse on children, the cognitive skills and behavior ratings of 268 school-age children placed in family foster care were examined. As a group, the children in family foster care presented with low average cognitive skills and made significant improvement in cognitive functioning during placement. The children with prenatal exposure to drugs scored significantly lower in cognitive skills at the beginning of placement but made significantly more progress than the other children during placement. Behavior ratings by the foster parents and teachers revealed that 29% of the children had scores in the significant range, and the children exposed prenatally to drugs had a higher incidence of behavior problems at school compared to family foster care peers. Recommendations for further study of these factors and for enhancing outcomes for children in care are provided.     

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.     

Judges', caseworkers', and substance abuse counselors' indicators of family reunification with substance-affected parents

The decision to reunify children with their substance-affected parent is highly complex and requires a tremendous amount of work and change on the part of the affected parent. This exploratory study identified indicators for safe reunification of children placed in foster care due to parental substance abuse. Judges who hear juvenile cases, private agency child welfare caseworkers, and substance abuse counselors from a large midwestern state were surveyed using an instrument composed of a preliminary list of indicators identified through focus groups with these professional groups. Responses from 196 professionals who rated the importance of each item and subsequent factor analysis resulted in identification of 97 indicators. These indicators were grouped into the categories of motivation, recovery, competency, and reliability; social support; parenting skills; and legal issues. Implications of the findings for practice are discussed.     

Parental Substance Use and Foster Care Reentry

Foster care involvement due to parental substance use is a common problem with many challenges associated with service delivery. Using administrative data from a Midwestern state between the years 2009 and 2015 (N = 17,420), this study examines characteristics of substance-abusing families at the time of entry into the foster care system and estimates the risk of reentry subsequent to reunification. Bivariate findings and survival analysis for reentry suggests substance-using parents are more likely to be involved in additional allegations associated with foster care involvement. These results highlight the need for improved services integration and coordinated delivery among service systems.     

PARENTAL SUBSTANCE USE AND FOSTER CARE: EVIDENCE FROM TWO METHAMPHETAMINE SUPPLY SHOCKS

Foster care caseloads have nearly doubled over the last three decades. Parental methamphetamine (meth) use grew significantly during the same period. While child welfare workers and law enforcement claim that parental meth use contributes to foster care growth, the evidence for a causal effect has not been determined. This paper presents the first evidence of a causal effect of meth on foster care admissions using two exogenous supply‐side interventions in meth markets from the late 1990s for identification. First, we find that restrictions on meth precursor distribution caused meth use (proxied by white meth self‐referred treatment cases) to decline 4.1%. Second, using two‐stage least squares, we estimate a positive elasticity of foster care cases with respect to meth use of 1.54. We also estimate elasticities of 1.03 and 1.49 for cases of child neglect and parental abuse, respectively. These results suggest that child welfare policies should be designed specifically for the children of meth‐using parents. (JEL I12, J13, K42)     

Parental visiting and family reunification: could inclusive practice make a difference?

This study examines whether inclusive practice, or parental involvement in foster children's lives while in placement, is correlated with more frequent visiting and a greater likelihood of reunification. This hypothesis was tested among a random sample of 230 twelve- and thirteen-year-olds placed in traditional family foster care. Results suggest that mothers who visit their child and are involved in case reviews and child care activities visit more frequently than mothers who visit in settings such as agency offices and have no other types of involvement. In addition, visiting frequency is highly predictive of reunification. These associations were not explained by maternal substance abuse, mental illness, or the child's placement history.     

Achieving Permanence in Foster Care for Young Children: A Comparison of Kinship and Non-Kinship Placements

ABSTRACT

A number of child welfare policies have reinforced the use of kinship care as the most preferred placement for foster children, reflecting the philosophy that maintaining children within their own extended family system contributes to their stability and well-being. Given the growing utilization and legislative emphasis on kinship care along with the push for an immediate implementation of permanency plans for children in foster care, this study examines how the permanency goal under the 1997 Adoption and Safe Families Act (ASFA) is being implemented and achieved. The reunification and permanency placement (adoption or legal guardianship) outcomes of children in relative and non-relative care are analyzed, focusing on the experiences of young children. Based on public child welfare agency data from 2000 to 2003, child, case, and placement variables are explored to identify which set of factors best explains case outcomes. The present study identifies the total length of foster placement (kinship and non-kinship), the length of family maintenance services, and the number of placement changes as the most important variables in determining family reunification and permanent placement (legal guardianship and adoption) outcomes for young children.     

Reunification of foster children: Factors associated with reunification outcomes in Flanders and the Netherlands

Although a significant number of foster children eventually return to their birth parents, evidence-based models for permanency planning are scarce, and there is a lack of clear decision-making criteria for reunification. This study aimed to establish further knowledge about reunification. Both reunification pace and factors which are associated with reunification were examined. The focus was on factors related to the foster child, the birth parents, the foster parents and the foster placement, and reasons for removal. Case file analysis was performed for 580 Flemish and Dutch foster children ages 0–18. Cox regression analyses showed contact with birth parents to be most strongly associated with reunification. Moreover, particularly placement related factors (e.g., legal framework, additional support services, contact with birth parents) increased the likelihood of reunification. Furthermore, over a period of six years approximately 15% of foster placements led to reunification notably during the first 2.5 years of placement. Policy makers and foster care professionals are therefore encouraged to timely aim for permanency planning. Reunification efforts should be planned from the start of the foster placement. If subsequently reunification proves not feasible, permanency should be secured within the foster family.     

Underserved parents,underserved youth: Considering foster parent willingness to foster substance-using adolescents

Adolescents involved with foster care are five times more likely to receive a drug dependence diagnosis when compared to adolescents in the general population. Prior research has shown that substance use is often hidden from providers, negating any chance for treatment and almost guaranteeing poor post-foster care outcomes. There are virtually no studies that examine the willingness (and its determinants) to foster youth with substance abuse problems. The current study conducted a nationally-distributed survey of 752 currently licensed foster care parents that assessed willingness to foster youth overall and by type of drug used, and possible correlates of this decision (e.g., home factors, system factors, and individual foster parent factors such as ratings of perceived difficulty in fostering this population). Overall, willingness to foster a youth involved with alcohol and other drugs (AOD) was contingent upon the types of drugs used. The odds that a parent would foster an AOD-involved youth were significantly increased by being licensed as a treatment foster home, having fostered an AOD-involved youth in the past, having AOD-specific training and past agency-support when needed, and self-efficacy with respect to positive impact. Surprisingly, when religion played a large part in the decision to foster any child, the odds of willingness to foster an AOD-involved youth dropped significantly. These results suggest that a large proportion of AOD-involved youth who find themselves in the foster care system will not have foster families willing to parent them, thereby forcing placement into a variety of congregate care facilities (e.g., residential treatment facilities, group homes). Specific ways in which the system can address these issues to improve placement and permanency efforts are provided.     

Foster home licensing and risk of reentry to out-of-home care following family reunification

Family reunification without subsequent reentry is the primary permanency goal for children placed in foster care. While a number of placement-level factors have been examined for their effect on subsequent reentry to care, no study to date has considered foster care licensing. The current study uses statewide administrative data to construct a cohort of foster care youth who entered care between 2009 and 2012 and were reunified by the start of 2013 (N = 7752) to investigate the association between types of foster care and the probability of reentry to foster care up to two years following reunification. We focus specifically on the licensing status of foster homes, and employ propensity score analysis to address selection bias in placement type. A propensity-weighted cox proportional hazard model revealed that youth placed in licensed relative care (LRC) homes and licensed non-relative care (LNC) homes were more likely to reenter foster care than those youth placed in unlicensed relative care (URC) homes during their first spell of foster care.     

Does fathers' involvement in services affect mothers' likelihood of reunification with children placed in foster care?

Social science literature shows associations between fathers' involvement with their children and beneficial developmental outcomes of those children. A related but smaller body of research in the child welfare services arena has found measures of father involvement to be positively associated with beneficial child welfare outcomes, including child's reunification with parent after placement in foster care. However, the pathway by which father involvement affects reunification likelihood has not been determined. This study builds on the existing body of literature by testing a theoretical basis for the relationship between father involvement (measured as service use) and mothers' reunification in a model controlling for family structure. I find that fathers' involvement in services improves mothers' likelihood of reunification, independently of family structure. Results suggest that agency efforts to involve fathers in services make sense both when the aim is to prepare the father for possible custody, and when the aim is to reunify the mother.     

Parental substance misuse and child protection in a British sample. A survey of children on the child protection register in an inner London district office

The relationship between parental misuse of alcohol and/or illegal drugs and child maltreatment has received considerable attention in the USA, while comparatively few British studies have been published. In both countries, research suggests that it is a large and growing problem and that it has a significant negative impact on children. This study looks at 50 families with 95 children on the Child Protection Register (CPR) in an inner London area through an examination of files and social workers' rating of parental substance misuse as a child protection concern. Parental substance use, as defined by social workers, was considered by social workers to be a cause for concern in 52% of families. Alcohol (in 24% of families) and heroin (in 16%) were the main substances of concern. Substance misuse was strongly related to neglect and cases were twice as likely to be subject to care proceedings. Very little involvement of substance misuse professionals in child protection procedures was found. Different profiles of social work concern were found for alcohol and for illegal drugs. Reasons for this difference and areas for further research are discussed. Copyright © 2000 John Wiley & Sons, Ltd.     

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.     

Predictors of foster care exits to permanency: A competing risks analysis of reunification, guardianship, and adoption

Although foster care is intended to be temporary, and policy explicitly requires permanency outcomes, many children experience lengthy stays and exit foster care without a permanent family. This study sought to identify which child and placement characteristics were important predictors of exit to three types of permanency outcomes: reunification, guardianship, and adoption. A sample of 3351 children who entered foster care in 2006 was observed for 30 to 42 months. Permanency outcomes were analyzed using competing risks survival analysis. Children exited foster care to different types of permanency at different rates and frequencies. Reunification occurred most quickly and frequently. Guardianship was second in terms of median duration but third in frequency. Adoption was the second most common exit but had the longest median duration. One in four children remained in foster care or exited without permanency. While patterns varied by type of permanency, three major categories of important predictors were identified: 1) demographic characteristics of age at entry and race, 2) clinical needs related to children's disabilities and mental health problems, and 3) continuity and connections represented by kin placements, sibling placements, early stability, and absence of runaway events. Implications for practice, policy, and research are discussed.     

Perspectives: Former foster youth refining the definition of placement moves

Research has demonstrated that children who experience numerous moves in foster care are more likely to exhibit behavioral problems and less likely to achieve reunification or permanency. However, current knowledge about how placement move transitions impact children is extremely limited.This study used qualitative methods to explore how former foster youth define a placement move. Results indicated that placement moves can be defined by: 1) Time and relationships; 2) Packing and leaving; 3) Loss of property; 4) Returning home; 5) Type of placement; and 6) Decision-making process. An alternative definition of a placement move is offered and implications for child welfare policy, research and practice are provided.