A significant number of substance-abusing parents in the child welfare system do not complete substance abuse treatments. Consequently, their children experience longer stays in substitute care settings, and the risk of the termination of parental rights is increased. This study identifies and determines the specific factors that explain the completion of substance abuse treatment for substance-abusing caregivers in child welfare. The sample includes 871 caregivers enrolled in the Illinois Alcohol and Other Drug Abuse waiver demonstration. Approximately 22% of these caregivers successfully completed all required levels of substance abuse treatment. The multivariate models indicate that age, employment status, and legal involvement were significantly associated with the likelihood of completing substance abuse treatment. Heroin users were significantly less likely to complete treatment as compared with alcohol, cocaine, and marijuana users. The findings are discussed in terms of policy and practice implications for public child welfare systems.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
Arfken, C., Klein, C., Menza, S., & Schuster, C. (2001). Gender differences in problem severity at assessment and treatment retention. Journal of Substance Abuse Treatment, 20, 53-57.
3.
Armenian, S., Chutuape, M., & Stitzer, M. (1999). Predictors of discharges against medical advice from a short-term hospital detoxification unit. Drug and Alcohol Review, 56, 1-8.
4.
Beardsley, K., Wish, E., Fitzelle, D., O’Grady, K., & Arria, A. (2003). Distance traveled to outpatient drug treatment and client retention. Journal of Substance Abuse Treatment, 25, 279-285.
5.
Belenko, S. (2001). Research on drug courts: A critical review, 2001 update. New York: National Center on Addiction and Substance Abuse at Columbia University.
6.
Besinger, B. A., Garland, A. F., Litrownik, J., & Landsverk, A. (1999). Caregiver substance abuse among maltreated children placed in out-of-home care. Child Welfare, 78(2), 221-239.
7.
Bradburn, N. M., & Sudman, S., Blair, E., Locander, W., Miles, C., Singer, E., et al. (1979). Improving interview method and questionnaire design. San Francisco: Jossey-Bass.
8.
Brewer, D., Catalano, R., Haggerty, K., Gainey, R., & Fleming, C. (1998). A meta-analysis of predictors of continued drug use during and after treatment for opiate addiction. Addiction, 93, 73-92.
9.
Bride, B. (2001). Single-gender treatment of substance abuse: Effect on treatment retention and completion. Social Work Research, 25, 223-232.
10.
Center on Addiction and Substance Abuse. (1999). No safe heaven: Children of substance-abusing parents. New York: Columbia University Press.
11.
Chaffin, M., Kelleher, K., & Hollenberg, J. (1996). Onset of physical abuse and neglect: Psychiatric, substance abuse, and social risk factors from perspective community data. Child Abuse and Neglect, 3, 191-203.
12.
Chan, L., Wingert, W., Wachsman, L., Schuetz, S., & Rogers, C. (1986). Differences between dropouts and active participants in a pediatric clinic for substance abuse mothers. American Journal of Drug and Alcohol Abuse, 12, 89-99.
13.
Cook, C., Booth, B., Blow, F., McAleenan, K., & Bunn, J. (1994). Risk factors for AMA discharge from VA inpatient alcoholism treatment programs. Journal of Substance Abuse Treatment, 11, 239-245.
14.
Copeland, J., & Hall, W. (1992). A comparison of predictors of treatment dropouts of women seeking drug and alcohol treatment in a specialist women’s and two traditional mixed sex-treatment services. British Journal of Addiction, 87, 883-901.
15.
Delaware Division of Family Services. (2002). Linking child protective workers with substance abuse counselors: Delaware’s Title IV-E child welfare waiver. New Castle: Delaware Department of Health and Social Services.
16.
Famularo, R., Kincherff, R., & Fenton, T. (1992). Parental substance abuse and the nature of child maltreatment. Child Abuse and Neglect, 16(4), 475-483.
17.
Fuller, T., & Wells, S. (2003). Predicting maltreatment recurrence among CPS cases with alcohol and other drug involvement. Children and Youth Services Review, 25(7), 553-569.
18.
Green, C., Polen, M., Dickinson, D., Lynch, F., & Bennett, M. (2002). Gender differences in predictors of initiation, retention, and completion in an HMO-based substance abuse treatment program. Journal of Substance Abuse Treatment, 23, 285-295.
19.
Haller, D., Knisely, J., Elswick, R., Dawson, K., & Schnoll, S. (1997). Perinatal substance abusers: Factors influencing treatment retention. Journal of Substance Abuse Treatment, 14, 513-519.
20.
Hser, Y., Anglin, M. D., Grella, C., Longshore, D., & Predergast, M. L. (1997). Drug treatment career: A conceptual framework and existing research findings. Journal of Substance Abuse Treatment, 14, 543-558.
21.
Hser, Y., Maglione, M., & Boyle, K. (1999). Validity of self-report of drug use among STD patients, ER patients, and arrestees. American Journal of Drug and Alcohol Abuse, 25, 81-91.
22.
Hser, Y., Polinsky, M. L., Maglione, M., & Anglin, M. D. (1999). Matching clients needs with drug treatment services. Journal of Substance Abuse Treatment, 16, 299-305.
23.
Hughes, T. (1993). Research on alcohol and drug use among women: A review and update. In B. McElmurry & R. Parker (Eds.), Annual review of women’s health (pp. 245-285). New York: National League for Nursing Press.
24.
Jaudes, P., Ekwo, E., & Van Voorhis, J. (1995). Association of drug abuse and child neglect. Child Abuse and Neglect, 19(9), 1065-1075.
25.
Joe, G. W., Simpson, D. D., & Sells, S. B. (1994). Treatment process and relapse to opioid use during methadone maintenance. American Journal of Drug and Alcohol Abuse, 20, 173-197.
26.
Kathleen, C., Charla, N., Samuel, B., Elinore, M., Tami, F., & Bruce, R. (2000). One year follow-up of disulfiram and psychotherapy for cocaine-alcohol users: Sustained effects of treatment. Addiction, 95, 1335-1349.
27.
Kelly, P., Blacksin, B., & Mason, E. (2001). Factors affecting substance abuse treatment completion for women. Issues in Mental Health Nursing, 22, 287-304.
28.
Knight, D. K., Logan, S. M., & Simpson, D. D. (2001). Predictors of program completion for women in residential substance abuse treatment. American Journal of Drug and Alcohol Abuse, 27(l), 1-18.
29.
Laken, M., McComish, J., & Ager, J. (1997). Predictors of prenatal substance use and birth weight during outpatient treatment. Journal of Substance Abuse Treatment, 14, 359-366.
30.
Lang, M., & Belenko, S. (2000). Predicting retention in a residential drug treatment alternative to prison program. Journal of Substance Abuse Treatment, 19, 145-160.
31.
Lundgren, L. M., Schilling, R. F., & Peloquin, S. D. (2005). Evidence-based drug treatment practice and the child welfare system: The example of methadone. Social Work, 50(1), 53-63.
32.
Maluccio, A., & Ainsworth, F. (2003). Drug use by parents: A challenge for family reunification practice. Children and Youth Services Review, 25(7), 511-533.
33.
Marlowe, D. B., Glass, D. J., Merikle, E. P., Festinger, D. S., Dematteo, D. S., Marczyk, G. R., et al. (2001). Efficacy of coercion in substance abuse treatment. In F. J. Tims, C. G. Leukefeld, & J. J. Platt (Eds.), Relapse and recovery in addictions (pp. 208-227). New Haven, CT: Yale University Press.
34.
Marlowe, D. B., & Kirby, K. C. (1999). Effective use of sanctions in drug courts: Lesions from behavioral research. National Drug Court Institute Review, 2, 1-32.
35.
Marsh, J. C., D’Aunno, T. A., & Smith, B. D. (2000). Increasing access and providing social services to improve drug abuse treatment for women with children. Addiction, 95, 1237-1247.
36.
Marsh, J. C., Ryan, J., Choi, S., & Testa, M. (2006). Integrated service for families with multiple problems: Obstacles to family reunification. Children and Youth Services Review, 28, 1074-1087.
37.
McCaul, M., Svikis, D., & Moore, R. (2001). Predictors of outpatient treatment retention: Patient versus substance use characteristics. Drug and Alcohol Review, 62, 9-17.
38.
McElrath, K. (1994). A comparison of two methods for examining inmates’ self-reported drug use. International Journal of Addictions, 29, 517-524.
39.
McHanon, R., Kouzerkanani, K., & Malow, R. (1999). A comparative study of cocaine-treatment completers and dropouts. Journal of Substance Abuse Treatment, 163, 17-22.
40.
McLellan, A. T., Grissom, G. R., Zanis, D., Randall, M. A., Brill, P., & O’Brien, C. P. (1997). Problem-service matching in addiction treatment: A prospective study in 4 programs. Archives of General Psychiatry, 54, 730-735.
41.
McLellan, A. T., Luborsky, L., & Woody, G. E. (1983). Predicting response to alcohol and drug abuse treatments: Role of psychiatric severity. Archives of General Psychiatry, 40, 620-625.
42.
Melnick, G., De Leon, G., Thomas, G., & Kressel, D. (2001). A client-treatment matching protocol for therapeutic communities: First report. Journal of Substance Abuse Treatment, 21, 119-128.
43.
Miller, N., Hoffmann, N., Ninonuevo, F., & Astrachan, B. (1997). Lifetime diagnosis of major depression as a multivariate predictor of treatment outcome for inpatients with substance use disorders from abstinence-based programs. Annals of Clinical Psychiatry, 9, 127-137.
44.
Moore, B., & Budney, A. (2002). Abstinence at intake for marijuana dependence treatment predicts response. Drug and Alcohol Dependence, 67, 249-257.
45.
Nellori, N., & Ernst, F. (2004). Predictors of treatment completion for patients receiving residential drug and alcohol treatment. Addictive Disorders and Their Treatment, 3, 36-42.
46.
Pecora, P. J., Whittaker, J. K., Maluccio, A. N., Barth, R. P., & Plotnick, R. D. (2000). The child welfare challenge (2nd ed.). New York: Aldine de Gruyter.
47.
Pollack, H., Danziger, S., Seefeldt, K., & Jayakody, R. (2002). Substance abuse among welfare recipients: Trends and policy responses. Social Service Review, 76, 256-274.
48.
Simpson, D., Joe, G., Rowan-Szal, G., & Greener, J. (1997). Drug abuse treatment process components that improve retention. Journal of Substance Abuse Treatment, 14, 565-572.
49.
Smith, B. D. (2003). How parental drug use and drug treatment compliance relate to family reunification. Child Welfare, 82, 335-365.
50.
Smith, B. D., & Marsh, J. (2002). Client-service matching in substance abuse treatment for women with children. Journal of Substance Abuse Treatment, 22, 161-168.
51.
Stack, K., Cortina, J., Samples, C., Zapata, M., & Arcand, L. (2000). Race, age, and back pain as factors in completion of residential substance abuse treatment by veterans. Psychiatric Services, 51, 1157-1161.
52.
Substance Abuse and Mental Health Services Administration. (2002). Results from the 2001 National Household Survey on Drug Abuse: Volume I. Summary of national findings (Office of Applied Studies, NHSDA Series H-17, DHHS Pub. No. SMA 02-3758). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
53.
Sung, H., Belenko, S., & Feng, L. (2001). Treatment compliance in the trajectory of treatment progress among offenders. Journal of Substance Abuse Treatment, 20, 153-162.
54.
U.S. Department of Health and Human Services. (1999). Blending perspectives and building common ground: A report to Congress on substance abuse and child protection. Washington, DC: Government Printing Office.
55.
U.S. General Accounting Office. (1998). Foster care: Agencies face challenges securing stable homes for children of substance abusers (GAO/HEHS-98-182). Washington, DC: Author.
56.
U.S. General Accounting Office. (2003). Foster care: States focusing on finding permanent homes for children, but long-standing barriers remain (GAO-03-626T). Washington, DC: Author.
57.
Vaughn, T., Sarrazin, M., Saleh, S., Huber, D., & Hall, J. (2002). Participation and retention in drug abuse treatment services research. Journal of Substance Abuse Treatment, 23, 387-397.
58.
Wallave, A., & Weeks, W. (2004). Substance abuse intensive out-patient treatment: Does program graduation matter?Journal of Substance Abuse Treatment, 27, 27-30.
59.
Wolf, R. V. (2000). The story of the Manhattan family treatment courts. Journal of the Center for Families, Children and the Courts, 2, 5-19.
60.
Wolock, I., & Magura, S. (1996). Prenatal substance abuse as a predictor of child maltreatment re-reports. Child Abuse and Neglect, 20, 1183-1193.
61.
Young, N. K., Gardner, S. L., & Dennis, K. (1998). Responding to alcohol and other drug problems in child welfare: Weaving together practice and policy. Washington, DC: Child Welfare League of America.
62.
Zarkin, G., Dunlap, L., Bray, J., & Wechsberg, W. (2002). The effect of treatment completion and length of stay on employment and crime in outpatient drug-free treatment. Journal of Substance Abuse Treatment, 23, 261-271.
