Enhancing Family Stability: Child Removal and CPS Re-Referral Outcomes Through the Family-Based Recovery Program.

Abstract

This study used a subset of data from a randomized controlled trial that evaluated the effects of an in-home substance use and dyadic therapy model that provides treatment to child welfare-involved parents. Participants (N = 388) were randomly assigned to Family-Based Recovery (FBR) (n = 268) or treatment-as-usual (TAU) (n = 120). Two child welfare outcomes were examined 18 months post-randomization: out-of-home placements (OOHP) and child protective service (CPS) re-referrals. Overall, 17.3% of parent-child dyads experienced OOHP and 24% CPS re-referrals. Fourteen percent of FBR-assigned dyads experienced an OOHP compared to 24% of TAU dyads. There were no differences in the CPS re-referral outcome by group assignment (FBR: 23.9%; TAU: 24.2%). Cox Proportional Regression results showed adjusted hazard rates of OOHP for FBR-assigned dyads were half compared to TAU-assigned dyads (.52, 95% CI [.32, .85], p = .009). Survival curves showed FBR had fewer dyads with OOHP episodes, and the OOHP event was statistically delayed compared to those assigned to TAU (Wald X² = 6.89; p = .009). Hazard rates of CPS re-referrals were similar for both groups, and no differences were found in the survival curves for CPS re-referrals between FBR and TAU. Results indicate that FBR is an effective model for caregivers experiencing SUD while reducing the likelihood of OOHP.