Substance use treatment completion does not mediate the relationship between family treatment court participation and reunification: Results from five courts in the Southwestern U.S.

IF 3.6 2区 医学 Q1 PSYCHIATRY
Margaret Lloyd Sieger , Jessica Becker , Jon D. Phillips , Cindy Nichols , Elizabeth J. Goldsborough , John Prindle
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引用次数: 0

Abstract

Background

Family treatment courts (FTC) apply judicial theory and behavioral economics to increase parent substance use treatment completion and family reunification for families in foster care due to parental substance use disorder. Dozens of quasi-experiments and case studies suggest FTC programs outperform traditional child welfare courts. However, methodological limitations in earlier research limit causal inference.

Study purpose

The current study aimed to examine the relationship between FTC participation and family reunification, and to investigate whether substance use treatment completion mediates this relationship.

Methods

Foster care, substance use treatment, and FTC administrative records from 2018 to 2022 were probabilistically linked across six counties in a Southwestern U.S. state. The final sample included 200 FTC-involved and 1367 comparison child/caregiver dyads. To address selection bias, we applied inverse probability weighting based on propensity scores. The weights balanced the treatment and control groups based on fifteen covariates, including demographic characteristics, child welfare system involvement, and novel substance use treatment metrics such as caregivers’ Addiction Severity Index scores, level of care recommendation, and primary substance of choice.

Results

Applying the weight, our logistic regression model revealed that FTC-involved dyads’ odds of reunification were 66 % greater compared to dyads served in traditional settings (OR = 1.66, 95 % CI: 1.14–2.40). The mediation model revealed that the effect of FTC participation on reunification was independent of treatment completion.

Conclusions

FTC demonstrates its own treatment effect on family reunification, above and beyond substance use treatment experiences. These findings point to a “value added” for FTC participation. In an area of practice characterized by low rates of success, identifying effective, real-world interventions for families is significant.
物质使用治疗完成不调解家庭治疗法庭参与和团聚之间的关系:结果从五个法院在美国西南部
家庭治疗法院(FTC)运用司法理论和行为经济学来提高因父母物质使用障碍而被寄养的家庭的父母物质使用治疗的完成和家庭团聚。数十个准实验和案例研究表明,联邦贸易委员会的项目优于传统的儿童福利法庭。然而,早期研究方法的局限性限制了因果推理。研究目的本研究旨在探讨参与联邦贸易委员会与家庭团聚之间的关系,并探讨药物使用治疗完成是否在这种关系中起中介作用。方法将2018年至2022年美国西南部一个州六个县的寄养、药物使用治疗和FTC行政记录进行概率关联。最后的样本包括200个联邦贸易委员会参与的和1367个比较儿童/照顾者的夫妇。为了解决选择偏差,我们应用了基于倾向得分的逆概率加权。权重基于15个协变量平衡治疗组和对照组,包括人口统计学特征、儿童福利系统参与和新型物质使用治疗指标,如照顾者成瘾严重程度指数得分、护理推荐水平和主要物质选择。结果应用权重,我们的逻辑回归模型显示,与传统环境中服务的夫妻相比,参与ftc的夫妻团聚的几率高出66% (OR = 1.66, 95% CI: 1.14-2.40)。中介模型显示,联邦贸易委员会参与对统一的影响与治疗完成无关。结论sftc对家庭团聚的治疗效果优于药物使用治疗经验。这些发现指向了FTC参与的“附加价值”。在一个以低成功率为特征的实践领域,为家庭确定有效的、现实的干预措施是重要的。
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来源期刊
Drug and alcohol dependence
Drug and alcohol dependence 医学-精神病学
CiteScore
7.40
自引率
7.10%
发文量
409
审稿时长
41 days
期刊介绍: Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.
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