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Maternal substance use disorders (SUDs) are a known risk factor for poor child welfare outcomes. Efforts to expose the mechanism of this disparity typically focus on the mother’s addiction treatment experiences. However, treatment completion rates are typically higher than reunification rates and current theory does little to explain why some mothers reunify and others do not. This article aims to widen the lens on this area of research through application of a social determinants of health framework. A systematic review of the literature pertinent to mothers with SUDs seeking reunification identifies existing gaps and makes recommendations for practice, policy, and future research. [ABSTRACT FROM AUTHOR]

Although prior research has established that maternal substance use disorders (SUDs) are associated with poor foster care outcomes, few earlier studies have sought to differentiate between families with maternal SUDs who reunify and those who do not reunify. This study applied the intersectional social determinants of a health framework to examine the effect of socioeconomic status (SES) risks on the likelihood of reunification for 325 mothers with SUDs and their children in foster care. Multivariate Cox regression models assessed four SES risk factors separately and cumulatively: single parent; income less than $15 000; unemployment; and severe housing issues. The study results reveal that none of the SES factors alone reduced the chances of reunification, but did so in combination. Compared to cases with one risk, cases with three risks were 39.1 per cent less likely to reunify and four‐risk cases were 49.3 per cent less likely to reunify. Cases with zero, one and two risks did not significantly differ. The primary implication of this study is that families with maternal SUDs in child welfare are a heterogeneous group whereby reunification depends on SES risk severity. In practice, these findings suggest that improving reunification for families with maternal SUDs may be aided by reducing the total number of socioeconomic risk factors, rather than eliminating specific risks. © 2018 John Wiley & Sons, Ltd. 'Examine[s] the effect of socioeconomic status risks on the likelihood of reunification for 325 mothers with substance use disorders and their children in foster care' Key Practitioner Messages: Families affected by parental SUDs in child welfare are a heterogeneous group whose outcomes vary based on the severity of socioeconomic risk.Mothers with SUDs in child welfare are significantly worse off socioeconomically compared to fathers with SUDs.The impact of SES on reunification outcomes depends on the accumulation of risk, rather than individual factors.Substance abuse treatment must be augmented with efforts to reduce the cumulative SES burden on families. [ABSTRACT FROM AUTHOR]

Although parental substance abuse has been identified as a risk factor for poor foster care outcomes, current research on effective interventions is limited. A few studies have shown that parenting interventions improved parenting skills and family functioning and decreased time to reunification among children in foster care due to parental substance abuse. However, more research is needed to evaluate whether these interventions positively impact reentry rates. Using propensity score analyses to establish a matched comparison group, survival analyses evaluated the relationship between participation in a parenting intervention, the Strengthening Families Program (SFP), and reentry among a sample of 493 children previously reunified with their parents. The overall reentry rate was 20.9%. Analyses indicated that there was no difference in reentry rates between the SFP (23.7%) and comparison groups (18.6%). Significant predictors of reentry were child behavior problems, family poverty, and reunification between 15 and 18 months from removal. [ABSTRACT FROM AUTHOR]

Literature on family drug treatment courts ( FDTCs) suggests that parental participation in these courts is associated with improved substance abuse treatment and child welfare system outcomes. Despite these beneficial outcomes, FDTCs serve only 7-10% of eligible child welfare involved families. As part of a FDTC evaluation, this FDTC site sought to provide stakeholders with information about costs and benefits. Considering the program costs alongside the cost avoidance from reduced time in foster care, this analysis determined that FDTC participation resulted in a net savings per child of $9,710. The cost component of the evaluation proved valuable, challenging, and informative. [ABSTRACT FROM AUTHOR]

Parental substance abuse is one of the most prominent reasons that children enter foster care. The relative role of substance type in delaying reunification has remained elusive. This study sought to understand the impact of parental use of alcohol, methamphetamine, other drugs, and poly-substances on reunification rates for children in foster care. The authors used administrative foster care data from a Midwestern state between years 2007 and 2012 to evaluate the unique contribution of each substance use domain. Results suggest that parental methamphetamine use has the most significant impact on the likelihood of reunification, followed by other drugs, and poly-substances. These findings further indicate that children removed due to any parental drug use stay in foster care for an average of 49-156days longer than their peers. Implications for research and practice are addressed. [ABSTRACT FROM AUTHOR]

Parental substance abuse is a major factor in families experiencing foster care placement, yet little is known about the potential of screening in determining risk or identifying subpopulations for which elevated risk occurs. One Midwestern state recently implemented screening. This research uses information gathered as part of the screen's implementation to conduct a latent class analysis. The research was extended to provide a detailed examination of differences in child and family characteristics across classes, and to compare the screen results with caseworker impressions. Three distinct typologies emerged, with the high-risk and moderate-risk designations comprising only one quarter of the cases. [ABSTRACT FROM PUBLISHER]

This study examined measures of placement stability and social–emotional well-being for a federally-funded demonstration project of inhome Parent Management Training-Oregon model (PMTO) for children in foster care with serious emotional disturbance (SED). Following a cultural exchange framework for translational research and a tollgate approach to evaluation, this formative study tested these measures prior to further investment in summative evaluation. The research aim was to observe whether measures of social–emotional well-being and placement stability performed as expected. Using a pretest–posttest randomized consent trial, children identified as SED within six months of entering foster care were randomly assigned to PMTO or to a services-as-usual comparison group ( N = 121). A multi-group structural equation model was tested to observe the relationship of baseline social–emotional wellbeing and placement stability on post-test social–emotional well-being. Results showed that post-test well-being was significantly predicted by baseline well-being for both groups and, importantly, only the intervention group demonstrated significant effects of placement stability on post-test well-being. For the intervention group, as placement stability increased, post-test social skills significantly improved, demonstrating an association between well-being and placement stability that was not evident in the comparison group. Overall, wellbeing measures performed as expected and detected relationships between variables and variation as hypothesized. Additionally, placement stability may have been mediated by the PMTO intervention. In conclusion, by using a real world example of the translational research concept of cultural exchange between university-based researchers and agency-based practitioners, this study shows that formative evaluation offers an important opportunity to test ad hoc research questions inspired by the process of implementation itself. [ABSTRACT FROM AUTHOR]