Indicators for safe family reunification: how professionals differ

Many professionals who work with substance-affected families consider the time limits prescribed by the Adoption and Safe Families Act (1997) to be unrealistically short. The high prevalence of substance use in child welfare cases requires professionals to quickly determine when it is safe to reunify children placed because of abuse or neglect in concert with this serious family problem. This exploratory study identified similarities and differences on different indicators of safe reunification between judges who hear juvenile cases, private agency child welfare caseworkers, and substance abuse counselors. The study examined these professionals' rating of the importance of each indicator. Judges, caseworkers, and counselors from a large midwestern state were surveyed. All groups agreed on the importance of 15 of the 19 identified areas of functioning. Judges and substance abuse counselors significantly differed on four factors; counselors and caseworkers differed on two. Implications of the findings for practice are discussed.

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The Adoption and Safe Families Act of 1997 (ASFA), in concert with the influence of alcohol- and drug-related problems on child welfare cases, has placed greater decision-making pressure on judges who hear juvenile cases, child welfare caseworkers, and substance abuse counselors serving this population. ASFA shortened the time for making permanency decisions to 12 months. This has resulted in judges who hear juvenile cases, child welfare professionals, and substance abuse counselors suggesting that the renewed emphasis on moving children to a safe and permanent home in a short period of time greatly challenges parents with substance use disorders (Semidei, Radel, & Nolan, 2001).

Rationale for the study

The increased pressure is partially attributable to the greater number of cases identified as involving parents with substance use disorders. For example, an investigation of the relationships among childhood abuse, subsequent adult functioning, and child placement with a sample of low-income, urban African American mothers reported substance use disorders highly correlated with child placement (Marcenko, Kemp, & Larson, 2000). Others have reported that 40% to 80% of all child welfare abuse and neglect cases involved parental substance use disorders (Young, Gardner, & Dennis, 1998). In consideration of the large number of child welfare cases involving substance-affected parents, the question is "How do key decision-makers weigh indicators for safe reunification with substance-affected parents?"

Literature review

Providing services for parents with substance use disorders is challenging. Recovery is an ongoing process beset with formidable tasks and multiple pitfalls and setbacks (Brown & Lewis, 1999; DiClemente & Prochaska, 1998; Leshner, 1997; Meyer, 1996; Miller, Gorski, & Miller, 1992). Family reunification only increases pressure by adding responsibilities recovering parents are expected to take on (Hohman & Butt, 2001). Developing healthy recovery from alcohol and drug use disorders in concert with learning skills necessary for effective parenting is difficult, and parents, primarily women, face innumerable challenges.

The literature suggests that parenting mothers recovering from alcohol and drug use disorders face multiple challenges including systemic obstacles, negative social attitudes, and traumatic personal histories. Systemic problems may include the potential conflict resulting from who is treated as the client (Karoll & Poertner, 2002a), child welfare workers' lack of skills, knowledge, or experience in working with substance-affected parents (Hess & Folaron, 1991; van Wormer, 1995), or poverty (Dore & Doris, 1997; Freundlich, 1997). Many substance-affected parenting women are financially or psychologically dependent on abusive or drug using partners (Miller & Cervantes, 1997). Stigma (Copeland, 1997; Royce & Scratchley, 1996) and society's unwillingness to release women from child-rearing obligations or management of their family's affairs (Hanke & Faupel, 1993) are attitudinal obstacles for recovering women. So too is the view that substance-affected mothers are unfit, which subjects them to societal disapproval (Baker & Carson, 1999). Society also continues to deem substance use disorders primarily restricted to men (Wilke, 1994), evidenced by treatment programs' unwillingness or inability to serve pregnant women (Blume, 1997; Finkelstein, 1993). Finally, a woman's personal history of sexual or physical abuse in childhood, adulthood, or both (Kang, Magura, Laudet, & Whitney, 1999; Marcenko et al., 2000) and an ever-present risk of relapse (Pagliaro & Pagliaro, 1999) pose other significant threats to reunification and recovery.

The current timetable for judicial decision-making in child reunification cases in concert with the multiple obstacles to successful recovery may suggest that termination of parental rights is the only logical solution. However, successful treatment for alcohol and drug use disorders, continued maintenance of recovery, and family reunification are possible given adequate time and appropriate primary and ancillary services (Miller, 1995). For example, Smith (1999) found treatment compliance increased the probability of family reunification even after accounting for continued parental drug use. In two state-sponsored projects, successful treatment for substance use disorders (Marsh, D'Aunno, & Smith, 1998) and reunification (Brindis, Clayson, & Berkowitz, 1997) were reported.