Targeting services to reduce need after a child abuse investigation: Examining complex needs, matched services, and meaningful change

Abstract

Background and purposeMatching needs and services following a child protective services (CPS) investigation is important for families with complex needs (i.e. mental health, substance use, and domestic violence) because several studies indicate that a service match is associated with important child welfare outcomes including decreased substance abuse, lowered rates of maltreatment, and increased family reunification. However, few of these studies have examined whether matching services reduces the different areas of need that service matching targets. In response, this study examined the change in need among families with complex needs that received matched services in a community-based prevention program following an initial CPS investigation. MethodsThe sample consisted of 836 families with complex needs related to mental health, substance use, and domestic violence that had an unfounded or inconclusive CPS investigation between July 2006 and December 2010. Eligible families had a child five or younger that remained at home after an initial CPS investigation and were at moderate to high risk of future maltreatment. The Family Assessment Form (FAF) was used to indicate need in three areas (concrete, clinical, and educational/parenting) and families received an array of services including concrete, educational/parenting, and/or clinical services. A match occurred if a caregiver had an aforementioned need and received a corresponding service. Reduced need was indicated by a change from a mean score of >3 (problematic functioning) on the FAF to a mean score of <3 (adequate functioning). Paired sample t-tests and Pearson Chi-2 analyses were used to examine bivariate associations between matched services by area of need on reduced need. Multivariate logistic regressions were conducted to determine the impact of matched services on reduced need in targeted areas and overall while controlling for caregiver demographic characteristics including ethnicity, age, income, number of caregivers and children, and history of abuse. FindingsBivariate analyses revealed that matched concrete and educational/parenting services was significantly associated with reduced need in targeted areas. For matched clinical services, this pattern was found for mental health and substance use but not for domestic violence. Multivariate analyses indicated that receiving matched concrete services was associated with an increased likelihood of overall reduced need (OR = 3.46; 95% CI = 1.84, 6.52) as was a match for educational/parenting need related to caregiver–child interactions (OR = 2.16; 95% CI = 1.15, 4.04). For clinical need, receiving matched clinical services for mental health (OR = 4.11; 95% CI = 2.39, 7.09) was associated with an overall reduction in need but not for substance use or domestic violence. Conclusion and implicationsMatching needs and services for families with complex needs following a CPS investigation remains important considering the number of families with complex needs that come to the attention CPS. Findings from this study highlight that matching needs and services can reduce targeted areas of need, overall need, and may serve as a catalyst for change in multiple areas of need.