Reunification Rates Research Articles

National training and development curriculum training program impact on placement, permanency, and stability

BackgroundResource parent trainings are an important factor in caregiver readiness and retention, which can improve placement stability and permanency achievement for children and youth, especially those who are marginalized. ObjectiveResource parents need access to evidence-based training programs attentive to caring for children and youth from a variety of diverse backgrounds. This study evaluates placement, permanency, and stability outcomes of children whose resource parents were trained in one such program: the National Training and Development Curriculum (NTDC). Participants and settingParticipants include adults who completed a resource parent training program (N = 3822) and children in their care (N = 2565) in the U.S. states of Florida, Georgia, Illinois, and Missouri. MethodsThis quasi-experimental study involved statistical testing of caregivers and children using AFCARS data. Propensity-score matching was used to control for differences in the child permanency analysis. ResultsWith a better understanding of the realities of fostering, NTDC participants were slightly less likely to foster after training (OR = 0.6; p < .001), self-selecting out before taking a child into the home. Those who did foster were more likely to foster a child who is a teen (OR = 1.4; p = .004), Asian/Asian American (OR = 3.8; p = .02), Black/African American (OR = 1.6; p < .001), or Hispanic/Latinx (OR = 1.7; p = .002). Children of NTDC caregivers entered legal adoptions (OR = 2.0; p = .003) and guardianships (OR = 2.9; p = .03) at higher rates than children of comparison caregivers, while rates of reunification (OR = 1.3; p = .11) were not statistically different. ConclusionsEvidence points to the effectiveness of NTDC in preparing resource parents to provide care for a diverse range of children by age, race, and ethnicity, and for those children to achieve permanency.

The Importance of Sibling Relationships for Children in Foster Care.

There are approximately 500,000 children in the foster care system in the United States of America. With exposure to chronic and cumulative trauma, they constitute a population with an increased risk of developing mental health concerns and adverse outcomes in later life, including contact with the forensic system. Legislative frameworks that have been developed to facilitate improved outcomes are outlined, although these vary between states, and the focus is often on the parental relationship. Several studies have emphasized the importance of sibling relationships and that placing siblings in the same foster home is associated with higher rates of placement stability, reunification, adoption and guardianship, and fostering positive sibling relations. The multifaceted role of the clinician in promoting recovery from trauma, enhancing resiliency, and thoughtfully prescribing and advocating for familial relationships is discussed.

Linked administrative data can inform policy and practice: An academic - government research partnership in South Australia.

ObjectiveTo describe how the Better Evidence Better Outcomes Linked Data (BEBOLD) platform has been used to partner with government agencies to generate evidence to support service reform that contributes to improving outcomes for children and families in contact with the child protection system. ApproachData was drawn from the BEBOLD platform, a whole-of-population linked de-identified administrative data platform for all children in South Australia born from 1991-2016 (n~500,000), as well as their parents. Data linked included birth registrations, perinatal statistics, child protection services, family health services, education, youth justice, housing and homelessness, emergency department presentations and hospitalisation, as well as adult drug and alcohol services. ResultsWe present case studies illustrating how the BEBOLD platform has been used to 1) investigate the descriptive epidemiology of child protection contact patterns with a focus on priority populations (e.g. young parents); 2) describe service interactions of child protection populations in a way that highlights prevention potential (e.g. the overlap between public housing and child protection); and 3) identify policy defined target populations to inform contracting of support services (e.g. estimate counterfactual reunification rates for a defined population to inform development of a Social Impact Bond). ConclusionUsing linked data to take an intelligent system view of potential priority populations can inform policy and service delivery in a resource restricted setting. Descriptive epidemiology of child protection contact patterns, population sizes, transitions, and characteristics can aid services to explore elements of service or system design including eligibility criteria.

Peer parent programs in child welfare: A systematic review

BackgroundMentoring, specifically peer mentoring, emerged in the child welfare setting in the early 2000s. Peer parent programs provide child welfare involved families a unique opportunity to connect with parents that have successfully navigated the child welfare system and who share similar lived experiences. No systematic review has been conducted to summarize findings associated with parental participation in peer parent programs and associated child welfare case outcomes. ObjectiveThis study systematically summarizes the effectiveness of peer parent programs in child welfare on case outcomes, specifically permanency, time-in-care, and re-entry post reunification. MethodsFour citations were identified for review from seven academic databases. A data template was utilized to extract the following information from each study: location, target of intervention, research design, setting of intervention, intervention description, peer parent criteria, inclusion and exclusion criteria for participants, sample size, statistical tests, outcomes assessed, and key findings. ResultsSeveral peer parent programs have been developed to support and empower child welfare involved families with the aim of improving case outcomes. All of the peer parent programs reviewed had a positive impact on reunification rates; that is, parents who participated in a peer mentor program were more likely to reunify with their child(ren) when compared to non-participants. Results regarding time-in-care and re-entry post reunification at 12 and 24 months were mixed. ConclusionsChild welfare agencies should consider developing peer parent programs as they appear to be a promising intervention to support parents and increase positive child welfare outcomes.

Racial/ethnic disproportionality in reunification across U.S. child welfare systems

BackgroundRacial/ethnic disparities are persistent in referrals and removals of children into child welfare systems. Yet, less is known about disparities in reunification, and how system factors may contribute to more equitable outcomes for families of color. ObjectiveThis study examined racial/ethnic disparities in reunification rates across U.S. child welfare systems controlling for child- and system-factors. Participants and settingData for this study came from the 2017 Adoption and Foster Care Analysis and Reporting System (AFCARS). We utilized a subsample of n = 284,382 children ages 0–5. MethodsWe used a bottom-up model building-approach to examine child- and system-factors associated with reunification. A series of multilevel models were run. ResultsLess than 3% of the variance in reunification occurred between state child welfare systems. Native American children had lower odds of reunification than White children (AOR = 0.87, p < .001), while Hispanic children had higher odds of reunification (AOR = 1.08, p < .001). Random effects were present for race/ethnicity and interaction terms between race/ethnicity and parental drug use were significant. ConclusionsRacial/ethnic disparities are present in reunification, though these may vary across child welfare systems. Thus, future research could examine state systems that have better outcomes for families of color and examine factors that might explain these relationships.

Health Determinants, Maternal Addiction, and Foster Care: Current Knowledge and Directions for Future Research

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.

Short-term family foster care in Flanders: An exploratory study into the factors associated with family reunification decisions

Since the entry into force of the foster care decree in Flanders (01/01/2014), a distinction is made between short-term and long-term family foster care. In short-term foster care, a foster child is placed in a foster family for at most one year with the aim of reunification, or, if this is not possible, clarifying the child's future (long-term family foster care or residential care). The present study is the first to examine reunification rates and characteristics associated with reunification decisions in Flemish short-term foster care. Case files of 125 short-term foster care placements that started after 01/01/2014 and ended before 31/12/2015 of all Flemish foster care agencies were analyzed. Short-term foster care resulted in 27% of the cases in a reunification. Bivariate analyses showed that seventeen variables were significantly associated with a reunification. Inclusion of these variables in a logistic regression model resulted in a significant model that explained 52% of the variance, with the only predictive variable being the pedagogical skills of the mother at the end of the placement. This is promising. It implies that in developing a methodology to promote reunification, improving the pedagogical skills of mothers must be given a prominent place.

Parenting intervention effects on reunification: A randomized trial of PMTO in foster care.

Evidence-supported parenting interventions (ESPIs) have expanded into child welfare because a growing research base has demonstrated positive results among children with serious emotional and behavioral problems. Despite a clear federal policy emphasis on reunification, few randomized trials have tested ESPIs with biological families of children in foster care; even fewer studies have investigated the distal outcomes of ESPIs. The aim of the current study was to examine the effects of Parent Management Training, Oregon (PMTO) model on reunification. Children in foster care with emotional and behavioral problems were randomized to in-home PMTO (n = 461) or services as usual (SAU) (n = 457). Cox regression models tested whether children in the PMTO group achieved higher rates of reunification. We applied life tables data for integrals calculations to estimate days saved in foster care. Analyses were conducted as intent-to-treat (ITT), and per protocol analysis (PPA). ITT results showed reunification rates were 6.9% higher for the PMTO group (62.7%) than the SAU group (55.8%) with 151 days saved per typical child. PPA indicated that intervention completion strengthened effects as PMTO completers' reunification rates (69.5%) were 13.7% higher than the SAU group (55.8%), and were 15.3% higher than non-completers (54.2%). Days saved were also greater for completers as compared to the SAU group (299 days) and non-completers (358 days). Overall, findings suggest that an in-home parenting intervention positively affected reunification as delivered to biological parents of children and youth in foster care with serious emotional and behavioral problems. Implications and future considerations for research are discussed.

How does FDAC Succeed with Parents with Substance Misuse Problems? Exploring Relational Practices within the English Family Drug and Alcohol Court

Parental substance misuse is a significant risk factor for child maltreatment and is frequently involved in care proceedings. Outcomes are often poor and family reunification is prone to breakdown. In this article, the contribution of the English Family Drug and Alcohol Court (FDAC) is examined. Adapted from the US family drug treatment court model, FDAC offers a radically different approach to ordinary care proceedings by treating parents as well as adjudicating. The article draws on a mixed‐methods evaluation of FDAC which reports better recovery and reunification rates than ordinary court. It presents findings from interviews with 42 parents and 154 court observations of 89 cases, focusing on FDAC's relational practices. The article concludes that these relational practices offer hope to substance‐misusing parents and that the approach merits wider attention because of its therapeutic potential and distinctive approach to justice.‘The contribution of the English Family Drug and Alcohol Court (FDAC) is examined’Key Practitioner Messages FDAC is a helpful approach to care proceedings for substance‐misusing parents. Parents value clear, consistent and honest messages about their progress when delivered in the context of trusted relationships and intensive support. Parents need holistic help that takes into account damaging early‐life experiences. ‘Parents need holistic help that takes into account damaging early‐life experiences’

Live-In Family Enhancement (LIFE): a comprehensive program for healing and family reunification

Family enhancement is an approach to child protection that has been recommended by numerous reviews of child welfare practice. A recent example emerged from a comprehensive review of the child welfare system in Manitoba, Canada. The inquiry recommended that family enhancement be utilised in all child welfare cases, and be funded at levels reasonable enough to allow comprehensive support for families seeking to re-unify. Agency staff told the inquiry, however, that current resources permitted only limited service, for insufficient time, and for only a small percentage of families in care. An Indigenous agency in Manitoba, Metis Child, Family, and Community Services, has devised an innovative approach in which parents were fostered along with their children. This allows the agency to make a wide range of resources available to families on a 24-hour basis for 8-to-12-month periods. The costs do not appear to exceed those of regular fostering of children. This Live-In Family Enhancement (LIFE) program was extensively evaluated in 2015. The findings show a significant set of benefits to families such as stronger attachment between parents and children, improved parenting skills for caregivers, strengthened social support for families, newly acquired household management skills, successful completion of employment training, and significantly improved trust in social workers and the agency. Many of these factors are correlated, in research, with increased rates of family reunification. The paper documents these findings, and recommends that this approach be expanded for use in prevention as well as reunification.

A longitudinal analysis of the impact of child custody loss on drug use and crime among a sample of African American mothers

This study examines the influence of child custody loss on drug use and crime among a sample of African American mothers. Two types of custody loss are examined: informal custody loss (child living apart from mother but courts not involved), and official loss (child removed from mother’s care by authorities). MethodsUsing data from 339 African American women, longitudinal random coefficient models analyzed the effects of each type of custody loss on subsequent drug use and crime. Resultsindicated that both informal and official custody loss predicted increased drug use, and informal loss predicted increased criminal involvement. Findings demonstrate that child custody loss has negative health implications for African American mothers, potentially reducing their likelihood of regaining or retaining custody of their children. ConclusionsThis study highlights the need to integrate drug treatment and other types of assistance into family case plans to improve reunification rates and outcomes among mothers, children, and families. Additionally, the finding that informal loss predicts increased drug use suggests that community-based efforts within the mother’s social network could be implemented to intervene before child welfare system involvement becomes necessary.

The Interplay Between Housing Stability and Child Separation: Implications for Practice and Policy.

Greater understanding of how residential stability affects child separation and reunification among homeless families can guide both child welfare and homeless policy and practice. This article draws upon two longitudinal studies examining services and housing for homeless families and their relationship to family and housing stability. Both studies were conducted in the same state at roughly the same time with similar instruments. The first study, examining families' experiences and outcomes following entry into the homeless service system in three counties in Washington State, found that at 18months following shelter entry, families that are intact with their children were significantly more likely to be housed in their own housing (46%) than families that were separated from one or more of their children (31%). The second study, a quasiexperimental evaluation of a supportive housing program for homeless families with multiple housing barriers, found that the rates of reunification for Child Protective Services (CPS)-involved families receiving supportive housing was comparable to that for families entering public housing without services, but significantly higher than the rate of reunification for families entering shelter. Taken together, the findings from both studies contribute to the evidence underscoring the importance of housing assistance to homeless families involved in the child welfare system.

Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration

Children under three comprise a sizable and growing proportion of foster care placements. Very young children who enter the child welfare system experience disruptions of critical attachments that are essential to this formative stage of brain development, as well as other traumatic events, leaving them at great risk for lifelong impairments. To reverse these concerning outcomes, babies who have been removed from their homes require intensive, relationship-based interventions that promote secure attachment to a primary caregiver and holistic attention the child's developmental needs. Child welfare decision-makers must be informed of infant brain development and knowledgeable about the particular needs and circumstances of each child. This article describes a model with these features that has been developed and tested in the Bronx, New York, one of the nation's poorest urban counties with high rates of foster care. The Project utilizes evidence-based Child-Parent Psychotherapy (CPP) as its core intervention, and emphasizes collaboration and information sharing– driven by the CPP clinician– with judges, child welfare workers, attorneys and other social service and mental health providers, thereby encouraging developmentally and relationally informed case planning and permanency decisions. The model is evaluated using pre and post treatment psychosocial measures and program outcome data. Results indicate improvement in parenting interactions, positive child welfare outcomes (including increased rates of reunification, fewer returns to foster care), and improved safety and wellbeing. Results highlight the need for child welfare practices to be more closely aligned with the current science of infant brain development, and to incorporate a specialized approach to address the unique needs of infants.

The Impact of Family Unification Housing Vouchers on Child Welfare Outcomes.

This study addresses whether providing housing vouchers through the Family Unification Program (FUP) to families involved in the child welfare system reduces child maltreatment and the need for child welfare services. The study uses child welfare administrative data on 326 children in Portland, Oregon, and 502 children in San Diego, California from the point at which their families were referred to the program through 18months post-referral. Using a quasi-experimental waitlist comparison design, probit regressions show little impact of FUP on preventing child removal from home, but some positive impact on reunification among children already placed out of home. Hazard estimations show receipt of FUP speeds up child welfare case closure. Impacts on new reports of abuse and neglect are mixed, but point toward reduced reports. Low rates of removal among intact comparison families and high rates of reunification for children in out-of-home care suggest poor targeting of housing resources. Housing vouchers are being given to families not bearing the risks the program is intended to address. The presence of some positive findings suggests that housing vouchers might help reduce child welfare involvement if better targeting were practiced by child welfare agencies.

Evaluating Parents in Partnership: A Preliminary Study of a Child Welfare Intervention Designed to Increase Reunification

ABSTRACTChild welfare systems struggle with how best to accomplish reunification for children who have been removed from their home due to child maltreatment. Parent mentor programs may facilitate the reunification process. In these programs, parents who have successfully reunified with their children after child welfare involvement provide support and guidance for parents currently navigating the system. The current study examines (a) whether distance was a barrier to participation in orientation of a parent mentor program (called Parents in Partnership [PIP]) for 98 parents involved with the child welfare system and (b) whether participation affected reunification outcomes for 73 parents. Logistic regression models showed parents who lived closer to the PIP orientation location were more likely to participate in the orientation. Further, parents who attended PIP orientation were 5 times more likely to reunify with their children. Parent mentor programs may be one way to increase the likelihood of reunification for families involved in the child welfare system and may increase the engagement of fathers involved with the child welfare system. Future research should examine whether participation in parent mentor programs reduces the length of time children stay in foster care in addition to increasing rates of reunification.

Keeping it in the family: The impact of a Family Finding intervention on placement, permanency, and well-being outcomes

Child-centered recruitment via Family Finding has gained national attention as an approach to search, discover, and engage kin and fictive kin to support the attachment and permanency needs of children in foster care. However, despite its promise it has received scant attention in the empirical literature. The current study compared the outcomes of a front-end Family Finding intervention (n=196) and a comparison group (n=262) among children in foster care in Cook County Illinois between the ages of 6 and 13. Results showed that there were no differences between the intervention and comparison group on reunification rates, placement stability, or on longitudinal externalizing behavior and internalizing symptoms. However, the intervention found close to 75% more relatives than the control group, and many of these relatives were significant figures in the children's lives. The intervention was also associated with a higher proportion of relative placements to total placements for a subgroup of children with five or more placements. Further, the effect of the intervention on this proportion (relative placements to total placements) was mediated by the greater number of relatives found in the intervention. Finally, the intervention was associated with relatively better Concurrent Planning. These results suggest that Family Finding has the potential to impact proximal outcomes related to discovery, engagement and planning but is currently not impacting more distal outcomes such as permanency and well-being. Family Finding approaches should continue to innovate, possibly through integration with psychosocial interventions, to affect more distal variables such as well-being outcomes.

Troubling Trends in Canada's Immigration System Via the Excluded Family Member Regulation: A Survey of Jurisprudence and Lawyers

When a law purports to combat a problem, many of us take for granted that it is doing it effectively, and that it in turn is not harming people. This paper looks at one regulation that, while aiming to protecting the integrity of the immigration system, in fact erodes the humanitarian and compassionate objective of reunifying families and imposes harm on persons within and outside of Canada. Regulation 117(9)(d) of the Immigration and Refugee Protection Regulations imposes a life-time ban on sponsoring a family member if the sponsor, when immigrating to Canada, did not disclose the existence of the family member and therefore have them examined by immigration officials. This piece investigates the harms imposed by regulation 117(9)(d) by conducting two surveys: a survey of case law and a survey of lawyers. The findings are alarming. First, in looking at the reasons for non-disclosure and non-examination, 90 percent of cases had nothing to do with fraud, but involved tragic and heartbreaking reasons. Second, even in cases where children were involved, the best interests of those children did not lead to greater rates of family reunification. Third, while the courts have pointed to alternative remedies such as humanitarian and compassionate assessments, the surveys reveal that this, at best, only provides relief to half of the 90 percent not engaged in fraudulent activity. Finally, this regulation not only imposes family separation, but it also punishes sponsors who engaged in “misrepresentation” via non-disclosure of a family member, and places a chill on persons seeking alternative remedies to bring their family to Canada. The paper concludes that the problem of fraud in family reunification is overblown, and that regulation 117(9)(d) does more harm than good and should be repealed.

Assessing the Relationship Between a Peer-Mentoring Program and Case Outcomes in Dependency Court

Building successful family-centered programs to support families whose children have been removed can be especially challenging to child welfare agencies. Peer-mentoring programs match families new to the dependency system with a mentor who has successfully reunified with their children. The current study examines the relationship between a peer-mentoring program, Parent for Parent (P4P), engagement levels of parents, and case outcomes for these families. Findings revealed that participants in the peer-mentoring program experienced increased engagement levels and improved outcomes for their cases. Specifically, mothers and fathers who participated in P4P increased their compliance with case plans and visitation, as well as increased presence at court hearings. Reunification rates increased for all families who participated in the peer-mentoring program, compared to those who did not. Few associations were found between racial and ethnic groups and program participation. The implications of these findings and suggestions for future research are discussed.

The impact of drugs, infants, single mothers, and relatives on reunification: A Decision-Making Ecology approach

Using a Decision-Making Ecology (DME) approach and proportional hazards models, the study isolated four case factor profiles that interacted strongly with race and resulted in disparate reunification outcomes for African American children compared with Anglos. The four interrelated factors were drug involvement, a solo infant case, single mothers, and relative placements. A cohort of 21,763 children from the Texas Department of Family and Protective Services who were placed for the first time in care, who were under 13 and either Anglo or African American were followed for 20 months or more post entry into care. Starting with an initial model consisting of main effects only and consistent with other studies, African American children had a 12% lower hazard rate of reunification compared to Anglo children. However, when a set of case profiles involving combinations of single parents, single infants, drug involvements and kinship placements were crossed with race, the magnitude of the effect of race on hazard rates fanned out from no difference to as much as 68% that of Anglo children. The results show that racial disparities in outcomes resulting from complex, contextual decision making cannot be modeled well with simple main effects models.

Examining the role of methamphetamine in permanency: A competing risks analysis of reunification, guardianship, and adoption.

Parental methamphetamine use has drawn significant attention in recent years. Despite prior research that shows that parental substance abuse is a risk factor for lengthy foster care stay, little is known about the effect of specific types of substance use on permanency. This study sought to compare the impact of parental methamphetamine use to alcohol use, other drug use, and polysubstance use on the timing of 3 types of permanency: reunification, guardianship, and adoption. Using an entry cohort of 16,620 children who had entered foster care during a 5-year period, competing risks event history models were conducted for each permanency type. Findings showed that, after controlling for several case characteristics, parent illicit drug use significantly impacted the timing of the 3 types of permanency, but alcohol use did not. Methamphetamine, other drug, and polysubstance with methamphetamine use were associated with lower rates of reunification and higher rates of adoption. Guardianship was also predicted by other drug and polysubstance use without methamphetamine; however, methamphetamine use was not associated with guardianship. Notably, the methamphetamine groups comprised the youngest children and had the shortest median time to adoption. Results suggest that type of parental substance use is predictive of permanency exits and that parental illicit drug use may require tailored strategies for improving permanency outcomes. Further implications of the findings are discussed.