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Protecting Children in Families Affected by Substance Use Disorders
Office on Child Abuse and Neglect, Children's Bureau., ICF International. |
|Year Published: 2009|
Child Protective Services and Substance Use Disorder Treatment Providers: Similarities and Differences
In This Chapter
Just as there often is an overlap between the clients who child protective services (CPS) and substance use disorder (SUD) treatment agencies serve, there also is common ground in the structures and the principles that guide these two systems. CPS caseworkers and SUD treatment providers should understand the similarities and the differences between the two systems so that they can offer the most comprehensive services possible to children and families. This chapter traces the areas of similarity and difference between the CPS and SUD treatment systems.
Areas of Similarity
There are many areas in which CPS and SUD treatment agencies overlap, including programmatic goals, the characteristics of the families served, management challenges, and new demands regarding outcomes.
Though their primary emphases may differ, both CPS and SUD treatment agencies want family members to stop abusing substances and want children to be safe. In addition, they serve many families in common, even though they may be working with different family members. Professionals in each field should recognize that involving and providing appropriate services to the entire family is the most effective way of addressing the family's issues.
Since both systems have common goals, they also should share the responsibility for achieving them. CPS caseworkers need to know whether parents are sufficiently recovered from SUDs before recommending that their children live at home, but CPS caseworkers cannot treat SUDs. SUD treatment providers know that children provide an important incentive for parents to enter and remain in treatment, but SUD treatment providers cannot make decisions regarding where children will live. When each agency only emphasizes its own particular objective, it is unlikely that either will succeed. When both focus on the broader goals of helping the entire family, despite pressures and forces that make that focus difficult, the odds are better that the agencies and the families will succeed.
Shared Characteristics of Families Served
As discussed earlier, individuals with SUDs and parents who maltreat their children often have many other problems (e.g., mental illness, health issues, histories of domestic violence, poverty). They require services that are beyond the scope of either CPS or SUD treatment agencies. Many of these problems overlap, so both CPS and SUD treatment agencies find themselves trying to address problems, such as a serious mental disorder, criminal records, HIV/AIDS, and limited job skills. Too often, each agency tries to tackle these varied problems on its own, overlooking opportunities to share this enormous responsibility with others.
Shared Management and Operational Challenges
CPS and SUD treatment program administrators and staff often face similar challenges in managing their agencies and operating their programs. These challenges may be external, such as locating services that families need, coordinating with agencies that provide those services, navigating complex bureaucracies, and responding to political opinions or media coverage that portray families as unworthy of support. Other challenges are internal, such as difficulties in hiring and training staff, high staff turnover and burnout, low pay, and outdated computer record-keeping systems.
To the extent that administrators and staff can design strategies that build on their common management challenges, they may ease some of these burdens. For example, both CPS and SUD treatment managers spend time locating and coordinating services, such as housing or mental health counseling, frequently for the same families. Time could be saved, and possibly outcomes improved, if managers collaborated in securing these services. In addition, managers could design joint training programs for staff from both agencies and seek continuing education units for staff who participate.
Shared Pressures to Attain Measurable Outcomes
Federal legislation requires both CPS and SUD treatment agencies to achieve measurable results, such as employment for adults and permanency decisions for children. Therefore, managers from both systems are required to design and to monitor their programs to attain those results. This means that managers in both systems have to:
- Establish clear goals for staff
- Create internal monitoring and progress review systems
- Identify problems early and resolve them quickly.
CPS and SUD treatment program managers can share ideas for establishing processes that lead to measurable results. They also can collaborate in designing monitoring and tracking systems in a way that provides useful information between their agencies as well as within them.
Areas of Difference
Notwithstanding these similarities, CPS and SUD treatment agencies may become confused or frustrated when trying to work together, even when they share overarching goals. The two systems differ in some fundamental ways, including how families enter programs, the choices available to families while they are participating, and the consequences for families if they cannot meet the standards required for completion. These different contexts lead to different experiences for families involved with each system. Likewise, staff in each system face disparate experiences and challenges.
Parents can be angry or frightened when CPS caseworkers come to their homes and question their children and neighbors, especially when caseworkers determine that their children have to be removed. When families come to the attention of CPS agencies, they often become involved with the courts, SUD treatment agencies, and other service providers. If they refuse to comply with the requirements established by these agencies, or if they cannot make adequate progress, they know they risk losing their children permanently.
In contrast, people generally enter SUD treatment voluntarily when they decide they are ready, and they leave when they want, even if they still are using substances. At times, however, courts order treatment as a condition of probation or parole. Coercive treatment has increased over the past several years, in part due to the increase in the use of drug courts, which are special courts designed for arrestees who have SUDs.
CPS and SUD treatment agencies also differ in the following ways:
- The primary focus of CPS is on the safety and well-being of children, and the primary focus of SUD treatment is on adult recovery. Staff of the two systems may see themselves as serving different clients, even if the clients are from the same family.
- The two systems operate under different laws and regulations.
- Funding for the two systems comes from different sources and with different conditions, even while often serving the same family.
- CPS caseworkers and SUD treatment providers may have different training, professional backgrounds and credentials, and disciplines. They also commonly use different terms and have different definitions of certain terms. For example, CPS caseworkers usually do not differentiate between substance use, abuse, or addiction. Caseworkers generally only want to know if the substance use affects an individual's ability to parent.
- Data collection requirements, computer systems, and management reporting requirements are often inconsistent or incompatible between the two systems.
Both systems operate within strict confidentiality guidelines and staff can be uncomfortable sharing information with each other, which can cause frustration. (See Chapter 8, Putting It Together: Making the Systems Work for Families, for a more detailed discussion of confidentiality issues.)
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