Research partnership shows parenting skills program more effective at reuniting families

Substance use has a long list of negative effects on families, especially those with young children, including social and emotional damages and even removal from the home. A research partnership including the University of Kansas has found a parenting skills program to be more effective than child welfare services as usual in reunifying children with families, while improving the health of young children as well.

Researchers from KU's School of Social Welfare worked with social service agencies in Oklahoma for more than 15 years to test several evidence-based interventions to enhance the safety, permanency and well-being of children and families affected by substance use. Findings from the researchers' recent evaluation of their five-year initiative, the Oklahoma Partnership Child Well-Being Initiative—Phase 3 (OPI-3), showed families who took part in a research-backed parenting skills program demonstrated statistically significant improvements in both child and parent domains.

OPI-3

For OPI-3, KU researchers worked with the Oklahoma Department of Mental Health and Substance Abuse Services and the federal funder, U.S. Administration for Children, Youth and Families, Children's Bureau. The project served young children up to 4 years old and their families who were child welfare involved and substance-affected in Oklahoma County between December 2019 and July 2022. In all, 84 cases were enrolled in OPI-3, serving 112 adults and 171 children.

"We want to know what works, under what conditions and for what populations. Our projects focus on serving child welfare involved families with children either at risk of removal or who have already experienced removal from their birth families," said Kiley Liming, KU associate researcher senior and project evaluator. "Together with our community partners, we want to provide services for the nation's most vulnerable populations—services that meet not only the child's needs, but the parents as well."

The evidence-based intervention Attachment and Biobehavioral Catch-Up, known as ABC, is a 10-session parenting skills program designed to enhance child-caregiver attachment through parental sensitivity, nurturance and decreasing intrusiveness, ultimately reducing toxic stress in children. OPI-3 participants received one of three versions of ABC, based on the child's age.

Both parents and children showed positive outcomes. Liming and Jody Brook, professor of social welfare, found that the OPI-3 children had high rates of trauma exposure, with nearly 40% reporting exposure to at least two adverse childhood experiences at program enrollment. After receiving the ABC intervention, OPI-3 children had statistically significant improvements in their social–emotional development and had positive improvement trends in communication and problem-solving.

OPI-3 caregivers who completed the intervention demonstrated significant improvements in decreased intrusive behaviors and positive improvement trends on both the sensitivity and positive regard domains. The ABC caregivers also had significant improvements in parental self-efficacy and responsiveness to their child's crying cues.

"Ultimately, our goal is to reunify families affected by substance use when it is safe to do so. If safe reunification is not possible, then we want the child to achieve safe and lasting permanency," Liming said. "We want to be sure these interventions are helping children and families, and our results are promising."

Liming and Brook rigorously examined the impacts of the ABC intervention; the impact analysis included 66 children who took part in OPI-3, and their progress was compared to 139 children who received traditional child welfare services.

The impact evaluation examined three child welfare outcomes:

• If the child experienced repeat maltreatment reports after study participation
• If the child experienced substantiated repeat maltreatment after study participation
• If children were removed from the home, if they had increased chances of reunification and if they reunified at faster rates than peers who did not take part in the program.

Results showed that children who took part in the ABC intervention did not statistically differ from their counterparts in likelihood of subsequent or substantiated maltreatment reports—regardless of ABC age curriculum received. However, for children who had experienced removal, results showed significant improvements in both likelihood of and time to reunification. In order from youngest to oldest age groups of the ABC intervention, 30% of participants in the respective group experienced reunification by 431 days (modified ABC), 271 days (ABC-Infant), and 378 days (ABC-Toddler), respectively. For the control group, 30% of children experienced reunification 766 days after removal.

"Those numbers speak volumes about how long young children who have been affected by substance use are spending in out-of-home care," Liming said. "We want a safe and stable child-caregiver attachment to happen. When we look at the impacts of our program, we find distinct positive child welfare outcomes."

The research partners also showed ABC can be effective via virtual delivery. The ABC intervention traditionally is delivered in-home and in-person, but the COVID-19 pandemic necessitated a shift to telehealth.

The OPI-3 initiative was the latest to show positive outcomes in helping reunite families affected by substance abuse. Brook has led evaluation partnerships with Oklahoma agencies for more than 15 years, which resulted in increased rates of family reunification.

Oklahoma Infant Toddler Courts

KU researchers will also be part of a new partnership to determine the effectiveness of Infant Toddler Courts intended to safely reunite families with young children. The Oklahoma Department of Mental Health and Substance Abuse Services has received a five-year, $3.1 million grant to enhance and expand Infant Toddler Courts, also known as Safe Babies, throughout Oklahoma. The initiative will enhance the two existing Oklahoma specialty courts in Tulsa and Payne counties and will expand to additional sites.

The partnership will deliver the evidence-based Safe Babies Approach with eligible families. Similar to OPI-3, the OK ITCP aims to increase reunification and achieve lasting permanency by improving parenting skills, reducing trauma for children—prenatally through age 3—and providing equitable services and resources to vulnerable families. Liming and Brook said the goal is to build a sustainable program that helps reduce and repair harm and safely reunite families while serving as a model for similar programs across the country.

"We're very excited and hopeful for this program. Our current sites have good outcomes so far," Liming said. "As the initiative's evaluators, we want to implement an evaluation that will track and produce concrete outcomes for our Oklahoma sites—to show them that their hard work has paid off and that we can provide effective services to vulnerable populations while safely reunifying families or increasing lasting permanency."

Provided by University of Kansas