Latent classes among substance-involved families in child welfare: Associations with treatment completion and reunification

Background: While often treated as a single group in previous studies, families involved with the child welfare system (CWS) because of parental substance use disorder (SUD) present with various combinations of risk factors and needs (e.g., housing instability, criminal justice involvement, single parenthood, etc.) that affect treatment and child welfare outcomes. Understanding these differential risk and need factors is important for effective case planning and service provision. The generalizability of existing research on this topic is limited by geographic and/or demographic homogeneity, small sample sizes, or short observation windows. The current study sought to examine latent risk/need profiles among families with parental SUD in child welfare using a large, longitudinal multi-state sample and compare treatment and reunification outcomes across classes.Participants & Setting: This study included N = 13,291 parent-child dyads served by the Regional Partnership Grant (RPG) program, which funded implementation of 53 demonstration projects from 29 states between 2007 and 2012. RPG projects aimed to increase well-being and permanency for children in CWS due to parental SUD. Methods: Latent class analysis was used to identify groupings among the study sample on the basis of six key parent-level risk and need factors. A latent class regression model (LCR, Bandeen-Roche et al., 1997) was used to examine differences in the likelihood of treatment completion and reunification across classes controlling for covariates.Results: Model fit statistics supported a four-class solution: Moderate Risk/Need, Criminal Justice Risk, Complex Risk & Need, and Opioid Use Disorder. The LCR suggested that the Criminal Justice Risk class had the highest odds for treatment completion but lowest odds of reunification. The Complex Risk & Need class had the lowest odds for treatment completion. A significant interaction indicated that the individuals in the Opioid Use Disorder class were more likely to reunify if they completed treatment.Conclusions: Heterogeneity exists among families involved with the child welfare system due to parental substance use. The findings suggest, however, that they present with distinct patterns of risk/need characteristics. Moreover, these combined characteristics are associated with the likelihood that a parent completes SUD treatment and is reunified with their child. Comprehensive and collaborative service delivery must respond to the varied risks and needs of these families.