March 10, 2006
Posted online March 15, 2006
Child-welfare study shows recovery coaches
can help reunite families
By Craig Chamberlain,
CHAMPAIGN, Ill. — On any given day, as many as 70
percent of the Illinois children in foster care are in that
situation, at least in part, because their parents abuse drugs or
alcohol. Only a small percentage will ever be reunited with their
What if those parents, however, had extra help from a
"recovery coach," someone whose primary job was to
prod and encourage them to get and complete treatment for
A five-year study by the University of Illinois at
Urbana-Champaign, involving 1,300 parents of 1,900 children in
foster care in Cook County, found that having such a coach does
make a difference for a small but significant number of
The parents in the study who were assigned coaches "got
into treatment more quickly, completed treatment at a higher
rate, were more likely to get their children back, and were less
likely to have a subsequent allegation of maltreatment,"
according to Joseph Ryan, the study's principal
Because fewer children spent less time in foster care, Ryan
said, the intervention also saved the Illinois Department of
Children and Family Services about $5.6 million over the five
years of the study, conducted between April 2000 and June
Ryan is a professor in the Children and Family Research
Center, part of the university's School of Social Work. He
will present his findings today (March 10) at the University of
Chicago at a working symposium titled "Accepting the
Challenge of Substance Use in Family Reunification," funded
by DCFS and attended by its director, Bryan Samuels.
The findings also are part of a report prepared for DCFS,
which supported the study and shared needed data as part of a
decade-long agreement with the Children and Family Research
Center. The study was done in connection with a federal waiver
giving the state temporary authority to redirect child-welfare
Almost no experimental studies have been conducted to test
interventions for substance-abusing families in the child-welfare
system, and the waiver made this one possible, Ryan said.
Families for the study were drawn from foster-care cases opened
in Chicago and suburban Cook County during the study period, by
way of assessments conducted by the Juvenile Court Assessment
One-third of the parents in the study were randomly assigned
to a control group, which had access to substance-abuse treatment
but did not have recovery coaches. Within that group, 11.6
percent were reunited with their children before the end of the
study. The other two-thirds were assigned to the demonstration
group; each had the services of a coach. Within that group, 15.5
percent were reunited.
The improvement is significant in research terms, in savings
and for the families involved, especially since families with
serious drug problems are "a really difficult population to
work with," Ryan said. "The idea is to sort of chip
away at solving the problem of substance abuse in child welfare.
No single intervention is going to do it."
Of the mothers in the study, 64 percent had had at least one
prior substance-exposed infant, meaning medical tests on the
child showed evidence of substance abuse during pregnancy.
Forty-two percent had had more than one.
The task is made more difficult because, for most of these
parents, substance abuse is only one of the problems creating a
barrier to safe reunification, Ryan said. Sixty-two percent of
the families in the study were dealing with at least three major
problems simultaneously, according to the records of their
child-welfare caseworkers. The most common were domestic violence
(30 percent), mental health (40 percent) and problems related to
housing (56 percent).
The study found that the existence of those co-occurring
problems, along with a lack of progress within those problem
areas, appear to be the two factors limiting or obstructing the
reunification process, Ryan said.
Parents who completed treatment for substance abuse, but did
not make progress in other problem areas, improved their chances
for reunification, but only slightly. "The ones who have
multiple problems and are only making progress in substance abuse
have a very low likelihood of getting their children back,"
The rate of reunification was much higher for those who not
only completed treatment, but also made progress in other
Overall, 28 percent of those in the demonstration group, the
group that had coaches, completed treatment for substance abuse.
Those who completed treatment were significantly more likely than
those who did not to achieve reunification: 28 percent versus 8
percent. The women who completed treatment were significantly
less likely to then give birth to a substance-exposed child: 7.9
percent versus 18.8 percent.
What Ryan sees in the study is evidence that targeted help
with other problems besides substance abuse could build upon the
success found with recovery coaches. "A unique contribution
of this study is that we've identified that these problems
are impacting the likelihood of reunification," he
The prospect, which he hopes to test in any extension of this
study, is that more children could eventually be reunified safely
with their families, a primary goal of the child-welfare