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June 2017Vol. 18, No. 4A Randomized Control Trial of Recovery Coaches in Foster Care

Substance use disorders can profoundly affect child welfare outcomes, as parental use of drugs and alcohol can increase the risk of child maltreatment as well as hinder efforts at permanency and reunification for children in foster care.

An article in the Journal of Substance Abuse Treatment focuses on early access to substance use services and parental connections to a recovery coach. The study pays special attention to the timing of the intervention, particularly with regard to the timing of the comprehensive screening and access to substance use services in relation to the temporary custody hearing. The study hypothesis was that a short lag in the time it takes between the temporary custody hearing and screening and referral for substance use services increases the odds of family reunification, especially if a recovery coach has been assigned to the family.

The study sample included all Cook County (IL) families enrolled in the Illinois title IV-E Alcohol and Other Drug Abuse Demonstration Waiver as of December 31, 2012. To qualify for the study, families needed to have been referred to the Juvenile Court Assessment Program (JCAP) at the time of their temporary custody hearing or at any time within 90 days before the hearing and had to meet the following eligibility requirements: the family resided in Cook County, temporary custody of the families' children had been granted to the Illinois Department of Children and Family Services, and the parents were assessed by JCAP within 180 days of the temporary custody hearing. After the JCAP assessment, families were randomly assigned to either a control group (1,078 children, 31 percent) to receive services as usual or an experimental group (2,362 children, 69 percent) to receive services as usual with the addition of services from a recovery coach.

Findings showed that there was a significant difference in reunification rates within three years among the families who worked with recovery coaches (21 percent) and those in the control group (16 percent). The researchers found that although both groups received a timely assessment, only the group that worked with recovery coaches in addition to receiving customary substance use services showed a significant impact on reunification. These results highlight the need for specialized services, such as those from a recovery coach, in addition to timely, comprehensive substance use assessments after temporary custody hearings. This can help caseworkers address these families' needs and may impact permanency planning and eventual reunification. 

"Timing Matters: A Randomized Control Trial of Recovery Coaches in Foster Care," by Joseph P. Ryan, Brian E. Perron, Andrew Moore, Bryan G. Victor, and Kune Park, Journal of Substance Abuse Treatment, 77, 2017, is available through ScienceDirect at