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Screening and Assessment

Screening parents and children involved in the child welfare system for the effects of substance use disorders and other co-occurring risk factors is an essential part of determining risk and safety. Collaboration and communication across the systems responsible for serving families are necessary to provide the child welfare, substance use disorder treatment, and court systems with timely access to the screening and assessment results they need to make informed decisions. Screenings are brief, rapidly administered tools that determine whether a problem or condition exists and if there is a need for an assessment. An assessment is a comprehensive process conducted by a treatment professional to identify if the person meets diagnostic criteria and determine critical areas to be addressed in the client’s treatment plan.

The following resources relate to screening and assessment for substance use disorders among families involved with child welfare services.

Contact us at or 1(866) 493-2758 to learn more about implementing trauma-informed care and trauma-specific services for families affected by substance use disorders.

Policy and Practice Guides

  • Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR)
    Substance Abuse and Mental Health Services Administration, 2006

    This guidebook presents the SAFERR model for helping staff of public and private agencies respond to families affected by substance use disorders and is based on the premise that when parents misuse substances and maltreat their children, the only way to make sound decisions is to draw from the talents and resources of at least three systems: child welfare, alcohol and drugs, and the courts.
  • Cover Page
  • Drug Testing in Child Welfare: Practice and Policy Considerations (PDF 904 KB)
    Substance Abuse and Mental Health Services Administration, 2010

    This document guides child welfare agency policymakers in developing practice and policy protocols on the use of drug testing in child welfare practice. This guidance describes the practice and policy issues that policymakers must address to include drug testing in the comprehensive assessment and monitoring that child welfare agencies provide.
  • TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment
    Substance Abuse and Mental Health Services Administration, 2013

    This guide helps clinicians influence the change process in their clients by incorporating motivational interventions into substance use disorder treatment programs. It describes different interventions that can be used at all stages of change.
  • Screening and Assessment for Family Engagement and Retention
    National Center on Substance Abuse and Child Welfare, 2014

    This webinar presents information on screening and assessment for family engagement and retention. Screening and assessment, as well as communication and active collaboration across systems, help ensure that parents in need of substance abuse treatment are identified and receive appropriate treatment in a timely manner. This webinar explores strategies and issues involved at both a systems and practice level.

State and Local Examples

Additional Resources

  • Screening, Brief Intervention, and Referral to Treatment (SBIRT)
    Substance Abuse and Mental Health Services Administration, 2017

    SAMHSA’s webpage provides an overview and resources related to SBIRT. SBIRT is an approach to the delivery of early intervention and treatment to people with substance use disorders and those at risk of developing these disorders.

Related Research Articles

Barbosa, C., Cowell, A. J., Landwehr, J., Dowd, W., & Bray, J. W. (2016). Cost of screening, brief intervention, and referral to treatment in health care settings. Journal of Substance Abuse Treatment, 60(1), 54-61. doi:

Boudreaux, E. D., Haskins, B., Harralson, T., & Bernstein, E. (2015). The remote brief intervention and referral to treatment model: Development, functionality, acceptability, and feasibility. Drug and Alcohol Dependence, 155(1), 236-242. doi:10.1016/j.drugalcdep.2015.07.014

Chasnoff, I. J., McGourty, R. F., Bailey, G. W., Hutchins, E., Lightfoot, S. O., Pawson, L.,… & Campbell, J. (2005). The 4P’s Plus screen for substance use in pregnancy: Clinical application and outcomes. Journal of Perinatology, 25(6), 368-374. doi:10.1038/

Kerker, B. D., Horowitz, S. M., & Leventhal, J. M. (2004). Patients’ characteristics and providers attitudes: Predictors of screening pregnant women for illicit substance use. Child Abuse and Neglect, 28(2), 209-223. doi:10.1016/J.chiabu.2003.07.004

Ondersma, S. J., Svikis, D. S., Thacker, L. R., Beatty, J. R., & Lockhart, N. (2014). Computer-delivered screening and brief intervention (e-SBI) for postpartum drug use: A randomized trial. Journal of Substance Abuse Treatment, 46(1), 52-59. doi:10.1016/j.jsat.2013.07.013

Patterson, D. A., Wolf, S., Ramsey, A. T., & Berk-Clark, C. (2015). Implementing outside the box: Community-based social service provider experiences with using an alcohol screening and intervention. Journal of Social Service Research, 41(2), 233-245.

Roberts, S. C. M., & Nuru-Jeter, A. (2010). Women’s perspectives on screening for alcohol and drug use in prenatal care. Women’s Health Issues, 20(1), 193-200. doi:10.1016/j.whi.2010.02.003

Roberts, S. C. M., & Nuru-Jeter, A. (2012). Universal screening for alcohol and drug use and racial disparities in child protective services reporting. Journal of Behavioral Health Services & Research. 39(1), 3-16. doi:10.1007/s11414-011-9247-x

Roberts, S., Ralph, L. J., Wilsnack, S. C., & Foster, D. G. (2016). Which women are missed by primary health-care based interventions for alcohol and drug use? Addictive Behaviors, 55, 32-37. doi:10.1007/s11414-011-9247-x

Stucky, B. D., Edelen, M. O., & Ramchand, R. (2014). A psychometric assessment of the GAIN Individual Severity Scale (GAIN-GISS) and Short Screeners (GAIN-SS) among adolescents in outpatient treatment programs. Journal of Substance Abuse Treatment, 46(2), 165-173. doi:10.1016/j.jsat.2013.07.007

Traube, D. E., He, A. S., Zhu, L., Scalise, C., & Richardson, T. (2015). Predictors of substance abuse assessment and treatment completion for parents involved with child welfare: One state’s experience in matching across systems. Child Welfare, 94(5), 45-66.

Wright, T. E., Terplan, M., Ondersma, S. J., Boyce, C., Yonkers, K., Chang, G.,… & Creanga, A. A. (2016). The role of screening, brief intervention, and referral to treatment in the perinatal period. American Journal of Obstetrics and Gynecology, 215(5), 539-547. doi:10.1016/j.ajog.2016.06.038

Wu, L., Blazer, D. G., Woody, E. G., Burchett, B., Yang. C., Pan, J.,… & Linga, W. (2012). Alcohol and drug dependence symptom items as brief screeners for substance use disorders: Results from the Clinical Trials Network. Journal of Psychiatric Research, 360-369. doi:10.1016/j.jpsychires.2011.12.002

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