Project Description

North CarolinaThe Robeson County Bridges for Families program implemented a comprehensive interagency collaborative approach to provide a continuum of care utilizing evidence-based practices for substance-involved families referred to the Department of Social Services (DSS) in Roberson County, in rural eastern North Carolina. This approach improved the safety, permanency, and well-being of children in out-of-home placement or at risk of out-of-home placement because of their parent or caretaker's substance use disorder. It also improved the overall well-being and functional capacity of families. Services included a family drug treatment court, residential substance abuse treatment services where children were able to live with their parents, evidence-based substance abuse outpatient services, other individual, group, and family therapy, strong interagency and interdepartmental collaboration at the local and state levels, and cross-discipline collaborative training in best practices for child welfare, mental health, substance abuse treatment, and family drug treatment courts. The Robeson County Bridges for Families Program served as a model for statewide strategic planning efforts to support recovery-oriented systems-of-care that improve outcomes for children and families affected by parental and caretaker substance abuse.

Target Population

Robeson County Bridges for Families Targeted:

Substance-involved families referred to DSS in Robeson County whose children were in out-of-home placement or at risk of out-of-home placement because of their parent or caretaker's substance use disorder.

Major Program Goals

Goal 1: Increase capacity of the substance abuse treatment, child welfare, and court systems in Robeson County and in North Carolina to respond to the needs of children in or at risk of out of home placement because of their parent or caretaker's substance abuse. Additionally, improve the overall well-being and functional capacity of families

Goal 2: Increase knowledge about the effects of methamphetamine and other drugs on children involved in family support and child protective services staff

Goal 3: Increase the documentation in Robeson DSS and the North Carolina Division of Social Services (NC DSS) reporting systems for methamphetamine and other substance abuse for families referred to DSS for family support or to CPS

Goal 4: Improve coordination of care across systems and collaboration between Robeson DSS, court system, and prevention and treatment providers at RHCC to improve access to needed treatment services for children already in or at risk for out-of-home placement and their parent(s) or caregiver(s) with methamphetamine abuse or other substance abuse diagnosis

Goal 5: Reduce recurrence of maltreatment among families participating in the RPG funded continuum of care

Goal 6: Provide training to child welfare staff related to methamphetamine and other substance abuse, including how to identify signs of addiction, understanding the link between addiction and domestic violence for adult caregivers and child abuse and/or neglect-related trauma

Goal 7: Decrease out-of-home placement duration of stay for children involved in the program

Goal 8: Increase parental capacity to provide for their children’s needs as measured by parent/caregiver communication skills, days of abstinence, and employability

Goal 9: Increase family communication skills, social skills, and peer resistance and communication skills, and a reduction in behavioral problems among children and adolescents

Goal 10: Decrease acting-out behavior PTSD symptoms, depressive symptoms, and improve social competence among children referred for treatment due to their parent’s or caregiver’s methamphetamine or other substance use disorder and who are found to be in need of Trauma Focused–Cognitive Behavioral Therapy (TF-CBT)

Goal 11: Increase length of stay in treatment for participants of the FDTC

Goal 12: Improve DSS family service agreement outcomes for participants of the FDTC

Major Program Services

Case Management and In-Home Services

  • “Traditional” Case Management
  • Intensive/Coordinated Case Management
  • Family Group Decision Making/Family Case Conferencing
  • Wraparound/Intensive In-Home Comprehensive Services

Parenting/Family Strengthening

  • Standard and Enhanced Parenting Skills Training/Education
  • Evidence-Based Parenting or Family Strengthening Program - Strengthening Families Program

Family Therapy/Counseling

Mental Health and Trauma Services for Adults

  • Mental Health Services
  • Trauma-Informed Services
  • Trauma-Specific Services - Seeking Safety

Substance Abuse Treatment for Adults

  • Long-Term Residential/Inpatient (more than 30 days) – Matrix Model
  • Intensive Outpatient Treatment

Specialized Outreach, Engagement, and Retention

  • Co-location of Staff

Family-Centered Substance Abuse Treatment or Family-Based Substance Abuse Services

Substance Abuse Prevention Services

  • Information Dissemination
  • Prevention Education
  • Alternative Activities
  • Problem Identification and Referral

Screening and Assessment – Child Welfare and Other Children’s Issues

  • Screening and Assessment for Child Welfare Issues

Screening and Assessment – Substance Use and Other Adult Issues

  • Screening and Assessment for Substance Use Disorders
  • Other Specialized Adult Screening and Assessment – Trauma/Domestic Violence, Mental Health/Co-Occurring Disorders

Children’s Services

  • Developmental Services
  • Mental Health Counseling

Housing Services

  • Housing Support Services
  • Transitional, Interim, or Temporary Short-Term Housing

Cross-Systems Collaboration

  • Clinical and Program Training
  • Cross-systems Policies and Procedures
  • Regular Joint Case Staffing Meetings
  • Co-location of Staff
  • Cross-systems Information Sharing and Data Analysis
  • Partner Meetings – Regional Partnership and Program Management

Family Treatment Drug Court/Dependency Drug Court

Other

  • Physical Healthcare Services for Children

Partner Agencies and Organizations

The RPG encouraged service providers to develop and/or strengthen cross-system linkages between substance abuse treatment, child welfare, dependency court, and other service systems. The Robeson County Bridges for Families project included the following partners:

Child Welfare

  • Robeson County Division of Social Services
  • North Carolina Department of Health and Human Services

Substance Abuse

  • North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services
  • Robeson Health Care Corporation
  • Southeastern Regional MH/DD/SAS Local Management Entity
  • Eastpointe Local Management Entity/Management Care Organization, Developmental Disabilities and Substance Abuse Services

Courts

  • The Designated Respondent Attorney
  • The North Carolina Guardian Ad Litem program

Criminal Justice, Law Enforcement, Legal and Related Organizations

  • Office of Drug Control Policy
  • Attorney General

Other Community and Child and Family Services

  • The Southeastern Family Violence Center
    Housing

Mental Health

Health Services

  • North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services
  • Robeson County Department of Public Health

Education

Employment

Other Evaluation and Training

  • University of North Carolina at Chapel Hill

Other

  • Family Treatment Drug Court

Evaluation

This project proposed a quasi-experimental design. The treatment group consisted of clients receiving Bridges for Families services. The comparison group consisted of clients receiving typical child welfare and substance abuse services during the RPG grant period but not the RPG enhanced services. Data for the comparison group was matched at the population level.

Grantees measured performance indicators in the following domains: safety, permanency, child and adult well-being, and adult recovery. For additional information regarding program outcomes, please contact key personnel.

Sustainability Strategies and Activities

North Carolina DHHS was successful in securing resources to sustain completely their efforts and services beyond the Federal grant period. The grantee demonstrated the efficacy of their RPG services in a successful proposal for a Prevention and Family Recovery grant from The Duke Foundation.

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Reports

Project Details

  • Lead Agency:
    North Carolina Department of Health and Human Services
    Location:
    Lumberton, North Carolina
  • Geographic Area and Congressional District Served:
    State: North Carolina
    City of Lumberton; 7th Congressional District; Rural
  • Federal Grant:
    2 years
  • Proposed Number Served (2 years):
    Children: 338
    Adults: 174
    Families: 167*
  • *Number served represents clients served through March 2014.
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