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Project Description

TennesseeThe Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) proposed to extend implementation of Building Strong Families (BSF) to continue to address the complex needs of children (ages 0-18) in or at-risk of out-of-home placement due to parent/caretaker methamphetamine or other substance abuse. TDMHSAS partnered with Tennessee's Department of Children's Services and the Administrative Office of the Courts; Centerstone, the area's primary behavioral health treatment provider, and Centerstone Research Institute, a nonprofit research,/evaluation organization, to establish and implement an evidence based, trauma-informed, culturally competent continuum of outreach, treatment, education/counseling, and supportive services for children and families utilizing the evidence-based Intensive Family Preservation Services Model.

Using the Intensive Family Preservation Services model, BSF supported at-risk families by providing services that reduced the need for out-of-home placement and promoted child safety, permanency, and wellbeing. Through a collaborative effort of agencies and organizations, integrated services and enhanced continuity of care BSF, provided families with interventions to build skills and capacities that contributed to healthy, well-functioning families. BSF provided in-home counseling, basic skills education, psycho-education, and linkages with social/ community support services, including substance abuse treatment programs/recovery supports. BSF in-home specialists were available 24/7 to provide crisis intervention and intensive services to keep children out of harm's way.

The BSF Collaborative Council, representing all project partners, local service agencies, government agencies and funding stream representatives, individuals in recovery, parents/caretakers, and other community stakeholders, worked to ensure sustainability of the project. BSF maintained evaluation project strategies and models and conducted comprehensive performance measurement to develop and disseminate a thoroughly documented service model for replication across the state and nation.

Target Population

BSF Targeted:

Children in or at risk of out of-home placement due to parent/caretaker substance use disorder.

Major Program Goals

Goal 1: Establish a community-based treatment program for children and families

Goal 2: Increase community awareness/education

Goal 3: Improve child outcomes related to safety, permanency, and well-being

Goal 4: Improve adult outcomes for parents/caregivers with substance use disorders

Goal 5: Improve family outcomes

Goal 6: Improve regional partnership/service capacity level

Major Program Services

Case Management and Case Conferencing

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

Parenting/Family Strengthening

  • Evidence-Based Parenting or Family Strengthening Program - Intensive Family Preservation Services

Family Therapy/Counseling

Mental Health and Trauma Services for Adults

  • Mental Health Services
  • Trauma-Informed Services

Specialized Outreach, Engagement, and Retention

  • Cognitive Behavioral Strategies - Motivational Interviewing/Motivational Enhancement Therapy

Substance Abuse Prevention Services

  • Information Dissemination
  • Community-Based Process

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

  • Screening and Assessment for Child Welfare Issues
  • Screening and Assessment for Trauma
  • Other Specialized Child Screening and Assessment – Mental Health/Psychological, Substance Use, Developmental

Screening and Assessment – Substance Use and Other Adult Issues

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

Cross-Systems Collaboration

  • Clinical and Program Training
  • Regular Joint Case Staffing Meetings
  • Cross-systems Information Sharing and Data Analysis
  • Partner Meetings – Regional Partnership and Program Management


  • Referral and Linkage to Substance Abuse Treatment for Adults
  • Referrals and Linkages to Children’s Services

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 BSF project included the following partners:

Child Welfare

  • Tennessee Department of Children’s Services

Substance Abuse

  • Tennessee Department of Mental Health and Substance Abuse Services
  • Centerstone of Tennessee
  • TennCare


  • Tennessee Administrative Office of the Courts
  • Court Appointed Special Advocates for Children

Criminal Justice, Law Enforcement, Legal and Related Organizations

Other Community and Child and Family Services

  • KidLink Treatment Services
  • Coffee Co. Anti-Drug Coalition
  • Coffee Co. Children's Advocacy Center
  • Child Care Resource and Referral


  • Homes of Hope of Bedford County

Mental Health

  • Volunteer Behavioral Health

Health Services

  • Department of Public Health

Other Evaluation and Training

  • Centerstone Research Institute


  • Local government organizations


This project proposed a quasi-experimental design. The treatment group consisted of clients receiving BSF 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

Through sponsorship from one of the collaborative partners, Tennessee DMHSAS was able to sustain an annual conference that came about because of the RPG. Additionally, the regional partnership established through the grant continued; representatives from the partner groups have continued to participate on a steering group and the regional collaborative council. Tennessee DMHSAS received a RPG II grant to continue services to this population through implementation of an Intensive Family Preservation Services model in conjunction with Seeking Safety.

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Project Details

  • Lead Agency:
    Tennessee Department of Mental Health Substance Abuse Services
    Nashville, Tennessee - Kassandra
  • Geographic Area and Congressional District Served:
    State: Tennessee
    City of Nashville; 5th Congressional District; Rural
  • Federal Grant:
    2 years
  • Proposed Number Served (2 years):
    Children: 600
    Adults: 436
    Families: 289
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