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Project Description

California The Family Integrated Treatment (FIT) Program, an initiative of the County of San Diego's Health and Human Services Agency's Divisions of Child Welfare Services and Alcohol and Drug Services, in partnership with Rady Children's Hospital - San Diego, McAlister Institute, Vista Hill Foundation and Mental Health Systems Inc., provided enhanced services for mothers struggling with methamphetamine and other drug addiction. The program provided:

  • Evidence-based parenting development for mothers
  • Structured evidenced informed developmental and trauma assessments
  • Evidence based trauma treatment for children
  • Enhanced visitation for families with children in out-of-home placements

Target Population

County of San Diego, Child Welfare Services targeted:

  • San Diego County - East, South and North Coastal Regions Active or referred families with children aged 0-8 who are at risk of out of home placement due to mother’s methamphetamine or other substance Abuse whose mothers are receiving outpatient recovery services.

Major Project Goals

  • To provide comprehensive assessment and trauma treatment services for children of mothers in outpatient drug treatment programs.
  • To enhance parent development services for mothers in outpatient drug treatment programs.
  • To provide enhanced visitation and therapy for families with mothers in outpatient drug treatment programs.
  • To increase system capacity and collaboration.

Key Major Program Services

Case Management and In-Home Services

  • “Traditional” Case Management
  • Intensive/Coordinated Case Management
  • Family Group Decision Making/Family Case Conferencing

Parenting/Family Strengthening

  • Standard Parenting Skills Training
  • Enhanced Parenting Services
  • Evidence-Based Parenting or Family Strengthening Program – Incredible Years

Visitation Services

  • Supervised Visitation
  • Supportive Supervised Visitation

Mental Health and Trauma Services for Adults

  • Mental Health Services and Psychiatric Care
  • Trauma-Informed Services
  • Trauma-Specific Services – Seeking Safety

Substance Abuse Treatment for Adults

  • Long-Term Residential/Inpatient (more than 30days)
  • Residential/Inpatient Treatment – Specialized for Parents with Children
  • Partial Hospitalization
  • Intensive Outpatient – Matrix Model
  • Non-Intensive Outpatient or Other Step-Down
  • Aftercare/Continuing Care/Recovery Community Support Services

Specialized Outreach, Engagement and Retention

  • Cognitive Behavioral Strategies – Motivational Interviewing
  • Peer/Parent Mentor
  • Co-location of Staff

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 – Developmental, Behavioral/Socio-Emotional

Screening and Assessment – Substance Use and Other Adult Issues

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

Children’s Services

  • Early Intervention and Developmental Services
  • Remedial/Academic Supports
  • Mental Health Counseling
  • Trauma Services for Children/Youth – Parent Child Interaction Therapy (PCIT), Parent Child Attunement Therapy, (PCAT), Child Parent Psychotherapy (CPP), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Cross-Systems/Interagency 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

Housing Services

  • Housing Assistance

Partner Agencies and Organizations

The County of San Diego, Child Welfare Services Project includes the following partners:

Child Welfare

  • Regional/ County Child Welfare Agency

Substance Abuse

  • Substance Abuse Treatment Agency/ Provider(s)


  • Other Dependency Courts

Mental Health and Health Services

  • Mental Health Services Provider(s)
  • Children’s Health Provider/Hospital

Other Community and Child and Family Services

  • Other Child/Family Services Provider

Other Evaluation and Training

  • Evaluator (University-Affiliated or Other)

Performance Indicators


Recurrence of maltreatment: The percentage of children in the treatment group that experienced an occurrence and/or recurrence of maltreatment within 6 months was 4.5% while it was 5.8% for the comparison group.

Likewise, at 12 months, the percentage of children that experienced an occurrence/and/or recurrence of maltreatment was lower for the treatment group (2.9%) than for the comparison group (7.0%).


Length of Stay in Foster Care: Children in the treatment group had a lower median number of days in foster care (median 371 days) than the comparison group (median = 552.5).

Sustainability Status

Able to sustain specific components/scaled down version of program model

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Project Details

  • Lead Agency:
    County of San Diego, Health and Human Services Agency Child Welfare Services
  • Geographic Area and Congressional District Served:
    San Diego County; Congressional District 50-52
  • Federal Grant:
    $500,000/5 years
  • Evaluation Design and Comparison Group Type:
    Quasi-experimental, Same-time, Matched Population-Level
  • Proposed Number Served (5 years):
    Children: 597
    Adults: 400
    Families: 400
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