Engagement and Retention

Timely access to treatment services is critical for engagement and retention of high-risk families who are affected by substance use disorders and are involved with child welfare services. Engagement and retention are important for the parents and children to ensure family safety, permanency, well-being, and recovery. Parents often face many obstacles during the treatment and recovery process. Consequently, child welfare professionals, treatment agencies, juvenile and family court personnel, family treatment court providers, recovery coaches or mentors, and family advocates play an integral role in removing barriers to treatment access and completion; providing active support and ensuring that needs are met as families move through the recovery process.

• Highlighted Resource

  • The Use of Peers and Recovery Specialists in Child Welfare Settings
    (PDF 2.2 MB)

    National Center on Substance Abuse and Child Welfare, 2018

    Child welfare agencies and family court programs have integrated peers and recovery specialists into their service delivery to support families affected by substance use disorders. There are two primary models that deliver support for families: 1) peer support by persons with lived experience of substance use disorders and child welfare involvement, and 2) support by professionally trained recovery specialists. Professionals can learn how to apply the peer or recovery specialist modes described in this monograph to their own communities.

    View Document The Use of Peers and Recovery Specialists in Child Welfare Settings

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  Policy and Practice Resources

  • Understanding Engagement of Families Affected by Substance Use Disorders: Child Welfare Practice Tips
    (PDF 566 KB)

    National Center on Substance Abuse and Child Welfare, 2019

    Child welfare workers can use this tool to learn practical tips to engage families affected by substance use in the child welfare system. The document is a quick-resource guide, designed for use while in the field.

    See Also

    • Screening and Assessment Tips (PDF 605 KB)
    • Need to Know Tips for Child Welfare Staff (PDF 627 KB)

    View Document Understanding Engagement of Families Affected by Substance Use Disorders: Child Welfare Practice Tips
  • Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR)
    (PDF 3 MB)

    Substance Abuse and Mental Health Services Administration, 2006

    SAFERR is a collaborative model that helps child welfare professionals, substance use treatment providers, and family court professionals make better-informed decisions to identify parents in need of services and to better communicate important information across agencies. The focus of SAFERR is to improve outcomes for children and families affected by substance use disorders. Also included are strategies to aid in fostering connections, communication techniques, and collaborative capacities across agencies. Sample screening and assessment tools are provided to assist the staff of public and private agencies in responding to families in their caseloads.

    View Document Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR)
  • TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment
    (PDF 2.95 MB)

    Substance Abuse and Mental Health Services Administration, 2013

    This Treatment Improvement Protocol (TIP) provides topic-specific, best-practice guidelines for the prevention and treatment of substance use and mental health disorders. This resource draws from the experience and knowledge of clinical, research, and administrative experts about effective practice for treatment and prevention. The primary purpose of the TIP is to guide clinicians to influence the change process with their clients by incorporating motivational interventions into substance use disorder treatment programs. The document describes specific interventions that can be used at each stage of change.

    View Document TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment
  • TAP 33: Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)
    (PDF 4.2 MB)

    Substance Abuse and Mental Health Services Administration, 2013

    This Technical Assistance Publication (TAP) describes the core elements of SBIRT programs for individuals with, or at risk of developing, substance use disorders. The document also provides information about challenges, barriers, costs, and sustainability in relation to such programs.

    View Document TAP 33: Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)

• State and Local Examples

  • Connecticut Women’s Recovery Engagement Access Coaching Healing (REACH) Program

    Connecticut State Department of Mental Health and Addiction Services

    The Women’s REACH program provides outreach, education, engagement, case management, recovery coaching, community connections to treatment, and recovery support resources to pregnant and parenting women. The program provides female Recovery Navigators who engage pregnant or parenting women with substance use disorders or co-occurring disorders in services.

    Visit Website Connecticut Women’s Recovery Engagement Access Coaching Healing (REACH) Program
  • Sobriety Treatment and Recovery Teams (START)

    California Evidence-Based Clearinghouse for Child Welfare, 2017

    The START program is an intensive child welfare program for families with co-occurring substance use disorders and child maltreatment. Child protective services workers trained in family engagement are paired with family mentors and use a system-of-care and team decision-making approach with families, treatment providers, and court advocates. Service delivery is integrated with local substance use treatment services.

    Visit Website Sobriety Treatment and Recovery Teams (START)
  • Three Strategies To Help Primary Care Teams Treat Substance Use Disorders
    (PDF 3.9 MB)

    California Improvement Network, 2019

    Primary care organizations and care teams are working to integrate substance use treatment services. This discussion provides proven strategies, best practices, and tools that are used by organizations within California to expand the capacity of primary care teams in behavioral health care organizations to be confident and more willing to provide substance use treatment services.

    View Document Three Strategies To Help Primary Care Teams Treat Substance Use Disorders
  • Family Recovery and Reunification Program
    (PDF 184 KB)

    Illinois Department of Children and Family Services, 2017

    The Illinois Family Recovery and Reunification Program (also known as the “Recovery Coach Program”) helps families when parental substance misuse is present and children have been removed from the custody of one or both parents and placed in foster care. Child welfare services uses this program to reunify families when parents can provide a safe and drug-free home for their children. Case managers engage these parents in treatment and additional services needed to achieve recovery and family unity, including parenting classes, individual and family counseling, and assistance in finding housing and employment.

    View Document Family Recovery and Reunification Program
  • New York’s Statewide System Reform Program
    (PDF 522 KB)

    Statewide System Reform Program Collaborative, 2017

    In collaboration with the New York State Office of Children and Family Services and the New York State Office of Alcoholism and Substance Abuse Services, the Child Welfare Court Improvement Project created a brief document for judges to improve their approach to child welfare cases in which a parental substance use disorder is a factor. This bench card encourages judges to ask questions related to substance use screening for all child welfare cases on their court docket to encourage consistent screening practices and standardized approaches to engagement with screening, assessment, and treatment.

    View Document New York’s Statewide System Reform Program

• Related Online Trainings, Videos, and Webinars

  • Screening and Assessment for Family Engagement and Retention
    

    National Center on Substance Abuse and Child Welfare, 2017

    The New England Addiction Technology Transfer Center partnered with the National Center on Substance Abuse and Child Welfare (NCSACW) to develop a web-based series on effective strategies, practices, and policies intended for families affected by substance use disorder. This webinar presents information on screening and assessment for family engagement and retention within the child welfare system. Screening, assessment, communication, and active collaboration across systems help ensure that parents in need of substance use disorder treatment are identified and that they receive appropriate treatment in a timely manner. The webinar also explores challenges and effective strategies at both the systems and practice levels.

    Watch Video Screening and Assessment for Family Engagement and Retention
  • Better Together: Developing a Coordinated Response for Families Affected by Substance Use Disorders
    

    National Center on Substance Abuse and Child Welfare, 2015

    The Children’s Bureau and NCSACW staff facilitated this webinar for Children’s Justice Act grantees to share information on collaborative practice at the “front-end” of child welfare services. The webinar presenters share lessons learned from collaborative site examples and discuss the complex needs of families.

    Watch Video Better Together: Developing a Coordinated Response for Families Affected by Substance Use Disorders
  • Motivational Incentives: Positive Reinforcers to Enhance Successful Treatment Outcomes (MI: PRESTO)

    National Institute on Drug Abuse, Substance Abuse and Mental Health Services Administration

    MI:PRESTO is an interactive, online course that focuses on the process of adopting motivational incentives in a clinical setting. In this training, clinical supervisors and other behavioral healthcare practitioners will learn how to use the seven principles of motivational incentives to adopt motivational incentives as an evidence-based practice to reduce substance misuse and promote positive outcomes for patients.

    Visit Website Motivational Incentives: Positive Reinforcers to Enhance Successful Treatment Outcomes (MI: PRESTO)
  • Retention Toolkit

    Washington State Department of Social and Health Services, 2019

    The State of Washington has conducted research to determine whether treatment for substance use disorder directly correlates to positive outcomes, including a reduction in substance use and less involvement in the criminal justice system. This toolkit can help clinicians and treatment organizations learn how to improve client engagement and retention in substance use disorder outpatient treatment settings. The resource is easy to use and includes resources that individual providers, other staff who interact with clients, or entire organizations can use to improve client retention in treatment.

    Visit Website Retention Toolkit
  • A Tour of Motivational Interviewing: An Interprofessional Road Map for Behavior Change

    University of Missouri Kansas City School of Nursing and Health Studies Mid-America Addiction Technology Transfer Center, 2018

    Motivational interviewing is a form of conversation for strengthening a person’s motivation and commitment to changing specific behaviors. It can be used by many health professionals including nurses, counselors, and social workers. This resource is a 4-hour, self-paced online course that provides an overview of the essential skills for effectively implementing motivational interviewing.

    Visit Website A Tour of Motivational Interviewing: An Interprofessional Road Map for Behavior Change

• Additional Resources

  • Family Engagement and Retention in Substance Use Disorders Case Planning

    Child Welfare Information Gateway, 2019

    Family engagement is one strategy that may increase caregiver retention in substance use disorder treatment programs. This webpage provides resources and examples of strategies and interventions that increase substance use disorder treatment retention among families in child welfare.

    Visit Website Family Engagement and Retention in Substance Use Disorders Case Planning
  • Motivational Interviewing Reminder Card (Am I Doing This Right?)
    (PDF 792 KB)

    Center for Evidence-Based Practices at Case Western Reserve University, 2012

    Motivational interviewing is a client-centered counseling style that promotes behavior change. This document is an 11-question quick guide to assist professionals in building self-awareness about attitudes, thoughts, and communication styles as they implement motivational interviewing with clients.

    View Document Motivational Interviewing Reminder Card (Am I Doing This Right?)