Screening and Assessment

When a family comes to the attention of child welfare services, determining the presence of a parental substance use and mental disorders, as well as related child and family effects, is the first step in ensuring the safety, permanency, and well-being of the family. Child welfare workers and healthcare professionals may implement evidence-based screening tools, which present a set of standard questions to determine parental substance use and need for a referral for further assessment. An assessment is a comprehensive process conducted by a treatment professional to determine a diagnosis and individual treatment needs. Child welfare, treatment, and healthcare professionals also play a role in screening and assessing infants for the effects of prenatal substance exposure, as well as children and adolescents for their own substance use, trauma, and mental disorders. Although there are a variety of tools for screening and assessing parents, children, and families and a range of substance use treatment and other services, it is only through collaboration and communication across the systems responsible for helping families that professionals will gain the information they need to make informed decisions and that families will be engaged into the appropriate treatment.

• Highlighted Resource

  • Screening and Assessment for Family Engagement and Retention
    

    National Center on Substance Abuse and Child Welfare, 2017

    This webinar provides information on screening and assessment for family engagement and retention as well as strategies and issues related to both the systems and practice level. This webinar also offers information about Connecticut’s Recovery Specialist Voluntary Program, a voluntary, intensive case management and recovery support program for parents whose substance use disorder was a contributing factor to their child’s removal from the home. Through use of recovery specialists, this program engages and maintains parents in appropriate substance use treatment services and provides linkages to increase recovery supports.

    Watch Video Screening and Assessment for Family Engagement and Retention

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  Policy and Practice Guides

  • Understanding Screening and Assessment of Substance Use Disorders—Child Welfare Practice Tips
    (PDF 604 KB)

    National Center on Substance Abuse and Child Welfare, 2019

    Child welfare professionals can use this technical assistance tool to access information about identifying and addressing substance use disorders by parents involved with child welfare services, including signs and symptoms, screening practices, and referral for assessment.

    See Also

    • Engagement of Families Tips (PDF 566 KB)
    • Tips for Child Welfare Staff (PDF 627 KB)

    View Document Understanding Screening and Assessment of Substance Use Disorders—Child Welfare Practice Tips
  • Screening and Assessment Tools Chart

    National Institute on Drug Abuse, 2018

    This chart is a comprehensive listing of substance use disorder screening and assessment tools that service providers can use with clients from adolescence to adulthood. It is organized by substance type, client age, and administration method to help professionals find the right tool for their practices.

    Visit Website Screening and Assessment Tools Chart
  • 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, which is an approach to the delivery of early intervention and treatment to persons with substance use disorders and those at risk of developing those disorders.

    Visit Website Screening, Brief Intervention, and Referral to Treatment (SBIRT)
  • TAP 33: Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)
    (PDF 4.14 MB)

    Substance Abuse and Mental Health Services Administration, 2013

    This Technical Assistance Publication describes the core elements of SBIRT programs and provides general administrative and managerial information relevant to implementing SBIRT services. The audiences for this resource are healthcare providers, treatment professionals, and administrators and governmental entities.

    View Document TAP 33: Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT)
  • Drug Testing in Child Welfare: Practice and Policy Considerations
    (PDF 904 KB)

    Substance Abuse and Mental Health Services Administration, 2010

    This publication provides child welfare policymakers with information about 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.

    View Document Drug Testing in Child Welfare: Practice and Policy Considerations
  • Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR)
    (PDF 3 MB)

    Substance Abuse and Mental Health Services Administration, 2006

    This guidebook presents the SAFERR model for helping the staff of public and private agencies respond to families affected by substance use disorders. The guidebook 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, substance use treatment, and the courts.

    View Document Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR)

• Related Online Trainings, Videos, and Webinars

  • Better Together: Developing a Coordinated Response to Families Affected by Substance Use Disorders
    

    National Center on Substance Abuse and Child Welfare, 2015

    This webinar provides an overview of collaborative practice at the front end of child welfare cases that involve families affected by substance use disorders (e.g., intake and investigation). The presenters share lessons learned from collaborative site examples.

    Watch Video Better Together: Developing a Coordinated Response to Families Affected by Substance Use Disorders
  • Early Screening and Assessment in Family Drug Courts
    

    Family Drug Court Training and Technical Assistance Program-Learning Academy, 2016

    This webinar provides key elements of screening, assessment, monitoring, and the principles that drive these critical processes, as well as the importance of early identification, timely assessments, and ongoing monitoring. The video also discusses cross-system collaboration that is based on a commitment to sharing information and ensuring that families receive the services they need to achieve safety, well-being, and permanency.

    Watch Video Early Screening and Assessment in Family Drug Courts
  • Identifying Substance Use as a Risk Factor in Child Welfare Cases
    

    Family Drug Court Training and Technical Assistance Program-Learning Academy, 2015

    This webinar offers practice principles to guide screening and assessment protocols for working with families affected by substance use disorders and involvement with the child welfare system. Dr. Norman G. Hoffmann provides an overview of the UNCOPE screening tool and its efficacy in identifying individuals in need of a clinical substance use assessment. The webinar also offers a discussion of challenges and considerations for use of the UNCOPE in child welfare practice.

    Watch Video Identifying Substance Use as a Risk Factor in Child Welfare Cases

• State and Local Examples

  • Colorado Dependency and Neglect System Reform Implementation Guide

    Statewide System Reform Project Collaborative, 2017

    This guide provides a discussion about universal substance use screening in child welfare and the five principles implemented by the demonstration sites from the Colorado Dependency and Neglect System Reform. The guide provides local protocols used for the implementation and examples of how each county implemented the principles.

    Visit Website Colorado Dependency and Neglect System Reform Implementation Guide
  • Indiana Service Standards for Substance Use Disorder Assessment
    (PDF 85 KB)

    Indiana Department of Child Services, 2017

    This document explains the services standards for substance use treatment professionals contracted by the Indiana Department of Child Services (DCS). The standards require that providers who complete substance use disorder assessments include screening questions that relate to child safety and identify potential risk to a child because of parental substance use and guide appropriate reporting to DCS.

    View Document Indiana Service Standards for Substance Use Disorder Assessment
  • Statewide System Reform Program New York
    (PDF 5.21 KB)

    Statewide System Reform Project Collaborative, 2017

    In collaboration with the New York Office of Children and Family Services and the 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 that contain substance use disorders. This bench card encourages judges to ask questions related to substance use screening to encourage consistent screening practices and standardized approaches to screening, assessment, and treatment engagement.

    View Document Statewide System Reform Program New York
  • Arizona DCS Practice Guidelines: Drug Testing
    (PDF 54 KB)

    Arizona Department of Child Safety, 2016

    These drug testing practice guidelines provide frontline child welfare staff in Arizona with procedures for the appropriate use of drug and alcohol testing as well as determining appropriate testing panels, schedules, frequency, and discontinuation. The guidelines encourage use of a four-pronged approach to decision making that includes reviewing screening tools, assessing signs and symptoms, identifying corroborating reports, and drug/alcohol testing. The guidance emphasizes that drug testing is only one component of a comprehensive assessment of safety threats, protective capacities, and treatment needs, and it should never be used punitively.

    View Document Arizona DCS Practice Guidelines: Drug Testing
  • West Virginia Prenatal Risk Screening Instrument
    (PDF 64.8 KB)

    Health and Human Resources, Bureau of Public Health, 2016

    As required by the Uniform Maternal Screening Act, the Maternal Risk Screening Advisory Committee developed this uniform maternal risk screening tool. The tool is required by West Virginia law to be submitted by every provider of maternity care for women in West Virginia.

    View Document West Virginia Prenatal Risk Screening Instrument
  • Guidelines for Identifying Substance-Exposed Newborns
    (PDF 899 KB)

    Arizona Statewide Task Force on Preventing Prenatal Exposure to Alcohol and Other Drugs, 2016

    Created to address the growing epidemic of prenatal exposure to alcohol and other drugs, these guidelines provide best-practice resources for combatting the problem. Included is information about improving the ability of healthcare providers to effectively identify at-risk pregnancies and substance-exposed newborns and standardized recommendations in screening, treatment, and management.

    View Document Guidelines for Identifying Substance-Exposed Newborns

• Additional Resources

  • Perinatal Substance Use: Virginia Guide for Hospital and Health Care Providers
    (PDF 442 KB)

    Virginia Department of Social Services, 2017

    Virginia law requires that as a routine component of prenatal care, mandated licensed practitioners establish and implement a medical history protocol that will screen all pregnant patients for substance use to determine the need for further evaluation. Virginia developed this brochure to outline these laws (including recent updates to align with changes in the Child Abuse Prevention and Treatment Act).

    View Document Perinatal Substance Use: Virginia Guide for Hospital and Health Care Providers