ASU study: Parents who complete Arizona recovery program more likely to be reunited with kids, hold down jobs

Parents involved with the Arizona child welfare system stand a significantly better chance of getting their kids back if they complete a state-run substance abuse program. That's the finding of a new report by Arizona State University’s Center for Applied Behavioral Health Policy. The report also found the program improves the odds of parents getting and keeping a job. 

“These findings demonstrate the powerful effects that effective treatment of substance abuse can have upon both the individual experiencing the substance abuse but also their children,” said Michael Shafer, director of the Center for Applied Behavioral Health Policy. “Our results indicate that those individuals who completed treatment were significantly more likely to become employed, to better their employment, and most importantly, to get their children back.”  

Arizona Families F.I.R.S.T. (Families in Recovery Succeeding Together) began in 2000 as a partnership between Arizona’s Department of Economic Security and Department of Health Services. It helps families involved in the child welfare system by addressing problems related to parental alcohol and drug abuse. About 70 percent of all new referrals to Arizona Families F.I.R.S.T in fiscal year 2015 involved allegations of child abuse.

One of the program’s main goals is to help children reach permanent homes by reuniting them with parents, placing them through adoption, or matching them with a guardian. About half (48 percent) of children whose parents received services in 2014 found stable homes by the end of 2015. That number jumped to 65.5 percent among children whose parents finished the Arizona Families F.I.R.S.T program. Most importantly, 84.8 percent of these children were reunited with their parents, compared to only 52.6 percent among children whose parents dropped out. By comparison, the Arizona Auditor General’s Office reports a mere 33 percent permanency rate statewide and a 40 percent rate nationally.

“The results demonstrate that when individuals complete their treatment, they are significantly more likely to reduce or eliminate their dangerous use of alcohol or drugs,” Shafer said. “That, in turn, allows them to reunite with their children and improve their economic situation, which leads to a more supportive and nurturing home environment for those children.”   

Parents who finished the program were also significantly more likely to find or keep jobs than those who did not, at a rate of 52.4 vs. 32.7 percent. Along similar lines, 36.7 percent of parents were working full-time jobs by program close — a significant uptick from the 25.3 percent of parents who were employed full-time at intake. By contrast, only 21.7 percent of program dropouts held full-time jobs by the end of the study period, marking a smaller increase from the 17.1 percent rate at intake. 

The program also showed evidence of success in another of its key areas of focus: sobriety. Parents who were tested showed an 85 percent sobriety rate, despite 99.1 percent of assessed clients reporting problems with alcohol or drugs at intake. The data did not strongly show one way or the other whether Arizona Families F.I.R.S.T improved child safety.

Overall, referrals to the program jumped 34 percent in 2015 over the previous year. Yet, despite rapid initial outreach, only one half (50.9 percent) of potential clients entered the program, and only one tenth (11.5 percent) finished it. On average, participants took roughly 313 days to complete Arizona Families F.I.R.S.T.

“It is disconcerting that a large segment of people who start the treatment program never complete it, either because they drop out, or because the program discharges them,” observed Shafer. “Unfortunately, the evaluation procedures approved by the Department of Child Safety did not allow for a better understanding of the causes for such a high rate of treatment non-completion.”   

ASU’s Center for Applied Behavioral Health Policy suggests a number of ways to improve outcomes. That includes creating an enriched referral system, developing strategies that could improve retention, and upgrading data documentation to expand prospects for future analysis.

"Our findings point to a number of troubling indicators,” said Shafer. “Most notably, many individuals who get referred to the program never enroll. The causes for this are not clear, but the high rate of personnel turnover at the Department of Child Safety, incomplete or inadequate referral procedures, and insufficient outreach and engagement on the part of the treatment provider could be some of the causes.”  

Arizona Families F.I.R.S.T bases its approach on family needs. The program blends a number of resources and strategies including face-to-face outreach, individual and group treatment, counseling, and recovery services. The program also provides support for case management, transportation, employment, and housing. During the period studied, treatment and support services were provided by the Department of Child Safety, Regional Behavioral Health Authorities and contracted community providers – Arizona Partnership for Children, Southeastern Arizona Behavioral Health Services, and Terros.

Arizona State University’s Center for Applied Behavioral Health Policy has served as the evaluator for this legislatively mandated assessment since 2004.