BLOG: How can we help parents and children to reunify after a child protection removal of a child? Sadly, very few programs and services available for professionals today can document that they can ensure a safe reunification between children and parents.
Blogpost by Jill Duerr Berrick, Zellerbach Family Foundation Professor at U.C. Berkeley, U.S., and Professor II at the Centre for Research on Discretion and Paternalism, UiB, Norway.
Since 1980, federal law in the U.S. has prioritized reunification for children who are separated to foster care. Parents are offered a range of time-limited services to help mitigate safety risks and bring their children home. Services might include parent education classes, substance abuse treatment, mental health counseling, visitation support, or case management. The U.S. is not alone in prioritizing reunification as a principle goal of child welfare, though not all countries embrace the values of family reunification following placement into foster care.
Research from several studies in the U.S. indicates that about one-half of parents who see their children separated to foster care ultimately reunify (U.S. DHHS, 2021), though the age of the child and other child or family characteristics can impact reunification rates substantially. Reunification is a shared goal across U.S. states, but it is also the most unstable of permanency options for children. Many children eventually return to foster care, resulting in a net reunification rate that is probably closer to about 35% (Brown et al., 2020; Smith et al., 2017). Accounting for reentries to care, the instability of reunification is substantially higher than rates of adoption dissolution (Rolock et al., 2019; Sattler & Font, 2020) or of disrupted guardianships (Parolini et al., 2018).
If I were a child welfare professional working with a parent recently separated from her child, I would not have confidence that I could help her reunify. There is no robust body of research available that could direct my client to a useful service.Jill Duerr Berrick
Reunification rates could probably be boosted. Millions of federal, state, and local dollars are spent on reunification services in the U.S., but in spite of our philosophical enthusiasm for reunification, its priority in federal law, and dedicated judicial timelines that accommodate reunification goals, the research base to support reunification services is notably thin. Over 400 programs are listed in the California Evidence-Based Clearinghouse – a repository of information about evidence-based programming in child welfare. Of these, only six programs are listed under the category of “reunification.” Zero programs have a scientific rating of “1” to indicate that a program is evidence-based. Two programs have a scientific rating of “2” — they are “supported by research evidence,” and four programs have a scientific rating of “3,” suggesting that these programs are currently only “promising.”
Existing research suggests that certain parental behaviors may be associated with reunificationJill Duerr Berrick
If I were a child welfare professional working with a parent recently separated from her child, I would not have confidence that I could help her reunify. There is no robust body of research available that could direct my client to a useful service.
Today, many child welfare professionals hope that reunification services are effective, but they can offer parents few assurances that reunification services “work.” Indeed, studies of intensive services (Fraser et al., 1996), recovery coaches (Ryan et al., 2006), and substance abuse treatment (Green et al., 2007) all have a remarkably thin evidence base as it pertains to a reunification goal. Some small-scale studies hint at promising approaches including efforts that improve inter-professional communication (Philips, 2022), peer support programs (Berrick et al., 2011; Lalayants, 2020), and family-centered treatment (Pierce et al., 2022), but this body of research requires replication across varied contexts before we can be assured that these programs are evidence-based.
What needs to be addressed?
Existing research suggests that certain parental behaviors may be associated with reunification. The most compelling evidence indicates that parents who are compliant with their case plan are most successful (Smith, 2003; 2008). Other research including social workers’ views about the factors associated with reunification shows that parental readiness, parental participation in services, a quality relationship with the social worker, and service availability may be indicative of success (Jedwab et al., 2018). Both of these studies largely speak to a parent’s attitude and behavior toward agents of the welfare state – but not how parents change their behavior and their relationship with their child. Moreover, the child protection system offers parents services to aid in changed behaviors. Where is the evidence that services are the effective mechanism of change?
The odds of reunification should not be dictated by who you are, but instead by how you behave toward your child.Jill Duerr Berrick
The largest body of research focuses on the child and parent characteristics that distinguish reunifying from non-reunifying families. For example, children with health, mental health, or disabling conditions are less likely to reunify. Children who were previously placed in care, or whose initial placement was in group care are less likely to reunify. And single parents and parents with substance abuse challenges are less likely to reunify, as are parents who infrequently visit with their children (Akin, 2011). Moreover, substance involved parents facing multiple socio-economic risks (e.g., poverty, plus unemployment, plus housing instability, etc.) face particular challenges on their road to reunification (Lloyd, 2018).
The odds of reunification should not be dictated by who you are, but instead by how you behave toward your child. Social workers generally believe that services are the lever for changed behavior, so it is past time to prove that’s the case.
Over-reliance on some services
Child welfare professionals may be optimistic about the promise of reunification services, but parents have good reason to be skeptical. One study found that parents were required to participate in eight service events per week as part of their case plan, and over one-third of parents were required to engage with services that did not even meet parents’ identified need (D’Andrade & Chambers, 2012). Such an over-reliance on services – particularly with such a thin research base – may strike parents as controlling at best, and punishing at worst.
The philosophical, judicial, and service frame in support of reunification is laudable. But philosophical platitudes absent solid research evidence is insufficient. Child welfare professionals should be able to say clearly and plainly: “If you work with me and participate in X service, I can give you a high degree of assurance that your child will come home.”
Child protection is grounded in a shared philosophy that children should live with their parents when it is safe to do so. Research is needed to identify service innovations that will help the field transform philosophy into practice.Jill Duerr Berrick
It’s time to develop the evidence so that social workers can tell parents and children that they will reunify and that we know how to help. Countries interested in incorporating reunification goals and services into their legal framework should also determine if they can support the research infrastructure needed to test different models of intervention.
Child protection is grounded in a shared philosophy that children should live with their parents when it is safe to do so. Research is needed to identify service innovations that will help the field transform philosophy into practice.
Akin, B. (2011). Predictors of foster care exits to permanency: A competing risks analysis of reunification, guardianship, and adoption. Children and Youth Services Review, 33(6), 999-1011.
Berrick, J.D., Cohen, E., & Anthony, E. (2011). Partnering with parents: Promising approaches to improve reunification outcomes for children in foster care. Journal of Family Strengths, 11(1), # 14.
Brown, S. M., Orsi, R., & Chen, P. C. B. (2020). Child, family, and case characteristics associated with reentry into out-of-home care among children and youth involved with child protection services. Child maltreatment, 25(2), 162-171.
D’Andrade, A., & Chambers, R. (2012). Parental problems, case plan requirements, and service targeting in child welfare reunification. Children and Youth Services Review, 34(10), 2131-2138.
Goering, E.S., & Shaw, T. (2017). Foster care reentry: A survival analysis assessing differences across permanency types. Child Abuse and Neglect, 68, 36-43.
Green, B.L., Rockhill, A., & Furrer, C. (2007). Does substance abuse treatment make a difference for child welfare case outcomes? A statewide longitudinal analysis. Children and Youth Services Review, 29, 460-473.
Jedwab, M., Chatterjee, A., & Shaw, T. (2018). Caseworkers’ insights and experiences with successful reunification. Children and Youth Services Review, 86, 56-63.
Lalayants, M. (2020). Peer support services in family reunification process in child welfare: perceptions of parents and family coaches. Journal of Family Social Work, 23(5), 449-471.
Lietz, C., & Strength, M. (2011). Stories of successful reunification: A narrative study of family resilience in child welfare. Families in society. 92(2), 203-210.
Lloyd, M. H. (2018). Poverty and family reunification for mothers with substance use disorders in child welfare. Child Abuse Review, 27(4), 301-316.
Parolini, A., Shlonsky, A., Magruder, J., Eastman, A. L., Wulczyn, F., & Webster, D. (2018). Age and other risk factors related to reentry to care from kin guardian homes. Child abuse & neglect, 79, 315-324.
Phillips, J. D. (2022). A mixed methods study of how interprofessional communication relates to timely reunification in the US child welfare system. Journal of Public Child Welfare, 1-26.
Pierce, B. J., Muzzey, F. K., Bloomquist, K. R., & Imburgia, T. M. (2022). Effectiveness of Family Centered Treatment on reunification and days in care: Propensity score matched sample from Indiana child welfare data. Children and Youth Services Review, 136, 106395.
Rolock, N., White, K. R., Ocasio, K., Zhang, L., MacKenzie, M. J., & Fong, R. (2019). A comparison of foster care reentry after adoption in two large U.S. states. Research on Social Work Practice, 29(2), 153-164. https://doi.org/10.1177/1049731518783857
Ryan, J.P., Marsh, J.C., Testa, M.F., & Louderman, R. (2006). Integrating substance abuse treatment and child welfare services: Findings from the Illinois Alcohol and other Drug Abuse Waiver demonstration. Social Work Research, 30(2), 95-107.
Sattler, K., & Font, S. (2020). Predictors of adoption and guardianship dissolution: The role of race, age, and gender among children in foster care. Child Maltreatment, 26(2), 216-227. https://doi.org/10.1177/1077559520952171
Smith, B.D. (2008). Child welfare service plan compliance: Perceptions of parents and caseworkers. Families in Society, 89(4), 521-532.
Smith, B.D. (2003). How parental drug use and drug treatment compliance relate to family reunification. Child Welfare, 82(3), 335-365.
U.S. Department of Health and Human Services (US.DHHS), Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2021). AFCARS Report, #28. Retrieved July 28, 2022: https://www.acf.hhs.gov/cbSmith, B.D. (2003). How parental drug use and drug treatment compliance relate to family reunification. Child Welfare, 82(3), 335-365.