These data reveal two general trends, although one is weaker than the other. Scores on the recognition scale typically increased early in participants work with their SALs, and this was the trend for both the alcohol and drug form data. It appears then that participants exhibited recognition of how AOD use may be problematic for them earlier rather than later in the pro- gram. Scores on the taking steps scale tended to increase on more of a trajectory, with alcohol form scores showing a steady increase. Median scores from the drug form data showed their most marked increases between the second and third assessment intervals, and then flattened. Data on the proportion of cases showing improved scores demonstrated a precipitous decrease between the third and fourth assessment intervals, revealing that this flattening was actually a substantial decrease in gains measured by the SOCRATES taking steps scale.
The curvilinear nature of the drug form taking steps scale data indicated that SALs should be attuned to potential challenges for participants between the third and fourth assessment inter- vals when drugs, rather than alcohol, are substances of choice. It might behoove the program to qualitatively identify the operating conditions behind these data and implement strategies to support participants during what appears to be a more difficult time.
2. TREATMENT ENTRY AND COMPLETION RATES
As noted in the literature review, very few parents with substance abuse issues involved with the child welfare system enter and complete substance abuse treatment, and even those who enroll in treatment, commonly experience dropouts and relapses. Outcomes from innovative efforts of the Illinois and Delaware Title IV-E Demonstration Waiver projects indicate that 53% of child welfare clients in the demonstration groups participated in some type of treat- ment episode. Outcomes from three evaluations of child welfare-involved parents or caregiv- ers with substance abuse problems indicate a treatment completion rate of 22% (Ryan, 2006), 23.4% (Gregoire & Schultz, 2001), and 24% (James Bell Associates, 2006).
In the PTP, 89% of participants were assessed as needing substance abuse treatment (Figure 28). Only 7% of participants referred to the program were assessed as not needing treatment, indicating that in the majority of cases, social workers’ initial assessments that parents were impaired by substance abuse were correct.
Figure 28 Treatment Authorization
Authorized for Treatment
Assessed as Not Needing Treatment
Did Not Complete A sse ssm e n t
Idaho Pre-Treatment Program