This compares favorably with outcomes of the Illinois Title IV-E Demonstration Waiver project, in which 53% of clients in the demonstration group participated in treatment and the “recovery coaches” delivered more intensive services (having at least 50 contacts throughout the program compared to the PTP average of 2.3 times).
A sub-set of findings relating to participants’ changes during the PTP showed significant posi- tive trends in their ability to recognize that alcohol and drug (AOD) use was problematic for them, and to initiate and maintain actions to change their AOD use. The importance of this trend was demonstrated by a logistic regression analysis that indicated that for every one point increase in final SOCRATES drug form taking steps scores, participants had a 50% increase in their likelihood of entering AOD treatment. (SOCRATES is explained later in this report.)
Treatment completion at the end of the project was 16%; however, including cases still open at treatment facilities (20%) brings the rate to 36%. The Illinois Demonstration project reported 59% of clients in the demonstration group had engaged in or completed treatment; Delaware’s Demonstration project (also using substance abuse counselors co-located within CPS) reported 24% of clients engaged in or completed treatment.
While comparable and even higher than the treatment entry in the Illinois project, to other demonstration projects, the rate of treatment entry and completion was low. Although a com- parison of this type is appropriate, it is important to take into account participant character- istics and contextual factors. Three major challenges in working with parents with substance abuse issues during the PTP could explain the low entry and completion rate in this study:
The complexity, history, and multiplicity of problems experienced by parents is not conducive to swift resolution. In addition to poverty, co-occurring disorders, domestic violence, and lack of housing, the majority of participants had issues with methamphetamine use (methamphetamine, in combination with others drugs, was the drug of choice for 71% of participants and the single drug of choice for 56%). A regression analysis of predictive factors in this study indicated that participants who had previous substantiated CPS referrals were far less likely to enter treatment after SAL services. Child welfare systems and substance abuse treatment providers are only recently grappling with the unique and intense problems of methamphetamine abusers referred by child welfare and are currently developing effective interventions.
The SAL positions were funded (half-time for the grant) and overstretched to adequately serve each region’s population, particularly in the rural Regions I and III. There was no provision in the model to provide follow-up services while participants were in treatment. A consistent response from stakeholders in the program was the need for more SALs with more time to devote to liaison services before, during, and after substance abuse treatment.
3) The funding and availability of substance abuse services paid by the state fluctuated widely over the time of implementation. The lack of inpatient services and funding priorities made it almost impossible to get participants access to inpatient treatment unless they were pregnant and intravenous drug users. A regression analysis of predictive factors indicated that PTP participants assessed as needing inpatient treatment were 97% less likely to enter AOD treatment at all.
Idaho Pre-Treatment Program