Summarized List of Publications and Reports
Sobriety Treatment and Recovery Teams for families with co-occurring substance use and child maltreatment: A propensity score-matched evaluation
This article provides an overview of a propensity score-matched evaluation comparing 521 children in START to 521 children who received usual child welfare services. A total of three outcomes were evaluated: 1) out-of-home placements within 12-months of the index maltreatment event; 2) reunification for children who were placed in out-of-home care; and 3) subsequent maltreatment within 12-months of the index maltreatment event. Results indicated that children in families receiving START were less likely to be placed in out-of-home care (OOHC) than children in families receiving usual services; for children placed in OOHC, a higher rate of those served by START were successfully reunified in spite of notable risk factors; and finally, while recurrent maltreatment during the first twelve months of services was found to be higher among children in families receiving START, perhaps this was a result of increased surveillance during the intervention relative to families receiving usual services.
Hall, M.T., Walton, M.T. Huebner, R.A., Higgins, G. E., & Kelmel, A.B. (2021). Sobriety Treatment and Recovery Teams for families with co-occurring substance use and child maltreatment: A propensity score-matched evaluation. Children and Youth Services Review 131, 106256.
The Sobriety Treatment and Recovery Teams program for families with parental substance use: Comparison of child welfare outcomes through 12-months post-intervention
This article highlights the first sustained effects study of START where outcomes were tested from the initial CPS report through 12-months post-intervention. Using propensity score matching, a total of 784 children receiving START services from across four sites were compared to 784 children receiving child welfare treatment as usual (TAU). Outcomes were tested during three intervals: 1) the intervention period; 2) six months post-intervention; and 3) 12-months post-intervention. Results indicated that the primary impact of START was significantly reduced rates of OOHC placement, with results sustained through 12-months post-intervention (accounting for both family clusters and site differences).
Huebner, R. A., Hall, M. T., Walton, M. T., Smead, E., Willauer, T., & Posze, L. (2021). The Sobriety Treatment and Recovery Teams program for families with parental substance use: Comparison of child welfare outcomes through 12 months post-intervention. Child Abuse and Neglect, 120, 105260.
Comparative outcomes for Black children served by the Sobriety Treatment and Recovery Teams program for child welfare families with parental substance abuse and child maltreatment
An urgent need exists for child welfare and substance use disorder (SUD) interventions that safely preserve Black families, engage parents in treatment services, and improve child and parent outcomes. This study is the first to test the effects of START on Black families by comparing chiwelfare and parent outcomes for 894 children and their 567 primary parents in three groups: 1) Black children served by START; 2) Black children served in treatment as usual (TAU); and 3) White children served in START. Comparisons included placement in state custody and repeat child abuse or neglect (CA/N) during the intervention period, and at 12-months post-intervention. In summary, START is a potent intervention, co-implemented with SUD treatment providers, that kept Black children safely with their families through the intervention and 12-months post-intervention periods. Scaling up effective programs, like START, that align with the goals of the Family First Prevention Services Act might reduce racial disparities and improve child welfare and SUD treatment outcomes.
Huebner, R.A., Willauer, T., Hall, M. T., Smead, E., Poole, V., Hibbeler, P.G., & Posze, L. (2021). Comparative outcomes for Black children served by the Sobriety Treatment and Recovery Teams program for child welfare families with parental substance abuse and child maltreatment. Journal of Substance Abuse Treatment. 108563.
Sobriety Treatment and Recovery Teams for families with co-occurring substance use and child maltreatment: A randomized controlled trial
This article provides an overview of a randomized controlled trial comparing START to usual child welfare services based on three outcomes: out-of-home care (OOHC) placements, reunification, and subsequent maltreatment. Based on a large sample from Jefferson County, Kentucky, this study showed lower rates of OOHC among START cases compared to usual services, and a higher overall reunification rate compared to the U.S. average despite increased risk factors.
Hall, M.T., Kelmel, A.B., Huebner, R.A., Walton, M.T., & Barbee, A.A. (2021). Sobriety Treatment and Recovery Teams for families with co-occurring substance use and child maltreatment: A randomized controlled trial. Child Abuse and Neglect, 114.
Peer mentoring services, opportunities, and outcomes for child welfare families with substance use disorders
As use of peer recovery support services in the child welfare setting grows, this article explores the specific services provided by peers as well as the risks, opportunities, and outcomes associated with hiring people in recovery from a substance use disorder. Results of the study include higher rates of parent-child unification when face-to-face visits occur regularly with the peer recovery specialist, and increased career advancement opportunities for individuals in peer roles.
Huebner, R.A., Hall, M.T., Smead, E., Willauer, T., Posze, L. (2018). Peer mentoring services, opportunities, and outcomes for child welfare families with substance use disorders. Children and Youth Services Review, 84, 239-246.
Serving families with child maltreatment and substance use disorders: A decade of learning
The Regional Partnership Grant (RPG) program demonstrated that family-centered strategies can improve child and parent outcomes. This article highlights the lessons from 10 years of implementing and evaluating programs to meet the needs of families affected by parental substance use and child maltreatment. The study highlights five specific, effective, family-centered strategies from START that can be implemented in any jurisdiction. The strategies outlined in the article, when operational, lead to improved parenting capacity, increased parental sobriety, and fewer out-of-home care placements for children.
Huebner, R.A., Young, N.K., Hall, M.T., Posze, L. & Willauer, T. (2017). Serving families with child maltreatment and substance use disorders: A decade of learning. Journal of Family Social Work, 20(4), 288-305.
“Like a marriage:” Partnering with peer mentors in child welfare
A family-centered, team approach in child welfare presents both opportunities and challenges when working with families who have substance use disorders. This article summarizes four key processes that support successful partnership between peer mentors, caseworkers, and supervisors. Findings from this article will support field staff and practitioners in developing strong collaborative teams that integrate peer mentors into child welfare settings.
Sears, J.S., Hall, M.T., Harris, L.M., Mount, S., Willauer, T., Posze, L., & Smead, E. (2017). “Like a marriage:” Partnering with peer mentors in child welfare. Child and Youth Service Review, 74, 80-86.
Medication-assisted treatment improves child permanency outcomes for opioid-using families in the child welfare system
Parents who are involved in child welfare system and use opioids are less likely to retain custody of their children. This is the first study of its kind to describe Medication-Assisted Treatment (MAT) utilization and child permanency outcomes for parents who use opioids and are involved with the child welfare system in comparison to those families who did not receive MAT services. Outcomes indicate additional months of MAT increased odds of parents retaining custody of their children. Receipt of MAT services did not differ by age, gender, county of residence, or drug use though individuals who identified themselves as White were more likely to participate in MAT services.
Hall, M. T., Wilfong, J., Huebner, R. A., Posze, L., & Willauer, T. (2016). Medication-assisted treatment improves child permanency outcomes for opioid-using families in the child welfare system. Journal of Substance Abuse Treatment, 71, 63-67.
Sobriety Treatment and Recovery Teams in rural Appalachia: Implementation and outcomes
This study describes the implementation and outcomes of START in a rural Appalachian county with high rates of poverty, nonmedical prescription drug use, and child maltreatment. Children served in START in the rural Appalachian county were less likely to experience reoccurrence of child abuse and neglect at six months, or re-enter foster care at 12 months.
Hall, M. T., Huebner, R. A., Sears, J. S., Posze, L., Willauer, T. & Oliver, J. (2015). Sobriety Treatment and Recovery Teams in rural Appalachia: Implementation and outcomes. Child Welfare, 94(5), 119- 138.
Sobriety Treatment and Recovery Teams: Implementation fidelity and related outcomes
Integrating service delivery strategies is a challenging process. This study examines the first five years of START implementation in Kentucky and describes the process of strengthening moderators of implementation fidelity, trends in adherence to START delivery standards, and trends in parent and child outcomes. Outcomes indicate achieving implementation fidelity to service delivery standards requires a pre-service year and two full years of operation along with persistent leadership. The framework in this study is useful in examining implementation processes, fidelity, and related outcomes.
Huebner, R.A., Posze, L., Willauer, T.M., & Hall, M.T. (2015). Sobriety Treatment and Recovery Teams: Implementation fidelity and related outcomes. Substance Use & Misuse, 50(10), 1341-1350.
Application of the Evaluation Framework for Program Improvement of START
This study applied the Children’s Bureau program evaluation framework to START, an integrated program between child welfare and substance use treatment providers. A cluster analysis of three subgroups concluded that intact families retained custody throughout treatment and achieved higher rates of sobriety.
Huebner, R.A., Willauer, T., Posze, L., Hall, M.T., & Oliver, J. (2015a). Application of the Evaluation Framework for Program Improvement of START, Journal of Public Child Welfare, 9(1), 42-64.
The impact of Sobriety Treatment and Recovery Teams (START) on family outcomes
START is an integrated model that pairs child protective workers with family mentors to address the complex needs of families affected by parental substance use and child maltreatment. This study examined the effect of START on parental sobriety and rates of child placement. Mothers in START achieved sobriety at 1.8 times the rate of typical treatment; children were placed in state custody at half the rate of treatment as usual. A cost analysis showed that for every dollar spent on implementing START, $2.22 was offset in the cost of foster care.
Huebner, R.A., Willauer, T., and Posze, L. (2012). The impact of Sobriety Treatment and Recovery Teams (START) on family outcomes. Families in Society, 93(3), 196-203.